Autistic traits and psychotic experiences in the general population: A moderated mediation model based on 7646 young adults from 12 Arab nations

Abstract

Abstract Most previous studies on the link of autistic traits (ATs) to psychotic experiences (PEs) were performed in clinical populations; hence, the need for further examination of this relationship within the extended autism-and psychosis-phenotypes in the general population. This study aimed to test the following hypotheses: (1) ATs will be positively related to PEs; (2) alexithymia will act as a mediator between ATs and PEs; (3) childhood trauma will moderate the mediation model of alexithymia between ATs and PEs. This cross-sectional research took place in 12 Arab countries among 7,646 young adults. The Autism-Spectrum Quotient-28, Prodromal Questionnaire-Brief, Toronto Alexithymia Scale, and Childhood trauma Self-Report Scale-12 were used. Analysis was done using PROCESS-Macro model-7 in SPSS. Childhood abuse significantly moderated the association between ATs and alexithymia. Higher ATs were significantly associated with higher alexithymia, and this association was stronger at lower than higher levels of childhood abuse. In turn, higher alexithymia was significantly associated with higher PEs. The direct association between ATs and PEs remained significant. The conditional indirect effect of ATs on PEs through alexithymia was significant at low, moderate, and high levels of childhood abuse. Furthermore, the index of moderated mediation was significant, indicating that childhood abuse significantly moderated the indirect association between ATs and PEs through alexithymia. The current results suggest that alexithymia and childhood trauma seem to be key factors that should be considered together as specific targets for treatment to improve the severity of psychotic symptoms and even possibly prevent psychosis in highly autistic young adults.