Abstract
BackgroundExisting research shows that adults with an autism spectrum disorder (ASD) are more vulnerable to develop overt psychosis. However, studies investigating (subclinical) psychotic experiences (PE) in ASD are scarce, and it is unknown if PE are accompanied with more distress in adults with ASD compared to the general population. This study examined lifetime PE and accompanying distress, momentary PE levels, and the impact of daily life stress and negative affect (NA) on momentary PE in males and females with ASD compared to controls.MethodsIn 50 adults with ASD (males N= 26, females N= 24) and 51 adults without ASD (males N= 26, females N= 25), the Community Assessment of Psychic Experiences (CAPE) was used to analyze group differences in frequency and distress of lifetime subclinical positive, negative, and depressive symptoms. The Experience Sampling Method (ESM) was used to measure momentary PE, NA, and stress (activity-related, event-related, and social stress) for 10 days. Multilevel analyses were conducted to test whether stress and NA were associated with momentary PE and whether these associations were modified by group or sex.ResultsAdults with ASD reported more lifetime CAPE negative and depressive symptoms, but similar levels of PE, than controls. Higher levels of accompanying distress were found in participants with ASD for each subscale. With respect to ESM momentary PE, higher levels were reported by adults with ASD and a stronger association between event-related stress and momentary PE was found compared to controls. This was not the case for NA, activity-related, and social stress. Overall, no significant differences between male and female outcomes were found.ConclusionAdults with ASD are more prone to encounter lifetime subclinical negative and depressive symptoms and accompanying distress compared to adults without ASD. Similar levels of lifetime PE in both groups were still accompanied with more distress in the ASD group. Furthermore, higher levels of ESM momentary PE were found in participants with ASD. Additionally, event-related stress may act as a risk factor for PE in both females and males with ASD, with a stronger risk-increasing effect than in their control counterparts.
Highlights
Individuals with an autism spectrum disorder (ASD) are more prone to develop overt psychosis relative to those without ASD [1, 2]
CAPE—Symptom Dimensions None of the individual CAPE symptom dimensions were significantly associated with the interaction between group and sex, and no significant effects were found for sex (Table 2)
The present findings show that even though adults with ASD reported an increased desire to be alone when in the company of others, momentary psychotic experiences (PE) levels associated with social stress were comparable in both groups
Summary
Individuals with an autism spectrum disorder (ASD) are more prone to develop overt psychosis relative to those without ASD [1, 2]. General population studies have shown that psychotic experiences (PE) are an important risk factor for a psychotic disorder [3, 4], psychopathology [5, 6], and suicidal ideation [7, 8]. Previous studies in general population samples demonstrated significantly higher levels of PE in females than in males [12, 13]. Existing research shows that adults with an autism spectrum disorder (ASD) are more vulnerable to develop overt psychosis. Studies investigating (subclinical) psychotic experiences (PE) in ASD are scarce, and it is unknown if PE are accompanied with more distress in adults with ASD compared to the general population. This study examined lifetime PE and accompanying distress, momentary PE levels, and the impact of daily life stress and negative affect (NA) on momentary PE in males and females with ASD compared to controls
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