Subjective Experiences of Quality of Life in Autistic Adults Across Race and Gender Identity: A Study of Happiness and Physical, Cognitive, and Social Well-Being
dc.contributor.advisor | W. Leigh Atherton, PhD | |
dc.contributor.author | Liles, Daniel Ernest | |
dc.contributor.committeeMember | Celeste Crawford, PhD | |
dc.contributor.committeeMember | Kenn Pritchard, PhD | |
dc.contributor.committeeMember | Steven Leierer, PhD | |
dc.contributor.committeeMember | Laura Klinger, PhD | |
dc.contributor.department | Addictions and Rehab Studies | |
dc.date.accessioned | 2025-06-05T16:52:17Z | |
dc.date.available | 2025-06-05T16:52:17Z | |
dc.date.created | 2025-05 | |
dc.date.issued | May 2025 | |
dc.date.submitted | May 2025 | |
dc.date.updated | 2025-05-22T21:12:03Z | |
dc.degree.college | College of Allied Health Sciences | |
dc.degree.grantor | East Carolina University | |
dc.degree.major | PHD-Counselor Preparation and Research | |
dc.degree.name | Ph.D. | |
dc.degree.program | PHD-Counselor Preparation and Research | |
dc.description.abstract | The need for effective programming and intervention to improve the Quality of Life for autistic individuals is well documented. Yet relatively little research is devoted to autistic adults, leaving substantial gaps in programs and services for this subgroup of the autistic population. A review of the current literature emphasized the need for a more robust understanding of predictive indicators of quality of life in the autistic adult population, the inclusion of quality of life domains that are important to the subjective experiences of autistic adults, and more representative samples within autism research. The current study, grounded in Maslow’s human needs theory, aimed to address these gaps by exploring the effects of race; gender identity; and Physical, Cognitive, and Social Health and Well-being satisfaction on Global Happiness Ratings in the autistic adult population. Hierarchical Multiple Regression was used to analyze the results of the study, which had a sample size of N = 83 adults who self-identified as being on the autism spectrum. The sample ranged in age from 18 years to 73 years, with a mean age of 34.7 years. Approximately 11% of the sample identified as Black, 69% identified as White, and the remaining 20% identified with Racial Intersectionality. Regarding gender identity, approximately 41% of the sample identified as Female, 42% identified as Male, and the remaining 17% identified as Gender Non-conforming. Physical Health and Well-being was found to be a significant positive predictor of Global Happiness Ratings for those who identified as Black. Because the impacts of race on quality of life domains has not been previously explored in the autistic adult population, this finding is the first of its kind to indicate that Black autistic adults may be more impacted by aspects related to Physical Health and Well-being than other demographic groups. Social Health and Well-being emerged as the strongest predictor of Global Happiness Ratings in the autistic adult sample. As Social Health and Well-being increased, so did Global Happiness at a relatively large rate with a high degree of certainty. This finding is consistent with previous studies and supports the inclusion of social health and well-being considerations at all levels of programs and services for autistic adults regardless of race and/or gender identity. In addition to the significant findings, trends were observed in the current study that warrant attention, including negative trends in global happiness for those who have racial intersectionality and those who are gender non-conforming. These trends are consistent with previous studies that have found indications of excess intersectional disparity and lower quality of life in those who live with multiple marginalized identities. Like all research, the current study had limitation that impacted the interpretability and generalizability of results. Specific limitation included those inherent to cross-sectional survey research and a lack of acceptable reliability in the Cognitive Health and Well-being domain utilized. However, this study contributed to the current body of knowledge of autistic adult quality of life and has several critical implications for clinical practice, administration and policy, and future research. Administration and policy efforts need to focus on social inclusivity so autistic adults, including those with other marginalized identities, will be seen as equitable members of society. Recommendations for future research include incorporating longitudinal designs in autistic quality of life studies, enhancing diversity within autistic samples, establishing professional consensus on the ideal instrument to use when measuring subjective quality of life in autistic adults, and integrating self- and informant-report measures to improve reliability and validity of findings. | |
dc.etdauthor.orcid | 0009-0007-2267-9850 | |
dc.format.mimetype | application/pdf | |
dc.identifier.uri | http://hdl.handle.net/10342/13998 | |
dc.language.iso | English | |
dc.publisher | East Carolina University | |
dc.subject | Health Sciences, Mental Health | |
dc.title | Subjective Experiences of Quality of Life in Autistic Adults Across Race and Gender Identity: A Study of Happiness and Physical, Cognitive, and Social Well-Being | |
dc.type | Doctoral Dissertation | |
dc.type.material | text |
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