Autistic women report high levels of pain, pain-related anxiety, and pain interference

Abstract Introduction: Evidence suggests autistic adults experience pain in different ways compared with nonautistic people. Autistic adults report greater pain-related anxiety, which is associated with increased pain sensitivity, and experience high rates of generalized anxiety. It is not yet clear how generalized anxiety may be related to pain-related anxiety for autistic people. Nonautistic women generally experience more pain sensitivity and pain interference. Thus, autistic women may be at greater risk of experiencing the impact of pain-related anxiety on their daily lives. Objectives: We sought to examine the relationship between pain-related anxiety, generalized anxiety, and pain's interference (eg, daily activities, mood) in autistic women's lives. Methods: The present study included N = 52 autistic adults, assigned female at birth (AFAB), who reported on their pain (Brief Pain Inventory), pain-related anxiety (Pain Anxiety Symptoms Scale-20) and generalized anxiety (Generalized Anxiety Disorder 7-Item scale). Results: In this sample, 65.4% of participants reported pain in the last 24 hours and high rates of pain interference overall. Autistic AFAB people reported high rates of generalized anxiety (11.75 ± 5.19) and pain-related anxiety (48.80 ± 13.54). Only the cognitive pain-related anxiety subscale was significantly correlated with generalized anxiety ( r = 0.30, P < 0.05). Total pain-related anxiety was associated with pain interference (enjoyment of life, r = 0.39, P < 0.01). Conclusion: Autistic AFAB people are experiencing high rates of pain, pain interference, anxiety, and pain-related anxiety. Given the relationship between pain and anxiety reported for autistic women, therapies that specifically target pain-related anxiety may have profound impacts on autistic women's quality of life.