Autism spectrum disorder (ASD) is associated with atypical autonomic nervous system (ANS) function. However, little is known about this relationship, while accounting for co-occurring mental health conditions (e.g. anxiety) that are also associated with ANS dysfunction. In addition, research on the ANS has typically involved physiological measurements, without using more clinically meaningful measures of ANS dysfunction, such as the self-reported frequency of ANS-related physical health symptoms. Furthermore, very little is known about ANS function in autistic adults, given that previous research has focused on ANS dysfunction in children with ASD. Addressing these gaps in the literature, we compared ANS function in adults with(out) ASD (Study 1). Although autistic adults reported greater ANS dysfunction than matched neurotypical controls, this difference was not significant after controlling for anxiety and depression. Similarly, in a large nonclinical sample (Study 2), we found that anxiety and stress mediated the relationship between autistic traits and ANS dysfunction. Together, we conclude that ANS dysfunction is not a feature of ASD per se, but instead attributable to the high levels of anxiety and stress in autistic adults. We discuss the clinical relevance of these findings for managing ANS dysfunction and other physical and mental health concerns in autistic adulthood.

Lay abstract

The autonomic nervous system (ANS) is responsible for the functioning of the heart, bladder, pupils and several other bodily functions. Therefore, when the ANS functions abnormally, individuals can experience a number of physical symptoms, including dizziness, abnormal sweating and digestive difficulties. Currently, it is unclear if autistic adults experience ANS dysfunction. Therefore, in this study, we investigated whether autistic adults report more ANS-related physical symptoms, indicating greater ANS dysfunction, and whether this may be related to autism, or rather anxiety, depression, or stress. The findings suggest that ANS dysfunction, where found in autism, is due to co-occurring stress and anxiety. We therefore propose that treating stress and anxiety may be an effective way to ameliorate ANS-related health problems in autistic adults.

中文翻译：

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自闭症的自主神经功能障碍：焦虑，抑郁和压力的作用

自闭症谱系障碍（ASD）与非典型自主神经系统（ANS）功能相关。然而，对于这种关系知之甚少，同时考虑到了同时发生的与ANS功能障碍有关的精神健康状况（例如焦虑）。此外，对ANS的研究通常涉及生理学测量，而没有使用更有意义的ANS功能障碍的临床意义测量，例如ANS相关身体健康症状的自我报告频率。此外，鉴于以前的研究集中于自闭症儿童的ANS功能障碍，对自闭症成年人的ANS功能知之甚少。为了弥补文献中的这些空白，我们将成人的ANS功能与（没有）ASD进行了比较（研究1）。尽管自闭症成年人报告称其ANS功能障碍的程度高于配对的神经性对照，在控制焦虑和抑郁后，这种差异并不明显。同样，在大量的非临床样本中（研究2），我们发现焦虑和压力介导了自闭症特征与ANS功能障碍之间的关系。在一起，我们得出结论，ANS功能障碍不是ASD的特征本身，而是归因于自闭症成年人的高度焦虑和压力。我们讨论了这些发现与管理自闭症成年患者ANS功能障碍以及其他身心健康问题的临床相关性。

放置摘要

自主神经系统（ANS）负责心脏，膀胱，瞳孔和其他几种身体功能。因此，当ANS功能异常时，个体会经历许多身体症状，包括头晕，异常出汗和消化困难。目前，尚不清楚自闭症成年人是否患有ANS功能障碍。因此，在这项研究中，我们调查了自闭症成年人是否报告了更多的与ANS相关的身体症状，表明更大的ANS功能障碍，以及这是否可能与自闭症有关，还是与焦虑症，抑郁症或压力有关。这些发现表明，自闭症中发现的ANS功能障碍是由于压力和焦虑共同发生。因此，我们建议治疗压力和焦虑症可能是缓解自闭症成年人ANS相关健康问题的有效方法。