Addressing Underdiagnosis of PTSD in Autistic Individuals: New Insights and Call for Inclusive Diagnostic Practices

Recent research highlights the concerning trend that Post-Traumatic Stress Disorder (PTSD) is often underrecognized and underdiagnosed among autistic people. A comprehensive analysis conducted by researchers at University College London reviewed data from over 190,000 autistic individuals worldwide, revealing that while formal PTSD diagnoses occur at rates comparable to the general population, many autistic people exhibit symptoms indicative of PTSD that go unnoticed.

The study, published in Clinical Psychology Review, compiled evidence from 30 studies involving both children and adults. It found that conventional diagnostic tools like the DSM and ICD may not fully capture trauma experiences unique to autistic individuals. Traumas such as bullying, restraint, sensory overload, and emotional neglect are often excluded from traditional definitions, leading to significant underestimations of PTSD prevalence in this group.

Screening tools tend to suggest much higher rates of probable PTSD—up to 14% in autistic children and 44% in autistic adults—indicating that many cases are missed in clinical assessments. Experts emphasize that this discrepancy stems from diagnostic overshadowing, where trauma symptoms are mistaken for autism traits or dismissed altogether.

Dr. Hassan Mansour, the lead author, advocates for the development of autism-sensitive diagnostic approaches. He emphasizes that the current manuals need updating to include broader trauma experiences relevant to autistic populations and recommends specialized training for clinicians to recognize overlapping symptoms.

The consequences of underdiagnosis are profound, potentially leading to chronic mental health issues like anxiety, depression, and suicidality, which are disproportionately common among autistic individuals. Systemically, misdiagnosis burdens mental health services, results in inappropriate interventions, and contributes to higher hospitalization rates.

To address these challenges, researchers call for the creation of autism-informed assessment tools, enhanced clinician education, and research inclusive of diverse communication and cognitive styles. Updating diagnostic criteria and practices aims to improve support pathways, reduce healthcare strain, and ensure autistic individuals receive appropriate mental health care.

Source: https://medicalxpress.com/news/2025-10-ptsd-overlooked-autistic-people-diagnosis.html