https://doi-org.ezproxy.derby.ac.uk/10.1002/aur.2306

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Nothing About Us Without Us

Who: Rumball, Happe, Grey

Journal: Autism Research

Published: April 2020

Title: Experience of Trauma and PTSD Symptoms in Autistic Adults: Risk of PTSD Development Following DSM-5 and Non-DSM-5 Traumatic Life Events

Study:

The DSM-V defines specifically which events can lead to the development of PTSD. However, autists experience and perceive the world differently to neurotypical people, and autists have increased anxiety responses to situations which NTs would not consider to be stressful. Events other than just the ones listed in the DSM-V might be traumatic to autists.

Two charts show a rate of PTSD in NT populations at 4.5% and in autistic populations at 45%.

DSM-V

ptsd

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Actual or threatened death, serious injury, or sexual violence, in one (or more) of the following ways:

• Directly experiencing the traumatic event(s)
• Witnessing in person the event(s) as it occurred to others
• Learning that the traumatic event(s) occurred to close family member or close friend, the event(s) must have been violent or accidental.
• Experiencing repeated or extreme exposure to aversive details of the traumatic event(s)

This study wanted to answer three questions.

1) What events are interpreted as traumatic by autistic adults?

2) What are the rates of probable current and lifetime PTSD in trauma-exposed autistic adults?

3) Is the experience of trauma type or PTSD influenced by gender or autistic traits?

DSM-V trauma:

62% of participants (72% of females and 48% of males) had experienced trauma as defined by the DSM-V. This was most commonly sexual assault and unwanted sexual experiences (86%) and physical assault (68%).

After these events, 48% of females and 40% of males developed PTSD.

Over the life, the probability of developing PTSD after a DSM-V trauma was 70% for autistic females and 40% for males.

Non-DSM-V trauma:

35% of participants (47% of females and 78% of males) had experienced a traumatic event that does not fall under the DSM-V definition.

These events included bullying, “non-traumatic bereavement“, mental health trauma (including eating disorders and “breakdowns”), abandonment by a significant other, the diagnostic process, experiences of therapy, being disturbed by ones own aggression towards others, and unexpected police contact.

After these events, 41% of females and 44% of males developed PTSD. This is the same rate as for DSM-V trauma.

Over the life, the probability of developing PTSD after a non-DSM-V trauma was 71% for autistic females and 56% for males.

All trauma:

The average number of traumatic events that autistic participants experienced was 4 events.

One individual had experienced 15 traumatic events, and five individuals (8.5%) had experienced no traumatic events.

PTSD traits were not related to autistic traits or to gender. However, males experienced more non-DSM-V traumatic events than females did.

After any trauma, the probability of developing PTSD was 43%-45%, which is much higher than the rate for neurotypical people (26.3%-33%)

This study found the lifetime probability of autistic people developing PTSD is 61%-63%, in comparison to 8%-12% in veterans, and 6% in non-veteran NT populations.

This shows that autistic people can develop PTSD from events that the DSM does not consider to be traumatic. It is important to consider the subjective interpretation of what is traumatic.

It is essential to follow up on the findings that autistic people are being traumatised by the autistic diagnosis process and by therapeutic intervention.

This study excluded people with an intellectual disability (IQ<70). It is important to investigate trauma & PTSD in this population.