Cultural and gendered expectations can have adverse impacts on the psychological wellbeing of autistic women, according to a new review that says there needs to increased knowledge and training for professionals.
The review, published in Research in Autism Spectrum Disorders, said that there is also a need to promote better awareness of safe relationships to reduce risks of abuse and exploitation for autistic women. Adaptations to communication, cognitive and sensory challenges, and psychological therapy are also suggested.
The authors said that the aim of the review was to research how psychological wellness is experienced by autistic women. This is because autistic women are at higher risk of experiencing mental health difficulties and suicidal behaviours than the general population. However, there are barriers to diagnostic assessments and mental health support reported by autistic women.
The hidden hurt of autistic women
Three themes were generated from the 12 qualitative studies in the review. These were:
“I tend to fall between the cracks”: misunderstood and ostracised
The review found that social camouflaging can also have detrimental influences on psychological wellbeing for autistic women. Camouflaging was reported to serve a protective function with a high emotional cost. It has the capacity to create ongoing confusion regarding the sense of self and identity, which can have further adverse effects on psychological wellbeing.
However, mutual acceptance, belonging, and support were identified as protective factors of psychological wellbeing.
Significant gains in wellbeing have been reported for autistic adults after receiving an autism diagnosis and the review found that autistic women felt that their quality of life would have improved if a diagnosis had been provided earlier.
The authors concluded: “The findings of this meta-synthesis indicate that poor psychological wellbeing experienced by autistic women is seen to be caused by the mistreatment, bullying, abuse and exclusion external others have imposed, alongside a failure of services to provide understanding and appropriate support in many cases.
“These factors may therefore have the potential to contribute to a vicious cycle of the development and reinforcement of a negative self-image, confused identify and self-blame, alongside a sense of isolation and hopelessness.”