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      Robust association between autistic traits and psychotic-like experiences in the adult general population: epidemiological study from the 2007 Adult Psychiatric Morbidity Survey and replication with the 2014 APMS

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          Abstract

          Background

          Studies have shown that there are overlapping traits and symptoms between autism and psychosis but no study to date has addressed this association from an epidemiological approach in the adult general population. Furthermore, it is not clear whether autistic traits are associated with specific symptoms of psychosis or with psychosis in general. We assess these associations for the first time by using the Adult Psychiatric Morbidity Survey (APMS) 2007 and the APMS 2014, predicting an association between autistic traits and probable psychosis, and specific associations between autistic traits and paranoia and strange experiences.

          Methods

          Participants ( N = 7353 in 2007 and 7500 in 2014) completed the Psychosis Screening Questionnaire (PSQ) and a 20-item version of the Autism Quotient (AQ-20). Binomial logistic regressions were performed using AQ-20 as the independent variable and probable psychosis and specific symptoms as dependent variables.

          Results

          In the APMS 2007 dataset, significant associations were found between autism traits and probable psychosis, paranoia, thought insertion, and strange experiences. These results were replicated in APMS 2014 but with the additional significant association between autistic traits and hallucinations. Participants in the highest quartile of the AQ-20, compared with the lowest quartile, had an increased risk of probable psychosis of odds ratio (OR) = 15.5 [95% confidence interval (CI) 4.57–52.6] in APMS 2007 and OR = 22.5 (95% CI 7.64–66.3) in APMS 2014.

          Conclusions

          Autistic traits are strongly associated with probable psychosis and psychotic experiences with the exception of mania. Limitations such as the cross-sectional nature of the study are discussed.

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          Most cited references33

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          A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder.

          A systematic review of all reported incidence and prevalence studies of population rates of subclinical psychotic experiences reveals a median prevalence rate of around 5% and a median incidence rate of around 3%. A meta-analysis of risk factors reveals associations with developmental stage, child and adult social adversity, psychoactive drug use, and also male sex and migrant status. The small difference between prevalence and incidence rates, together with data from follow-up studies, indicates that approximately 75-90% of developmental psychotic experiences are transitory and disappear over time. There is evidence, however, that transitory developmental expression of psychosis (psychosis proneness) may become abnormally persistent (persistence) and subsequently clinically relevant (impairment), depending on the degree of environmental risk the person is additionally exposed to. The psychosis proneness-persistence-impairment model considers genetic background factors impacting on a broadly distributed and transitory population expression of psychosis during development, poor prognosis of which, in terms of persistence and clinical need, is predicted by environmental exposure interacting with genetic risk.
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            Autistic traits in the general population: a twin study.

            Recent research has indicated that autism is not a discrete disorder and that family members of autistic probands have an increased likelihood of exhibiting autistic symptoms with a wide range of severity, often below the threshold for a diagnosis of an autism spectrum disorder. To examine the distribution and genetic structure of autistic traits in the general population using a newly established quantitative measure of autistic traits, the Social Responsiveness Scale (formerly known as the Social Reciprocity Scale). The sample consisted of 788 pairs of twins aged 7 to 15 years, randomly selected from the pool of participants in a large epidemiologic study (the Missouri Twin Study). One parent of each pair of twins completed the Social Responsiveness Scale on each child. The data were subjected to structural equation modeling. Autistic traits as measured by the Social Responsiveness Scale were continuously distributed and moderately to highly heritable. Levels of severity of autistic traits at or above the previously published mean for patients with pervasive developmental disorder not otherwise specified were found in 1.4% of boys and 0.3% of girls. Structural equation modeling revealed no evidence for the existence of sex-specific genetic influences, and suggested specific mechanisms by which females may be relatively protected from vulnerability to autistic traits. These data indicate that the social deficits characteristic of autism spectrum disorders are common. Given the continuous distribution of these traits, it may be arbitrary where cutoffs are made between research designations of being "affected" vs "unaffected" with a pervasive developmental disorder. The genes influencing autistic traits appear to be the same for boys and girls. Lower prevalence (and severity) of autistic traits in girls may be the result of increased sensitivity to early environmental influences that operate to promote social competency.
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              Is Open Access

              Do Student Samples Provide an Accurate Estimate of the General Public?

              Most psychological studies rely on student samples. Students are usually considered as more homogenous than representative samples both within and across countries. However, little is known about the nature of the differences between student and representative samples. This is an important gap, also because knowledge about the degree of difference between student and representative samples may allow to infer from the former to the latter group. Across 59 countries and 12 personality (Big-5) and attitudinal variables we found that differences between students and general public were partly substantial, incoherent, and contradicted previous findings. Two often used cultural variables, embeddedness and intellectual autonomy, failed to explain the differences between both groups across countries. We further found that students vary as much as the general population both between and within countries. In summary, our results indicate that generalizing from students to the general public can be problematic when personal and attitudinal variables are used, as students vary mostly randomly from the general public. Findings are also discussed in terms of the replication crisis within psychology.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Psychological Medicine
                Psychol. Med.
                Cambridge University Press (CUP)
                0033-2917
                1469-8978
                November 2021
                May 22 2020
                November 2021
                : 51
                : 15
                : 2707-2713
                Article
                10.1017/S0033291720001373
                32441234
                3ff9ab5b-4917-41b3-9cc7-d40ee1b00eb3
                © 2021

                https://www.cambridge.org/core/terms

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