Alexithymia and intolerance of uncertainty predict somatic symptoms in autistic and non-autistic adults.

Researchers studied physical discomfort (pain, dizziness) in autistic and non-autistic adults. Autistic people reported more physical discomfort than others, even when accounting for their health conditions. Key factors that increased physical discomfort were difficulty understanding emotions, trouble with uncertainty, being female, and having health problems. This suggests autistic people may experience more physical discomfort partly due to these psychological factors.

This cross-sectional study examined somatic symptoms (pain, discomfort, dizziness) in 202 participants including 51 autistic adults, 32 potentially autistic individuals, and 119 non-autistic controls. Results showed autistic participants experienced significantly more somatic symptoms than non-autistic participants, even after accounting for their higher rates of physical and mental health conditions. Across all participants, alexithymia (difficulty identifying emotions), intolerance of uncertainty, female gender, physical health problems, and number of mental health conditions predicted higher somatic symptoms. Notably, autism diagnosis itself and interoceptive awareness did not directly predict somatic symptoms.

The findings suggest psychological factors prominent in autism may contribute to increased physical discomfort experiences.

Healthcare providers should assess alexithymia and intolerance of uncertainty when treating autistic individuals with physical symptoms. Interventions targeting emotion identification skills and uncertainty management may help reduce somatic symptom burden. Physical complaints in autistic individuals should not be dismissed as solely psychological but require comprehensive assessment considering both medical and psychological factors.

Cross-sectional design prevents causal conclusions. Sample included undiagnosed potentially autistic individuals which may affect group comparisons. Reliance on self-report measures for all variables. Sample size relatively small for subgroup analyses. No information provided about recruitment methods or participant demographics.

Autistic people have more physical health problems than non-autistic people. We were interested in whether autistic people experience more discomfort in their bodies than non-autistic people and whether certain psychological traits contribute to that. A survey was completed online by older adolescents and adults, 51 of whom were autistic, 32 of whom thought they might be autistic but were not diagnosed and 119 who were not autistic. They completed measures of somatic symptoms (daily experience of pain, discomfort, dizziness), alexithymia (difficulty identifying and expressing feelings), interoception (how much people are aware of their bodies) and intolerance of uncertainty (how people handle doubt or uncertainty), and reported any physical or mental health conditions.

We found that the autistic participants had more physical and mental health conditions than the non-autistic participants, but even when we took account of this, they experienced higher levels of somatic symptoms. We looked at which psychological factors influenced levels of somatic symptoms across the whole sample, and found that alexithymia, intolerance of uncertainty, having physical health problems, being female and the number of mental health conditions predicted somatic symptoms, while interoception and autism diagnosis did not. The findings suggest that people may be more likely to experience physical discomfort if they are female, and have difficulty identifying and expressing feeling and difficulty tolerating doubt. As these psychological factors are more prominent in autism, we think this is important for physical and mental health providers to know about, so that these psychological factors can be considered when assessing and treating autistic people.