Differentiating Autism Spectrum from CPTSD

[Armee]

For those of you with ASD diagnoses, how did you or your clinician differentiate between symptoms of ASD and CPTSD?

I just took a couple assessments...First the RAADS, which is for mild ASD that would escape clinical notice. This I scored 129 on which is clinically significant and indicative of ASD.  Since that was my result I then took the AQ where my total score of 34 was "consistent with ASD" and 3 of the 4 subscales were "pronounced." 1 scale was way below both normal and ASD (attention to detail).

On the 1 hand I can see how my symptoms of CPTSD could color my responses. On the other, my language development was delayed, my mom thought I had autism as a child, and I am nearly positive my mom was autistic.

I'm also curious if you have dual diagnoses if you find it helpful to have been evaluated and diagnosed for ASD?

[rainydiary]

I can't really speak to the differentiation between autism and CPTSD.  I often wonder to what extent it is wrapped up in stigma associated with autism. 

I was evaluated by a person that specializes in autism presentation in women/AFAB.  I mostly did the evaluation because I thought it would help me seek workplace accommodations.  That has not gone the way I hoped but I'm still glad I did the evaluation.

I have found identifying that I am autistic to be helpful in healing.  I accept myself more and do what works for me because I better understand myself. 

It's not always easy because autism is stigmatized and there is not supportive collective knowledge about autism.  It's also hard identifying this later in life and realizing that there aren't really any resources beyond what autistic people create for themselves.

[Kizzie]

I don't know if this helps but I Googled "What is the difference between autism and CPTSD?" and got this. I thought it was a fairly clear summary of how to distinguish between the two.

Cause - Autism is a neurodevelopmental condition that begins early in life, while CPTSD develops in response to trauma.

Social interaction - People with autism have long-standing social challenges, while people with CPTSD may withdraw from social interactions due to fear or distrust.

Emotional sharing - People with CPTSD may avoid sharing their emotions due to shame, guilt, or distrust, while people with autism may have difficulty communicating their emotions.

Other symptoms Both conditions can cause sensory sensitivities, repetitive behaviors, and difficulty regulating emotions.
Children who experience trauma early in life may display autism-like behaviors, which can lead to an autism diagnosis. However, a mental health professional can distinguish between the two conditions.

I know we've talked on here about CPTSD being an "acquired neurodiversity" due to changes in the brain from cumulative traumatic stress- here's one link: https://carescribe.io/blog/acquired-neurodiversity-an-overview/. 

Hope this is helpful.

[Armee]

Thanks Kizzie. Yeah that's helpful. Though that is more of an either/or examination while I am trying to wrap my mind around what about when it is both? Or how do you know if it is just CPTSD or if it is autism AND CPTSD? And does it matter? Does the therapeutic treatment for CPTSD address difficulties that might be from another condition like autism spectrum?

I think I'm willing to attribute my scores that are consistent with autism to a combination of CPTSD and then having aphantasia raises my autism scores on the imagination scale.

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Rainy thank you for including your experience. I'm so sorry that the attempt to request and receive appropriate accomodations didn't go the way they should have.

Did you for a time get any autism-related therapy? Did it help at all?

[rainydiary]

For me, I don't see autism as something that needs therapeutic intervention. I focus on strategies that affirm and support my needs as an autistic person. 

For me, being autistic is an identity and part of who I am.  I've found it most helpful to find ways to live authentically rather than focusing on changing this about myself. 

[Armee]

Thanks Rainy. Those are super good points.

[OwnSide]

The autism/complex trauma conundrum is a powerful interest of mine. Here's my take, as someone who is not diagnosed but currently gathering information in preparation for an assessment.

Consider that autism, as it is defined in the DSM-V/ICD-11 is symptom-based. It doesn't necessarily account for what causes those symptoms. Early life traumatic experiences could very well contribute to difficulties with social communication and relationships, sensory sensitivities, stimming, and need for sameness. Conversely, if you're someone that just naturally finds social communication more difficult than other people and has some quirks like sensory sensitivities, stimming, and need for sameness, you might find more of your day-to-day life experiences to be overwhelming and/or traumatic.

I've seen commentary on social media about how the diagnostic criteria for autism is based around autistic distress and does not describe what it would look like for an autistic person to thrive. I would suspect that diagnosable autism requires trauma by default because a diagnosis states that someone has a "disorder" that causes difficulty functioning. A person with autistic traits who has grown up in a supportive environment that has not traumatized them might not meet that criteria. Alternatively, an autistic person with complex trauma might cover their distress and difficulty functioning with a fawn response that makes their autistic traits more difficult for others to detect.

It can be a bit of a chicken and egg question where the outcome may not be an answer per se, but more of an identity formation/self-discovery process like rainydiary is describing. Coming to terms with autism and C-PTSD both involve reconciling with the past, learning to accept and support your limitations, and recognizing your strengths to build a sustainable future. The difference maker for me has been asking myself, "Where do I belong?" Do I belong with complex trauma survivors? Do I belong with autistic people? Do I feel like these are "my people"? Who in my community helps me feel understood and safe to be myself? Where can I find more of these people? These are questions I'm still working on, but working on them gives me some hope of being accepted (and accepting myself) without having to be defined.