Autistic adults respond more strongly to social rejection and exclusion on average than non-autistic adults. This sensitivity to ‘social pain’ is particularly associated with lower self-esteem. These are the findings of a new study by Alvin van Asselt, researcher at Vrije Universiteit Amsterdam, and colleagues, based on data from the Netherlands Autism Register (NAR).

Social pain refers to the emotional and physical distress people may experience in response to rejection, exclusion or loss. Autistic people are relatively likely to encounter negative social experiences, such as bullying, discrimination and a lack of social acceptance. However, little was known about their sensitivity to social pain and the factors associated with it.

Higher social pain sensitivity

For the study, 1,425 autistic adults and 187 non-autistic adults aged 16 and over completed a questionnaire about social pain. Autistic participants reported higher social pain sensitivity on average. The difference was statistically significant, although the effect was small.

Women reported higher social pain sensitivity than men. This difference was found among both autistic and non-autistic participants.

The researchers also examined whether social pain sensitivity among autistic adults was associated with self-esteem, cognitive empathy and sensory sensitivity. Lower self-esteem was clearly associated with higher social pain sensitivity. No associations were found with cognitive empathy or sensory sensitivity.

Because the data were collected at a single point in time, the study cannot establish cause and effect. Lower self-esteem may increase sensitivity to social rejection, but repeated experiences of rejection may also negatively affect a person’s self-esteem.

The importance of social acceptance

The findings challenge the assumption that autistic people are less aware of or less affected by negative social experiences. The researchers therefore emphasise the importance of support that not only focuses on the individual, but also promotes social acceptance, a sense of belonging and the prevention of exclusion.

First author Alvin van Asselt is completing a PhD at Vrije Universiteit Amsterdam on stress and social pain in autistic people. This publication is the fifth study included in his PhD thesis, 'Managing Stress and Social Pain in Autistic Individuals'.

The research used data from the Netherlands Autism Register (NAR), a longitudinal cohort for autistic people aged 16 and over. The NAR is one of the cohorts connected to Amsterdam Cohort Hub.

The study was conducted by Alvin van Asselt, Yvette Roke, Sander Begeer and Anke Scheeren and published in Autism Research.

Read the publication:
https://doi.org/10.1002/aur.70345

More about the PhD thesis:
https://research.vu.nl/en/publications/managing-stress-and-social-pain-in-autistic-individuals/