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Elucidating the presentation and identification of PTSD in autistic adults: a modified Delphi study

Freya Rumball (SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Adult Autism Service, Oxleas NHS Foundation Trust, Dartford, UK)
Rachel Parker (Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK)
Ailbhe Elizabeth Madigan (Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK)
Francesca Happe (SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK)
Debbie Spain (SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK)

Advances in Autism

ISSN: 2056-3868

Article publication date: 21 December 2023

77

Abstract

Purpose

Autistic individuals are at increased risk of trauma exposure and post-traumatic stress disorder (PTSD). Diagnostic overshadowing, however, often results in PTSD symptoms being mislabelled as autistic traits. This study aims to develop professional consensus on the identification and assessment of co-occurring PTSD in autistic adults.

Design/methodology/approach

An online modified Delphi design was used to gather professionals’ perspectives on key aspects of the identification and assessment of PTSD in autistic adults. Data were gathered qualitatively in Round 1 and then synthesised using content analysis into a list of statements that were rated in Round 2. Statements reaching 60–79% consensus and additional suggestions were sent out for rating in Round 3. Consensus for the final statement list was set at 80% agreement.

Findings

Overall, 108 statements reached consensus. These form the basis of professional-informed recommendations to facilitate the identification and assessment of PTSD symptoms in autistic adults.

Practical implications

The final Delphi statements provide a framework to assist with the assessment and recognition of traumatic stress reactions in autistic adults presenting to mental health, diagnostic or social services.

Originality/value

To the best of the authors’ knowledge, this is the first study to explore the presentation and identification of PTSD in autistic adults (with and without intellectual disability), using a bottom-up approach informed by professional consensus.

Keywords

Acknowledgements

This research was funded by a departmental research grant from King’s College London, Mental Health Studies MSc programme. FH is part-funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The authors are grateful to the research participants who offered their time and expert knowledge.

Citation

Rumball, F., Parker, R., Madigan, A.E., Happe, F. and Spain, D. (2023), "Elucidating the presentation and identification of PTSD in autistic adults: a modified Delphi study", Advances in Autism, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/AIA-08-2023-0053

Publisher

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Emerald Publishing Limited

Copyright © 2023, Emerald Publishing Limited

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