Most people are pretty familiar with the feeling of being burnt out. In recent decades in both clinical practice and research, “burnout” refers to “physical, emotional, or mental exhaustion accompanied by decreased motivation, lowered performance, and negative attitudes toward oneself and others, resulting from performing at a high level until stress and tension take their toll” (APA, 2018). Much of the research has occurred amongst health professionals (see here and here), and there is evidence that burnout is different to clinical depression, despite the observed symptom overlap (Parker & Tavella, 2021).
Autistic individuals face frequent challenges in navigating a primarily non-autistic world, which can often lead to a specific form of burnout including incapacity, exhaustion, and distress (Raymaker et al., 2020). It is difficult to accurately estimate prevalence, and one study reported that 69% of autistic adults had experienced autistic burnout at least once, making it worthy of specific measurement and a focus for support strategies (Mantzalas et al., 2024).
A recent study by Bougoure and colleagues (2025) sought to explore the psychometric properties of the AASPIRE Autistic Burnout Measure (ABM) in an independent sample. Their analysis assessed whether the ABM correctly and consistently measured autistic burnout and distinguishes it from other mental health problems and coping strategies (e.g., camouflaging). The ABM seeks to capture autistic burnout within various domains: prolonged exhaustion, loss of function, and reduced tolerance to stimuli, but the studies to date have not confirmed whether the measure best represents one factor or many. This is an important aim to work out whether any new measure is actually useful in assessing individual experiences or estimating prevalence across a population.
Burnout is characterised by prolonged exhaustion, loss of function, and reduced tolerance to stimuli; an experience autistic people may often face while navigating neurotypical societies.
Methods
Participants were invited to share their “psychosocial experiences of camouflaging” via social media, email lists, autism organisation website announcements, and the online platform Prolific. The study recruited primarily through social media and included both individuals who self-reported that they have a formal autism diagnosis (73.1%) and those who self-identified as autistic (26.9%). Participants completed the following questionnaires at either a single time point or two time points 12-months apart:
- Autistic Burnout Measure, plus a follow up question to check individual subjective assessments of autistic burnout: ‘Do you think that you are experiencing autistic burnout now?’.
- Sydney Burnout Measure (general, non-autism-specific burnout)
- Patient Health Questionnaire (depression symptoms)
- Generalised Anxiety Disorder Questionnaire (anxiety symptoms)
- Camouflaging of Autistic Traits Questionnaire
- Broader Autism Phenotype Questionnaire (autistic social, communication and behavioural characteristics)
The statistical analysis approach included confirmatory factor analysis, exploratory factor analysis, reliability and unidimensionality, construct validity and interpretability. Basically: what does the questionnaire measure and can we trust the results?
Results
The final participant sample included 379 autistic, English-speaking adults (18 – 77 years, mean age = 33.47; 46.4% male, 44.1% female, 8.7% other gender expressions, 0.8% prefer not to say). The results of the confirmatory factor analysis did not support a model containing one, two or four factors. As the confirmatory factor analysis did not provide convincing results, the exploratory factor analysis revealed support for a unidimensional construct of autistic burnout, as well as a three-factor solution made up of ‘cognitive dysfunction’, ‘emotional and sensory dysregulation’ and ‘social interaction and functional impairment’. There was substantial shared variance between the three factors, providing further support for a single factor solution.
Results also indicated that the ABM measures the same underlying construct and will produce consistent results across time (at least 12 months).
Arguably, some of the most interesting findings relate to how results on the ABM compare to individual self-assessment and measures of autistic traits, general burnout, camouflaging (masking of autistic traits), depression and anxiety.
Higher ABM scores were associated with:
- Answering “Yes” on a Single question self-assessment of autistic burnout
- Higher depression and anxiety
- Higher General Burnout
- More autistic traits (social, communication and behavioural characteristics self-reported on the Broader Autism Phenotype Questionnaire)
- Higher use of camouflaging behaviours
These findings suggest that the burnout measures successfully discriminate burnout from depression and anxiety symptoms. These is also modest evidence that the autistic-specific burnout measure was better at identifying individuals experiencing autistic burnout compared to a general burnout measure.
The findings suggest that the burnout measure successfully discriminated burnout from depression and anxiety symptoms.
Conclusions
The authors conclude that the ABM is a psychometrically reliable and valid measure of autistic burnout and succinctly summarise the strengths and limitations and opportunities for future research, some of which are captured below. The jury is still out regarding whether the measure is best represented by one or three factors, especially as these differ from the findings of initial validation studies, requiring further investigation.
The jury is still out on whether the Autistic Burnout Measure offers a significant improvement over and above existing measures of burnout, autistic traits, and mental health.
Strengths and limitations
This study is a great contribution to the literature on psychometric measurement of autistic burnout. The authors effectively highlight the importance of understanding the relationship between autistic burnout and mental health, emphasising the conceptual overlap between burnout and depression observed in both autistic and non-autistic populations.
While the study tentatively suggests that the Autistic Burnout Measure (ABM) may offer advantages over general burnout tools like the Sydney Burnout Measure, the strong correlations with other measures do not definitively justify a separate measure. Understandably, there is some indication that the 14-item version of the ABM (not available at the time the present study was conducted) may be preferable to the 27-item version, although further validation is needed in larger, more diverse samples, including participants across gender identities, neurotypes, and support needs.
The findings also raise important questions about the nature of autistic burnout itself: to what extent is it a response to cumulative, unsustainable demands, and to what extent is it intertwined with the lived and living experience of being autistic from the outset? The observed correlation between higher autistic traits and increased burnout is attributed to compounding challenges such as sensory overwhelm, social stressors, and insufficient accommodations, as well as camouflaging behaviours.
The evidence is preliminary in supporting the need for a specific measure of burnout for autistic adults.
Implications for practice
Understanding the factors that contribute to autistic burnout can inform strategies to reduce its impact and support coping in a predominantly non-autistic world. While the distinction between general burnout and autistic burnout is still under investigation, current evidence for the need for a separate measure remains tentative.
However, both psychometric and empathic validation is crucial for both research and clinical practice. Moreover, distinguishing autistic burnout from depression and anxiety is important, as treatment approaches differ significantly: sensory rest and camouflaging breaks may be more appropriate for autistic burnout, while behavioural activation is often used for depression. Misattributing one for the other can worsen outcomes, especially given the high risk associated with co-occurrence (Parker & Tavella, 2021). This paper is one example of the importance of transdiagnostic and transtheoretical approaches, questioning whether rigid distinctions between constructs are always meaningful or helpful in capturing the complexity of autistic experiences (Dalgleish et al., 2020).
A neuro-affirming approach to burnout should prioritise systemic and structural changes over placing responsibility solely on the individual. Collaborative and individualised formulation remains essential, especially in clinical practice, where holistic assessments must consider neurodivergence alongside other relevant factors. I see this in my experience as a clinical psychologist working with adults, including some autistic adults, and researching burnout in health professionals and those with mood and anxiety disorders. Burnout is not one-size-fits-all.
Studies such as the present exploration of the reliability and validity of the AASPIRE Autistic Burnout Measure offer valuable insights into what should be included in collaborative formulations, how we can better validate an individuals’ experiences, and how we measure prevalence. As with any questionnaire, we need to consider whether being able to quantify something for our own understanding is more helpful to the completer than simply asking a person “are you burnt out”?
Individual clinical formulation is essential when working with autistic and non-autistic individuals, regardless of the validated measures used.
Statement of interests
Melissa Black is a clinical psychologist and researcher who focuses on researching new transdiagnostic treatments and models of care for adults experiencing common mental health problems. She has recently collaborated on a trial for a new digital blended care intervention for burnout in health professionals. She works with a wide variety of adults in her clinical practice, including neurodivergent adults, but this is not a particular focus area for her research or clinical practice, and she identifies as neurotypical.
Edited by
Dr Dafni Katsampa.
Links
Primary paper
Bougoure, M., Zhuang, S., Brett, J. D., Maybery, M. T., English, M. C., Tan, D. W., & Magiati, I. (2025). Measuring autistic burnout: A psychometric validation of the AASPIRE Autistic Burnout Measure in autistic adults. Autism, 1–17.
Other references
American Psychological Association. (2018). Burnout. APA Dictionary of Psychology.
Dalgleish, T., Black, M., Johnston, D., & Bevan, A. (2020). Transdiagnostic approaches to mental health problems: Current status and future directions. Journal of Consulting and Clinical Psychology, 88(3), 179–195.
Lainidi, O. (2025). Workplace interventions can improve healthcare workers’ mental health and reduce burnout. National Elf Service.
Mantzalas, J., Richdale, A. L., Li, X., & Dissanayake, C. (2024). Measuring and validating autistic burnout. Autism Research, 17(7), 1417–1449.
Nabavi, N. (2020). Burnout and exhaustion amongst medical students in England. National Elf Service.
Parker, G., & Tavella, G. (2021). Burnout: Redefining its key symptoms. Psychiatry Research, 302, 114023.
Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Delos Santos, A., Kapp, S. K., Hunter, M., Joyce, A., & Nicolaidis, C. (2020). “Having all of your internal resources exhausted beyond measure and being left with no clean-up crew”: Defining autistic burnout. Autism in Adulthood, 2(2), 132–143.
