Exploring trauma and post-traumatic stress symptoms in autistic children and those with high autistic traits

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Autistic children and adults are at greater risk of exposure to negative life events, including bullying and trauma. Recently, Rumball, Happé and colleagues have suggested that features of cognitive style (e.g., detail focus) in autism may predispose to the development of post-traumatic stress disorder/symptoms. Rumball, Happé and Grey (2020) showed that autistic adults who report experiencing traumatic events have a higher rate of clinical level PTSD symptoms (c. 45% pass cut-off on the PCL-5) than expected in trauma-exposed general population samples (c. 9%). In addition, autistic people may be traumatised by experiences not traditionally recognised as traumas, and not qualifying for PTSD diagnosis in DSM-5 (Rumball, Brewin & Happé, 2019). These non-traditional traumas are associated with the same high rates of clinical level PTSD symptoms (43%) in autistic adults as the standard DSM-5 traumas (Rumball, Happé and Grey, 2020). Autistic adults with high levels of PTSD symptoms are also at higher risk of additional mental health problems (anxiety, depression), even compared to the already elevated risk for poor mental health amongst autistic people (Rumball et al, 2021). Autistic individuals have enhanced risk of adverse childhood experiences (ACES) and autistic children experience high rates of bullying and victimisation (Hoover & Kaufman, 2018). Autistic children therefore have increased vulnerability to developing trauma related symptoms and comorbid psychiatric problems (Kerns et al., 2015). Despite the high prevalence of childhood traumatic experiences in the autistic population, research on autism specific expressions of traumatic stress and treatment adaptations for traumatic stress psychopathology in children are severely lacking (Peterson et al. 2019). Cognitive styles and sensory memory encoding in autism, alongside predisposition for emotional dysregulation and sensory arousal, may present a pathway to traumatic sequalae. There is an unmet clinical need for research on the interplay of autism, trauma and PTSD psychopathology in children. AIM:How does autism/autistic traits impact children's subjective experience of trauma (DSM-5 and Non-DSM-5 qualifying), vulnerability to developing PTSD symptoms, and response to treatment? We hypothesise that children with high autistic traits will be at greater risk of developing PTSD symptoms following typical and atypical traumas - based on our work with autistic adults. In the absence of much research on autism and PTSD in children, other specific aims are exploratory.