The Expectancies and Motivations for Heavy Episodic Drinking of Alcohol in Autistic Adults.

Background: For autistic adults, the perceived benefits of drinking alcohol to facilitate social interaction may be particularly appealing. Alcohol may be considered "self-medication" for clinical features of autism or may be used to help cope with elevated levels of co-occurring anxiety. Methods: We developed an online survey and 507 autistic adults responded to questions concerning their expectancies and motivations for heavy episodic drinking. The survey also included questions about ways of seeking support, if needed, and barriers to seeking support. Results: Over half of those who had drunk alcohol reported heavy episodic drinking in the past year (6 or more units of alcohol at one time). Heavy episodic drinkers endorsed traditional expectancies (e.g., "Alcohol generally has powerful positive effects on people") and autism-specific expectancies (e.g., "Alcohol makes verbal communication easier") to a greater degree than nonheavy episodic drinkers. Autism-specific expectancies, not traditional expectancies, related to frequency of drinking. The strongest motivations for heavy episodic drinking were for social reasons and to enhance positive feelings, rather than for conformity or coping. If support was required for problematic drinking, the internet was the most commonly chosen resource, although 45% of the participants indicated that they would not seek support. Perceived barriers to support included concern that it would take place in an unfamiliar chaotic environment and concern about being misunderstood and judged by a therapist. Conclusions: This study is the first to identify the expectancies and motivations for heavy episodic drinking in autistic adults as well as identifying barriers to seeking support. There may be some autism-specific expectancies related to the nature of autism that impact upon heavy episodic drinking, as well as impacting upon seeking support. The autistic and broader autism communities can benefit from an awareness of these findings, and service providers can adapt support appropriately. Lay summary: