Is PTSD common in autism?

When you think of autism and PTSD (Post-Traumatic Stress Disorder), they might seem like two completely different conditions. Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by challenges in social interaction, communication, and repetitive behaviors. PTSD, on the other hand, is a mental health condition triggered by traumatic experiences.

Despite their differences, there is growing recognition of how autism and PTSD can intersect in some individuals, amplifying the challenges they face in everyday life.

In this blog by ABA Centers of America, we’ll explore the overlap between autism and PTSD, explain how these conditions affect each other, and offer insight into managing the symptoms that can arise from living with both.

Can Individuals with ASD Develop PTSD?

PTSD is commonly associated with traumatic events like accidents, abuse, or natural disasters. It can affect anyone, but individuals on the spectrum may be more vulnerable to trauma for several reasons. Sensory overloads, difficulty understanding social cues, and challenges with communication can make it hard for them to process traumatic events in ways that neurotypical people might. This unique way of navigating the world, coupled with an increased likelihood of experiencing bullying, isolation, or neglect, can heighten the risk of PTSD among individuals with ASD.

Moreover, the Journal of Autism and Developmental Disorders examined the link between PTSD and autism in 90 adult psychiatric outpatients, 63 of whom had autism or traits of it. Using psychiatric assessments and the MINI interview for diagnosing PTSD, researchers found that PTSD was more common in those with autism—21% of the autistic group had PTSD, compared to only 4% of those without autism. Despite both groups experiencing similar levels of trauma, there was a pattern showing that more autism symptoms were related to specific PTSD symptoms, like hyperarousal and anger outbursts.

But, recognizing PTSD in individuals with autism isn’t always straightforward. Symptoms of PTSD—such as anxiety, avoidance, or even meltdowns—can sometimes look similar to common behaviors associated with autism, making it harder to diagnose.

How PTSD Can Present Differently in Individuals with Autism

PTSD often involves symptoms like flashbacks, nightmares, hypervigilance, stress, and avoidance behaviors, according to the National Institute of Mental Health. In individuals with autism, these symptoms can appear differently, often blending with or exacerbating their existing traits. Let’s see some of the similarities and differences:

PTSD Symptoms:

• Recurring distressing memories or flashbacks
• Nightmares
• Avoidance of reminders related to the trauma
• Constant alertness or heightened awareness
• Being easily startled
• Extreme emotional reactions or emotional numbness
• Low self-worth
• Challenges with executive functioning

Autism Symptoms:

• Struggles with communication
• Difficulty interpreting social cues
• Focus on specific interests
• Repetitive actions and preference for routines
• Sensitivity to sensory experiences
• Trouble regulating strong emotions
• Difficulty controlling impulses
• Issues with executive functioning
• Tendency to dwell on thoughts

Shared Symptoms:

• • Detachment or dissociation
  • Social interaction challenges
  • Higher likelihood of being victimized
  • Negative self-image and low self-esteem
  • Increased rates of depression, self-harm, and substance use
  • Constant alertness and nervousness
  • Heightened sensitivity to sensory stimuli
  • Difficulty regulating emotions
  • Impulse control challenges
  • Problems with executive functioning
  • Trouble sleeping
  • Engaging in repetitive behaviors (stimming)