Bridging autism and psychosis: why childhood harm matters

Autism and psychosis share genetic and neurobiological underpinnings, have overlapping clinical features, and often co-occur. Here we examine the impact of intention-to-harm adverse childhood experiences (ACEs) on the autism-psychosis pathway. Preclinical and genomic studies indicate that neurodevelopmental and genetic vulnerabilities interact with social adversity to heighten risk of psychosis. Observational findings link bullying and abuse to stronger associations between autistic traits (ATs) and psychotic experiences (PEs), though confirmatory research is warranted. Transdiagnostic mental health services should systematically screen for harmful environmental stressors and implement resilience-building strategies for autistic or high-ATs individuals.