"Feeling Unwanted, When Nobody Wants You Around": Perceptions of Social Pain Among People With Autism.

Researchers interviewed 15 autistic adults about their experiences of social pain - the hurt from feeling left out or rejected. They found that autistic people want social connections but often experience pain from social situations. Four main areas were identified: what social pain means, what causes it, the loneliness that results, and how people cope with it. The study suggests programs are needed to help autistic people develop better coping skills and feel more accepted in their communities.

This qualitative study explored social pain experiences among 15 autistic adults through semi-structured interviews. Four primary themes emerged: definition and distinction of social pain from other pain types, internal and external sources of social pain, loneliness as an outcome reflecting gaps between desired and actual social contact, and coping strategies ranging from inward to outward approaches. The research revealed a discrepancy between autistic people's need for social interactions and the social pain they experience. Participants used identity-first language preferences.

The study proposes a theoretical model for understanding social pain in autism and calls for intervention programs to improve coping strategies and promote self-acceptance and community inclusion.

Results support developing targeted interventions to improve coping strategies for social pain in autism. Occupational therapists should consider the theoretical model when addressing social functioning. Programs should focus on self-acceptance and community inclusion while recognizing the gap between social desires and experiences in autistic individuals.

Small sample size of 15 participants limits generalizability. Qualitative design provides rich insights but cannot establish causal relationships. Online interview format may have affected participant responses. Study focused on adults only, limiting applicability to children and adolescents.

A paucity of studies have focused on pain experiences among people with autism spectrum disorder, particularly those addressing social pain in daily life contexts or learning from the perspective of autistic people. To explore the social pain experience of autistic people. A descriptive qualitative design followed by deductive thematic analysis. Interviews were semistructured to capture the social pain experience, coping strategies, and implications for the participation of autistic people.

Online interviews using Zoom videoconferencing software. Fifteen autistic people were recruited for the study using purposeful and criterion sampling. Four primary themes emerged from the data analysis: (1) a definition of social pain and the distinction between social pain and other types of pain; (2) the sources-internal, external, and combined-of social pain; (3) the loneliness outcome, which echoes the gap between the desire for and lack of social contacts; and (4) coping strategies pertaining to the continuum between inward and outward coping strategies to deal with social pain. The study indicates the existence of a discrepancy between autistic people's need for social interactions and the social pain they experience.

It calls for intervention programs for autistic people to improve their coping strategies and promote their self-acceptance and better inclusion in the community. What This Article Adds: Promoting social functioning is a prime role of occupational therapists, and this article adds a novel theoretical model that contributes to that role. The model represents the social pain experiences of autistic people and their strategies to overcome this phenomenon. Firsthand accounts of autistic people regarding social pain enable a better understanding of their desire to be involved in the social context.

This study suggests directions for further intervention programs to assist autistic people in fulfilling their wish for social relationships and enabling their enhanced integration into society. Positionality Statement: We recognize that use of person-first versus identity-first language is a source of debate and controversy. We have chosen to use identity-first language for two reasons. First, studies indicate person with autism is the term least preferred by autistic people (Botha et al., 2021).

Second, autistic is the term used by the majority of our participants during interviews.