Autism and anxiety: are key diagnostic 'deficit criteria' actually effective strategies for the self-management of anxiety in autistic adults?

目的是探索关键的自闭症诊断标准，通常被视为缺陷特征或行为，是否实际上是减少自闭症患者焦虑的有效策略。例如，“社会沟通和社会互动方面的持续缺陷”、“受限制的、重复的模式”和“坚持千篇一律”都可能是减少需要处理的新奇或具有挑战性的刺激水平的必要策略，从而减少焦虑。研究QUESTIONS1。“花时间独处”、“遵循常规”和“创造或寻找一个喜欢的感官环境”是自闭症成年人用来减少焦虑的策略吗？自闭症成年人如何在日常生活中使用这些策略？使用这些策略和自我报告的焦虑水平之间是否存在相关性？本提案是在参与性框架内进行探索性顺序研究，以便积极地让利益相关者个人参与研究；产生对社区成员来说更可信的证据，从而更有可能带来改变。作为一名自闭症研究人员，学生会有一个反射性的立场，在整个研究设计过程中，额外的利益相关者的投入对这个项目的有效性和覆盖面很重要。初步的定性研究将探讨参与者以前使用概述战略的经验，并为定量工作提供信息，以衡量优先考虑这些战略的有效性。根据参与小组的输入，将从15个记录和转录的半结构化访谈和/或研究人员指导的书面日记中收集定性数据，以探索自闭症患者如何以及为什么会花时间独处，遵循常规，创造或找到首选的感官环境来减少焦虑。样本量大到足以展示整个数据集的模式，但又小到足以关注个人经验。自闭症研究，无论是定性的还是定量的，通常都是通过社交媒体招募参与者，而社交媒体上的性别、年龄、种族和收入的范围和多样性可能各不相同。对定性数据的专题分析将为与参与小组一起开发的在线问卷提供信息，以衡量成年自闭症参与者对概述的策略在减少焦虑方面的有效性。该问卷每两个月重复两次，以比较结果，将纳入抑郁症，焦虑和压力量表（DASS-21），该量表在其他自闭症成人研究中使用，以提高其可靠性和有效性。将招募250名参与者，预计减少50%，完成120份调查，与其他针对自闭症成年人的研究类似。为了增加参与者的教育多样性，可以提供一系列选择，如朗读功能，以符合建议的基于实践的指导方针，将自闭症成年人纳入研究。对调查问题的回答将使用描述性统计进行总结。为了解决概述的策略与自我报告的焦虑之间的相关性问题，将使用多变量回归分析问卷结果，控制潜在的混杂因素，如年龄、性别和教育。

AIMThe aim is to explore whether key autism diagnostic criteria, often seen as deficit traits or behaviours, are actually effective strategies for reducing anxiety in autistic individuals. For instance, "persistent deficits in social communication and social interaction," "restricted, repetitive patterns" and "insistence on sameness" may all be necessary strategies in reducing levels of novel or challenging stimuli to be processed and thus, reducing anxiety.RESEARCH QUESTIONS1. Are 'spending time alone,' 'following routines' and 'creating or finding a preferred sensory environment' strategies which autistic adults use to reduce anxiety?2. How do autistic adults use these strategies in their day-to-day life?3. Is there a correlation between using these strategies and self-reported anxiety levels?METHODOLOGYThis proposal is for an exploratory sequential study within a participatory framework in order to actively involve stakeholder individuals in the research; generating evidence which may be viewed as more credible to community members, and so more likely to bring about change. While the student will have a reflexive stance as an autistic researcher, additional stakeholder input throughout the study design is important for the validity and reach of this project. An initial qualitative study will explore participants' previous experiences of using the outlined strategies and inform quantitative work designed to measure the effectiveness of prioritising these strategies.Depending on participatory group input, qualitative data will be collected from 15 recorded and transcribed semi-structured interviews, and/or researcher directed written diaries to explore how and why autistic people might spend time alone, follow routines and create or find preferred sensory environments to reduce anxiety. The sample size is large enough to demonstrate patterns across the dataset but small enough to focus on individual experiences. Autism research studies, both qualitative and quantitative, commonly recruit participants via social media where the range and diversity of genders, ages, ethnicities and incomes are likely to be varied. Thematic analysis of the qualitative data will inform development of an online questionnaire developed with the participatory group to measure how effective adult autistic participants feel the outlined strategies are in reducing anxiety. This questionnaire, repeated twice at two-monthly intervals to compare results, will incorporate the Depression, Anxiety and Stress Scale (DASS-21) as used by other studies with autistic adults for its reliability and validity. 250 participants will be recruited, with an expected drop-off of 50%, to have 120 completed surveys, similarly to other studies with autistic adults. To increase the educational diversity of participants a range of options such as read-aloud features may be offered, in line with recommended practice-based guidelines for including autistic adults in research. Responses to survey questions will be summarised using descriptive statistics. To address the question of correlations between the outlined strategies and self-reported anxiety, the questionnaire results will be analysed using multivariate regression, controlling for potential confounders such as age, gender and education.