Demographic and psychological predictors of alcohol use and misuse in autistic adults.

William Mandy,Meng-Chuan Lai,Simon Baron-Cohen,Carrie Allison,Laura Hull,Maya Bowri,Paula Smith

doi:10.1177/1362361321992668

Abstract

This study explored demographic and psychological predictors of alcohol use and misuse in a high-functioning, community sample of 237 autistic adults aged 18–75 (mean = 41.92 and standard deviation = 13.3) recruited in the United Kingdom. An online survey measured demographic information, autistic traits, depression, generalised anxiety, social anxiety, mental well-being, social camouflaging and alcohol use with the Alcohol Use Disorders Identification Test. The sample was divided into three groups (non-drinkers, non-hazardous drinkers and hazardous drinkers) and multinomial logistic regression models were used to investigate associations between alcohol use and demographic factors, autistic traits, mental health variables and social camouflaging. Our results demonstrated a U-shaped pattern among autistic adults, with non-drinkers and hazardous drinkers scoring significantly higher than non-hazardous drinkers on levels of autistic traits, depression, generalised anxiety and social anxiety. In multivariate analysis, autistic non-drinkers were less likely to be male (odds ratio = 0.44; 95% confidence interval = 0.22–0.87) and had more autistic traits (odds ratio = 2.50; 95% confidence interval = 1.19–5.28). Gender and level of autistic traits may be the most significant factors in predicting alcohol use in the autistic community.Lay abstractAlcohol use and misuse are associated with a variety of negative physical, psychological and social consequences. The limited existing research on substance use including alcohol use in autistic adults has yielded mixed findings, with some studies concluding that autism reduces the likelihood of substance use and others suggesting that autism may increase an individual’s risk for substance misuse. This study investigated demographic and psychological predictors of alcohol use and misuse in a sample of 237 autistic adults. An online survey was used to obtain data on demographic information, autistic traits, depression, generalised anxiety, social anxiety, mental well-being, social camouflaging and alcohol use. The sample was divided into three groups (non-drinkers, non-hazardous drinkers and hazardous drinkers) in order to investigate associations between alcohol use and demographic factors, autistic traits, mental health variables and social camouflaging. Our results demonstrated a U-shaped pattern among autistic adults, with non-drinkers and hazardous drinkers scoring higher than non-hazardous drinkers on levels of autistic traits, depression, generalised anxiety and social anxiety. Autistic non-drinkers were less likely to be male and had more autistic traits. Gender and level of autistic traits may be the most significant factors in predicting alcohol use in the autistic community.

Highlights

Alcohol consumption is common within general populations in the United Kingdom, Europe and North America, in part because it can help people feel relaxed and part of a social group (Abbey et al, 1993)
Our results demonstrated a U-shaped pattern among autistic adults, with non-drinkers and hazardous drinkers scoring higher than non-hazardous drinkers on levels of autistic traits, depression, generalised anxiety and social anxiety
This study explored demographic and psychological predictors of alcohol use and misuse in a sample of autistic adults

Summary

Introduction

Alcohol consumption is common within general populations in the United Kingdom, Europe and North America, in part because it can help people feel relaxed and part of a social group (Abbey et al, 1993). Whereas social affiliation has a significant role to play in alcohol use, mental health problems including depression and anxiety are likely be implicated in misuse in the general population, where alcohol could become a coping strategy for managing such problems (National Collaborating Centre for Mental Health [NCCMH], 2011). In the United Kingdom, 24% of adults in England and Scotland regularly drink above the government’s low-risk guidelines (Alcohol Change, 2020), despite alcohol misuse being a widely acknowledged public health concern and major cause for morbidity and mortality (NCCMH, 2011). Alcohol is implicated in a number of chronic physical health conditions and mental health difficulties, is associated with injury, accidents and adverse social outcomes including violence and relationship breakdown, and the economic burden of alcohol-related problems worldwide is substantial (NCCMH, 2011)

Objectives

Methods

Results

Conclusion