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Quality of life in adults with autism spectrum disorder: influence of age, sex, and a controlled, randomized mindfulness-based stress reduction pilot intervention

Quality of Life Research
B. Blair Braden, Broc A. Pagni, Leanna Monahan, Melissa J. M. Walsh, Maria V. Dixon, Shanna Delaney, Lisa Ballard, John E. Ware Jr.
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Supplementary Information

The online version contains supplementary material available at https://​doi.​org/​10.​1007/​s11136-021-03013-x.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.



Adults with autism spectrum disorder (ASD) consistently report worse functional health and well-being, compared to neurotypical (NT) peers. In a series of studies, we aimed to elucidated the effects of sex, age, and their interaction on health-related quality of life (HRQoL) and evaluated the effectiveness of mindfulness-based stress reduction (MBSR) for improving health-, disability-, and autism-related QoL, with possible sex and age outcome moderators, in adults with ASD.


Study 1 used the 36-Item Short Form Survey to compare mental and physical HRQoL composite scores in adults with ASD (n = 67) and matched NT adults (n = 66). Study 2 was a randomized pilot evaluation of the effect of MBSR, compared to an active control intervention with social support and relaxation education (support/education; n = 56), on the World Health Organization QoL BREF, Disability, and Autism-Specific scales in adults with ASD.


In Study 1, we replicated findings that mental HRQoL is worse in both men and women with ASD, compared to NT counterparts, but physical HRQoL is only worse in women with ASD. We present novel findings that older age is associated with better mental HRQoL in women with ASD only. In Study 2, MBSR improved disability-related QoL in adults with ASD over and above the support/education intervention, but both interventions improved mental HRQoL. Lastly, both interventions were more effective for HRQoL improvements in women with ASD.


Findings encourage precision medicine approaches tailored to age and sex groups for best HRQoL outcomes in adults with ASD. Identifier: NCT04017793.

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