In this study, we consecutively recruited treatment-seeking young autistic adults without intellectual impairment aged 16–30 years who presented to a mental health service and evaluated general health (distress, quality of life, and disability), functioning (work loss days and social functioning), and mood symptoms (depression, anxiety, and stress) in those diagnosed with autism spectrum disorder ( n = 96). This group was compared to young adults presenting to the same service with primary mental health disorders (depression, n = 343; bipolar, n = 132; psychosis, n = 166; and anxiety, n = 303). This study also investigated the influence of mood symptoms on general health and functioning in the autism spectrum disorder group. Young autistic adults reported significant general health and functioning impairments that were of similar degree to those presenting with primary mental health disorders. Interestingly, the autistic group also reported similarly high levels of mood symptoms to those with primary depressive and anxiety disorders. In the autistic group, depressive symptoms were strongly associated with distress, quality of life, and work loss days, while stress symptoms were strongly associated with disability. This study highlights further research, and mental health services are required specifically targeting young autistic adults to address their significant unmet needs.

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The World Health Organization Disability Assessment Schedule II (WHODAS‐II) is one of the most widely used generic assessments for measuring disability levels in both clinical and nonclinical populations, with sound psychometrics that is also aligned with the International Classification of Functioning framework. However, its psychometric properties have not been explored extensively in individuals with autism spectrum disorder (ASD). This study examined the psychometric properties of the 36‐item and 12‐item Self‐Report WHODAS‐II from 109 individuals diagnosed with ASD and without intellectual disability (IQ ≥ 70). Participants were consecutively recruited from the Brain and Mind Centre in New South Wales, Australia. The WHODAS‐II showed adequate internal consistency for all domain scores (α = 0.78–0.97 for 36‐item) and for the summary scale (α = 0.95 for 36‐item; 0.86 for 12‐item). All items also exhibited satisfactory correlations with their respective domain (r = 0.39–0.94 for 36‐item) and summary scores (r = 0.42–0.71 for 36‐item; 0.42–0.67 for 12‐item), except item 4.5 “sexual activity” from the 36‐item WHODAS‐II (r = 0.19). Concurrent validity was shown by moderate correlations between similar constructs across the WHODAS‐II and the World Health Organization Quality of Life BREF (Ps < 0.05). The second‐order 7‐factor model showed the best fit for the 36‐item WHODAS‐II, while the second‐order 6‐factor model demonstrated an acceptable fit for the 12‐item WHODAS‐II. The model fit could be improved with some modifications. The Schmid‐Leiman transformation further confirmed the appropriateness of the second‐order factor structure. Overall, the results indicated that the WHODAS‐II is a viable generic self‐report measure for disability in autistic individuals without ID. Autism Res 2019, 12: 1101–1111. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary The majority of autistic people have a disability with a profound or severe limitation in their core activities. However, there is currently limited research identifying reliable and valid self‐report measures for disability in the autistic population. This study examined the psychometric properties of the World Health Organization Disability Assessment Schedule II (WHODAS‐II) from 109 autistic individuals without intellectual disability. Our results suggest that the WHODAS‐II is a viable generic self‐report measure for disability in autistic individuals.

Sex differences in autism may in part be understood by an atypical sex profile of executive function and non-executive function. In this study, we compared females and males with autism against non-autistic individuals on neuropsychological and self-report measures to examine whether any sex differences in executive function and non-executive function might be unique to autism. Our study showed a significant overall female advantage for measures of psychomotor speed, cognitive flexibility, verbal learning and memory and semantic fluency. There was no significant interaction effect between diagnosis and sex. No sex differences were observed on the self-report measure of executive function. Our results suggest that while females show different cognitive performance to males, these sex differences were not specific to the autistic cohort. Lay abstract Research comparing females and males with a diagnosis of autism suggests that there are sex differences in some characteristics such as behaviour regulation. One area not studied in detail is whether females and males with autism perform differently in tests of cognitive ability. The results of previous research are quite mixed. One explanation may be that some research comparing females and males with autism did not include a neurotypical control group for comparison. As a result, it is not clear whether the sex differences in cognitive ability observed in people with autism are similar to differences between neurotypical males and females. To better understand whether there are unique differences between males and females with autism, it is important to also compare them with neurotypical males and females. In our research, we included a neurotypical group and compared males and females with and without a diagnosis of autism. We found that the sex differences in autism are similar to what we observe in males and females without autism. Our study showed that compared with males, females (with and without autism) do better in assessments of processing speed, cognitive flexibility, verbal learning and memory and semantic fluency. Our results suggest that although females show different cognitive performance to males, these sex differences were not specific to the group with a diagnosis of autism.

Neuroticism, a 'Big Five' personality trait, has been associated with sub-clinical traits of both autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The objective of the current study was to examine whether causal overlap between ASD and ADHD traits can be accounted for by genetic and environmental risk factors that are shared with neuroticism. We performed twin-based structural equation modeling using self-report data from 12 items of the Neo Five-Factor Inventory Neuroticism domain, 11 Social Responsiveness Scale items, and 12 Adult ADHD Self-Report Scale items obtained from 3,170 young adult Australian individual twins (1,081 complete pairs). Univariate analysis for neuroticism, ASD, and ADHD traits suggested that the most parsimonious models were those with additive genetic and unique environmental components, without sex limitation effects. Heritability of neuroticism, ASD, and ADHD traits, as measured by these methods, was moderate (between 40% and 45% for each respective trait). In a trivariate model, we observed moderate phenotypic (between 0.45 and 0.62), genetic (between 0.56 and 0.71), and unique environmental correlations (between 0.37and 0.55) among neuroticism, ASD, and ADHD traits, with the highest value for the shared genetic influence between neuroticism and self-reported ASD traits (r g = 0.71). Together, our results suggest that in young adults, genetic, and unique environmental risk factors indexed by neuroticism overlap with those that are shared by ASD and ADHD.

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Aim This study aimed to: (a) examine whether treatment‐seeking young adults with social anxiety disorder (SAD) demonstrate similar degrees of distress, quality of life (QoL) and disability to those with other mental disorders; and (b) investigate the impact of comorbidity, specific comorbid conditions and antidepressants use on distress, QoL and disability in treatment‐seeking young adults with SAD. Methods A cohort of treatment‐seeking young adults (aged 16‐45) diagnosed with SAD (N = 298) or other mental health disorders (N = 842; including depression, N = 349; bipolar, N = 141; psychosis, N = 173) completed self‐report assessments of distress, QoL and disability. Results Young adults with SAD showed distress and disability of similar degree to those with most other mental disorders. Specifically, young adults with SAD reported significantly lower QoL than those with major depressive disorder or obsessive‐compulsive disorder. Furthermore, young adults with SAD had the most difficulties in getting along with others and the second highest level of distress in comparison to other psychiatric groups. In comparison to antidepressants use, the presence of comorbidity showed a substantial negative influence on these health outcomes, particularly when presenting with comorbid depression or obsessive‐compulsive disorder. Conclusions Findings highlight significant impairments in young adults seeking treatment for SAD and the important moderating influence of comorbidity. This emphasizes the urgent need for effective management and treatment for its presentation and comorbidities in mental health services targeting young adults.