Autistic traits are associated with the presence of post-traumatic stress symptoms and suicidality among subjects with autism spectrum conditions and Anorexia nervosa

Introduction: Recently, growing attention has been paid to the presence of undetected Autism Spectrum Disorder (ASD) and subthreshold autistic traits (ATs) among females, and on their gender specific manifestation. In particular, the recent literature focused on the overlap between autism spectrum and eating disorders, which share with ASD not only features such as of cognitive inflexibility but also a link with trauma- and stress-related disorders. In this framework, we aimed to assess the interaction between ATs, stress- or trauma-related symptoms, and the risk of suicidality in subjects with different mental conditions.

Methods: 184 subjects were divided in three diagnostic groups: Broad autism phenotype (BAP), Anorexia Nervosa (AN) and Healthy Controls (HCs) and assessed with the Adult Autism Subthreshold Spectrum (AdAS Spectrum) questionnaire, the Trauma and Loss Spectrum - Self Report (TALS - SR) questionnaire and the Mood Spectrum - Self Report (MOODS - SR) questionnaire.

Results: AN subjects reported notable ATs reinforcing the hypothesis that AN might represent an atypical ASD manifestation more common in women. Furthermore, both AN and BAP subjects showed a considerable presence of trauma/stress associated symptoms. The dimension of trauma/stress related symptoms also appeared to be associated with ATs, and to significantly mediate the relationship between ATs and suicidality risk. Lastly, AN were found to have a stronger correlation with the presence of post-traumatic stress symptoms.

Conclusions: the results support the presence of a link between ATs and AN. Moreover, AN seems to be more strongly associated with post-traumatic stress symptoms than BAP. ATs and trauma/stress related symptoms may interact in shaping suicidality risk in these patients.