Autistic adults are 2.5 times more likely than the general population to experience anxiety, with
increased risk among those with intellectual disability (ID). Autistic adults with mild ID are particularly
under-supported, with existing anxiety interventions such as cognitive behavioural therapy (CBT) not
tailored or systematically evaluated in this population. Consequently, many are left without adequate
support, contributing to poorer health outcomes.
One factor that may contribute to anxiety in autism is interoception - the processing of internal bodily
signals. Autistic adults demonstrate heterogeny in interoceptive profiles, particularly interoceptive
attention. This variability may help explain inconsistent findings regarding the effectiveness of anxiety
interventions targeting interoceptive processes in autistic populations. However, research in this area
has been limited by a lack of accessible interoception measures for autistic adults with mild ID.
Developing acceptable measures is therefore a priority to determine whether individual differences in
interoception influence treatment efficacy.
This PhD will investigate the role of interoception in anxiety in autistic adults, including those with mild ID. Study 1 will examine the validity, reliability, and feasibility of the heartbeat evoked potential (HEP) as a measure of interoceptive attention in autistic and neurotypical adults, using mobile EEG to promote accessibility. Study 2 will co-design a HEP protocol for autistic adults with mild ID. Study 3 will employ an existing anxiety intervention for this population to test the hypothesis that interoceptive
attention is a mechanism of change and/or moderates treatment efficacy, informing the development
of personalised interventions and promoting equitable care.