Phenotypic divergence between individuals with self-reported autistic traits and clinically ascertained autism https://www.nature.com/articles/s44220-025-00385-8
So: "These findings highlight the need for a differentiation between clinically ascertained and trait-defined samples in autism research."
Quite a bit to take away from this study. Not least that if you are going to include the 'self-diagnosed' in your autism study, you perhaps need to say so in the title, abstract and body text, and potentially conduct separate analyses of any findings based on formally diagnosed with autism vs. self-diagnosed with autism. No, you can't honestly say your study is 'about autism' if not everyone in your cohort has received a formal professional diagnosis of autism. Sorry.
Further: "Despite having comparable self-reported autistic traits, the online high-trait group reported significantly more social anxiety and avoidant symptoms than in-person ASD participants."
This is another important point and so beautifully fits in with the ICD-11 diganostic description of autism, highlighting how there are 18 boundary conditions that can 'look like autism' but aren't autism. In this case, how the self-reported (in this cohort) may well have features that whilst looking like autism are more likely to stem from an anxiety or personality led disorder: https://icd.who.int/browse/2024-01/mms/en#437815624
I know such studies aren't going to make an iota of difference to those chained to the 'anyone can self-diagnose autism (replace with other behaviourally defined condition that doesn't have an objective diagnostic marker yet)' mindset. But for everyone else who does believe in science and the value of expert assessments, yet more proof that autistic traits are no longer the exclusive domain of a diagnosis of autism and the only way to tease out autism from 'condition(s) that manifests autistic traits' is via a comprehensive, expert-led assessment.
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