Self-Reported Psychosocial Outcomes of Autistic Adults Living in China and The Netherlands

Background: Despite an estimated population of 10 million autistic individuals in China, little is known about Chinese autistic adults. Cultural and contextual factors may impact objective and subjective psychosocial outcomes of autistic adults. In this descriptive study, we aim to compare the psychosocial outcomes of autistic adults between China, an Eastern Asian country, and The Netherlands, a Western European country. Method: Based on self-report online questionnaires, we compared objective psychosocial functioning (employment, living situation, friendship), life satisfaction, and internalized autism-related stigma of 36 Chinese (23 males and 13 females) and 29 Dutch (18 males and 11 females) autistic adults. The majority of participants in both countries (Chinese: 66.7%; Dutch: 82.8%) self-reported having an IQ above 70. Results: Chinese and Dutch participants exhibited similar levels of employment, quality of friendships, and life satisfaction (M-Chinese = 5.81; M-Dutch = 6.28). Chinese autistic adults more often lived with their parents and reported more autism-related internalized stigma than Dutch adults (M-Chinese = 2.25; M-Dutch = 1.79, p < 0.001). Autism-related internalized stigma was negatively correlated with friendships and life satisfaction across both samples. Conclusions: Heightened internalized stigma among Chinese autistic adults compared with the Dutch may reflect cultural differences in attitudes toward autism. Strategies aimed at reducing internalized stigma could help to improve the social connections and life satisfaction of autistic adults within the global autistic community. This cross-country study is a first step in understanding the psychosocial outcomes of autistic adults in China.