Clinical Evidence for Increased Dissociative Experiences in Adults with High Levels of Autistic Traits: A Comparative Study

Abstract

ABSTRACT Autism spectrum disorder (ASD) is associated with a variety of mental health conditions, including dissociation. In addition to high rates of trauma exposure, vulnerability for dissociation in autism may be heightened by social differences, cognitive inflexibility, and sensory sensitivities. This study examined dissociative symptoms across levels of autistic traits using existing clinical data from 716 individuals receiving mental health care (“clients”) in Australia. Clients completed the Multidimensional Inventory of Dissociation-60 (MID-60), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), and the Adverse Childhood Experiences Questionnaire (ACE-Q) or Life Events Checklist for DSM-5 (LEC-5). Clients were grouped according to their RAADS-R scores, measuring autistic traits. Analyses first compared those with high autistic traits (HA; ≥120; n = 338) to below-threshold autistic traits (BA; <120; n = 378). The latter group was then subdivided into those with moderate autistic traits (MA; 65–119; n = 214) and low autistic traits (LA; <65; n = 164) for more comprehensive analysis. HA clients had the highest scores on all trauma and dissociation measures and subscales, and clinically elevated dissociation was significantly more prevalent among HA clients (68%) than BA clients (33%; OR = 4.42) and LA clients (15%; OR = 12.59). MA clients also scored higher than LA clients in almost all domains. Autistic traits and dissociation severity were significantly correlated overall and for all subscales, with the strongest correlations found for the RAADS-R Sensory-Motor domain. All relationships remained significant after controlling for ACEs. This highlights the need for routine screening and tailored interventions addressing both autistic traits and dissociation.