A Mixed Methods Exploration of the Sense of Self among People Diagnosed with Asperger Syndrome in Adulthood

Asperger syndrome is a relatively recent diagnostic classification. Several factors, including a high prevalence of mental illness, mean receiving a diagnosis in adulthood is a very unique experience but remarkably there is little literature about the impact on individuals. Instead the dominance of the medical/psychiatric paradigm pervades and limits understanding and possibilities. The main implication is a lack of clarity about what support services are needed and effective, and as such the needs of this population are often overlooked. This is the first study to explore the sense of self among a sample of males and females diagnosed with Asperger syndrome in adulthood using social constructionist and constructivist ideas. It was interested in whether personal construal of the self before diagnosis and self after diagnosis were differentiated. Given the importance in the development of self-concept of discriminations between the self and others, the research also sought to explore how people diagnosed with Asperger syndrome in adulthood construe other people with and without Asperger syndrome. Using the repertory grid and other techniques from Personal Construct Psychology (Kelly, 1955) in combination with a semi-structured interview, this study presents a novel exploration of idiosyncrasies and commonalities across a demographically diverse sample of eight participants. An extended analysis of a unique subsample of women diagnosed aged 50 years and over was undertaken. Both cognitively complex and simple construct systems were found across the sample. Findings indicated the self before diagnosis was construed critically and was more elaborated than the self after diagnosis. Several participants had a reduced sense of self following diagnosis. The diagnosis offered an explanation of symptoms but for some participants these symptoms were a way of life and accommodating the new label with the existing view of self posed challenges. An overarching and striking theme was the sense of difference felt by participants before and after diagnosis. This study offers a fresh insight into a virtually unexplored population which, through dissemination, may influence the way clinical psychologists and other practitioners work to support adults diagnosed with Asperger syndrome. Recommendations for clinical practice included approaches that target the need for individuality, commonality and sociality, and should be gender-specific where possible. Such approaches might elaborate multiple aspects of self, the diagnosis and related dilemmas. They should support people to widen their perceptual field to alternative ways of construing and explore change. The mixed method approach was assessed to be a strength of the study and a number of recommendations for future research are presented.