Ten weeks in: COVID-19-related distress in adults with autism spectrum disorder.
Pre-existing anxiety plus pandemic distress predicted worsening mental health in autistic adults—screen and support these clients now.
01Research in Context
What this study did
Adams et al. (2021) followed autistic adults for ten weeks after COVID-19 began. They asked how pandemic stress and pre-existing anxiety shaped later anxiety and depression.
Each week participants filled out short online surveys. The team tracked who felt more upset over time.
What they found
Two out of three adults said the pandemic added distress. Those who already had anxiety and then faced extra COVID stress reported sharper rises in anxiety and depression weeks later.
Surprisingly, the whole group’s average symptoms stayed flat. Only people with both early risk factors got worse.
How this fits with other research
Ferron et al. (2023) and Riebel et al. (2025) extend these findings. They show self-compassion can soften the link between autistic traits and mood problems. Teaching kindness toward oneself may buffer the same stress reaction E et al. observed.
Pitchford et al. (2019) is a predecessor that mapped the stress path earlier. In general-population adults, sensory over-responsivity plus stress best explained autism-linked anxiety. E et al. now confirm that outside stressors like a pandemic can ignite that pathway in diagnosed adults.
McMaughan et al. (2023) and Andrews et al. (2024) add urgency. Autistic youth are hospitalized for mental-health crises far more often than peers. Together the papers sketch a life-span picture: external stress hits autistic people harder, and without support the result can be emergency care.
Why it matters
Screen every autistic adult for anxiety, even if they seem calm. When new stress arrives—illness, job loss, routine change—step up contact. Brief weekly check-ins and self-compassion skills could prevent the downward slide these studies flag.
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02At a glance
03Original abstract
This study used data collected from 275 adults in the United States with autism spectrum disorder both before the pandemic and then 10 weeks into the pandemic to assess COVID-19-related distress and its impact. Two-thirds of those surveyed reported some type of distress related to the pandemic (i.e. difficulty coping or negative impact on emotional and mental health). While there were no changes in depressive and anxiety symptoms from prior to COVID-19 to 10 week later in the group as a whole, self-reported distress predicted increases in both anxiety and depression across the two timepoints. Furthermore, adults with higher levels of anxiety prior to the pandemic were more likely to report distress, and women were more likely to report a negative impact of the pandemic on their emotional and mental health. Findings highlight the importance of monitoring with adults with autism spectrum disorder to assess their need for mental health support, and providing ongoing support to those who already experience anxiety even before the pandemic.
Autism : the international journal of research and practice, 2021 · doi:10.1177/13623613211005919