Coronavirus-19 (COVID-19) is transforming every aspect of our lives. Identified in late 2019, COVID-19 quickly became characterized as a global pandemic by March of 2020. Given the rapid acceleration of transmission, and the lack of preparedness to prevent and treat this virus, the negative impacts of COVID-19 are rippling through every facet of society. Although large numbers of people throughout the world will show resilience to the profound loss, stress, and fear associated with COVID-19, the virus will likely exacerbate existing mental health disorders and contribute to the onset of new stress-related disorders for many. The field of traumatic stress should address the serious needs that will emerge now and well into the future. However, we propose that these efforts may be limited, in part, by ongoing gaps that exist within our research and clinical care. In particular, we suggest that COVID-19 requires us to prioritize and mobilize as a research and clinical community around several key areas: (a) diagnostics, (b) prevention, (c) public outreach and communication, (d) working with medical staff and mainstreaming into nonmental health services, and (e) COVID-19-specific trauma research. As members of our community begin to rapidly develop and test interventions for COVID-19-related distress, we hope that those in positions of leadership in the field of traumatic stress consider limits of our current approaches, and invest the intellectual and financial resources urgently needed in order to innovate, forge partnerships, and develop the technologies to support those in greatest need. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Military personnel deployed to war zones are exposed to a broad array of traumatic events^1,2 and are at risk for posttraumatic stress disorder (PTSD) and other readjustment problems. Posttraumatic stress disorder can be debilitating, especially when complicated by comorbid depression and substance use.^3,4

While autism and trauma were often linked in psychoanalytic theory, very few scientific attempts have been made to explore the associations and comorbidity between the two. Instead, each area has grown separately, yielding large bodies of theoretical and clinical knowledge. In this article, we suggest several possible pathways that may link trauma and autism. First, autism spectrum disorder (ASD) may serve as a vulnerability marker for posttraumatic stress disorder (PTSD), specifically by increasing the risk for exposure to traumatic events. Second, PTSD, once it has appeared, may exacerbate certain ASD symptoms, for example, through maladaptive coping strategies and reduced help-seeking. Third, there may be shared underlying mechanisms for PTSD and ASD, including neurological abnormalities associated with both disorders, as well as cognitive and behavioral mechanisms, such as increased rumination, cognitive rigidity, avoidance, anger, and aggression. In addition, the unique characteristics of ASD may determine which events are experienced as particularly traumatic (e.g., social insults and degradation, sensory overstimulation, abrupt changes in known routines) and affect both the manifestation and severity of posttraumatic sequelae among diagnosed individuals. Research conducted separately in the areas of PTSD and ASD strongly suggests several potential pathways connecting both disorders. We conclude that there is a pressing need for more PTSD-ASD research, focusing not only on the prevalence of traumatic stress in individuals with autism, but also on their potentially unique perception of traumatic events, particularly from the social sphere. Such research may carry important clinical implications. (PsycINFO Database Record

People with Autism Spectrum Disorder show an increased risk of experiencing potentially traumatic events, particularly social victimization. However, Autism Spectrum Disorder and Post-Traumatic Stress Disorder co-occurrence was hardly studied. We examined exposure to potentially traumatic life events and PTSD symptoms in adults with Autism Spectrum Disorder vs typical adults. Twenty-five adults with Autism Spectrum Disorder and 25 typical adults were comparable on age and gender. Participants self-reported on potentially traumatic life events of social and non-social nature, and on PTSD symptoms related to their most distressing event. Results showed higher rates of probable-Post-Traumatic Stress Disorder in the Autism Spectrum Disorder group (32%) compared with the typical adults group (4%). Individuals with Autism Spectrum Disorder reported more PTSD symptoms, particularly re-experiencing and hyper-arousal, compared with typical adults, although the latter was elevated only in females with Autism Spectrum Disorder. Participants with Autism Spectrum Disorder, especially females, reported more negative life events, particularly social events, than typical adults. Sixty percent of Autism Spectrum Disorder participants, but only 20% of typical adults, chose a social event as their most distressing event. Individuals with Autism Spectrum Disorder and probable-Post-Traumatic Stress Disorder co-occurrence presented poorer social skills compared with those with Autism Spectrum Disorder alone. Results indicate increased vulnerability of individuals with Autism Spectrum Disorder to trauma and Post-Traumatic Stress Disorder, especially due to social stressors. Females with Autism Spectrum Disorder may be particularly vulnerable to Post-Traumatic Stress Disorder. Lay People with Autism Spectrum Disorder show an increased risk of experiencing traumatic events, particularly social victimization. However, Autism Spectrum Disorder and Post-Traumatic Stress Disorder co-occurrence was hardly studied. We examined exposure to traumatic life events and Post-Traumatic Stress Disorder symptoms in adults with Autism Spectrum Disorder vs typical adults. Two groups took part in this study: Twenty-five adults with Autism Spectrum Disorder and 25 typical adults of similar age and male to female ratio. Participants completed questionnaires on potentially traumatic life events of social and non-social nature, as well as on Post-Traumatic Stress Disorder symptoms related to their most distressing event. Participants also filled out an autism traits questionnaire. Results showed a higher Post-Traumatic Stress Disorder rate in the Autism Spectrum Disorder group (32%) compared with the typical group (4%). Individuals with Autism Spectrum Disorder reported more Post-Traumatic Stress Disorder symptoms, particularly re-experiencing and increased physiological arousal, compared with typical adults, although the latter was elevated only in females with Autism Spectrum Disorder. Participants with Autism Spectrum Disorder, especially females, reported more negative life events, particularly social events, than typical adults. Sixty percent of Autism Spectrum Disorder participants, but only 20% of typical participants, chose a social event as their most distressing event. Individuals with Autism Spectrum Disorder who were also suspected as having Post-Traumatic Stress Disorder (based on their questionnaires) presented poorer social skills compared with those with Autism Spectrum Disorder alone. Results indicate that individuals with Autism Spectrum Disorder are more susceptible to trauma and Post-Traumatic Stress Disorder, particularly due to social stressors. Females with Autism Spectrum Disorder may be especially vulnerable to Post-Traumatic Stress Disorder.