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Abstract
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Impact of Trauma and Adversity on Psychotic Symptoms in Autistic Adolescents
Aims: To identify which types of adversity and maltreatment best predict psychotic symptoms, considering relevant sociodemographic and clinical factors.
Methods: Our sample comprised seventy autistics adolescents and their families (aged 12-18, IQ >85) attended at the Child and Adolescent Mental Health Service (CAMHS) at the Hospital Clínic in Barcelona, Spain. We conducted simple and multiple regression analyses to determine which subtypes of adversity (ACEs) and maltreatment (JVQ), including relevant clinical and sociodemographic covariates, best predicted positive and negative symptomatology as measured by the CAPE-42. The final models were constructed using a forward stepwise procedure.
Results:
• Positive Symptoms:
The adversity model (R²Adj=0.59) identified Sexual Abuse (β=0.44; SE=0.10; p=0.00004), Emotional Neglect (β=0.29; SE=0.09; p=0.001), Family Origin (β=0.33; SE=0.07; p=0.00003), and Psychiatric Admissions (β=0.40; SE=0.12; p=0.001).
The maltreatment model (R²Adj=0.46) highlighted Sexual Victimization (β=0.04; SE=0.01; p=0.0007), Family Origin (β=0.23; SE=0.09; p=0.01), Psychiatric Admissions (β=0.31; SE=0.14; p=0.03), and being Male (β=0.22; SE=0.11; p=0.04).
• Negative Symptoms:
The adversity model (R²Adj=0.47) included Emotional Abuse (β=0.432; SE=0.12; p=0.0008), Sexual Abuse (β=0.387; SE=0.13; p=0.004), Internalizing Symptoms (β=0.028; SE=0.006; p=0.00003), Family Origin (β=0.436; SE=0.11; p=0.0001), and Family Income (β=0.105; SE=0.04; p=0.01).
The maltreatment model (R²Adj=0.56) identified Child Maltreatment (β=0.046; SE=0.013; p=0.0006), Peer and Sibling Victimization (β=0.017; SE=0.008; p=0.043), Internalizing Symptoms (β=0.018; SE=0.006; p=0.003), Family Origin (β=0.275; SE=0.088; p=0.003), and Female Sex (β=0.291; SE=0.104; p=0.007).
Conclusions:
Sexual abuse and emotional neglect are strong predictors of positive psychotic symptoms, while emotional abuse and child maltreatment are significant for negative symptoms. Clinical and sociodemographic factors also play crucial roles. Assessing these antecedents and psychotic experiences should be incorporated into autism assesment and intervention protocols.
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