{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:39:43Z","timestamp":1793608783458,"version":"4.5.0"},"reference-count":74,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","award":["ES\/P000703\/1"],"award-info":[{"award-number":["ES\/P000703\/1"]}],"id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"King\u2019s College London"},{"name":"London Interdisciplinary Social Science Doctoral Training Partnership"},{"DOI":"10.13039\/100019418","name":"nihr maudsley biomedical research centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019418","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009362","name":"south london and maudsley nhs foundation trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009362","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"national institute for health and care research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000377","name":"Dunhill Medical Trust","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000377","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Autism"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    \u2018Autistic burnout\u2019 is increasingly conceptualised as an experience of severe exhaustion, increased sensory difficulties and need for solitude, resulting from not having needs met across contexts. We interviewed 20 autistic adults (eight diagnosed with autism in childhood) about their experiences of autistic burnout. In this reflexive thematic analysis, we focused on how burnout felt, comparing the experiences of those diagnosed in childhood versus adulthood. We created five themes. We understood burnout to be, at times, (1)\n                    <jats:italic toggle=\"yes\">a powering down and\/or<\/jats:italic>\n                    (2)\n                    <jats:italic toggle=\"yes\">the overactivation, of the mind and body<\/jats:italic>\n                    , resulting in (3)\n                    <jats:italic toggle=\"yes\">a craving for sensory and social rest<\/jats:italic>\n                    . For those diagnosed in adulthood, burnout seemed to be experienced as more chronic and confusing. Some participants diagnosed in adulthood (4)\n                    <jats:italic toggle=\"yes\">made the world more bearable by using substances<\/jats:italic>\n                    , coping with the contributors to and effects of burnout. Especially affecting those diagnosed in adulthood, (5)\n                    <jats:italic toggle=\"yes\">not knowing why this was happening took a (sometimes dangerous)<\/jats:italic>\n                    toll; for a few, it led to contemplating suicide. This study brings new insights into burnout experiences of adults diagnosed with autism at different life points.\n                  <\/jats:p>\n                  <jats:sec>\n                    <jats:title>Lay abstract<\/jats:title>\n                    <jats:p>Some autistic people experience severe exhaustion as a result of not having their needs met that sometimes prevents them from being able to take part in daily life. Some people refer to this as \u2018autistic burnout\u2019. In this study, we spoke to 20 autistic adults, eight of whom were diagnosed with autism in childhood. We analysed our participants\u2019 interviews through an approach called reflexive thematic analysis. Through this process, we created five themes around the question of how autistic burnout felt for these participants. We were also interested in how participants diagnosed with autism in childhood versus in adulthood described their burnout experiences. This is because research has shown that not having an autism diagnosis earlier in life could, indirectly, lead to not understanding one\u2019s own needs accurately and not having the right support from others. The five themes we created were (1) the powering down of the mind and body, (2) the overactivation of the mind and body, (3) craving social and sensory rest, (4) making the world more manageable by using substances and (5) not knowing why this is happening to you can take a (sometimes dangerous) toll. Themes 1, 2 and 3 seemed to be shared between participants regardless of age at autism diagnosis. However, these experiences seemed to be more disabling for participants diagnosed in adulthood. Themes 4 and 5 related particularly to those diagnosed with autism in adulthood. This study adds an important insight: perspectives on burnout experiences from adults diagnosed with autism at different life points.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13623613261422117","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T08:49:27Z","timestamp":1772268567000},"page":"1014-1027","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["How does \u2018autistic burnout\u2019 feel? A qualitative study exploring experiences of earlier and later-diagnosed autistic adults"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3177-9841","authenticated-orcid":false,"given":"Dorota","family":"Ali","sequence":"first","affiliation":[{"name":"King\u2019s College London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3564-5808","authenticated-orcid":false,"given":"Will","family":"Mandy","sequence":"additional","affiliation":[{"name":"University College London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9226-4000","authenticated-orcid":false,"given":"Francesca","family":"Happ\u00e9","sequence":"additional","affiliation":[{"name":"King\u2019s College London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Ai W. Cunningham W. A. Lai M. C. (2022). Reconsidering autistic \u2018camouflaging\u2019 as transactional impression management. Trends in Cognitive Sciences 26(8) 631\u2013645. https:\/\/doi.org\/10.1016\/j.tics.2022.05.002","DOI":"10.1016\/j.tics.2022.05.002"},{"key":"e_1_3_3_3_1","doi-asserted-by":"crossref","unstructured":"Ali D. Bougoure M. Cooper B. Quinton A. M. G. Tan D. Brett J. Mandy W. Maybery M. Magiati I. Happ\u00e9 F. (2025). Burnout as experienced by autistic people: A systematic review. Clinical psychology review 122 102669. https:\/\/doi.org\/10.1016\/j.cpr.2025.102669","DOI":"10.1016\/j.cpr.2025.102669"},{"key":"e_1_3_3_4_1","doi-asserted-by":"crossref","unstructured":"Arnold S. R. Higgins J. M. Weise J. Desai A. Pellicano E. Trollor J. N. (2023a). Confirming the nature of autistic burnout. Autism 27(7) 1906\u20131918. https:\/\/doi.org\/10.1177\/13623613221147410","DOI":"10.1177\/13623613221147410"},{"key":"e_1_3_3_5_1","doi-asserted-by":"crossref","unstructured":"Arnold S. R. Higgins J. M. Weise J. Desai A. Pellicano E. Trollor J. N. (2023b). Towards the measurement of autistic burnout. Autism 27(7) 1933\u20131948. https:\/\/doi.org\/10.1177\/13623613221147401","DOI":"10.1177\/13623613221147401"},{"key":"e_1_3_3_6_1","doi-asserted-by":"crossref","unstructured":"Avlund S. H. Thomsen P. H. Schendel D. J\u00f8rgensen M. Carlsen A. H. Clausen L. (2021). Factors associated with a delayed autism spectrum disorder diagnosis in children previously assessed on suspicion of autism. Journal of Autism and Developmental Disorders 51(11) 3843\u20133856. https:\/\/doi.org\/10.1007\/s10803-020-04849-x","DOI":"10.1007\/s10803-020-04849-x"},{"key":"e_1_3_3_7_1","doi-asserted-by":"crossref","unstructured":"Baggetta P. Alexander P. A. (2016). Conceptualization and operationalization of executive function. Mind Brain and Education 10(1) 10\u201333. https:\/\/doi.org\/10.1111\/mbe.12100","DOI":"10.1111\/mbe.12100"},{"key":"e_1_3_3_8_1","volume-title":"A realist theory of science","author":"Bhaskar R.","year":"2008","unstructured":"Bhaskar R. (2008). A realist theory of science. Verso Books."},{"key":"e_1_3_3_9_1","doi-asserted-by":"crossref","unstructured":"Bianchi R. Schonfeld I. S. Laurent E. (2015). Is it time to consider the \u2018burnout syndrome\u2019 a distinct illness? Frontiers in Public Health 3 Article 158. https:\/\/doi.org\/10.3389\/fpubh.2015.00158","DOI":"10.3389\/fpubh.2015.00158"},{"key":"e_1_3_3_10_1","doi-asserted-by":"crossref","unstructured":"Bianchi R. Truchot D. Laurent E. Brisson R. Schonfeld I. S. (2014). Is burnout solely job-related? A critical comment. Scandinavian Journal of Psychology 55 357\u2013361. https:\/\/doi.org\/10.1111\/sjop.12119","DOI":"10.1111\/sjop.12119"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-69909-7_3470-2"},{"key":"e_1_3_3_12_1","doi-asserted-by":"crossref","unstructured":"Brosnan M. Adams S. (2022). Adapting drug and alcohol therapies for autistic adults. Autism in Adulthood 4(3) 214\u2013223. https:\/\/doi.org\/10.1089\/aut.2021.0047","DOI":"10.1089\/aut.2021.0047"},{"key":"e_1_3_3_13_1","doi-asserted-by":"crossref","unstructured":"Brown C. M. Newell V. Sahin E. Hedley D. (2024). Updated systematic review of suicide in autism: 2018\u20132024. Current Developmental Disorders Reports 11 225\u2013256. https:\/\/doi.org\/10.1007\/s40474-024-00308-9","DOI":"10.1007\/s40474-024-00308-9"},{"key":"e_1_3_3_14_1","doi-asserted-by":"crossref","unstructured":"Butwicka A. L\u00e5ngstr\u00f6m N. Larsson H. Lundstr\u00f6m S. Serlachius E. Almqvist C. Fris\u00e9n L. Lichtenstein P. (2017). Increased risk for substance use-related problems in autism spectrum disorders: A population-based cohort study. Journal of Autism and Developmental Disorders 47 80\u201389. https:\/\/doi.org\/10.1007\/s10803-016-2914-2","DOI":"10.1007\/s10803-016-2914-2"},{"key":"e_1_3_3_15_1","doi-asserted-by":"crossref","unstructured":"Carpiniello B. Pinna F. (2017). The reciprocal relationship between suicidality and stigma. Frontiers in Psychiatry 8 Article 35. https:\/\/doi.org\/10.3389\/fpsyt.2017.00035","DOI":"10.3389\/fpsyt.2017.00035"},{"key":"e_1_3_3_16_1","doi-asserted-by":"crossref","unstructured":"Cashin A. Buckley T. Trollor J. N. Lennox N. (2016). A scoping review of what is known of the physical health of adults with autism spectrum disorder. Journal of Intellectual Disabilities 22(1) 96\u2013108. https:\/\/doi.org\/10.1177\/1744629516665242","DOI":"10.1177\/1744629516665242"},{"key":"e_1_3_3_17_1","doi-asserted-by":"crossref","unstructured":"Chapman L. Rose K. Hull L. Mandy W. (2022). \u2018I want to fit in . . . but I don\u2019t want to change myself fundamentally\u2019: A qualitative exploration of the relationship between masking and mental health for autistic teenagers. Research in Autism Spectrum Disorders 99 102069. https:\/\/doi.org\/10.1016\/j.rasd.2022.102069","DOI":"10.1016\/j.rasd.2022.102069"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1215\/9780822373520"},{"key":"e_1_3_3_19_1","doi-asserted-by":"crossref","unstructured":"Clarey M. M. Abel S. Ireland M. J. Brownlow C. (2025). Autistic burnout on Reddit: A Sisyphean struggle with daily tasks. Journal of Autism and Developmental Disorders. Advance online publication. https:\/\/doi.org\/10.1007\/s10803-025-06765-4","DOI":"10.1007\/s10803-025-06765-4"},{"key":"e_1_3_3_20_1","doi-asserted-by":"crossref","unstructured":"Cook J. Hull L. Mandy W. (2024). Improving diagnostic procedures in autism for girls and women: A narrative review. Neuropsychiatric Disease and Treatment 20 505\u2013514. https:\/\/doi.org\/10.2147\/NDT.S372723","DOI":"10.2147\/NDT.S372723"},{"key":"e_1_3_3_21_1","doi-asserted-by":"crossref","unstructured":"Daniels A. M. Mandell D. S. (2014). Explaining differences in age at autism spectrum disorder diagnosis: A critical review. Autism 18(5) 583\u2013597. https:\/\/doi.org\/10.1177\/1362361313480277","DOI":"10.1177\/1362361313480277"},{"key":"e_1_3_3_22_1","doi-asserted-by":"crossref","unstructured":"Demetriou E. A. DeMayo M. M. Guastella A. J. (2019). Executive function in autism spectrum disorder: History theoretical models empirical findings and potential as an endophenotype. Frontiers in Psychiatry 10 Article 753. https:\/\/doi.org\/10.3389\/fpsyt.2019.00753","DOI":"10.3389\/fpsyt.2019.00753"},{"key":"e_1_3_3_23_1","doi-asserted-by":"crossref","unstructured":"Diemer M. C. Ros-Demarize R. Bradley C. C. Kanne S. Kim S. H. Parish-Morris J. Snyder L. G. Wodka E. ; SPARK Consortium;Carpenter L. A. (2025). Comparative analysis of autistic women across the lifespan: Childhood vs. adulthood diagnosis. Autism Research 18(8) 1651\u20131663. https:\/\/doi.org\/10.1002\/aur.70073","DOI":"10.1002\/aur.70073"},{"key":"e_1_3_3_24_1","doi-asserted-by":"crossref","unstructured":"Diestel S. Cosmar M. Schmidt K. H. (2013). Burnout and impaired cognitive functioning: The role of executive control in the performance of cognitive tasks. Work & Stress 27(2) 164\u2013180. https:\/\/doi.org\/10.1080\/02678373.2013.790243","DOI":"10.1080\/02678373.2013.790243"},{"key":"e_1_3_3_25_1","doi-asserted-by":"crossref","unstructured":"Drisko J. W. (2024). Transferability and generalization in qualitative research. Research on Social Work Practice 35(1) 102\u2013110. https:\/\/doi.org\/10.1177\/10497315241256560","DOI":"10.1177\/10497315241256560"},{"key":"e_1_3_3_26_1","doi-asserted-by":"crossref","unstructured":"Dworzynski K. Ronald A. Bolton P. Happ\u00e9 F. (2012). How different are girls and boys above and below the diagnostic threshold for autism spectrum disorders? Journal of the American Academy of Child and Adolescent Psychiatry 51(8) 788\u2013797. https:\/\/doi.org\/10.1016\/j.jaac.2012.05.018","DOI":"10.1016\/j.jaac.2012.05.018"},{"key":"e_1_3_3_27_1","doi-asserted-by":"crossref","unstructured":"Gavelin H. M. Domell\u00f6f M. E. \u00c5str\u00f6m E. Nelson A. Launder N. H. Neely A. S. Lampit A. (2021). Cognitive function in clinical burnout: A systematic review and meta-analysis. Work & Stress 36(1) 86\u2013104. https:\/\/doi.org\/10.1080\/02678373.2021.2002972","DOI":"10.1080\/02678373.2021.2002972"},{"key":"e_1_3_3_28_1","doi-asserted-by":"crossref","unstructured":"GBD 2016 Alcohol and Drug Use Collaborators. (2018). The global burden of disease attributable to alcohol and drug use in 195 countries and territories 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet Psychiatry 5(12) 987\u20131012. https:\/\/doi.org\/10.1016\/S2215-0366(18)30337-7","DOI":"10.1016\/S2215-0366(18)30337-7"},{"key":"e_1_3_3_29_1","first-page":"1","article-title":"On the inside looking in: Methodological insights and challenges in conducting qualitative insider research","volume":"19","author":"Greene M.","year":"2014","unstructured":"Greene M. (2014). On the inside looking in: Methodological insights and challenges in conducting qualitative insider research. The Qualitative Report, 19, 1\u201313.","journal-title":"The Qualitative Report"},{"key":"e_1_3_3_30_1","doi-asserted-by":"crossref","unstructured":"Grillon C. Quispe-Escudero D. Mathur A. Ernst M. (2015). Mental fatigue impairs emotion regulation. Emotion 15(3) 383\u2013389. https:\/\/doi.org\/10.1037\/emo0000058","DOI":"10.1037\/emo0000058"},{"key":"e_1_3_3_31_1","doi-asserted-by":"crossref","unstructured":"Guseva Canu I. Marca S. C. Dell\u2019Oro F. Bal\u00e1zs \u00c1. Bergamaschi E. Besse C. Bianchi R. Bislimovska J. Koscec Bjelajac A. Bugge M. Busneag C. I. \u00c7a\u011flayan \u00c7. Cerni\u021banu M. Costa Pereira C. Dernov\u0161\u010dek Hafner N. Droz N. Eglite M. Godderis L. G\u00fcndel H. Wahlen A. (2021). Harmonized definition of occupational burnout: A systematic review semantic analysis and Delphi consensus in 29 countries. Scandinavian Journal of Work Environment & Health 47(2) 95\u2013107. https:\/\/doi.org\/10.5271\/sjweh.3935","DOI":"10.5271\/sjweh.3935"},{"key":"e_1_3_3_32_1","doi-asserted-by":"crossref","unstructured":"Haasbroek H. Morojele N. (2022). A systematic literature review on the relationship between autism spectrum disorder and substance use among adults and adolescents. Review Journal of Autism and Developmental Disorders 9 1\u201320. https:\/\/doi.org\/10.1007\/s40489-021-00242-1","DOI":"10.1007\/s40489-021-00242-1"},{"key":"e_1_3_3_33_1","doi-asserted-by":"crossref","unstructured":"Hartley G. Sirois F. Purrington J. Rabey Y. (2023). Adverse childhood experiences and autism: A meta-analysis. Trauma Violence & Abuse 25(3) 2297\u20132315. https:\/\/doi.org\/10.1177\/15248380231213314","DOI":"10.1177\/15248380231213314"},{"key":"e_1_3_3_34_1","doi-asserted-by":"crossref","unstructured":"Higgins J. M. Arnold S. R. Weise J. Pellicano E. Trollor J. N. (2021). Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout. Autism 25(8) 2356\u20132369. https:\/\/doi.org\/10.1177\/13623613211019858","DOI":"10.1177\/13623613211019858"},{"key":"e_1_3_3_35_1","doi-asserted-by":"crossref","unstructured":"Howe S. Hull L. Sedgewick F. Hannon B. McMorris C. (2023). Understanding camouflaging and identity in autistic children and adolescents using photo-elicitation. Research in Autism Spectrum Disorders 108 Article102232. https:\/\/doi.org\/10.1016\/j.rasd.2023.102232","DOI":"10.1016\/j.rasd.2023.102232"},{"key":"e_1_3_3_36_1","doi-asserted-by":"crossref","unstructured":"Jacobson D. Mustafa N. (2019). Social identity map: A reflexivity tool for practicing explicit positionality in critical qualitative research. International Journal of Qualitative Methods 18 1609406919870075. https:\/\/doi.org\/10.1177\/1609406919870075","DOI":"10.1177\/1609406919870075"},{"key":"e_1_3_3_37_1","doi-asserted-by":"crossref","unstructured":"Jertberg R. M. Begeer S. Geurts H. M. Chakrabarti B. Van der Burg E. (2025). Slow but steady: Similarities and differences in executive functioning between autistic and non-autistic adults. Autism Research 18 802\u2013819. https:\/\/doi.org\/10.1002\/aur.70015","DOI":"10.1002\/aur.70015"},{"key":"e_1_3_3_38_1","doi-asserted-by":"crossref","unstructured":"Kaltenegger H. C. Doering S. Gillberg C. Wennberg P. Lundstr\u00f6m S. (2021). Low prevalence of risk drinking in adolescents and young adults with autism spectrum problems. Addictive Behaviors 113 106671. https:\/\/doi.org\/10.1016\/j.addbeh.2020.106671","DOI":"10.1016\/j.addbeh.2020.106671"},{"key":"e_1_3_3_39_1","doi-asserted-by":"crossref","unstructured":"Keville S. Meek C. Ludlow A. K. (2021). Mothers\u2019 perspectives of co-occurring fatigue in children with autism spectrum disorders. Fatigue: Biomedicine Health & Behavior 9(4) 209\u2013226. https:\/\/doi.org\/10.1080\/21641846.2021.2008169","DOI":"10.1080\/21641846.2021.2008169"},{"key":"e_1_3_3_40_1","doi-asserted-by":"crossref","unstructured":"Kiehl I. Pease R. Hackmann C. (2024). The adult experience of being diagnosed with autism spectrum disorder: A qualitative meta-synthesis. Autism 28(5) 1060\u20131074. https:\/\/doi.org\/10.1177\/13623613231220419","DOI":"10.1177\/13623613231220419"},{"key":"e_1_3_3_41_1","doi-asserted-by":"crossref","unstructured":"Kim J. H. Lee J. Shim S. Cheon K. A. (2024). Association of self-harm and suicidality with psychiatric co-occurring conditions in autistic individuals: A systematic review and pooled analysis. EClinicalMedicine 77 102863. https:\/\/doi.org\/10.1016\/j.eclinm.2024.102863","DOI":"10.1016\/j.eclinm.2024.102863"},{"key":"e_1_3_3_42_1","doi-asserted-by":"crossref","unstructured":"Kofler M. J. Soto E. F. Singh L. J. Harmon S. L. Jaisle E. M. Smith J. N. Feeney K. E. Musser E. D. (2024). Executive function deficits in attention-deficit\/hyperactivity disorder and autism spectrum disorder. Nature Reviews Psychology 3 701\u2013719. https:\/\/doi.org\/10.1038\/s44159-024-00350-9","DOI":"10.1038\/s44159-024-00350-9"},{"key":"e_1_3_3_43_1","doi-asserted-by":"crossref","unstructured":"Koutsimani P. Montgomery A. Masoura E. Panagopoulou E. (2021). Burnout and cognitive performance. International Journal of Environmental Research and Public Health 18(4) 2145. https:\/\/doi.org\/10.3390\/ijerph18042145","DOI":"10.3390\/ijerph18042145"},{"key":"e_1_3_3_44_1","doi-asserted-by":"crossref","unstructured":"Kronenberg L. M. Slager-Visscher K. Goossens P. J. van den Brink W. van Achterberg T. (2014). Everyday life consequences of substance use in adult patients with a Substance Use Disorder (SUD) and co-occurring Attention Deficit\/Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD): A patient\u2019s perspective. BMC Psychiatry 14 Article 264. https:\/\/doi.org\/10.1186\/s12888-014-0264-1","DOI":"10.1186\/s12888-014-0264-1"},{"key":"e_1_3_3_45_1","doi-asserted-by":"crossref","unstructured":"Lai M.-C. Kassee C. Besney R. Bonato S. Hull L. Mandy W. Szatmari P. Ameis S. H. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: A systematic review and meta-analysis. The Lancet Psychiatry 6(10) 819\u2013829. https:\/\/doi.org\/10.1016\/S2215-0366(19)30289-5","DOI":"10.1016\/S2215-0366(19)30289-5"},{"key":"e_1_3_3_46_1","doi-asserted-by":"crossref","unstructured":"Leedham A. Thompson A. R. Smith R. Freeth M. (2019). \u2018I was exhausted trying to figure it out\u2019: The experiences of females receiving an autism diagnosis in middle to late adulthood. Autism 24(1) 135\u2013146. https:\/\/doi.org\/10.1177\/1362361319853442","DOI":"10.1177\/1362361319853442"},{"key":"e_1_3_3_47_1","doi-asserted-by":"crossref","unstructured":"Leung F. Y. Shah P. Mason D. Livingston L. A. (2023). Re-examining the association between the age of learning one is autistic and adult outcomes. Autism 28(2) 433\u2013448. https:\/\/doi.org\/10.1177\/13623613231173056","DOI":"10.1177\/13623613231173056"},{"key":"e_1_3_3_48_1","doi-asserted-by":"crossref","unstructured":"Lewis L. F. Stevens K. (2023). The lived experience of meltdowns for autistic adults. Autism 27(6) 1817\u20131825. https:\/\/doi.org\/10.1177\/13623613221145783","DOI":"10.1177\/13623613221145783"},{"key":"e_1_3_3_49_1","doi-asserted-by":"crossref","unstructured":"Mahony C. O\u2019Ryan C. (2022). A molecular framework for autistic experiences: Mitochondrial allostatic load as a mediator between autism and psychopathology. Frontiers in Psychiatry 13 Article 985713. https:\/\/doi.org\/10.3389\/fpsyt.2022.985713","DOI":"10.3389\/fpsyt.2022.985713"},{"key":"e_1_3_3_50_1","doi-asserted-by":"crossref","unstructured":"Malterud K. Siersma V. D. Guassora A. D. (2015). Sample size in qualitative interview studies: Guided by information power: Guided by information power. Qualitative Health Research 26(13) 1753\u20131760. https:\/\/doi.org\/10.1177\/1049732315617444","DOI":"10.1177\/1049732315617444"},{"key":"e_1_3_3_51_1","doi-asserted-by":"crossref","unstructured":"Malwane M. I. Nguyen E. B. Trejo S.Jr Kim E. Y. Cucal\u00f3n-Calder\u00f3n J. R. (2022). A delayed diagnosis of autism spectrum disorder in the setting of complex attention deficit hyperactivity disorder. Cureus 14(6) Article e25825. https:\/\/doi.org\/10.7759\/cureus.25825","DOI":"10.7759\/cureus.25825"},{"key":"e_1_3_3_52_1","doi-asserted-by":"crossref","unstructured":"Mantzalas J. Richdale A. L. Adikari A. Lowe J. Dissanayake C. (2022). What is autistic burnout? A thematic analysis of posts on two online platforms. Autism in Adulthood 4(1) 52\u201365. https:\/\/doi.org\/10.1089\/aut.2021.0021","DOI":"10.1089\/aut.2021.0021"},{"key":"e_1_3_3_53_1","doi-asserted-by":"crossref","unstructured":"Mantzalas J. Richdale A. L. Dissanayake C. (2022). A conceptual model of risk and protective factors for autistic burnout. Autism Research 15(6) 976\u2013987. https:\/\/doi.org\/10.1002\/aur.2722","DOI":"10.1002\/aur.2722"},{"key":"e_1_3_3_54_1","doi-asserted-by":"crossref","unstructured":"Mantzalas J. Richdale A. L. Li X. Dissanayake C. (2024). Measuring and validating autistic burnout. Autism Research 17(7) 1417\u20131449. https:\/\/doi.org\/10.1002\/aur.3129","DOI":"10.1002\/aur.3129"},{"key":"e_1_3_3_55_1","doi-asserted-by":"crossref","unstructured":"Munday K. Papadopoulos C. Adkin T. Gray-Hammond D. (2025). Improving substance-use services for autistic adults: Insights and recommendations from autistic adults. Autism in Adulthood. Advance online publication. https:\/\/doi.org\/10.1089\/aut.2024.0213","DOI":"10.1089\/aut.2024.0213"},{"key":"e_1_3_3_56_1","doi-asserted-by":"crossref","unstructured":"Nayyar J. M. Stapleton A. V. Guerin S. O\u2019Connor C. (2025). Exploring lived experiences of receiving a diagnosis of autism in adulthood: A systematic review. Autism in Adulthood 7(1) 1\u201312. https:\/\/doi.org\/10.1089\/aut.2023.0152","DOI":"10.1089\/aut.2023.0152"},{"key":"e_1_3_3_57_1","doi-asserted-by":"crossref","unstructured":"Neville F. Sedgewick F. McLean S. White J. Bray I. (2024). Reacting retreating regulating and reconnecting: How autistic adults in the United Kingdom use time alone for well-being. Autism in Adulthood. Advance online publication. https:\/\/doi.org\/10.1089\/aut.2024.0148","DOI":"10.1089\/aut.2024.0148"},{"key":"e_1_3_3_58_1","doi-asserted-by":"crossref","unstructured":"Nguyen W. Ownsworth T. Nicol C. Zimmerman D. (2020). How I see and feel about myself: Domain-specific self-concept and self-esteem in autistic adults. Frontiers in Psychology 11 Article 913. https:\/\/doi.org\/10.3389\/fpsyg.2020.00913","DOI":"10.3389\/fpsyg.2020.00913"},{"key":"e_1_3_3_59_1","unstructured":"NHS England. (2025 June 11). Staying safe from suicide. https:\/\/www.england.nhs.uk\/long-read\/staying-safe-from-suicide\/"},{"key":"e_1_3_3_60_1","doi-asserted-by":"crossref","unstructured":"Nowell L. S. Norris J. M. White D. E. Moules N. J. (2017). Thematic analysis: Striving to meet the trustworthiness criteria: Striving to meet the trustworthiness criteria. International Journal of Qualitative Methods 16(1) 1609406917733847. https:\/\/doi.org\/10.1177\/1609406917733847","DOI":"10.1177\/1609406917733847"},{"key":"e_1_3_3_61_1","doi-asserted-by":"crossref","unstructured":"Oexle N. Herrmann K. Staiger T. Sheehan L. R\u00fcsch N. Krumm S. (2018). Stigma and suicidality among suicide attempt survivors: A qualitative study. Death Studies 43(6) 381\u2013388. https:\/\/doi.org\/10.1080\/07481187.2018.1474286","DOI":"10.1080\/07481187.2018.1474286"},{"key":"e_1_3_3_62_1","doi-asserted-by":"crossref","unstructured":"Oredipe T. Kofner B. Riccio A. Cage E. Vincent J. Kapp S. K. Dwyer P. Gillespie-Lynch K. (2022). Does learning you are autistic at a younger age lead to better adult outcomes? A participatory exploration of the perspectives of autistic university students. Autism 27(1) 200\u2013212. https:\/\/doi.org\/10.1177\/13623613221086700","DOI":"10.1177\/13623613221086700"},{"key":"e_1_3_3_63_1","doi-asserted-by":"crossref","unstructured":"Pellicano E. den Houting J. (2022). Annual research review: Shifting from \u2018normal science\u2019 to neurodiversity in autism science. Journal of Child Psychology and Psychiatry and Allied Disciplines 63(4) 381\u2013396. https:\/\/doi.org\/10.1111\/jcpp.13534","DOI":"10.1111\/jcpp.13534"},{"key":"e_1_3_3_64_1","doi-asserted-by":"crossref","unstructured":"Phung J. Penner M. Pirlot C. Welch C. (2021). What I wish you knew: Insights on burnout inertia meltdown and shutdown from autistic youth. Frontiers in Psychology 12 Article 741421. https:\/\/doi.org\/10.3389\/fpsyg.2021.741421","DOI":"10.3389\/fpsyg.2021.741421"},{"key":"e_1_3_3_65_1","doi-asserted-by":"crossref","unstructured":"Pyszkowska A. Nowacki A. Stefanek F. (2025). The two-edged sword of playing a role in daily life: Social camouflaging among adults on the autism spectrum. A thematic analysis. Research in Autism 124 202597. https:\/\/doi.org\/10.1016\/j.reia.2025.202597","DOI":"10.1016\/j.reia.2025.202597"},{"key":"e_1_3_3_66_1","doi-asserted-by":"crossref","unstructured":"Ratto A. B. Bascom J. daVanport S. Strang J. F. Anthony L. G. Verbalis A. Pugliese C. Nadwodny N. Brown L. X. Z. Cruz M. Hector B. L. Kapp S. K. Giwa Onaiwu M. Raymaker D. M. Robison J. E. Stewart C. Stone R. Whetsell E. Pelphrey K. Kenworthy L. (2023). Centering the inner experience of autism: Development of the self-assessment of autistic traits. Autism in Adulthood 5(1) 93\u2013105. https:\/\/doi.org\/10.1089\/aut.2021.0099","DOI":"10.1089\/aut.2021.0099"},{"key":"e_1_3_3_67_1","doi-asserted-by":"crossref","unstructured":"Raymaker D. M. Teo A. R. Steckler N. A. Lentz B. Scharer M. Delos Santos A. Kapp S. K. Hunter M. Joyce A. Nicolaidis C. (2020). \u2018Having all of your internal resources exhausted beyond measure and being left with no clean-up crew\u2019: Defining autistic burnout. Autism in Adulthood 2(2) 132\u2013143. https:\/\/doi.org\/10.1089\/aut.2019.0079","DOI":"10.1089\/aut.2019.0079"},{"key":"e_1_3_3_68_1","doi-asserted-by":"crossref","unstructured":"Renaud C. Lacroix A. (2023). Systematic review of occupational burnout in relation to cognitive functions: Current issues and treatments. International Journal of Stress Management 30(2) 109\u2013127. https:\/\/doi.org\/10.1037\/str0000279","DOI":"10.1037\/str0000279"},{"key":"e_1_3_3_69_1","doi-asserted-by":"crossref","unstructured":"Ross A. Grove R. McAloon J. (2023). The relationship between camouflaging and mental health in autistic children and adolescents. Autism Research 16(1) 190\u2013199. https:\/\/doi.org\/10.1002\/aur.2859","DOI":"10.1002\/aur.2859"},{"key":"e_1_3_3_70_1","doi-asserted-by":"crossref","unstructured":"Russell G. Stapley S. Newlove-Delgado T. Salmon A. White R. Warren F. Pearson A. Ford T. (2022). Time trends in autism diagnosis over 20 years: A UK population-based cohort study. Journal of Child Psychology and Psychiatry and Allied Disciplines 63(6) 674\u2013682. https:\/\/doi.org\/10.1111\/jcpp.13505","DOI":"10.1111\/jcpp.13505"},{"key":"e_1_3_3_71_1","doi-asserted-by":"crossref","unstructured":"Stagg S. D. Belcher H. (2019). Living with autism without knowing: Receiving a diagnosis in later life. Health Psychology and Behavioral Medicine 7(1) 348\u2013361. https:\/\/doi.org\/10.1080\/21642850.2019.1684920","DOI":"10.1080\/21642850.2019.1684920"},{"key":"e_1_3_3_72_1","doi-asserted-by":"crossref","unstructured":"Tan C. D. (2018). \u2018I\u2019m a normal autistic person not an abnormal neurotypical\u2019: Autism Spectrum Disorder diagnosis as biographical illumination. Social Science & Medicine 197 161\u2013167. https:\/\/doi.org\/10.1016\/j.socscimed.2017.12.008","DOI":"10.1016\/j.socscimed.2017.12.008"},{"key":"e_1_3_3_73_1","doi-asserted-by":"crossref","unstructured":"Walker T. (2017). Approaches to critical realism: Bhaskar and Lonergan. Journal of Critical Realism 16(2) 111\u2013127. https:\/\/doi.org\/10.1080\/14767430.2017.1288062","DOI":"10.1080\/14767430.2017.1288062"},{"key":"e_1_3_3_74_1","doi-asserted-by":"crossref","unstructured":"Weinstein N. Vuorre M. Adams M. Nguyen T. (2023). Balance between solitude and socializing: Everyday solitude time both benefits and harms well-being. Scientific Reports 13 21160. https:\/\/doi.org\/10.1038\/s41598-023-44507-7","DOI":"10.1038\/s41598-023-44507-7"},{"key":"e_1_3_3_75_1","doi-asserted-by":"crossref","unstructured":"Wolbring G. Lillywhite A. (2023). Burnout through the lenses of equity\/equality diversity and inclusion and disabled people: A scoping review. Societies 13(5) 131. https:\/\/doi.org\/10.3390\/soc13050131","DOI":"10.3390\/soc13050131"}],"container-title":["Autism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13623613261422117","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13623613261422117","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13623613261422117","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:51:07Z","timestamp":1777380667000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13623613261422117"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":74,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/13623613261422117"],"URL":"https:\/\/doi.org\/10.1177\/13623613261422117","relation":{},"ISSN":["1362-3613","1461-7005"],"issn-type":[{"value":"1362-3613","type":"print"},{"value":"1461-7005","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,28]]}}}