An examination of the effect of social contexts on autistic adolescents’ mental health

Abstract

Autistic youth are at a heightened risk for experiencing internalizing mental health problems. These risks are further compounded by intersectional layers of marginalization, which have been documented to permeate throughout autism identification, care, education, and social treatment. The present dissertation took a Critical-Race Disability Studies (DisCrit) approach to meta-analyze quantitative self-reports from autistic youth with integrated qualitative information pertaining to internalizing mental health experiences over the past decade. Self-report data were prioritized to center autistic voices and emphasize the social mechanisms which impact lived experiences. Meta-analyzed data from autistic youth showed a significant, small increase in severity of internalizing mental health problems after the COVID-19 pandemic began. Qualitative information gleaned directly from autistic youth suggested that personal, relational, and support resources play a role in their wellbeing, and that uncertainty about the future increases feelings of anxiety. Both access to resources and uncertainty about the future were impacted by the COVID-19 pandemic, which provides a contribution to the contextualization to the observed increase in internalizing mental health problems. Further quantitative analyses synthesized with qualitative findings suggest differences in experiences of internalizing mental health across different intersecting identities (e.g., gender and autism). Further, DisCrit analysis highlighted current gaps in research on intersectional factors related to lived experiences, placing an emphasis on the need for future research which intentionally interrogates the intersections of systemic racism, ableism, classism, and sexism in relation to lived experiences with autistic youth.