Differential Associations of Adversity and Victimisation With Psychotic Experiences in Autistic Adolescents

This study examined the unexplored associations between childhood adversity, maltreatment, and psychotic experiences in autistic adolescents, focusing on how trauma subtypes relate to positive and negative dimensions.

Participants were 73 autistic adolescents (12-18 years, IQ > 85) with a confirmed ASD diagnosis (DSM-5; ADOS-2/ADI-R), recruited from the Child and Adolescent Mental Health Service (CAMHS) at Hospital Clínic de Barcelona. Linear regression models assessed which subtypes of adversity (ACEs) and maltreatment (JVQ), controlling for clinical and sociodemographic covariates, were associated with positive (PPE) and negative (NPE) psychotic experiences as measured by the CAPE-42. Final models were selected via forward stepwise procedures and internally validated using bootstrapped cross-validation.

For PPE, the adversity model (Adj. R² = 0.498) identified sexual abuse, emotional neglect, family origin, and psychiatric admissions as significant correlates. The maltreatment model (Adj. R² = 0.398) included the JVQ Sexual Victimization and Peer and Sibling Victimization subscales, family origin, and psychiatric admissions. For NPE, the adversity model (Adj. R² = 0.399) identified internalizing symptoms, physical abuse, female sex, and family origin, while the maltreatment model (Adj. R² = 0.553) identified family origin, the JVQ Child Maltreatment subscale, internalizing symptoms, female sex, and the JVQ Peer and Sibling Victimization subscale.

Childhood trauma showed distinct patterns of association with psychotic dimension profiles. Sexual abuse, emotional neglect, and peer victimisation were linked to increased PPE, whereas child maltreatment and peer victimisation were more strongly associated with NPE. These findings highlight the importance of integrating systematic trauma assessment into autism care.