A mixed-methods investigation into positive body image in autistic individuals

<p dir="ltr">Positive body image is a multifaceted construct broadly defined as “an overarching love and respect for the body”. Accumulating research has explored this construct among historically marginalised populations (i.e., identity groups who experience discrimination and exclusion), identifying both commonalities and unique experiences. However, one group that remains largely unexamined is the autistic population. Using an exploratory sequential, mixed-methods design, the overarching aim of this thesis was to develop a theory of positive body image in autistic adults from the United Kingdom. In Study 1, I developed a grounded theory of positive body image with 20 autistic individuals using a qualitative framework. In Study 2, I used my qualitative findings to develop a revised version of the Body Appreciation Scale-2 – the BAS-2A – and examined its factorial stability and psychometric properties in 550 autistic adults. In Study 3, I tested the measurement invariance of the BAS-2A among subgroups of autistic adults across sexual identity (n = 376) and disability status (n = 378). In Study 4, I investigated direct associations between autistic traits and body appreciation in a sample of 530 autistic adults. Finally, in Study 5, I tested a mediational model whereby the association between positive autistic identity and flourishing is mediated by body appreciation in autistic adults (N = 384). Overall, my findings indicate that positive body image in autistic adults involves appreciating and respecting one's autistic body across its aesthetic, functional, and sensory aspects. To capture this construct, my findings support a revised 12-item BAS-2A as a psychometrically robust measure of body appreciation for use in autistic adults. In addition, my results showed that masking and alexithymia are negatively associated with body appreciation. Finally, body appreciation significantly and positively mediated the association between positive autistic identity and flourishing. While aspects of autistic people’s body appreciation accord with existing theory, I found multiple autism-specific components which require further investigation in the wider autistic population.</p>