Co-occurrence of autistic and psychotic traits: implications for depression, self-harm and suicidality

Abstract

Background There is increasing interest in the clinical and aetiological overlap between autism spectrum disorders and schizophrenia spectrum disorders, reported to co-occur at both diagnostic and trait levels. Individually, sub-clinical autistic and psychotic traits are associated with poor clinical outcomes, including increased depressive symptomatology, self-harming behaviour and suicidality. However, the implications when both traits co-occur remain poorly understood. The study aimed to (1) examine the relationship between autistic and psychotic traits and (2) determine if their co-occurrence increases depressive symptomatology, self-harm and suicidality. Methods Cross-sectional data from a self-selecting (online and poster advertising) sample of the adult UK population (n = 653) were collected using an online survey. Validated self-report measures were used to assess sub-clinical autistic and psychotic traits, depressive symptomatology, self-harming behaviour and suicidality. Correlation and regression analyses were performed. Results A positive correlation between sub-clinical autistic and positive psychotic traits was confirmed (rs = 0.509, p < 0.001). Overall, autistic traits and psychotic traits were, independently, significant predictors of depression, self-harm and suicidality. Intriguingly, however, depression was associated with a negative interaction between the autistic domain attention to detail and psychotic traits. Conclusions This study supports previous findings that sub-clinical autistic and psychotic traits are largely independently associated with depression, self-harm and suicidality, and is novel in finding that their combined presence has no additional effect on depression, self-harm or suicidality. These findings highlight the importance of considering both autistic and psychotic traits and their symptom domains in research and when developing population-based depression prevention and intervention strategies.

Autism Spectrum Disorder and Clinical High Risk for Psychosis: A Systematic Review and Meta-analysis

“…There has been an increasing interest in the overlap of ASD and prodromal symptoms of psychosis (Chisholm et al, 2015 ; Sampson et al, 2020 ). The shared clinical features among both conditions include unusual thought content, deficits in social interaction, and stereotyped behaviours (De Crescenzo et al, 2019 ; Hommer & Swedo, 2015 ).…”

Personality Traits, Dimensions, and Suicidal Behavior in Posttraumatic Stress Disorder: Results From a Cross-Sectional Study in a Mexican Hospital

“…On the other hand, our correlation analysis also demonstrated a significant relationship between schizotypal traits and self-harm. Such a finding is also interesting, bearing in mind that a recent report found that self-harm was associated with psychotic traits, without specifically addressing schizotypal ones [ 24 ]. In fact, past research has shown that people with these traits are at increased risk for social withdrawal and isolation, which might explain this association [ 25 ].…”

How Cognitive Control, Autistic and Schizotypal Traits Shape Context Adaptation of Divergent Thinking

“…First, the sample consisted of students only and thus may not be representative of the general population. However, by sampling from different universities and fields of study, in which certain traits are clearly more represented (see Table 1), the distribution of these traits in our overall sample might approximate their distribution within the general population (see Sampson et al, 2020). Second, the results of the context adaptation task may be limited by the instructions, which did not explicitly ask participants to draw creative objects, but to draw as many objects as possible.…”

“…A parallel line of research stems from the association of underlying cognitive styles with certain psychopathologies, such as autism and schizophrenia, and their expression at nonclinical, personality-variation levels with enhanced creative abilities (Acar, Chen, & Cayirdag, 2018;Fitzgerald & Lyons, 2013). We focus on autistic and positive schizotypal traits-subthreshold features of autism and schizophrenia within the neurotypical population-because they have been proposed to play prominent roles in both divergent thinking (Abu-Akel et al, 2020;Claridge & McDonald, 2009;Crespi, Leach, Dinsdale, Mokkonen, & Hurd, 2016;Jung, 2014) and cognitive control-related processes (Abu-Akel, Apperly, Spaniol, Geng, & Mevorach, 2018;Spaniol, Shalev, & Mevorach, 2018), and because they can co-occur in the same individual (Abu-Akel, Wood, Hansen, & Apperly, 2015;Sampson et al, 2020;Sierro, Rossier, & Mohr, 2016).…”