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

自闭症儿童和成人暴露在负面生活事件中的风险更大，包括欺凌和创伤。最近，Rumball、Happé和他的同事们提出，自闭症的认知风格特征(例如，细节专注)可能容易导致创伤后应激障碍/症状的发展。Rumball、Happé和Grey(2020)的研究表明，报告经历创伤事件的自闭症成年人的临床水平创伤后应激障碍症状的发生率(PCL-5的及格率为45%)高于创伤暴露的普通人群样本中的预期(约9%)。此外，自闭症患者可能会受到传统上不被视为创伤的经历的创伤，并且没有资格在DSM-5中被诊断为创伤后应激障碍(Rumball，Brewin&Happé，2019年)。这些非传统创伤与自闭症成人中与标准DSM-5创伤相同的临床水平的创伤后应激障碍症状(43%)有关(Rumball，Happé和Grey，2020)。具有高水平创伤后应激障碍症状的自闭症成年人也有更高的额外心理健康问题(焦虑、抑郁)的风险，即使与自闭症患者中心理健康不良的风险已经很高相比也是如此(Rumball等人，2021年)。自闭症患者患不良童年经历(ACE)的风险增加，自闭症儿童遭受欺凌和受害的比率很高(Hoover&Kaufman，2018)。因此，自闭症儿童更容易出现创伤相关症状和共病精神问题(Kerns等人，2015年)。尽管儿童创伤经历在自闭症人群中的发病率很高，但关于创伤应激的自闭症特有表现和儿童创伤应激心理病理学的治疗适应性的研究严重缺乏(Peterson等人)。2019年)。自闭症的认知方式和感觉记忆编码，以及情绪调节失调和感觉唤醒的倾向，可能是导致创伤性后遗症的途径。对自闭症、创伤和儿童创伤后应激障碍精神病理学相互作用的研究有一个尚未得到满足的临床需求。目的：自闭症/自闭症特征如何影响儿童的创伤主观体验(DSM-5和非DSM-5)、易出现创伤后应激障碍症状以及对治疗的反应？我们假设，在典型和非典型创伤之后，具有高度自闭症特征的儿童将有更大的风险发展为创伤后应激障碍症状-基于我们对自闭症成年人的工作。在缺乏对儿童自闭症和创伤后应激障碍的大量研究的情况下，其他具体目标还只是探索性的。

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.