# Experiences of Trauma and PTSD Symptoms in Autistic Adolescents: Preliminary Findings

## TL;DR

Autistic adolescents experience high rates of trauma and PTSD symptoms, even when events don't meet standard definitions, suggesting a need for more flexible assessments.

## Contribution

The study highlights the subjective experience of trauma in autistic adolescents and suggests that current diagnostic criteria may not fully capture their unique processing of traumatic events.

## Key findings

- Autistic adolescents showed higher rates of probable PTSD (43–57%) compared to typically developing peers (7–32%).
- Traumatic events reported by autistic adolescents often did not meet DSM-5 criteria, unlike those in maltreatment-exposed adolescents.
- Symptom severity and PTSD rates in autistic adolescents were comparable to those in maltreatment-exposed adolescents.

## Abstract

Psychological trauma and post-traumatic stress disorder (PTSD) are under-researched in autistic individuals. We explored the experience of trauma and PTSD symptoms in a sample of autistic adolescents (n = 30) aged 10–16 years (without a maltreatment history; 47% female), compared to a group of typically-developing (TD; n = 29) and a group of (non-autistic) maltreatment-exposed adolescents (n = 28), matched on key demographics. Caregiver reports indicated that a wide range of events were deemed traumatic to autistic adolescents, including those not meeting DSM-5’s Criterion A for trauma for a PTSD diagnosis (e.g., bullying and bereavement). Caregiver- and self-reports converged to show more severe PTSD symptoms, and higher rates of probable PTSD, in autistic adolescents (43–57%) relative to the TD adolescents (7–32%). Symptom severity and rates of probable PTSD were comparable between the autistic and maltreatment-exposed adolescents (50–54%), except that, for autistic adolescents, the index trauma mostly did not match DSM-5 criteria, whereas it did for maltreatment-exposed adolescents. This short report’s early findings supports the need for improved assessment of trauma exposure and PTSD symptoms in autistic adolescents. A flexible approach to how trauma is defined in this population may be needed, considering subjective experiences and autism-related processing differences.

Psychological trauma and post-traumatic stress disorder (PTSD) are not well studied in autistic young people. We looked at experiences of trauma and PTSD symptoms in autistic adolescents aged 10–16 years (n = 30; 47% female) who did not have a history of maltreatment. We compared them with two groups of adolescents: typically developing (TD; n = 29) and maltreatment-exposed (n = 28), with similar ages and other key characteristics. Caregivers reported that autistic adolescents experienced a wide range of events as traumatic, including events that would not usually count as trauma under standard PTSD rules (DSM-5), such as bullying or the death of a loved one. Both caregiver and adolescent reports showed that autistic adolescents had more severe PTSD symptoms and higher rates of probable PTSD (43–57%) compared with TD adolescents (7–32%). Interestingly, the severity of symptoms and rates of probable PTSD in autistic adolescents were similar to those in the maltreatment-exposed group (50–54%). However, while the maltreatment group’s trauma usually met DSM-5 criteria, the traumatic experiences in the autistic group often did not. These early findings highlight the importance of recognising trauma and PTSD symptoms in autistic adolescents, even when the events do not meet standard definitions of trauma. Assessments may need to be more flexible and consider each young person’s subjective experience, as well as differences in how autistic adolescents process events. Overall, the study suggests that autistic adolescents can be highly affected by stressful or upsetting experiences, and mental health support should take their unique perspectives into account.