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The mental health and adaptive functioning of adults with subdiagnostic autistic traits
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DOI：10.1186/s11689-026-09726-9.png)
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Abstract
En 中文
Autistic traits in the general population share the genetic liability with autism and distribute as a quantitative continuum. In addition, the risk for co-occurring psychotic and emotional symptoms, physical health conditions, and the associated functional impairment may increase along with the level of autistic traits. This study aimed to examine the potential clinical relevance of subdiagnostic autistic traits in adults, focusing on co-occurring mental health and neurodevelopmental problems and low adaptive dysfunctioning. A total of 659 adult participants (age range 20 to 83 years, mean age 34.49 ± 11.08 years, 53.3% female) were recruited from two teaching hospitals and a university, of whom 167 reported having psychiatric disorders. The Social Responsiveness Scale (SRS-2) was used to measure autistic traits and to categorize respondents into high, moderate, modest, and low autistic trait groups. Anxiety, depressive, attention-deficit/hyperactivity disorder (ADHD) symptoms and adaptive functions were measured by self-report instruments. Path analysis with structural equation modeling was applied to explore the relationship between autistic traits, ADHD symptoms and adaptive functioning and the mediating effects of emotional symptoms. Participants with psychiatric diagnoses had increased likelihood for high (OR 9.55, p < 0.001) and moderate (OR 5.05, p < 0.001) but not modest autistic traits. Of note, compared to the group with low autistic traits, even participants with only modest autistic traits had higher risk for anxiety, depressive and ADHD symptoms, as well as lower adaptive functioning which was measured by the Adaptive Behavior Assessment System (ABAS-II) (all p < 0.001). Among the mental health conditions, autistic traits was found the largest effect size directly explaining adaptive functioning (standardized ß - 0.39, p < 0.001) while paritally mediated by emotional symptoms. Beyond a dichotomous autism diagnosis, adults with subdiagnostic autistic trait levels have higher risk for psychiatric symptoms and disorders and adaptive functioning difficulties in various contexts, in line with the notion that there might be support needs along the autistic trait continuum. Our findings highlight that support for adults should be based on actual functional and mental health challenges across different levels of autistic traits, rather than clinical diagnosis only.
Keywords:
Adult
Autism
Autistic traits
Adaptive functioning
Adaptation
Mental health
Journal
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