The comorbidity between autism spectrum disorder and post-traumatic stress disorder is mediated by brooding rumination.
Brooding rumination is the missing link that turns autism traits into PTSD—treat the brooding, lower the trauma risk.
01Research in Context
What this study did
Ofer et al. (2022) asked adults with and without autism about PTSD symptoms and rumination.
They used surveys to see if brooding—the stuck, what-if kind of rumination—links autism to higher PTSD scores.
What they found
Autistic adults reported more PTSD symptoms than non-autistic adults.
Brooding rumination explained most of that gap, acting as the bridge between autism traits and trauma stress.
How this fits with other research
Ghaziuddin et al. (2002) already warned that depression is the top psychiatric partner in autism; Ofer shows one reason why—brooding keeps trauma alive.
Greenlee et al. (2024) found a different mental-health path: camouflaging behaviours, not brooding, drained wellbeing in autistic adults. Together the papers say, "Check both what people think and what they hide."
South et al. (2017) urge ASD-tuned anxiety tools; Ofer adds, "Add brooding probes to your intake—it's a PTSD risk flag.
Why it matters
If brooding drives PTSD in autistic clients, teaching brief distraction or reappraisal skills may cut trauma fallout. Add one brooding item to your intake today and you already narrow the target for your next session.
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02At a glance
03Original abstract
Autism spectrum disorder is a neurodevelopmental condition characterized by social communication difficulties and restricted repetitive behaviors. Individuals with autism spectrum disorder are often diagnosed with other psychiatric conditions, including attention deficit hyperactivity disorder, anxiety, and depression. However, research on post-traumatic stress disorder among individuals with autism spectrum disorder is scarce. Nonetheless, studies have shown that those with autism spectrum disorder may face an increased risk of exposure to traumatic events. Separate lines of research in autism spectrum disorder and post-traumatic stress disorder have shown that the two may share several vulnerability factors. One of those is ruminative thinking, that is, one's tendency to re-hash thoughts and ideas, in a repetitive manner. This article examined the role of two rumination types as potential factors connecting autism spectrum disorder and post-traumatic stress disorder: brooding (continuously comparing one's current condition to one's desired condition) and reflection (an introspective effort to cognitively solve one's problems). A total of 34 adults with autism spectrum disorder (with no intellectual impairment) and 66 typically developing adults completed questionnaires assessing post-traumatic stress disorder symptoms and rumination. The results showed increased post-traumatic stress disorder symptoms in adults with autism spectrum disorder, compared to typically developing adults. Brooding rumination was also higher among those with autism spectrum disorder. Finally, brooding, but not reflection, served as a mechanism connecting autism spectrum disorder and post-traumatic stress disorder, that is, those with autism spectrum disorder showed increased brooding, which in turn predicted more post-traumatic stress disorder symptoms. This study has potential clinical implications. Rumination and cognitive inflexibility, which are common in autism spectrum disorder, could exacerbate post-traumatic symptoms among individuals with autism spectrum disorder who experience traumatic events. Interventions targeting brooding rumination and cognitive flexibility may assist in alleviating post-traumatic symptoms in individuals with autism spectrum disorder.
Autism : the international journal of research and practice, 2022 · doi:10.1177/13623613211035240