Autism and Traumatic Stress – Gaps in Research

I want to begin this journey by saying that I have wanted to formally curate research and organize my own thoughts about autism, stress, and trauma for quite some time. Today I found the abstract highlighted below and decided the time was now.

We need to be talking about autism and traumatic stress.

We need to be researching autism and traumatic stress.

We need to be connecting the dots between these two currently separate fields of inquiry, integrating the knowledge.

And so, so importantly, most importantly, we need to be listening to autistic experience surrounding autism and traumatic stress and centering the voices of those persons living at the intersection of autism and trauma.

Like many other autistic persons, I live at the intersection of autism and trauma. I will absolutely be writing about my own experience as this project develops. Significantly, only some of us know we inhabit that intersectional space where autism and trauma co-exist and compound. I know I exist here, but I only recently learned that was the case. Too many of us are not yet aware that we exist at this intersection. Over time, I will be talking about why so many are unaware or only recently became aware of our relationship to autism and trauma.

For now, I open this collection, this new project, by drawing attention to a recent publication that formalizes “a pressing need” for more research about autism and trauma.

Please be patient with me as I work out how I’d like to do my citations and links. Please remember that I will be linking to research that medicalizes and pathologizes autism and trauma, and please take good care of yourselves as you read and click. I disagree with the pathologization of both experiences and identities and see from a lens that is self-educating in the neurodiversity paradigm, trauma-sensitivity, and disability rights (more about my own positionality can be found in the About section). However, I also see value in scientific investigation of autism and trauma, especially from fields that are centering neuroscience, autonomics, epigenetics, endocrinology, and psychoneuroimmunology over behaviorist reductionism. Also please be patient with me when all I have to share is a link to the abstract as is the case here. I hope to find a way to access full length articles of everything I share, but for now that isn’t the case.

Without further ado:

Link to the abstract.

PTSD and autism spectrum disorder: Co-morbidity, gaps in research, and potential shared mechanisms.

I would like to highlight the following from the abstract:

“In this article, we suggest several possible pathways that may link trauma and autism. First, autism spectrum disorder (ASD) may serve as a vulnerability marker for posttraumatic stress disorder (PTSD), specifically by increasing the risk for exposure to traumatic events. Second, PTSD, once it has appeared, may exacerbate certain ASD symptoms, for example, through maladaptive coping strategies and reduced help-seeking. Third, there may be shared underlying mechanisms for PTSD and ASD, including neurological abnormalities associated with both disorders, as well as cognitive and behavioral mechanisms, such as increased rumination, cognitive rigidity, avoidance, anger, and aggression. In addition, the unique characteristics of ASD may determine which events are experienced as particularly traumatic (e.g., social insults and degradation, sensory overstimulation, abrupt changes in known routines) and affect both the manifestation and severity of posttraumatic sequelae among diagnosed individuals.”

I am going to attempt to translate that into less pathologizing language. This is my first try doing anything like this, so I doubt it will be flawless. That is scary for me! But I’m going to try anyway:

In this article, the authors suggest several possible pathways that may link trauma and autism. First, autism may serve as a vulnerability marker for a posttraumatic stress injury, specifically by increasing risk for exposure to traumatic events such as being targeted by others for physical violence, sexual violence, exploitation, and bullying. Second, posttraumatic stress injury, once it has appeared, may exacerbate certain autistic struggles, for example, through lack of systems of support in place to (a) equip autistic persons with healthy self-care and emotional regulation strategies, (b) prioritize consent and autonomy for autistic persons from early childhood, (c) build authentic trust between autistic persons and their caregivers and community so that autistic persons learn they can ask for and receive help, (d) assist autistic persons with alternative means of communicating traumatic experiences, and (e) identify markers that an autistic person has potentially experienced trauma. (I’m really adding things here, but I was pretty dissatisfied with how this was originally written. It felt victim-blamey to me, you know?). Third, there may be shared, underlying mechanisms for post-traumatic injuries and autism (Emphasis added. Can I get a HECK YES!!?!), including creative neurological adaptations associated with both experiences, as well as downstream developmental, cognitive, and behavioral manifestations, such as altered autonomic nervous system activity, hypervigilance manifesting, for example, as increased rumination, cognitive rigidity related to loss of control being a trigger, altered fear learning, altered relationships, memory differences, meltdowns with possible anger and aggression (fight), bolting and avoidance strategies (flight), shutdown and disassociative type experiences (freeze), and perfectionism and rule learning/rule following (submit/appease). (Whew! They sure did miss a lot!). (This next part deserves some limelight. . .)

In addition, the unique characteristics of autism may determine which lived experiences register as  traumatic injuries (e.g. social insults and degradation, sensory-related pain, lack of agency and control over body, time, and re-exposure to traumatic experiences) and affect both the manifestation and severity of posttraumatic sequelea.

The authors conclude by calling on the research community to do more research about the relationships between autism and trauma. They state that, “Such research may carry important clinical implications.” I would add that such research also carries significant implications for the parenting of autistic children and the human rights of all autistic persons.

At this point, you may be wondering why I made some of the language choices I made above. I will try to address that in a future post. For now, I am excited to hit Publish and officially launch this project! My research and writing here probably aren’t exactly what the abstract above anticipated as an answer to its call.

Nevertheless, they persisted.

(And by “they,” I mean the non-binary me.)