A Guide To The Differences And Similarities Of Autism And CPTSD

Autism and complex post-traumatic stress disorder (CPTSD) are both neurological conditions that affect how individuals experience the world, but they are distinctly different. Despite similarities in some of their symptoms, the causes and treatments for these conditions vary. 

To understand how autism and CPTSD compare, we must first understand each condition.

What is PTSD?

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that may occur in individuals who have experienced severe trauma. There are many potential causes of PTSD, including being involved in a serious accident, witnessing violence, or being in a war or conflict.

Characterized by the failure to recover after a traumatic event, PTSD comes with symptoms of chronic or unexplained anxiety, flashbacks, or nightmares relating to the incident. There may also be feelings of detachment from friends and family. These symptoms are challenging for many, making day-to-day life difficult. 

PTSD can last months or years, with certain places or situations triggering memories of the event, often accompanied by intense physical and mental reactions. Those with PTSD usually change their behavior. They avoid triggering situations that may cause an uncomfortable response.

What is CPTSD?

Complex post-traumatic stress disorder¹ is similar to PTSD but has different potential causes and additional symptoms. Classical PTSD results from a single traumatic event, while CPTSD is often developed over many years from repeated traumas, such as continuous childhood abuse or domestic violence.

Individuals are at a higher risk of developing CPTSD if their traumas occur from a  young age or are perpetrated by someone close to them.

CPTSD often comes with drastic changes in the way a person lives their life. In fact, an older name for CPTSD was “Enduring Personality Change After Catastrophic Event” (EPCACE), a reference to the significant alterations to the personality of those suffering from CPSTD.

CPTSD symptoms include all PTSD symptoms, but with the addition of emotional dysregulation, negative self-cognitions, and interpersonal hardship. 

In addition to PTSD symptoms, CPTSD patients may also experience:

• Constant anger or distrust of the world

• Intense feelings of emptiness

• Dissociative symptoms like depersonalization and derealization

• Consistent difficulties remaining calm

CPTSD is a serious psychiatric condition that significantly affects those suffering from it, potentially leading to significant changes in that person’s personality and how they relate to the world. Many symptoms of borderline personality disorder (BPD)² overlap with those of CPTSD.

What is autism spectrum disorder?

Autism spectrum disorder (ASD), simply known as autism, is a life-long condition affecting how someone interprets the world, communicates and interacts with others, and thinks and behaves.

A broad range of conditions characterized by problems with social skills, repetitive behaviors, and communication challenges, ASD can significantly impact how independent a person can be.

ASD occurs in roughly 1 in 44 children. It’s usually diagnosed at 2–3 years of age but can sometimes be diagnosed as early as 18 months. 

Causes of autism spectrum disorder

The causes of autism are not well understood. It’s believed that both genetic and environmental factors play a role. 

Researchers³ believe that genetics are important because the risk of autism is higher in children with a family history of the disorder. However, the reasons for this are not well-understood.

Environmental factors have also been found to be important. For example, older parents are more likely to have a child with ASD than younger parents. Problems during pregnancy or birth also increase the risk, and the mother’s diet during pregnancy seems to be important in determining her child’s risk of developing ASD.

Symptoms of autism spectrum disorder

Those diagnosed with ASD exhibit several symptoms. These are primarily related to difficulties with social interaction and susceptibility to sensory overload. 

ASD patients often don’t make eye contact, struggle to hold a conversation, and find it difficult to understand others’ reactions, emotions, and motivations.

Repetitive or restrictive symptoms may also appear. These include repeating certain behaviors, having an intense interest in a subject, or being severely upset by small changes in their routine. Difficulties sleeping are also common in those with ASD.

Those on the autism spectrum may also have strengths associated with their condition, such as being visual and auditory learners, having excellent memory and recall, and excelling in subjects like science and music. 

How do CPTSD and autism compare?

CPTSD and autism have similar symptoms, but the root cause of these behaviors is different. ASD starts during the process of development of the nervous system and begins very early in life. 

By contrast, CPTSD develops in response to a traumatic situation.

Individuals with CPTSD or ASD can both exhibit a reduced interest in social interactions. For those with CPTSD, this stems from social withdrawal, as the affected person feels afraid of others and finds it hard to trust them. 

Those with ASD simply don’t get as much benefit from social interaction as others do, making it less appealing to them.

Both disorders can also cause difficulties in sharing emotions. Those suffering from CPTSD may avoid sharing their emotions because they don’t trust others or feel intense shame and guilt. 

By contrast, those with ASD have a reduced social communication ability and can’t quite figure out how to tell others about their emotions.

If a child develops CPTSD due to trauma early in life, they could also be misdiagnosed with autism. However, a mental health professional should be able to distinguish these two conditions because they are different.

The lowdown

CPTSD and ASD are different conditions, although certain aspects of the symptoms can overlap. Talk to a doctor if you are concerned that you or someone you know may have one of these conditions. There are many options for managing the symptoms, which allow for a fulfilling and happy life.

Frequently asked questions

Can complex PTSD be misdiagnosed as autism?

Yes, the two conditions have many overlapping symptoms and may occasionally confuse each other. A clinician could misinterpret why the child isn’t communicating well and connecting with others. 

It’s certainly possible that a child with autism could also develop PTSD. Making this second diagnosis, however, can be very challenging given the overlap in symptoms.

Is PTSD common in those diagnosed with autism?

The risk of PTSD is higher in those who are more likely to experience significant traumatic events in their life, which is the case for those with ASD. 

Those with autism experience sensory overload more quickly than others, making them more susceptible to developing PTSD. A recent study⁴ showed up to 60% of ASD individuals had experienced PTSD-like symptoms in their life, compared to 6.8%⁵ in the general population.

What does PTSD look like in autism?

Those with autism often experience the sensory-related symptoms of PTSD more strongly than those without an ASD diagnosis. 

Although all people with autism tend to be more reactive to situations than others, those who also have PTSD will experience this to a greater degree. They may also experience an increase in symptoms like anxiety and insomnia.