Diagnostic overshadowing in PTSD and autism: trauma in ASD

The majority of people will, at some point, experience a traumatic event, but only 3.9-5.6% will develop a post-traumatic stress disorder, or PTSD (WHO, 2024).

In autistic people, PTSD may be especially pronounced through maladaptive coping and traumatic memories. Autistic individuals tend to exhibit high avoidance coping, attentional bias towards threatening stimuli, and other autism-associated characteristics or tendencies that, despite being precursors of PTSD, are often dismissed as a ‘normal’ part of ASD (Ehlers & Clark, 2000; Lage et al., 2024).

This can lead to a ‘diagnostic overshadowing’ bias, which means that the PTSD-related challenges and unique features of PTSD in autistic people go unrecognised….