Neurodivergent individuals, such as those who are autistic and have ADHD, may struggle with mental health due to societal stigma, inadequate healthcare accommodations, and compounded stress from intersecting marginalized identities, increasing their vulnerability to anxiety, depression, and other psychological challenges.
Kroll, E., Lederman, M., Kohlmeier, J., Ballard, J., Zant, I., & Fenkel, C. (2025). Examining the mental health symptoms of neurodivergent individuals across demographic and identity factors: A quantitative analysis. Frontiers in Psychology, 16, 1499390. https://doi.org/10.3389/fpsyg.2025.1499390
Key Points
- Gender and sexual minorities were significantly more likely to identify as neurodivergent compared to straight and gender binary individuals.
- Intersectional identities involving gender and sexuality notably affected depression and anxiety scores among neurodivergent individuals.
- Non-binary neurodivergent individuals reported higher depression symptoms compared to binary gender identities.
- Pansexual and bisexual neurodivergent individuals reported heightened depression and anxiety compared to heterosexual counterparts.
- No significant interactions were observed between racial identity and neurodivergence regarding mental health symptoms.
- Identity-affirming mental health care effectively reduced disparities in mental health symptoms among diverse neurodivergent populations.
Rationale
Previous research has consistently shown that neurodivergent individuals often face poorer mental health outcomes despite high healthcare utilization.
Historically, studies primarily focused on white male populations, overlooking how intersecting identities like gender, sexuality, and race might influence mental health outcomes differently.
This gap in understanding intersectionality prompted the current study, aiming to develop a more nuanced and equitable approach to mental health care for neurodivergent populations, particularly those with multiple marginalized identities.
Method
The study utilized quantitative analyses of survey data collected from a virtual intensive mental health outpatient program.
Surveys included self-reported demographic information and standardized mental health assessments completed at intake and discharge between May 2023 and March 2024.
Procedure
- Participants completed intake surveys including demographic data and mental health assessments.
- Discharge surveys repeated mental health assessments.
- Researchers performed two-way MANOVAs to examine interactions between neurodivergent identity and demographic factors (gender, sexuality, race).
- Significant interactions identified by MANOVAs prompted additional two-way ANOVAs to explore specific relationships further.
Sample
The study included 14,219 individuals aged 11-35, predominantly presenting high-acuity mental health concerns.
The sample represented diverse identities, including variations in gender, sexuality, race, and neurodivergent conditions.
Measures
- Demographics: Age, gender, sexuality, race, neurodivergent status.
- Depression: Assessed using the Patient Health Questionnaire modified for adolescents (PHQ-A), measuring depression severity.
- Anxiety: Assessed using the Generalized Anxiety Disorder scale (GAD-7), measuring anxiety severity.
- Self-harm: Number of days participants engaged in self-harm behaviors in the 30 days preceding the survey.
Statistical measures
Statistical methods included two-way MANOVAs and ANOVAs, chi-square tests for assessing relationships between demographics, post-hoc Games-Howell tests, and Bonferroni corrections to control for multiple comparisons.
Results
Significant findings included heightened depression symptoms among non-binary neurodivergent individuals compared to binary gender identities, highlighting unique pressures faced by this group.
Neurodivergent individuals identifying as bisexual or pansexual also reported significantly higher depression and anxiety levels compared to heterosexual counterparts.
Conversely, racial identity did not significantly intersect with neurodivergence in predicting mental health symptoms, suggesting potential limitations in measurement sensitivity or distinct societal dynamics influencing these factors.
Insight
This study provides valuable insights into how intersecting marginalized identities, particularly gender and sexuality, exacerbate mental health symptoms among neurodivergent populations.
The pronounced symptoms among non-binary, bisexual, and pansexual individuals underline unique identity-related stressors.
These findings extend previous research advocating for intersectional approaches to treatment.
Future research should delve deeper into specific subgroup analyses within racial categories and explore broader identity intersections within diverse cultural contexts.
Implications
The findings encourage mental health professionals to adopt intersectional, identity-affirming treatment practices.
Policymakers and practitioners should foster healthcare environments that acknowledge and actively support multiple identity dimensions.
While these approaches promise improved mental health outcomes, implementation challenges include comprehensive clinician training and systemic adjustments in healthcare settings.
Strengths
This study had several methodological strengths, including:
- Extensive, diverse sample enhancing study robustness and generalizability.
- Comprehensive demographic and mental health measures.
- Advanced statistical approaches to evaluating intersectionality.
Limitations
This study also had several limitations, including:
- Dependence on self-reported demographic and neurodivergent identity information.
- Potential oversimplification due to broad racial categories.
- General anxiety measures may not capture specific anxiety disorders.
Socratic Questions
- How does reliance on self-reported identities influence the validity and applicability of these results?
- What alternative methodologies could more accurately capture complex racial identity intersections with neurodivergence?
- Could the lack of significant racial identity interactions reflect methodological limitations rather than true societal trends?
- How might intersectional disparities vary across different cultural or healthcare system contexts?
- What specific actions should mental health professionals take to practically integrate intersectionality into existing clinical frameworks?
