Adverse childhood experiences exacerbate peripheral symptoms of autism spectrum disorder in adults

Abstract

Aim: Adverse childhood experiences are potentially traumatic events with long-lasting effects on the health and well-being of patients with autism spectrum disorder (ASD). It is important to clarify which types of long-lasting autism-related symptoms are influenced by childhood experiences to design future intervention studies. However, few studies have examined the association between childhood experiences and autistic symptoms in large samples of adults with ASD and individuals with typical development (TD). In this study, we evaluate the effects of adverse childhood experiences on multiple ASD phenotypes among both individuals with ASD and those with TD.

Method: We combined questionnaire evaluations; Childhood Abuse and Trauma Scale, the Japanese version of the Autism-Spectrum Quotient, Conners' Adult ADHD Rating Scale, the Japanese version of the Impact of Event Scale-Revised, and the Japanese version of the Adolescent/Adult Sensory Profile.

Results: Individuals with ASD and those with TD (n = 205 and 104, respectively) were included. There were significant correlations between the extent of adverse childhood experiences and severity of attention-deficit/hyperactivity disorder symptoms, posttraumatic stress disorder symptoms, and hypersensitivity in both participants with ASD and those with TD. By contrast, ASD core symptoms showed no significant correlation with adverse childhood experiences in either group. These results remained consistent after adjusting for age, sex, and the estimated intelligence quotient.

Conclusion: These findings suggest the need for a detailed disentanglement of ASD-related core and peripheral symptoms of adverse childhood experiences, which may help to appropriately set outcomes for future early interventions for the childhood experiences of individuals with ASD.

Keywords: adverse childhood experiences; attention‐deficit/hyperactivity disorder; autism spectrum disorder; sensory hypersensitivity.

Fig. 1

(a) Density plot of the Child Abuse and Trauma Scale (CATS) total score. Compared with the group with typical development (TD), the group with autism spectrum disorder (ASD) had a higher mean and variance of the CATS total score, i.e. ASD was associated with more adverse childhood experiences (ACEs). (b) However, when stratified by ASD diagnosis, the total CATS score was not significantly associated with the severity of ASD core symptoms as assessed by the Autism‐Spectrum Quotient (AQ) total score in the univariate linear regression models. These results suggest that innate ASD characteristics may be associated with ACEs, but ACEs are not associated with the worsening of core ASD symptoms.

Fig. 2

Above: density plots of Conners' Adult ADHD Rating Scale (CAARS) scores. The autism spectrum disorder (ASD) group had higher CAARS scores than the group with typical development (TD). Below: linear regression analyses stratified into the ASD and TD groups, showing that adverse childhood experiences are associated with higher CAARS scores independent of ASD diagnosis. ADHD, attention‐deficit/hyperactivity disorder; CATS, Child Abuse and Trauma Scale.

Fig. 3

Above: density plots of Impact of Event Scale‐Revised (IES‐R) scores. The autism spectrum disorder (ASD) group had higher IES‐R scores than the typical development (TD) group. Below: linear regression analyses stratified into the ASD and TD groups, showing that adverse childhood experiences are associated with higher IES‐R scores independent of ASD diagnosis. CATS, Child Abuse and Trauma Scale.

Fig. 4

Above: density plots of Adolescent/Adult Sensory Profile (AASP) scores. Compared with the typical development (TD) group, the autism spectrum disorder (ASD) group had higher AASP scores for “low registration,” “sensory sensitivity,” and “sensation avoiding,” and lower scores for “sensation seeking.” Below: in the ASD group, a higher Child Abuse and Trauma Scale (CATS) total score was associated with higher all AASP scores. In contrast, in the TD group, the CATS total score was significantly associated with low registration, sensory sensitivity, and sensation avoiding, as well as ASD, but not with sensation seeking.