This study was conducted to examine the subjective (psychological) and objective (physiological) stress responses of autistic individuals guided by the Transactional Theory of Stress and Coping by Lazarus and Folkman (1984). Subjective stress responses were measured through a Visual Analog Scale (VAS) rating by the participants on their stress perception and objective stress responses were measured through heart rate variability (HRV) using a heart rate monitor as participants underwent a standardized online Trier Online Stress Test (TSST; Kirschbaum et al., 1993) protocol to stimulate a social evaluative stress protocol. A systematic and qualitative interview was followed to investigate the appraisal of participants' perception on the TSST. Literature suggests lack of insight and poor reporting of stressful experiences among autistic individuals. Participants consisted of 12 young adults with autism spectrum disorder (ASD) and 24 typically developing young adults currently attending college. Both subjective and objective stress quantitative analyses resulted in non-significant findings. However, findings suggested some between-group differences in subjective stress responses and objective stress responses for each phase of the stress stimulation (i.e., Baseline, Stress Task, Recovery). Particularly, higher observed stress perception and HRV were noted during Baseline and Recovery and lower observed stress perception and HRV were noted during the Stress Task in the ASD group. Further exploration of qualitative data findings revealed that both groups were able to have insight and self-report physical stress response such as increased heart rate and sweating, further supporting the importance of the appraisal of the stressful experience. Clinical, education, and research implications are also addressed. In terms of clinical implications, the current study highlighted young adults are susceptible to stress and can benefit from stress management intervention regardless of ASD diagnosis. Early intervention to teach autistic individuals stress management skills may also be beneficial. Furthermore, the use of objective measures can raise the awareness of one's stress response, and that the appraisal of one's subjective perception of stress is equally important in understanding individual differences in the stress experience. In terms of education implications, educators should train health professionals such as rehabilitation counselors in understanding diverse ways of stress manifestation and coping. They should also be trained to teach stress coping skills when working with clients, including autistic individuals. In terms of research implications, the unique methodology to combine psychological data with physiological data, as well as appraisal process to obtain cognitive information to gain a more holistic perspective on the stress experiences of participants. Future research recommends increasing sample size and diverse demographic participants, matching participants with ASD with those without, re-examining different methods to characterize potential similarities and differences among ASD, typically developing and other clinical groups, further examining not only the stress phase but also the baseline and recovery phases of the stress stimulation, improving the ASD screening to verify autism diagnosis, recruiting participants who have not received stress management intervention or training, examining the impact of in person and online TSST, and investigating the impact of comorbid conditions on stress responses in the ASD population.
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