Oslo University Hospital, Norway.
Autism. 2024 May;28(5):1075-1089. doi: 10.1177/13623613231190948. Epub 2023 Aug 23.
Post-traumatic stress disorder is a mental health disorder that may be triggered by the experience of events perceived as terrifying or overwhelming. Examples of such events include being the victim of violence or sexual abuse. Compared with other people, autistic people have increased risk of being exposed to violence or sexual abuse. In addition, autistic people may be more vulnerable to developing post-traumatic stress disorder following such exposure. However, knowledge is limited concerning the prevalence of experiences involving violence and sexual abuse, and post-traumatic stress disorder, in autistic people with co-occurring intellectual disabilities. Detection of these experiences, and identification of post-traumatic stress disorder, may be challenging in these individuals, and previous research indicates that post-traumatic stress disorder symptoms may be overlooked or misinterpreted. In this study, we examined prevalence of post-traumatic stress disorder, violence and sexual abuse in a clinical sample of 88 autistic adults with intellectual disabilities referred for mental health assessment. Only 3.4% were diagnosed with post-traumatic stress disorder, even if experiences involving violence (34.1%) or sexual abuse (17.0%) were common. Anxiety and affective disorders were common diagnoses among participants with these experiences. Controlling for autism characteristics, level of intellectual disability and communication skills, experiences of violence/sexual abuse were found to be associated with a measure of 'challenging' behaviours. These results indicate that potentially traumatic experiences are common in autistic adults with intellectual disabilities referred for mental health assessment, and that post-traumatic stress disorder may be under-recognised. The findings highlight the importance of trauma screening and post-traumatic stress disorder assessment, as well as the importance of trauma-informed care, in this population.
创伤后应激障碍是一种心理健康障碍，可能由被视为可怕或压倒性的事件经历引发。此类事件的例子包括成为暴力或性虐待的受害者。与其他人相比，自闭症患者遭受暴力或性虐待的风险增加。此外，自闭症患者在经历此类暴露后可能更容易患上创伤后应激障碍。然而，关于自闭症患者伴有智力障碍者中涉及暴力和性虐待以及创伤后应激障碍的经历的流行率，知识有限。在这些人中，这些经历的检测以及创伤后应激障碍的识别可能具有挑战性，并且先前的研究表明，创伤后应激障碍的症状可能被忽视或误解。在这项研究中，我们检查了创伤后应激障碍、暴力和性虐待在 88 名患有智力障碍的自闭症成年人中的流行率，这些人因心理健康评估而被转介。尽管常见的经历包括暴力（34.1%）或性虐待（17.0%），但只有 3.4%的人被诊断为创伤后应激障碍。焦虑和情感障碍是参与者中常见的诊断。在控制自闭症特征、智力残疾程度和沟通能力后，发现暴力/性虐待经历与“挑战性”行为的衡量标准相关。这些结果表明，在因心理健康评估而转介的自闭症伴有智力障碍的成年人中，潜在的创伤经历很常见，而且创伤后应激障碍可能被低估。这些发现强调了在该人群中进行创伤筛查和创伤后应激障碍评估以及提供创伤知情护理的重要性。
