Adolescent trajectories of psychotic-like experiences and autistic traits and their association with cognition, environmental adversity, and white matter microstructure in the ABCD Study.
BACKGROUND Psychotic-like experiences (PLEs) and autistic traits across development are associated with poor mental health outcomes. However, the relationship between PLEs and autistic traits, and their links with clinical and biological predictors of longitudinal outcomes, remain poorly understood. METHODS PLEs and autistic traits were measured across a three year period using the Prodromal Questionnaire Brief and Child Behavior Checklist in 9,963 adolescents from the Adolescent Brain Cognitive Development Study®. Separate Growth Mixture Models identified trajectories for PLEs and autistic traits. Associations between trajectories with longitudinal internalizing and externalizing symptoms, cognition, environmental adversity, and harmonized diffusion measures of baseline fractional anisotropy (FA), were examined. RESULTS Four trajectories were found for both PLEs and autistic traits: persistently low, persistently elevated, increasing, and decreasing. Persistently low trajectories were associated with favorable profiles across measures. Increasing or persistently elevated PLEs were associated with lower baseline FA, cognition, and socioeconomic disadvantage and linked to worsening internalizing symptoms and environmental adversity. Persistently elevated autistic traits were associated with lower cognition, more environmental adversity, and reduced FA. Overlapping trajectories of co-elevated or increasing PLEs and autistic traits conferred the highest risk, with impairments across measures. Compared to only-elevated autistic traits, only-elevated PLEs were associated with lower psychopathology, higher family conflict and life events, lower cognition, and specific white matter alterations. CONCLUSIONS Adolescents with distinct longitudinal PLEs and autistic traits trajectories differed on psychopathology, cognitive performance, environmental adversity, and white matter microstructure. Examining trajectory-specific differences highlights heterogeneity in early adolescent neurodevelopment and may support the advancement of early-detection strategies for at-risk youth.