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PTSD in Autistic Adults

Dissociation in ASD

Well-Known Member
Hi everyone! I last posted a little over a year ago to announce the publication of a study that people here participated in ("Interpersonal Trauma And Posttraumatic Stress In Autistic Adults"). I'm thrilled to announce a second publication from the same dataset, "PTSD in Autistic Adults: Correlates of Meeting DSM–5 Criteria and Predictors of Professional Diagnosis." For anyone who doesn't have access to the journal, I'd be happy to send you a copy if you're interested in reading it.

The main takeaways are that autistic adults who meet criteria for PTSD have worse mental health, more difficulties functioning, and less employment than those without PTSD. They also report more traumas and interpersonal victimization. This is true regardless of whether or not they have a professional diagnosis of PTSD. PTSD was underdiagnosed overall; 44% of the study sample (n=677) met criteria for PTSD, but only 20% had a professional PTSD diagnosis. Accordingly, my co-authors and I also wanted to understand some of the risks for an autistic adult with PTSD not being diagnosed.

We found that among those who meet criteria for PTSD, a professional PTSD diagnosis is more likely if they're older, a woman or gender minority, unemployed or on disability, have more severe posttraumatic stress, have more comorbid disorders, and have less functional impairment. It's noteworthy that cisgender men are least likely to meet criteria for PTSD, but they're also the least likely to be diagnosed with PTSD if they do meet criteria. It might be that clinicians' perceptions of autistic men and of people with PTSD are in conflict. Additionally, that more difficulty functioning in daily life is a potential outcome of PTSD but also reduces the likelihood of a PTSD diagnosis is concerning. More effort is needed to help autistic adults with PTSD access appropriate therapy.

Thank you again to everyone who trusted us with your responses! Please reach out to me if you have any questions!
 

Bolletje

Overly complicated potato
V.I.P Member
Interesting results! It’s not often we get to hear the outcome of a study we’ve been asked to participate in on these forums. I really appreciate you taking the time to do this, thank you!
Congratulations on being able to publish a second article from your dataset too, you must be thrilled :)
 

SusanLR

Well-Known Member
V.I.P Member
More effort is needed to help autistic adults with PTSD access appropriate therapy.
I find this to be so true.
All of the PTSD specialists in my area do not take insurance and I can't afford to be
private pay.
Why PTSD is different to other mental health professions, I can't understand.
 

Neonatal RRT

Well-Known Member
V.I.P Member
I am trying to learn here, so please excuse my ignorance:

I am aware that the statistical incidence of PTSD is higher in the autistic population as compared to neurotypicals. I am aware that many of us, including myself, have deficits in emotional intelligence,...often taking minutes, hours, or days to process an emotional event or interaction. I am also aware that many of us also grew up with a lot of familial social dysfunction,...and I am not sure what came first,...seemingly toxic personalities within the family or the ASD-related social and communication deficits, as well as, a deficit in "theory of mind",...or some combination of both.

I can see how certain life events or interactions could be interpreted as "traumatic" to individuals who have deficits in "appropriate coping skills". However, I am still having difficulty understanding this whole PTSD thing,...as in my 56 years, I have experienced quite a few events in my life that certainly could be considered "traumatic",...and those events influenced my belief system,...but no PTSD. Is there a population of autistics that have significant emotional deficits that those traumatic events are not appropriately processed through the emotional centers of the brain? I guess I am questioning myself in this context.

Perhaps someone with a bit more experience and knowledge could elaborate on this topic more,...as it seems the literature I have reviewed seems lacking in perspective.
 

Dissociation in ASD

Well-Known Member
Interesting results! It’s not often we get to hear the outcome of a study we’ve been asked to participate in on these forums. I really appreciate you taking the time to do this, thank you!
Congratulations on being able to publish a second article from your dataset too, you must be thrilled :)
Thank you! I'm sorry that most researchers don't return to share their results. You all gifted me with your time and experiences; it's only fair that I let you know the study outcome!

Yes, I'm very happy with how the paper turned out and with the opportunity to share it with others!
 

Dissociation in ASD

Well-Known Member
I find this to be so true.
All of the PTSD specialists in my area do not take insurance and I can't afford to be
private pay.
Why PTSD is different to other mental health professions, I can't understand.
PTSD can be comparatively more difficult and time-intensive to treat than many other disorders. However, you're right that it's a huge problem that access to appropriate treatment can be so limited. PTSD can cause really severe negative outcomes when untreated, and it's especially concerning that so few mental health professionals feel comfortable treating it in autistic people. This is something that I'm hoping will change as awareness increases about the extent of the need, especially if it's matched by an increase in training for early-career professionals. If more providers feel confident treating PTSD in a wide variety of populations, it should hopefully become easier to find an accessible provider.
 

Dissociation in ASD

Well-Known Member
I am trying to learn here, so please excuse my ignorance:

I am aware that the statistical incidence of PTSD is higher in the autistic population as compared to neurotypicals. I am aware that many of us, including myself, have deficits in emotional intelligence,...often taking minutes, hours, or days to process an emotional event or interaction. I am also aware that many of us also grew up with a lot of familial social dysfunction,...and I am not sure what came first,...seemingly toxic personalities within the family or the ASD-related social and communication deficits, as well as, a deficit in "theory of mind",...or some combination of both.

I can see how certain life events or interactions could be interpreted as "traumatic" to individuals who have deficits in "appropriate coping skills". However, I am still having difficulty understanding this whole PTSD thing,...as in my 56 years, I have experienced quite a few events in my life that certainly could be considered "traumatic",...and those events influenced my belief system,...but no PTSD. Is there a population of autistics that have significant emotional deficits that those traumatic events are not appropriately processed through the emotional centers of the brain? I guess I am questioning myself in this context.

Perhaps someone with a bit more experience and knowledge could elaborate on this topic more,...as it seems the literature I have reviewed seems lacking in perspective.
Your questions are perfectly fine! What's important to remember is that there are many factors that increase the risk of PTSD. Examples include difficulties processing emotions; difficulties understanding the traumatic situation; a lack of social support; a tendency to ruminate on negative events; a biological predisposition to anxiety, depression, or dissociation; the severity of the trauma; if multiple traumas are experienced, the trauma has a long duration, or there are other adverse circumstances contributing to stress levels; and the age at which the trauma was experienced. For example, in my first study, I found that autistic individuals who experienced physical assault or sexual violence were almost twice as likely to develop PTSD compared to those who might have had other, non-interpersonal traumatic experiences such as surviving an accident or natural disaster.

I think it's really important to emphasize that autistic people often do experience things that are undeniably potentially traumatic experiences. There's sometimes a tendency to focus on things that might not be traumatic to neurotypicals, such as social rejection or major life changes, but I think this has a risk of de-emphasizing the risk of child maltreatment, intimate partner violence, or severe bullying. Autism does not cause these things to happen, nor is it caused by these traumas, but it is a risk factor and can be worsened by them. For example, the parents of an autistic child might neglect the child because they're unsure how to respond to the child's disability, and this can worsen the child's difficulties with social interaction. This can form a particularly challenging cycle of child maltreatment, worsened child behavior, and more maltreatment in response. Similarly, difficulties recognizing ill intentions can lead to the child being targeted by predators, which can lead to further confusion about appropriate boundaries.

All of this said, again, it's entirely possible to experience trauma and not develop PTSD despite having some risk factors. There does seem to be a biological component, and while autism increases the risk, it may not be entirely sufficient on its own. PTSD is also not the only potential posttraumatic syndrome! Some people might instead (or also) develop depression, social anxiety, eating disorders, or sleep disorders. Responses are very individual. Researchers look at trends on a group level, but it can't always predict how any specific person will react.

I hope that this helps. Please let me know if I can help clarify further.
 

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