Quantifying the contribution of specific autistic traits to quality of life in autistic adults

This publication is included in the Autistic Autism Scholarship Project. one author of this publication is identified as autistic in the project.

About the autistic author marker

Metadata sources used for this reference

OpenAlex Crossref OpenCitations
Learn more about the sources used

Leung, F. Y., Livingston, L. A., Mason, D., & Shah, P. (2024). Quantifying the contribution of specific autistic traits to quality of life in autistic adults. Neurodiversity, 2. https://doi.org/10.1177/27546330241261937

Publication date: 1 Jan 2024 Added to AutiHub: 22 Sep 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

This publication is integrated into AutiHub through:

Authors

Publication authors
4
Publication authors identified as autistic
1 / 4 (25.0%)
  1. Florence YN Leung
  2. Lucy A Livingston
  3. David Mason *
  4. Punit Shah

Abstract

Across research studies, autistic traits have consistently been found to predict the quality of life (QoL) of autistic adults. However, our understanding of their exact role remains limited, as autistic traits are typically examined as a unitary construct, with their multidimensional nature being largely overlooked. The present study examined the relative contribution of specific autistic trait domains – social anxiety, mentalising difficulties, and sensory reactivity – to QoL in autistic adults. Participants (N = 300) completed clinically relevant measures of their autistic traits (i.e., RAADS-14) and QoL (i.e., WHOQOL-BREF and ASQoL), and provided socio-demographic details. Results showed that the consistent presence of social anxiety and mentalising difficulties across development, but not sensory reactivity, significantly predicted poorer QoL, even after accounting for one another and potential confounders. Comparing their relative importance, social anxiety emerged as the most dominant predictor of QoL amongst all variables, followed by mentalising difficulties. These findings provide evidence for the divergent contributions of autistic trait domains to QoL, adding nuance to our understanding of factors relating to autistic adults’ QoL. Overall, this study underscores the importance of considering individual differences in autistic trait profiles when designing individualised support programmes, such as prioritising attention to the presence of social anxiety and mentalising difficulties, to enhance the QoL of autistic adults. Lay Abstract Research consistently shows that autistic adults with more autistic traits generally experience poorer quality of life (QoL). However, our understanding of how they exactly link remains limited. This is because overall autistic trait scores are typically examined, even though autistic traits encompass different types of characteristics (e.g., social and non-social). Specifically, it is yet to be determined which particular autistic traits contribute most to QoL differences among autistic adults. To address this question, the present study examined the relative contributions of three specific domains of autistic traits – social anxiety, mentalising difficulties, and sensory reactivity – to QoL in 300 autistic adults, using self-report questionnaires. We found that the extent to which the three domains contributed to QoL differed. The consistent presence of social anxiety and mentalising difficulties across development, but not sensory reactivity, significantly predicted poorer QoL. Further to this, the presence of social anxiety, followed by mentalising difficulties, were the most important predictors of poorer QoL compared to all other variables, including being male, not being in a relationship, and having one or more co-occurring mental health conditions. These findings suggest that individual differences in specific autistic trait domains should be particularly attended to in the design of more tailored, personalised support programmes, given their important influence on one's satisfaction with life. Overall, this study demonstrates that it would be useful to maximise the clinical use of autistic trait measures, such as moving beyond the focus on overall scores, with an aim to effectively enhance the QoL of autistic adults.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 17:07.

Cited references
28
With a DOI
25
Without a DOI, from raw bibliography text
3
5 / 28 (17.9%) cited references include at least one author identified as autistic.
References with data to complete
3 / 28 (10.7%)
References with detected author names
26 / 28 (92.9%)
Without detected author names
2
Without a structured title
3
Without a stable identifier
3
References with raw author names still to review
2
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
110
From DOI or external metadata
110
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
2
63 / 110 (57.3%) names are linked to an author already present in AutiHub. 47 / 110 (42.7%) names are not yet linked.
Names linked to a person identified as autistic
16 / 110 (14.5%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 16 / 63 (25.4%). Distinct people identified as autistic: 14 / 100 (14.0%).
  1. Dianne M. Hezel , Richard J. McNally (2014). Theory of Mind Impairments in Social Anxiety Disorder . Behavior Therapy, 45(4), 530-540. Elsevier BV.
    Type: Article DOI: 10.1016/j.beth.2014.02.010 OpenAlex: https://openalex.org/W1985866637
    Crossref OpenAlex OpenCitations
  2. Talha Alvi , Chrystyna D. Kouros , Junghee Lee , Daniel Fulford , Benjamin A. Tabak (2020). Social anxiety is negatively associated with theory of mind and empathic accuracy. Journal of Abnormal Psychology, 129(1), 108-113. American Psychological Association (APA).
    Type: Article DOI: 10.1037/abn0000493 OpenAlex: https://openalex.org/W2986865094
    Crossref OpenAlex OpenCitations
  3. González Moreno, Andrés Santiago (2013). Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association.
    Type: Book DOI: 10.1176/appi.books.9780890425596 OpenAlex: https://openalex.org/W4247665917
    Crossref OpenAlex OpenCitations
  4. The WHOQOL-Dis Group , M. J. Power , A. M. Green (2010). Development of the WHOQOL disabilities module . Quality of Life Research, 19(4), 571-584. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s11136-010-9616-6 OpenAlex: https://openalex.org/W2064643935
    Crossref OpenAlex OpenCitations
  5. Debbie Spain , Esra Zıvralı Yarar , Francesca Happé (2020). Social anxiety in adults with autism: a qualitative study . International Journal of Qualitative Studies on Health and Well-being, 15(1), 1803669. Informa UK Limited.
    Type: Article DOI: 10.1080/17482631.2020.1803669 OpenAlex: https://openalex.org/W3081432205
    Crossref OpenAlex OpenCitations
  6. Marieke de Vries , Hilde M. Geurts (2015). Influence of Autism Traits and Executive Functioning on Quality of Life in Children with an Autism Spectrum Disorder . Journal of Autism and Developmental Disorders, 45(9), 2734-2743. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-015-2438-1 OpenAlex: https://openalex.org/W2074678033
    Crossref OpenAlex OpenCitations
  7. Sandra Baez , María Alejandra Tangarife , Gabriela Davila-Mejia , Martha Trujillo-Güiza , Diego A. Forero (2023). Performance in emotion recognition and theory of mind tasks in social anxiety and generalized anxiety disorders: a systematic review and meta-analysis . Frontiers in Psychiatry, 14, 1192683-1192683. Frontiers Media SA.
    Type: Article DOI: 10.3389/fpsyt.2023.1192683 OpenAlex: https://openalex.org/W4377098090
    Crossref OpenAlex OpenCitations
  8. J. Espelöer , M. Hellmich , Kai Vogeley , C. M. Falter-Wagner (2021). Brief Report: Social Anxiety in Autism Spectrum Disorder is Based on Deficits in Social Competence . Journal of Autism and Developmental Disorders, 51(1), 315-322. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-020-04529-w OpenAlex: https://openalex.org/W3024316678
    Crossref OpenAlex OpenCitations
  9. James M. Lebreton , Robert E. Ployhart , Robert T. Ladd (2004). A Monte Carlo Comparison of Relative Importance Methodologies . Organizational Research Methods, 7(3), 258-282. SAGE Publications.
    Type: Article DOI: 10.1177/1094428104266017 OpenAlex: https://openalex.org/W2110287933
    Crossref OpenAlex OpenCitations
  11. Melissa D. Thye , Haley M. Bednarz , Abbey J. Herringshaw , Emma B. Sartin , Rajesh K. Kana (2018). The impact of atypical sensory processing on social impairments in autism spectrum disorder . Developmental Cognitive Neuroscience, 29, 151-167. Elsevier BV.
    Type: Article DOI: 10.1016/j.dcn.2017.04.010 OpenAlex: https://openalex.org/W2616084157
    Crossref OpenAlex OpenCitations
  12. Matthew Hotton , Sarah Coles (2016). The Effectiveness of Social Skills Training Groups for Individuals with Autism Spectrum Disorder . Review Journal of Autism and Developmental Disorders, 3(1), 68-81. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s40489-015-0066-5 OpenAlex: https://openalex.org/W2280614067
    Crossref OpenAlex OpenCitations
  13. Rebecca A. Charlton , Goldie A. McQuaid , Gregory L. Wallace (2023). Social support and links to quality of life among middle-aged and older autistic adults . Autism, 27(1), 92-104. SAGE Publications.
    Type: Article DOI: 10.1177/13623613221081917 OpenAlex: https://openalex.org/W4220740604
    Crossref OpenAlex OpenCitations
  14. THE WHOQOL GROUP (1998). Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment . Psychological Medicine, 28(3), 551-558. Cambridge University Press (CUP).
    Type: Article DOI: 10.1017/s0033291798006667 OpenAlex: https://openalex.org/W2429180991
    Crossref OpenAlex OpenCitations
  15. Jacquelyn A. Gates , Erin Kang , Matthew D Lerner (2017). Efficacy of group social skills interventions for youth with autism spectrum disorder: A systematic review and meta-analysis . Clinical Psychology Review, 52, 164-181. Elsevier BV.
    Type: Article DOI: 10.1016/j.cpr.2017.01.006 OpenAlex: https://openalex.org/W2579147877
    Crossref OpenAlex OpenCitations
  16. Eriksson J. M. (2013). bibr7-27546330241261937 Molecular Autism, 4(49), 1.
    Type: Other
    Crossref
  17. R Core Team (2026). R: A Language and Environment for Statistical Computing . R Foundation for Statistical Computing.
    Type: Article DOI: 10.32614/r.manuals OpenAlex: https://openalex.org/W2582743722
    OpenAlex
  18. Helen McConachie , David Mason * , Jeremy R. Parr , Deborah Garland , Colin Wilson , Jacqui Rodgers (2018). Enhancing the validity of a quality of life measure for Autistic people . Journal of Autism and Developmental Disorders, 48(5), 1596. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-017-3402-z OpenAlex: https://openalex.org/W2768942203
    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
  19. Reina S. Factor , Christine T. Moody , Katherine Y. Sung , Elizabeth A. Laugeson (2022). Improving Social Anxiety and Social Responsiveness in Autism Spectrum Disorder through PEERS® . Evidence-Based Practice in Child and Adolescent Mental Health, 7(1), 142-159. Informa UK Limited.
    Type: Article DOI: 10.1080/23794925.2021.2013138 OpenAlex: https://openalex.org/W4205201867
    Crossref OpenAlex OpenCitations
  21. Ling-Yi Lin , Pai-Chuan Huang (2019). Quality of life and its related factors for adults with autism spectrum disorder . Disability and Rehabilitation, 41(8), 896-903. Informa UK Limited.
    Type: Article DOI: 10.1080/09638288.2017.1414887 OpenAlex: https://openalex.org/W2772050964
    Crossref OpenAlex OpenCitations
  24. Bethany Oakley , Julian Tillmann , Jumana Ahmad , Daisy Crawley , Antonia San José Cáceres , R. J. Holt et al. (2021). How do core autism traits and associated symptoms relate to quality of life? Findings from the Longitudinal European Autism Project . Autism, 25(2), 389-404. SAGE Publications.
    Type: Article DOI: 10.1177/1362361320959959 OpenAlex: https://openalex.org/W3092212229
    Crossref OpenAlex OpenCitations
  25. Kristen Lyall (2023). What are quantitative traits and how can they be used in autism research? Autism Research, 16(7), 1289-1298. Wiley.
    Type: Article DOI: 10.1002/aur.2937 OpenAlex: https://openalex.org/W4377220928
    Crossref OpenAlex OpenCitations
  26. Cecile S. Sunahara , David Rosenfield , Talha Alvi , Zachary Wallmark , Junghee Lee , Daniel Fulford et al. (2022). Revisiting the association between self-reported empathy and behavioral assessments of social cognition. Journal of Experimental Psychology: General, 151(12), 3304-3322. American Psychological Association (APA).
    Type: Article DOI: 10.1037/xge0001226 OpenAlex: https://openalex.org/W4293825660
    Crossref OpenAlex OpenCitations
  27. R Core Team. (2022). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www . R-project.org/
    Type: Other
    Crossref
  28. World Health Organization. (2019). International Statistical Classification of Diseases and Related Health Problems (11th ed. ). https://icd.who.int/
    Type: Other
    Crossref