Dropping the mask:It takes two.

In some social situations, autistic people feel pressure to modify their innate social behaviour (i.e. camouflage), while in other social situations they feel free to engage in ways that feel authentic or true to themselves. To date, the latter aspect of autistic people’s experience has rarely been explored. Using an online qualitative survey, this study examined 133 autistic people’s experiences and perspectives of socialising in ways that felt authentic to them, with a particular focus on mixed-neurotype interactions and the role of nonautistic people. Using reflexive thematic analysis, four themes were generated: (1) embracing diverse communication styles, interests and perspectives; (2) creating a more inclusive mixed-neurotype social environment together; (3) minimising and managing mixed-neurotype miscommunication in mutually beneficial ways; and (4) enjoyable interactions involving reduced anxiety and exhaustion as well as genuine connection and rapport. These findings are discussed with reference to theory and research involving the construct of authenticity both inside and outside the field of autism research. The knowledge generated in this study illuminates a previously underexplored aspect of autistic people’s experience and elucidates potential avenues through which to enhance the social experiences and well-being of this group

Self-reported camouflaging behaviours used by autistic adults during everyday social interactions.

LAY ABSTRACT: Camouflaging can be thought of as the process through which autistic people modify their natural social behaviours to adapt to, cope within or influence the largely neurotypical (non-autistic) social world. Many autistic people experience negative reactions to their natural or intuitive social behaviours when interacting with non-autistic people. Over time, in response to these negative reactions, autistic people's social behaviour often changes. We refer to autistic people's changed behaviours as 'camouflaging behaviours'. Research exploring camouflaging behaviours is still at an early stage. This study investigated camouflaging behaviours used by autistic adults in everyday social interactions using a research method that was new to the field of autism. Specifically, 17 autistic adults were filmed taking part in a common everyday social situation - a conversation with a stranger. With the help of the video of this conversation, they then showed and described their camouflaging behaviours to a researcher. These autistic people identified and described a total of 38 different camouflaging behaviours. The detailed and specific information provided by autistic adults about camouflaging behaviours generated important new insights into the ways in which autistic people adapt to, cope within and influence the neurotypical (non-autistic) social world

Development of a disease-specific health utility score for Chronic Obstructive Pulmonary Disease from a Discrete Choice Experiment patient preference study

Acknowledgements; We wish to acknowledge the support of Katie Mycock, Tom Gardner, Phil Mellor, Pam Hallworth, Kate Sully, Sophi Tatlock, Beyza Klein, Gerard Criner, Pierre-Régis Burgel, Olivier Le Rouzic, Kip Adams, Kirsten Phillips, Mike McKevitt, and Kazuko Toyama for their involvement and contributions to the design, conduct and analysis of this patient preference study, and Kevin Marsh for comments and suggestions for further analyses based on a manuscript draft. Funding statement: The study was funded in full by Novartis Pharma AG. Byron Jones and Nigel Cook are employees of Novartis Pharma AG. At the time of writing, Florian Gutzwiller was an employee of Novartis Pharma AG.Peer reviewe

Camouflaging in an everyday social context:An interpersonal recall study

Camouflaging is a social phenomenon operating within everyday social interactions of autistic and non-autistic people. The current study explored autistic adults’ camouflaging in an everyday social context via interpersonal process recall methodology (Kegan, 1969). A total of 17 autistic adults (8 females, 6 males and 3 agender/gender-neutral individuals) participated in a 10-min controlled social task designed to replicate a common day-to-day social situation. Participants then watched a video of their interaction with a researcher, actively identifying instances of camouflaging and discussing their experiences of camouflaging. Using thematic analysis, four themes were generated: (1) a strong desire for, yet uncertainty in, securing social acceptance and connection; (2) camouflaging, developed over time, as a means to achieve social acceptance and connection; (3) experiencing intrapersonal and interpersonal camouflaging consequences during social interactions; and (4) authentic socialising as an alternative to camouflaging. These findings are discussed with reference to the existing literature on stigma management outside the field of autism. LAY ABSTRACT: Many autistic people report that, despite personal costs, they use strategies to hide their autistic characteristics or appear non-autistic at work, school or university, when speaking with health professionals, or while socialising with certain friends and family members. These strategies are often referred to as camouflaging. This study explores camouflaging during everyday social interactions. A total of 17 autistic adults were filmed taking part in a common everyday social situation – a conversation with a stranger. They then watched the video of this conversation with a researcher and answered questions about camouflaging. These autistic people told us that they (1) had a strong desire to socialise with and be valued by other people but, because of negative past experiences, they often felt unsure about their ability to do so; (2) used camouflaging to help them to socialise and be valued by others; (3) experienced negative consequences when camouflaging (e.g. fatigue, anxiety and difficulties in friendships); and (4) sometimes socialised in more autistic ways instead of camouflaging. This study shows us how autistic people often change their behaviour because of the way they are treated by nonautistic people and that autistic people may benefit from programmes that help them to socialise in more authentically autistic ways, but only if their autistic social behaviour is met with understanding and acceptance from non-autistic people

Beneficial physiological effects with blackcurrant intake in endurance athletes

Blackcurrant contains anthocyanins, known to influence vasorelaxation and peripheral blood flow. We examined the effects of 7 days intake of Sujon New Zealand blackcurrant powder (6g/day) on the lactate curve, maximum oxygen uptake, and cardiovascular responses at rest and during cycling. Thirteen trained triathletes with >3 yrs experience (8 men, age: 38±8 yrs, body mass: 71±9 kg, BF%: 19±5%, mean±SD) performed two incremental cycling protocols with recording of physiological and cardiovascular responses (Portapres® Model 2). Cardiovascular function was also measured in rest. Experimental design was double-blind, placebo-controlled, randomized and cross-over (wash-out 4 wks). Data was analysed with two-tailed t-tests and 2-way ANOVA and significance accepted at p<0.05. Plasma lactate was lower at 40%, 50%, 60% and 70% of maximum power by 27%, 22%, 17% and 13%. Intensity at 4 mmol∙L-1 OBLA was 6% higher with blackcurrant without effect on heart rate and oxygen uptake. Maximum values of oxygen uptake, heart rate and power were not affected by blackcurrant, but obtained with 14% lower lactate. In rest, blackcurrant increased stroke volume and cardiac output by 25% and 26%, and decreased total peripheral resistance by 16%, with no changes in blood pressure and heart rate. Cardiovascular responses during exercise at 40%, 50%, 60%, 70% and 80% intensity were not affected. Sujon New Zealand blackcurrant powder affects lactate production and/or clearance during exercise. Sujon New Zealand blackcurrant powder affects physiological and cardiovascular responses in rest and during exercise that may have implications for exercise performance

Blackcurrant Alters Physiological Responses and Femoral Artery Diameter During Sustained Isometric Contraction

Blackcurrant is rich in anthocyanins that may affect exercise-induced physiological responses. We examined tissue oxygen saturation, muscle activity, cardiovascular responses and femoral artery diameter during a submaximal sustained isometric contraction. In a randomised, double-blind, crossover design, healthy men (n = 13, age: 25 ± 4 years, BMI: 25 ± 3 kg·m−2, mean ± SD) ingested New Zealand blackcurrant (NZBC) extract (600 mg·day−1 CurraNZ™) or placebo (PL) for 7-days separated by 14-days washout. Participants produced isometric maximal voluntary contractions (iMVC) and a 120-s 30%iMVC of the quadriceps with electromyography (EMG), near-infrared spectroscopy, hemodynamic and ultrasound recordings. There was no effect of NZBC extract on iMVC (NZBC: 654 ± 73, PL: 650 ± 78 N). During the 30%iMVC with NZBC extract, total peripheral resistance, systolic, diastolic, and mean arterial pressure were lower with increased cardiac output and stroke volume. With NZBC extract, EMG root mean square of the vastus medialis and muscle oxygen saturation were lower with higher total haemoglobin. During the 30%iMVC, femoral artery diameter was increased with NZBC extract at 30 (6.9%), 60 (8.2%), 90 (7.7%) and 120 s (6.0%). Intake of NZBC extract for 7-days altered cardiovascular responses, muscle oxygen saturation, muscle activity and femoral artery diameter during a 120-s 30%iMVC of the quadriceps. The present study provides insight into the potential mechanisms for enhanced exercise performance with intake of blackcurrant

The impact of early stages of COVID-19 on the mental health of autistic adults in the United Kingdom:A longitudinal mixed-methods study

We used mixed methods to learn about the nature and drivers of mental health changes among autistic adults in the United Kingdom during the early stages of the COVID-19 pandemic. In quantitative analyses, we examined the nature and predictors of change in depression, anxiety and stress, prospectively measured in 70 autistic adults at Wave 1 (just before the United Kingdom’s first lockdown) and Wave 2 (10–15 weeks into the United Kingdom’s first lockdown). Retrospective Wave 2 reports of mental health change were also analysed for these 70 participants. For the qualitative analysis, 133 participants (including the 70 from the quantitative analyses) provided reports on their experiences of the pandemic at Wave 2. In quantitative analyses, retrospective reports indicated that participants’ mental health worsened, but prospective data showed a different picture, with overall anxiety and stress scores reducing between Waves 1 and 2. Nevertheless, the mental health impact of the pandemic on autistic adults was variable, with a sizable minority reporting a significant decline in mental health. Qualitative analysis yielded four themes that contributed to mental health changes: (a) adjusting to changes to the social world, (b) living with uncertainty, (c) disruptions to self-regulation, and (d) barriers to fulfilling basic needs. LAY ABSTRACT: During the COVID-19 pandemic, high levels of depression, anxiety and stress have been reported in the general population. However, much less has been reported about the impact of COVID-19 on the mental health of autistic people. What we did: In the present study, we investigated how the mental health of autistic adults in the United Kingdom changed during the early stages of the COVID-19 pandemic. In total, 133 participants completed an online survey at two different time points. Of the 133 participants, 70 completed the survey at the first time point just before the onset of the national lockdown. This allowed us to look at changes in their mental health, from before the lockdown to 10 to 15 weeks during lockdown. All participants (133) told us about their experiences of the pandemic. What we found: While many autistic adults told us that their mental health worsened, people’s experience varied. For some autistic adults, aspects of mental health (e.g. anxiety, stress) actually improved. Participants also described social changes that had occurred, at home and in the outside world. They described feelings of uncertainty during the pandemic, and discussed how the pandemic had affected some of their previous coping strategies. Participants also told us about their difficulties in accessing healthcare services and food during the early stages of the pandemic. In our article, we discuss these findings and focus on what needs to change to ensure that autistic people are better supported as the pandemic continues

Employer Responses to Dementia in the Workplace in Scotland

The reported study investigated how Scottish-based employers from different sectors respond to staff with dementia. Dementia is, and will increasingly be, a workplace issue as populations’ age, working lives extend and there is better recognition of early onset dementias and earlier diagnoses. To date, however, there is a little research on the workplace experiences of people with dementia and the policies, practices and attitudes of their employers. The requirement to support employees with dementia in the workplace has, amongst other things, a solid legal and human rights foundation. Dementia may be considered a disability under the Equality Act 2010 requiring employers to therefore make ‘reasonable adjustments’. The United Nations Convention on the Rights of Persons with Disabilities 2006, in turn, reinforces this.Using mixed-methods to interrogate workplace policies, practices and attitudes towards employees with dementia the study sought to: •discover the extent to which employers are currently meeting their legal, equality and human rights duties; •identify examples of good practice; and •make recommendations for possible adaptions so that legal and human rights standards can be met