Outcomes of Experiencing Interpersonal Violence in Autism: A Mixed Methods Systematic Review and Meta-Analysis

Area of Science:

• Neurodevelopmental Disorders
• Social Psychology
• Public Health

Background:

• Autistic individuals experience interpersonal violence at disproportionately high rates.
• Intersectionality and minority stress theories are crucial for understanding the unique vulnerabilities of marginalized groups, including autistic people.
• Previous research has not fully synthesized the lifelong health and developmental impacts of interpersonal violence specifically on autistic populations.

Purpose of the Study:

• To systematically review and meta-analyze the outcomes of interpersonal violence experienced by autistic individuals.
• To investigate gender-related differences in the outcomes of interpersonal violence among autistic people.
• To provide evidence for the application of minority stress and intersectionality theories in the context of autistic individuals' experiences with violence.

Main Methods:

• A systematic database search was conducted for mixed-methods, peer-reviewed research on interpersonal violence (physical, sexual, psychological) affecting autistic individuals.
• A random-effects meta-analysis pooled data from 9 studies (3,647 autistic participants, aged 1-80) to assess the association between violence and mental health outcomes.
• A narrative synthesis analyzed 57 studies (37,418 participants) to explore broader health, developmental, and functional outcomes compared to non-autistic controls.

Main Results:

• Interpersonal violence was significantly associated with worsened mental health in autistic individuals, particularly internalizing symptoms (d=0.66) and suicidal thoughts/behavior (d=0.63).
• Across 57 studies, violence correlated with adverse health, developmental, and functional outcomes in autistic individuals from childhood, including mental health and behavioral issues.
• Females and gender minorities reported greater intra- and interpersonal difficulties related to violence, starting in childhood and persisting into adulthood.

Conclusions:

• Interpersonal violence has profound, lifelong negative outcomes for autistic people, underscoring the relevance of minority stress and intersectionality.
• Autistic individuals, especially females and gender diverse people, exhibit heightened susceptibility to abuse from a young age.
• Societal conditioning may lead autistic individuals to respond to abuse with social desirability, superficial adaptivity, and dissociation, complicating support and intervention.