"That impending dread sort of feeling": Experiences of social interaction from the perspectives of autistic adults

Background: Quantitative research increasingly suggests that many autistic adults experience heightened levels of anxiety during social interaction. While anxiety related to social interactions is prevalent in the autistic population, little is known about how autistic individuals experience social situations - from anticipatory stages, through to in-vivo and post-event processing, and how these experiences may relate to social anxiety within the specific context of autistic adult populations.Method: This study sought to qualitatively explore the perspectives of autistic individuals in relation to their experience of social situations, with the aim of examining how these experiences may relate to anxiety during social interactions. Semi-structured interviews were conducted with 12 autistic adults with data being analysed using Reflexive Thematic Analysis to identify themes relevant to each stage of social interaction.Results: Themes derived from autistic adult participants suggest that several anxiety-related processes may be operating in autism, influencing social interaction experiences. Specifically, the sensory environment, topic of conversation and conversation partner, were identified as influencing the perceived success and comfort of interactions. Feelings of anxiety, as well as self monitoring and adaptive morphing were often identified as exhausting.Conclusion: Findings indicate a need to consider how anxiety and environmental factors influence the experiences of social interaction and communication for autistic adults.