Co-occurring mental health symptoms and cognitive processes in trauma-exposed ASD adults.
In trauma-exposed autistic adults, trying to block thoughts feeds PTSD and anxiety, while endless worry feeds depression—screen for both to pick the right treatment path.
01Research in Context
What this study did
Rumball et al. (2021) sent online surveys to autistic adults who had lived through trauma.
They asked how often people push thoughts away and how often they get stuck in loops of worry.
Then they looked at whether these habits lined up with PTSD, anxiety, or depression scores.
What they found
Trying to shut out thoughts went hand in hand with PTSD and anxiety.
Going over the same worry again and again went with depression, not anxiety.
Knowing which pattern shows up tells you which symptom set to target first.
How this fits with other research
Dincel et al. (2025) found that about one in eight autistic teens also feel spaced-out or dissociated after trauma. Together the two studies show trauma can show up as flashbacks, numbing, or stuck thoughts across ages.
Muniandy et al. (2023) showed that active coping shields well-being in autistic adults. Freya’s work adds that cutting thought suppression and breaking worry loops are two more active coping moves to teach.
Schaaf et al. (2015) saw that autistic youth already lean on suppression more than typical peers. Freya’s finding that suppression feeds adult PTSD supports starting reappraisal training early instead of letting the habit harden.
Why it matters
When an autistic client reports trauma, ask two quick questions: ‘Do you try to push the memory away?’ and ‘Do you replay the same worry on repeat?’ A yes to the first flags PTSD or anxiety tools like exposure or grounding. A yes to the second points toward behavioral activation or problem-solving for depression. You can match the intervention to the cognitive style in minutes.
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02At a glance
03Original abstract
BACKGROUND: Mental health problems are common amongst adults with an Autism Spectrum Disorder (ASD). Stressful and traumatic life events can trigger or exacerbate symptoms of anxiety, depression and PTSD. In the general population, transdiagnostic processes such as suppression and perseverative thinking are associated with responses to trauma and mental health symptoms. AIMS: This study explored the relationships between thought suppression, perseverative thinking and symptoms of depression, anxiety and PTSD in ASD adults who reported exposure to a range of DSM-5 and non-DSM-5 traumatic events. METHODS: 59 ASD adults completed a series of online self-report questionnaires measuring trauma, transdiagnostic cognitive processes, and mental health symptoms. RESULTS: Probable PTSD rarely occurred in isolation and was associated with depression and anxiety symptoms in trauma-exposed ASD adults. All cognitive processes and mental health symptoms were positively associated with one another, regardless of whether the trauma met DSM-5 PTSD Criterion A. When accounting for both cognitive processes, only thought suppression significantly predicted PTSD and anxiety symptoms, while only perseverative thinking significantly predicted depression symptoms. CONCLUSIONS AND IMPLICATIONS: These preliminary results suggest that different cognitive processes more strongly affect anxiety/PTSD versus depression symptom severity in trauma-exposed ASD adults, although co-occurring symptoms are common. Implications for assessment, treatment and future research are discussed.
Research in developmental disabilities, 2021 · doi:10.1016/j.ridd.2020.103836