Self-compassion as an antidote to self-stigma and shame in autistic adults.

Autistic individuals are frequently exposed to stigmatizing attitudes and discrimination. Through the lived experience of stigmatizing attitudes, autistic people can internalize the negative stereotypes associated with autism. This phenomenon is known as self-stigma. In non-autistic populations, self-stigma is associated with shame and negative mental health outcomes. In this study, we aim to better understand the mental health outcomes associated with self-stigma in autism and to investigate whether and how self-compassion compared to camouflaging may protect from self-stigma in autistic individuals. For this purpose, 689 adults who reported a diagnosis of autism were recruited online and completed self-reported questionnaires for self-stigma (Internalized Stigma of Mental Illness Scale-9 items), self-compassion (Self-Compassion Scale-short form), depression (Depression, Anxiety and Stress Scale-21) and camouflaging (Camouflaging Autistic Traits Questionnaire). We conducted mediation analysis and moderated mediation analysis. Our results indicate that self-stigma is highly prevalent in autistic adults (45.5%), correlated to depression (ρ (687) = 0.437, p < 0.001) and that internalized shame mediates the relationship between self-stigma and depressive symptoms (b = 1.48, 95% confidence interval = (1.11, 1.94)). Self-compassion moderates this mediation (Indirect Effect, IE = -0.305, 95% confidence interval = (0.601, 0.014), β = 0.183, z = 2.012, p = 0.044), whereas camouflaging does not (IE = 0.003, 95% confidence interval = (0.009, 0.015), β = 0.0531, z = 0.514, p = 0.607). These results highlight the protective effect of self-compassion on the negative impacts of self-stigma in autistic individuals. Future research should explore how to adapt existing compassion-focused interventions and evaluate their feasibility and efficacy to reduce self-stigma and shame in autistic populations.Lay abstractWhat is already known about the topic?Autistic individuals are frequently exposed to stigmatizing attitudes and discrimination. Negative stereotypes about autism, such as dangerousness or inability to work, are very frequent in our societies. Through exposure to these stigmatizing ideas, autistic people can internalize these ideas and begin to believe them to be true about themselves. This is self-stigma. Past research conducted with non-autistic individuals indicate that self-stigma can lead people to feel ashamed of who they are and deteriorate their mental health.What this paper adds?In this paper, we found that self-stigma in autistic people increases depressive symptoms through feelings of shame. We then showed that relating to self with compassion - that is, to be friendly towards oneself (kindness), be aware of one's feelings and thoughts (mindful awareness) and realize that everyone feels pain and makes mistakes (common humanity) - helps reducing the negatives consequences of self-stigma on mental health. We also demonstrated that camouflaging does not modify the impact of self-stigma on mental health.Implications for practice, research or policy?Because self-compassion can protect from the negative effects of self-stigma, future research should explore how to adapt existing compassion-focused interventions and evaluate their feasibility and efficacy to reduce self-stigma and shame in autistic people.