Robust association between autistic traits and psychotic-like experiences in the adult general population: epidemiological study from the 2007 Adult Psychiatric Morbidity Survey and replication with the 2014 APMS

Martinez, Anton Philipp; Wickham, Sophie; Rowse, Georgina; Milne, Elizabeth; Bentall, Richard P.

doi:10.1017/s0033291720001373

Cited by 10 publications

(8 citation statements)

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“…The latter is also in line with our finding that none of the ADHD patients reported paranoid APS. Other studies have linked autistic traits and psychotic-like experiences, including paranoia, in the adult community[ 67 ] and reported similarly high levels of paranoia in psychotic and autism-spectrum disorders[ 68 ]. In contrast to psychotic disorders in which paranoia was based upon victimization, suspicion, and threat of harm, in autism-spectrum disorders, paranoia was based less upon these but more so upon social cynicism[ 68 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical high-risk criteria of psychosis in 8–17-year-old community subjects and inpatients not suspected of developing psychosis

Schultze‐Lutter¹,

Walger²,

Franscini³

et al. 2022

WJP

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BACKGROUND In children and adolescents compared to adults, clinical high-risk of psychosis (CHR) criteria and symptoms are more prevalent but less psychosis-predictive and less clinically relevant. Based on high rates of non-converters to psychosis, especially in children and adolescents, it was suggested that CHR criteria were: (1) Pluripotential; (2) A transdiagnostic risk factor; and (3) Simply a severity marker of mental disorders rather than specifically psychosis-predictive. If any of these three alternative explanatory models were true, their prevalence should differ between persons with and without mental disorders, and their severity should be associated with functional impairment as a measure of severity. AIM To compare the prevalence and severity of CHR criteria/symptoms in children and adolescents of the community and inpatients. METHODS In the mainly cross-sectional examinations, 8–17-year-old community subjects ( n = 233) randomly chosen from the population register of the Swiss Canton Bern, and inpatients ( n = 306) with primary diagnosis of attention-deficit/hyperactivity disorder ( n = 86), eating disorder ( n = 97), anxiety including obsessive–compulsive disorder ( n = 94), or autism spectrum disorder ( n = 29), not clinically suspected to develop psychosis, were examined for CHR symptoms/criteria. Positive items of the Structured Interview for Psychosis-Risk Syndromes (SIPS) were used to assess the symptomatic ultra-high-risk criteria, and the Schizophrenia Proneness Instrument, Child and Youth version (SPI-CY) was used to assess the 14 basic symptoms relevant to basic symptom criteria. We examined group differences in frequency and severity of CHR symptoms/criteria using χ 2 tests and nonparametric tests with Cramer’s V and Rosenthal’s r as effect sizes, and their association with functioning using correlation analyses. RESULTS The 7.3% prevalence rate of CHR criteria in community subjects did not differ significantly from the 9.5% rate in inpatients. Frequency and severity of CHR criteria never differed between the community and the four inpatient groups, while the frequency and severity of CHR symptoms differed only minimally. Group differences were found in only four CHR symptoms: suspiciousness/persecutory ideas of the SIPS [ χ 2 (4) = 9.425; P = 0.051, Cramer’s V = 0.132; and Z = -4.281, P < 0.001; Rosenthal’s r = 0.184], and thought pressure [ χ 2 (4) = 11.019; P = 0.026, Cramer’s V = 0.143...

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Section: Discussionmentioning

confidence: 99%

Clinical high-risk criteria of psychosis in 8–17-year-old community subjects and inpatients not suspected of developing psychosis

Schultze‐Lutter¹,

Walger²,

Franscini³

et al. 2022

WJP

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“…An increasing number of studies also indicate that sub-clinical psychotic experiences are more common in individuals with autistic traits in the general population. This association has been observed in crosssectional studies 2,3 and in studies that followed children with autistic traits to a maximum of age 18 years [4][5][6][7] . Although psychotic experiences in adolescence are usually transient and of no clinical concern, persistent psychotic experiences have been associated with distress and poor mental health outcomes 8,9 , including the development of psychotic disorder 10 .…”

Section: Introductionmentioning

confidence: 56%

“…However, it is worth noting that in the ALSPAC cohort, social communication difficulties are associated with autism PRS, suggesting developmental origins 24 . In addition, social communication difficulties in the ALSPAC cohort seem to be relatively stable over time for male as well as female participants 3 . These studies support the idea that particularly social communication difficulties measured in the context of the present study do not necessarily stem from trauma exposure alone but reflect autism-related difficulties.…”

Section: Discussionmentioning

confidence: 94%

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Childhood trauma as a mediator of the association between autistic traits and psychotic experiences: evidence from the ALSPAC birth cohort

Dardani¹,

Schalbroeck²,

Jones³

et al. 2021

Preprint

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Introduction: There is increasing evidence that autistic traits are associated with psychotic experiences. However, the mechanisms underlying such associations are still unknown. In this longitudinal birth cohort study, we examine the relationship between childhood autistic traits and psychotic experiences in adolescence and young adulthood, and the influence of childhood trauma on this association.Methods: We analysed data from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. We used four dichotomized measures of autistic traits (social communication difficulties at age 7, repetitive behaviour at age 5, sociability at age 3, and pragmatic language at age 9). Psychotic experiences were assessed at ages 18 and 24 using the semi-structured Psychosis-Like Symptoms interview. Traumatic experiences between ages 5 to 11 were assessed with questionnaires and interviews administered to children and parents.Results: The maximum sample with complete data was 3410 for the autistic traits-psychotic experiences analyses and 3327 for the mediation analyses. The corresponding maximum sample sizes for the imputed data analysis were 10,053 and 8121, respectively. Social communication difficulties were associated with psychotic experiences (odds ratio [OR] = 1.43, 95% confidence interval [CI] 1.01–2.02), including those that were distressing and/or frequent (OR = 1.60, 95% CI 1.02–2.52). Childhood trauma mediated approximately 40% of this association. Other autistic traits showed no consistent relationship with psychotic experiences. Results were similar when we adjusted for schizophrenia polygenic risk scores (PRS).Discussion: Childhood social communication difficulties are associated with psychotic experiences by age 24. This association does not appear to be explained by genetic risk as captured by current schizophrenia PRS. The experience of trauma may be an important, potentially modifiable pathway between autistic features and later onset of psychotic psychopathology where interventions could be targeted.

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“…1 An increasing number of studies also indicate that subclinical psychotic experiences are more common in individuals with autistic traits in the general population. This association has been observed in cross-sectional studies 2,3 and in studies that followed children with autistic traits to a maximum of age 18 years. [4][5][6][7] Although psychotic experiences in adolescence are usually transient and of no clinical concern, persistent psychotic experiences have been associated with distress and poor mental health outcomes, 8,9 including the development of psychotic disorder.…”

Section: Introductionmentioning

confidence: 60%

Childhood Trauma As a Mediator of the Association Between Autistic Traits and Psychotic Experiences: Evidence From the Avon Longitudinal Study of Parents and Children Cohort

Dardani

Schalbroeck

Madley‐Dowd

et al. 2022

Schizophrenia Bulletin

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Background Little is known on whether associations between childhood autistic traits and psychotic experiences persist into adulthood and whether genetic confounding and childhood trauma influence them. Here we investigate the associations between childhood autistic traits and psychotic experiences until young adulthood and assess the influence of schizophrenia polygenic risk and childhood traumatic experiences, using the Avon Longitudinal Study of Parents and Children (ALSPAC) population-based birth cohort. Study design We used a measure of broad autistic traits (autism factor mean score), and four dichotomised measures of autistic traits capturing social communication difficulties (age 7), repetitive behaviours (age 5), sociability (age 3), and pragmatic language (age 9). Psychotic experiences were assessed at ages 18 and 24 using the semi-structured Psychosis-Like Symptoms interview (PLIKSi). Traumatic experiences between ages 5 and 11 were assessed with questionnaires and interviews administered to children and parents at multiple ages. Study results Broad autistic traits, as well as social communication difficulties, were associated with psychotic experiences that were distressing and/or frequent until age 24 (autism factor mean score, n = 3707: OR 1.19, 95%CI 1.01–1.39; social communication difficulties, n = 3384: OR 1.54, 95%CI 0.97–2.45). Childhood trauma mediated a substantial proportion of the identified associations (~28% and 36% respectively, maximum n = 3577). Schizophrenia polygenic risk did not appear to confound the associations. Multiple imputation analyses (maximum n = 13 105) yielded comparable results. Conclusions Childhood trauma may be an important, potentially modifiable pathway between autistic features and later onset of psychotic psychopathology.

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Robust association between autistic traits and psychotic-like experiences in the adult general population: epidemiological study from the 2007 Adult Psychiatric Morbidity Survey and replication with the 2014 APMS

Cited by 10 publications

References 28 publications

Clinical high-risk criteria of psychosis in 8–17-year-old community subjects and inpatients not suspected of developing psychosis

Clinical high-risk criteria of psychosis in 8–17-year-old community subjects and inpatients not suspected of developing psychosis

Childhood trauma as a mediator of the association between autistic traits and psychotic experiences: evidence from the ALSPAC birth cohort

Childhood Trauma As a Mediator of the Association Between Autistic Traits and Psychotic Experiences: Evidence From the Avon Longitudinal Study of Parents and Children Cohort

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