Posttraumatic Stress Disorder In Individuals with Diagnosis of Autism Spectrum Disorders

Background:   Studies with youth with developmental disabilities show higher risks of abuse, trauma and Post-Traumatic Stres Disorders (PTSD) than with typically developing individuals. However; there is lack of studies in specific groups such as individulas with Autism Specturm Disorders (ASD).

 Objectives: To assess the prevalance, types, associated risk factors with trauma and PTSD and its  clinical presentation in a group with ASD.

Methods: Study includes 69 individuals with diagnosis of ASD who were consecutively followed up at our  autism spectrum disorders clinic and met DSM-IV criteria. Assessment was achieved using semi-structured forms such as the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version, Post Traumatic Stress Disorder scale (K-SADS-PL, PTSD scale). The Aberrant Behavior Checklist (ABC) was filled by parents. A checklist form outlined by the authors and called ‘Trauma symptoms Investigation Form in Autistic Spectrum Disorders’ (TIF-ASD) was filled by the researchers to examine the course of symptoms in  subjects with positive  history of trauma.

Results:  26.1% (n:18) had history of trauma and  17.1% (n:12 )were  diagnosed with PTSD. Witnessing or being a victim of accidents/disasters /violence was the most common type of trauma. Interestingly, the rate of physical and /or sexual abuse was less than  that in the general population. Trauma history and PTSD rates were higher in girls than in boys. Deterioration in social and communicative abilities, increase in stereotypies, aggression, distractibility, sleep problems, agitation, hyperactivity, self-injury and loss of self-care skills were the most common symptoms detected following trauma.

 Conclusions: The relatively lower rate of trauma in our group could be related to the selection bias. The clinical presentation of PTSD in this group underscore the importance of   detailed assessment of  behavioral and emotional problems in individuals with ASD by rulling out any trauma history at periods which might otherwise be misdiagnosed as an exacerbation of symptoms of ASD.