How Do Autistic Traits and Trauma Affect Mental Health in Older Adults?

What you need to know

• Older adults with high autistic traits reported much higher rates of childhood and adulthood trauma compared to those with low autistic traits
• Those with high autistic traits also reported more current symptoms of post-traumatic stress disorder (PTSD), depression, and anxiety
• Experiencing severe trauma was associated with even greater mental health symptoms in those with high autistic traits
• The findings suggest older adults with high autistic traits may be more vulnerable to trauma and its long-term mental health effects

Autistic traits and vulnerability to trauma

Autism is a neurodevelopmental condition that affects about 1% of the population. It is characterized by differences in social communication and restricted, repetitive behaviors and interests. While autism is diagnosed in childhood, it is a lifelong condition. However, most autism research has focused on children and young adults, with little attention paid to autism in older age.

This study looked at autistic traits in adults aged 50 and older. Autistic traits refer to characteristics like difficulties with social communication that are found in diagnosed autism, but also exist to varying degrees in the general population. About 10-20% of people may have high autistic traits without meeting criteria for an autism diagnosis.

The researchers were interested in examining how autistic traits in older adults relate to experiences of trauma across the lifespan and current mental health symptoms. Previous research with younger adults has found that autistic individuals report higher rates of traumatic experiences and post-traumatic stress disorder (PTSD) compared to the general population. However, this had not been explored in older autistic adults or those with high autistic traits.

Higher rates of trauma reported

The study surveyed over 20,000 adults aged 50+ from the PROTECT study in the UK. About 1% (251 people) were identified as having high autistic traits based on their responses to questions about social communication difficulties in childhood and adulthood. The researchers compared this “Autism Spectrum Traits” (AST) group to a matched group of 9,179 participants with low autistic traits.

The results showed striking differences in reported trauma between the two groups:

• Almost 30% of the AST group reported experiencing severe trauma in childhood or adulthood, compared to less than 8% of the comparison group
• The AST group was 3-8 times more likely to report various types of childhood trauma, including emotional neglect/abuse, physical abuse, and sexual abuse
• They were also 3-5 times more likely to report trauma in adulthood

Notably, rates of emotional trauma were particularly elevated in the AST group. For example, they reported an 8-fold increase in childhood emotional neglect and a 7-fold increase in childhood emotional abuse compared to the low autistic trait group.

Greater mental health impacts

In addition to higher rates of trauma, the AST group also reported significantly more current symptoms of mental health conditions:

• They were 12 times more likely to report symptoms indicating probable PTSD
• They were 10 times more likely to report symptoms of depression and anxiety

Importantly, the impact of trauma on mental health symptoms appeared to be even greater for those with high autistic traits. Among those who experienced severe childhood trauma, about 50% of the AST group reported clinical levels of current PTSD symptoms, compared to only 13% of the comparison group.

A similar pattern was seen for those who experienced severe trauma in adulthood. The relationship between childhood trauma and current PTSD symptoms was particularly strong for the AST group.

Implications for supporting older adults with autistic traits

These findings suggest that older adults with high autistic traits may be more vulnerable to experiencing trauma across their lifespan, as well as developing mental health difficulties like PTSD, depression and anxiety as they age. The impact of severe trauma on mental health symptoms appears to be even greater for those with high autistic traits compared to the general population.

The researchers note this highlights the need for adequate mental health support for autistic individuals and those with high autistic traits across the lifespan. This includes those who may not have a formal autism diagnosis. Appropriate support could help prevent or mitigate the development of mental health problems and resulting crises as these individuals age.

Some key implications of this research include:

• The importance of trauma-informed care for autistic individuals and those with high autistic traits
• The need for mental health screening and support as part of healthcare for older autistic adults
• Potential benefits of early intervention to prevent or address trauma in autistic individuals
• Consideration of how autism may impact the experience and expression of PTSD symptoms

Limitations and future directions

The researchers note some limitations of the study, including its reliance on self-report measures and the use of a brief set of questions to identify autistic traits rather than a full diagnostic assessment. The study also cannot determine causation - that is, whether autistic traits increase vulnerability to trauma, or if trauma leads to more autistic-like traits.

Future research is needed to explore these relationships further, including studies with diagnosed autistic older adults. However, this study provides an important first look at how autistic traits may impact experiences of trauma and mental health into older adulthood. The findings suggest this is an area that deserves more attention to ensure appropriate support for autistic individuals across the lifespan.

Conclusions

• Older adults with high autistic traits report much higher rates of trauma in both childhood and adulthood compared to those with low autistic traits
• They also report more current symptoms of PTSD, depression and anxiety in older age
• The impact of severe trauma on mental health symptoms appears even greater for those with high autistic traits
• This highlights the need for trauma-informed mental health support for autistic individuals and those with high autistic traits across the lifespan