Understanding the Impact of Living Situation and Social Satisfaction on Depression and Substance Use in Autistic Young Adults Without Intellectual Disability

Abstract

Background: Autistic young adults face elevated risks for depression, and emerging evidence indicates that some engage in substance use. Residential status and social satisfaction may be related to these outcomes, yet little research has examined their interplay in autistic populations. Methods: Baseline data were drawn from 267 autistic young adults ages 18–24 (M=21.56; SD=1.76). Participants were predominantly female (65.63%), non-Hispanic White (75%), and enrolled in school (68.76%). Participants reported their current residential status, mental health, and substance use, and completed measures of social and role functioning, social satisfaction, and demographic characteristics. A unified mediation model tested whether social satisfaction mediated associations between residential status and (1) depression, (2) alcohol use, and (3) cannabis use, adjusting for relevant covariates. Results: Living alone, compared to living with a parental figure, was associated with greater social satisfaction, which in turn predicted fewer depression symptoms. In contrast, living alone or with friends or roommates was directly associated with elevated alcohol and cannabis use but showed no indirect effects through social satisfaction. Social satisfaction predicted lower depression but was not significantly related to alcohol or cannabis use. Conclusion: Residential status and social satisfaction jointly shape emotional and behavioral outcomes among autistic young adults. Independent living may enhance well-being when accompanied by fulfilling social connections, whereas peer cohabitation may increase exposure to substance use. Interventions that support autonomy, foster social engagement, and incorporate harm reduction strategies may be particularly valuable in promoting healthy transitions to adulthood for autistic individuals.