51
|
Abstract
Obsessive-compulsive disorder (OCD) and Autism spectrum disorder (ASD) are both highly heritable neurodevelopmental disorders that conceivably share genetic risk factors. However, the underlying genetic determinants remain largely unknown. In this work, the authors describe a combined genome-wide association study (GWAS) of ASD and OCD. The OCD dataset includes 2998 individuals in nuclear families. The ASD dataset includes 6898 individuals in case-parents trios. GWAS summary statistics were examined for potential enrichment of functional variants associated with gene expression levels in brain regions. The top ranked SNP is rs4785741 (chromosome 16) with P value=6.9×10-7 in our re-analysis. Polygenic risk score analyses were conducted to investigate the genetic relationship within and across the two disorders. These analyses identified a significant polygenic component of ASD, predicting 0.11% of the phenotypic variance in an independent OCD data set. In addition, we examined the genomic architecture of ASD and OCD by estimating heritability on different chromosomes and different allele frequencies, analyzing genome-wide common variant data by using the Genome-wide Complex Trait Analysis (GCTA) program. The estimated global heritability of OCD is 0.427 (se=0.093) and 0.174 (se=0.053) for ASD in these imputed data.
Collapse
|
52
|
Barnhill J, Bedford J, Crowley J, Soda T. A search for the common ground between Tic; Obsessive-compulsive and Autism Spectrum Disorders: part I, Tic disorders. AIMS GENETICS 2017; 4:32-46. [PMID: 31435502 PMCID: PMC6690237 DOI: 10.3934/genet.2017.1.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/09/2017] [Indexed: 01/14/2023]
Abstract
This article is the first of four articles designed to explore the complex interrelationship between Autism Spectrum Disorders (ASD); Obsessive compulsive and Related Disorders (OCRD) and Tic Disorders/Tourette's Syndrome (TD/TS). We begin with an overview TD/TS and follow-up with reviews of OCRD and ASD. The final article in this series represents a synthesis of the neurobiological and genetic markers shared by patients presenting with all three syndromes. The goal is to describe the complex endophenotype of these patients in an effort to better define gene markers that underlie these heterogeneous clinical syndromes. Tic disorders (TD) are a collection of hyperkinetic movements that begin in early childhood. Tics are transient for most affected preschool children but a subgroup development persistent movements or progress to develop Tourette Syndrome (TS). TDs as a group display high heritability rates but definitive gene markers still elude us. The difficulty defining genetic markers is in large part due to the diverse neurodevelopmental trajectory, changing topography and typology, development of a broad spectrum of neurocognitive and behavioral complications, and a mixed pattern of psychiatric comorbidities.
Collapse
Affiliation(s)
- Jarrett Barnhill
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - James Bedford
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - James Crowley
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA.,Department of Genetics, University of North Carolina, Chapel Hill, NC, USA.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Takahiro Soda
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| |
Collapse
|
53
|
Merricks KL, Nadeau JM, Ramos A, Storch EA. A Case Report of Intensive Exposure-Based Cognitive Behavioral Therapy for a Child With Comorbid Autism Spectrum Disorder and Obsessive-Compulsive Disorder. J Cogn Psychother 2017; 31:118-123. [PMID: 32755932 DOI: 10.1891/0889-8391.31.2.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) has proven to be an effective treatment modality for children with obsessive-compulsive disorder (OCD). Less research exists demonstrating efficacy for this treatment modality among children with comorbid diagnoses of OCD and autism spectrum disorder (ASD), and virtually, nothing has been reported examining intensive interventions for the most severe cases. As such, this article discusses the treatment of an adolescent male with severe OCD comorbid with ASD, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), and chronic tic disorder using a cognitive behavioral approach and ERP. We conclude with recommendations for continued clinical research to understand approaches to help nonresponders to standard therapeutic approaches with this challenging population.
Collapse
|
54
|
Hughes J, Simner J, Baron-Cohen S, Treffert D, Ward J. Is Synaesthesia More Prevalent in Autism Spectrum Conditions? Only Where There Is Prodigious Talent. Multisens Res 2017; 30:391-408. [DOI: 10.1163/22134808-00002558] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 02/19/2017] [Indexed: 12/28/2022]
Abstract
Savant syndrome is a condition where prodigious talent co-occurs with developmental difficulties such as autism spectrum conditions (ASC). To better understand savant skills, we previously proposed a link with synaesthesia: that savant syndrome may arise in ASC individuals who also happen to have synaesthesia. A second, unrelated claim is that people with autism may have higher rates of synaesthesia. Here we ask whether synaesthesia is indeed found more often in autism per se, or only in cases where autism co-occurs with savant skills. People with autism in previous studies when tested for synaesthesia were not differentiated into those with and without savant abilities. Here we tested three groups: people with autism who also have savant skills (), people with autism without savant skills (), and controls without autism (). We used a validated test to diagnose grapheme–colour synaesthesia. Results show a significantly higher prevalence of synaesthesia in people with ASC, but only those who also have savant skills. This suggests that synaesthesia in autism is linked to those with savant abilities rather than autism per se. We discuss the role of synaesthesia in the development of prodigious talent.
Collapse
Affiliation(s)
- James E. A. Hughes
- School of Psychology, Pevensey Building, University of Sussex, BN1 9QJ, UK
| | - Julia Simner
- School of Psychology, Pevensey Building, University of Sussex, BN1 9QJ, UK
- Department of Psychology, University of Edinburgh, 7 George Square, EH8 9JZ, UK
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge CB2 8AH, UK
| | - Darold A. Treffert
- Agnesian HealthCare, 430 East Division Street, Fond du Lac, WI 54935, USA
| | - Jamie Ward
- School of Psychology, Pevensey Building, University of Sussex, BN1 9QJ, UK
| |
Collapse
|
55
|
van der Plas E, Dupuis A, Arnold P, Crosbie J, Schachar R. Association of Autism Spectrum Disorder with Obsessive-Compulsive and Attention-Deficit/Hyperactivity Traits and Response Inhibition in a Community Sample. J Autism Dev Disord 2016; 46:3115-25. [DOI: 10.1007/s10803-016-2853-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
56
|
Arildskov TW, Højgaard DRMA, Skarphedinsson G, Thomsen PH, Ivarsson T, Weidle B, Melin KH, Hybel KA. Subclinical autism spectrum symptoms in pediatric obsessive-compulsive disorder. Eur Child Adolesc Psychiatry 2016; 25:711-23. [PMID: 26518580 DOI: 10.1007/s00787-015-0782-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 10/05/2015] [Indexed: 12/23/2022]
Abstract
The literature on subclinical autism spectrum (ASD) symptoms in pediatric obsessive-compulsive disorder (OCD) is scarce, and it remains unclear whether ASD symptoms are related to OCD severity. The aims of the present study were to assess the prevalence of ASD symptoms and age and sex differences in children and adolescents with OCD, and to explore the relation between ASD symptoms and OCD severity. This is the largest study of ASD symptoms in an OCD population to date, and the first directly aimed at elucidating sex and age differences in this matter. The study used baseline data from the Nordic Long-term OCD Treatment Study in which parents of 257 children and adolescents with OCD aged 7-17 completed the Autism Spectrum Screening Questionnaire. OCD severity was assessed with the Children's Yale-Brown Obsessive Compulsive Scale. Pediatric OCD patients were found to exhibit elevated rates of ASD symptoms compared to a norm group of school-age children. ASD symptoms were concentrated in a subgroup with a prevalence of 10-17 %. This subgroup was characterized by a male preponderance with a sex ratio of approximately 2.6:1, while children versus adolescents with OCD exhibited similar rates. Autism-specific social and communication difficulties were not related to OCD severity, while restricted repetitive behavior was positively related to OCD severity. The results indicate that clinicians need to be aware of ASD symptoms in children and adolescents with OCD since one out of ten exhibits such symptoms at a clinical sub-threshold.
Collapse
Affiliation(s)
- Trine Wigh Arildskov
- Research Department, Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Skovagervej 2, entry 81, 8240, Risskov, Denmark.
| | - David R M A Højgaard
- Research Department, Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Skovagervej 2, entry 81, 8240, Risskov, Denmark
| | - Gudmundur Skarphedinsson
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway
| | - Per Hove Thomsen
- Research Department, Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Skovagervej 2, entry 81, 8240, Risskov, Denmark
| | - Tord Ivarsson
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484, Oslo, Norway
| | - Bernhard Weidle
- Department of Child and Adolescent Psychiatry, St. Olavs University Hospital and Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Klostergate 46, 7491, Trondheim, Norway
| | - Karin Holmgren Melin
- Department of Child and Adolescent Psychiatry, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Katja A Hybel
- Research Department, Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Skovagervej 2, entry 81, 8240, Risskov, Denmark
| |
Collapse
|
57
|
Romero M, Aguilar JM, Del-Rey-Mejías Á, Mayoral F, Rapado M, Peciña M, Barbancho MÁ, Ruiz-Veguilla M, Lara JP. Psychiatric comorbidities in autism spectrum disorder: A comparative study between DSM-IV-TR and DSM-5 diagnosis. Int J Clin Health Psychol 2016; 16:266-275. [PMID: 30487870 PMCID: PMC6225088 DOI: 10.1016/j.ijchp.2016.03.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/29/2016] [Indexed: 12/19/2022] Open
Abstract
Background/Objective: The heterogeneous clinical presentations of individuals with Autism Spectrum Disorders (ASD) pose a significant challenge for sample characterization. Therefore the main goal of DSM-5 must be to identify subgroups of ASD, including comorbidity disorders and severity. The main goal of this study is to explore the psychiatric comorbidities and the severity of symptoms that could be relevant for the phenotype characterization in ASD and also to compare these results according to the different classification criteria between the DSM-IV-TR and the DSM-5. Method: A comparative study of severity and psychiatric comorbidities was carried out between a sample of participants that only met criteria for Pervasive Developmental Disorder (PDD) according to the DSM-IV-TR and a sample of participants that also met ASD criteria according to DSM-5 classification. The recruitment of children was via educational (N = 123). The psychiatric symptoms, comorbid disorders and severity of symptoms were assessed through The Nisonger Child Behavior Rating Form, clinical interview and The Inventory of Autism Spectrum Disorder, respectively. The psychiatric comorbidities considered were: anxiety, eating behavioural problems, self-aggressiveness, hetero–aggressiveness, self-harm, obsessive compulsive disorder and attention deficit and hyperactivity disorder. Results: Statistically significant differences between both groups were found regarding obsessive compulsive disorder, eating behavioural problems and severity. Conclusions: The results support the hypothesis that patients who meet the DSM-5 criteria have more severe symptoms, not only regarding the core autistic symptoms but also in relation with psychiatric comorbidities.
Collapse
Affiliation(s)
- Marina Romero
- King's College London, United Kingdom
- Universidad de Málaga, Andalucía TECH, IBIMA, Spain
- Corresponding author: Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom.
| | | | | | | | - Marta Rapado
- Hospital General Universitario Gregorio Marañón Madrid, Spain
| | | | | | | | | |
Collapse
|
58
|
Kim H, Lim CS, Kaang BK. Neuronal mechanisms and circuits underlying repetitive behaviors in mouse models of autism spectrum disorder. Behav Brain Funct 2016; 12:3. [PMID: 26790724 PMCID: PMC4719705 DOI: 10.1186/s12993-016-0087-y] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/05/2016] [Indexed: 12/30/2022] Open
Abstract
Autism spectrum disorder (ASD) refers to a broad spectrum of neurodevelopmental disorders characterized by three central behavioral symptoms: impaired social interaction, impaired social communication, and restricted and repetitive behaviors. However, the symptoms are heterogeneous among patients and a number of ASD mouse models have been generated containing mutations that mimic the mutations found in human patients with ASD. Each mouse model was found to display a unique set of repetitive behaviors. In this review, we summarize the repetitive behaviors of the ASD mouse models and variations found in their neural mechanisms including molecular and electrophysiological features. We also propose potential neuronal mechanisms underlying these repetitive behaviors, focusing on the role of the cortico-basal ganglia-thalamic circuits and brain regions associated with both social and repetitive behaviors. Further understanding of molecular and circuitry mechanisms of the repetitive behaviors associated with ASD is necessary to aid the development of effective treatments for these disorders.
Collapse
Affiliation(s)
- Hyopil Kim
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, 1 Gwanangno, Gwanak-gu, Seoul, 08826, South Korea.
| | - Chae-Seok Lim
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, 1 Gwanangno, Gwanak-gu, Seoul, 08826, South Korea.
| | - Bong-Kiun Kaang
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, 1 Gwanangno, Gwanak-gu, Seoul, 08826, South Korea.
| |
Collapse
|
59
|
Abstract
Anxiety disorders are one of the most common psychiatric comorbidities among children and adolescents with autism spectrum disorders (ASD). There has been a recent proliferation of research examining the prevalence, phenomenology, assessment and treatment of anxiety disorders among youth with ASD. While there is currently very limited support for the use of pharmacological agents to treat anxiety among youth with ASD and comorbid anxiety, there has been overwhelming support across numerous modestly sized controlled studies for the efficacy of cognitive behavioral therapy. This review discusses advances in the treatment literature for anxiety in youth with ASD, and discusses the current evidence base for whether standard treatment needs to be adapted for this population.
Collapse
Affiliation(s)
- Carly Johnco
- Department of Pediatrics, University of South Florida
| | - Eric A. Storch
- Department of Pediatrics, University of South Florida
- Department of Psychology, University of South Florida
- Department of Psychiatry & Behavioral Neurosciences, University of South Florida
- Department of Health Policy and Management, University of South Florida
- Rogers Behavioral Health – Tampa Bay
- All Children’s Hospital – Johns Hopkins Medicine
| |
Collapse
|
60
|
Reliability and Validity of Parent- and Child-Rated Anxiety Measures in Autism Spectrum Disorder. J Autism Dev Disord 2015; 45:3219-31. [DOI: 10.1007/s10803-015-2481-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
61
|
Examining and comparing social perception abilities across childhood-onset neurodevelopmental disorders. J Am Acad Child Adolesc Psychiatry 2015; 54:479-86.e1. [PMID: 26004663 DOI: 10.1016/j.jaac.2015.03.016] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/19/2015] [Accepted: 03/26/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Several neurodevelopmental disorders are associated with social processing deficits. The objective of this study was to compare patterns of social perception abilities across obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and control participants. METHOD A total of 265 children completed the Reading the Mind in the Eyes Test-Child Version (RMET). Parents or caregivers completed established trait/symptom scales. The predicted percentage of accuracy on the RMET was compared across disorders and by item difficulty and item valence (i.e., positive/negative/neutral mental states), then analyzed for associations with trait/symptom scores. RESULTS The percentage of correct RMET scores varied significantly between diagnostic groups (p < .0001). On pairwise group comparisons controlling for age and sex, children with ADHD and ASD scored lower than the other groups (p < .0001). When IQ was also controlled for in the model, participants with OCD performed better than controls (p < .001), although differences between other groups were less pronounced. Participants with ASD scored lowest on easy items. Those with ASD and ADHD scored significantly lower than other groups on items with positive valence (p < .01). Greater social communication impairment and hyperactivity/impulsivity, but not OCD traits/symptoms, were associated with lower scores on the RMET, irrespective of diagnosis. CONCLUSION Social perception abilities in neurodevelopmental disorders exist along a continuum. Children with ASD have the greatest deficits, whereas children with OCD may be hypersensitive to social information. Social communication deficits and hyperactive/impulsive traits are associated with impaired social perception abilities; these findings highlight overlapping cognitive and behavioral manifestations across disorders.
Collapse
|
62
|
Cadman T, Spain D, Johnston P, Russell A, Mataix-Cols D, Craig M, Deeley Q, Robertson D, Murphy C, Gillan N, Wilson CE, Mendez M, Ecker C, Daly E, Findon J, Glaser K, Happé F, Murphy D. Obsessive-Compulsive Disorder in Adults with High-Functioning Autism Spectrum Disorder: What Does Self-Report with the OCI-R Tell Us? Autism Res 2015; 8:477-85. [DOI: 10.1002/aur.1461] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 12/23/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Tim Cadman
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
| | - Debbie Spain
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London; UK
| | - Patrick Johnston
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
| | | | - David Mataix-Cols
- Karolinska Institutet; Department of Clinical Neuroscience; King's College London, Institute of Psychiatry, Psychology and Neuroscience; London UK
| | - Michael Craig
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust; London UK
- National Autism Unit, Bethlem Royal Hospital; Bromley Kent UK
| | - Quinton Deeley
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust; London UK
- National Autism Unit, Bethlem Royal Hospital; Bromley Kent UK
| | - Dene Robertson
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust; London UK
- National Autism Unit, Bethlem Royal Hospital; Bromley Kent UK
| | - Clodagh Murphy
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust; London UK
| | - Nicola Gillan
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
| | - C. Ellie Wilson
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust; London UK
| | - Maria Mendez
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust; London UK
| | - Christine Ecker
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
| | - Eileen Daly
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
| | - James Findon
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
| | - Karen Glaser
- Department of Social Science; Health and Medicine; King's College London; UK
| | - Francesca Happé
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London; UK
| | - Declan Murphy
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience; London UK
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley Foundation NHS Trust; London UK
- National Autism Unit, Bethlem Royal Hospital; Bromley Kent UK
| | | |
Collapse
|
63
|
Kerns CM, Kendall PC, Zickgraf H, Franklin ME, Miller J, Herrington J. Not to be overshadowed or overlooked: functional impairments associated with comorbid anxiety disorders in youth with ASD. Behav Ther 2015; 46:29-39. [PMID: 25526833 DOI: 10.1016/j.beth.2014.03.005] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Revised: 02/21/2014] [Accepted: 03/11/2014] [Indexed: 12/28/2022]
Abstract
This study's objective was to examine associations between comorbid anxiety disorders and difficulties commonly attributed to both anxiety and ASD (autism spectrum disorder) including self-injury, depressive symptoms, functional communication, social skill deficits and parent stress, in a well-characterized sample of youth with ASD. Fifty-nine verbally fluent participants (7-17 years; 93% Caucasian) diagnosed with ASD and their parents completed semistructured diagnostic interviews to confirm ASD diagnosis and assess for anxiety disorders. Parents completed questionnaires on child behavior and social skill as well as parental stress. Co-occurring anxiety disorders were associated with more parent-reported self-injurious behavior, depressive symptoms, and parental stress in youth with ASD, after controlling for other influential variables (e.g., ASD severity, cognitive ability, medication status). In contrast, youth with co-occurring anxiety disorders appeared to have significantly stronger parent-reported functional communication than youth with ASD alone as well as a comparable ability, according to parents, to initiate social interaction and develop relationships. Findings support a profile of challenges and relative strengths associated with the presence of anxiety disorders in youth with ASD. Though more research is needed to determine the direction of these associations, results provide further rationale for improving recognition and targeted treatment of this comorbidity in clinical practice.
Collapse
Affiliation(s)
| | | | | | | | - Judith Miller
- Children's Hospital of Philadelphia, Center for Autism Research
| | - John Herrington
- Children's Hospital of Philadelphia, Center for Autism Research
| |
Collapse
|
64
|
van den Bergh SFWM, Scheeren AM, Begeer S, Koot HM, Geurts HM. Age related differences of executive functioning problems in everyday life of children and adolescents in the autism spectrum. J Autism Dev Disord 2014; 44:1959-71. [PMID: 24562693 DOI: 10.1007/s10803-014-2071-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Numerous studies investigated executive functioning (EF) problems in people with autism spectrum disorders (ASD) using laboratory EF tasks. As laboratory task performances often differ from real life observations, the current study focused on EF in everyday life of 118 children and adolescents with ASD (6-18 years). We investigated age-related and individual differences in EF problems as reported by parents on the Behavioral Rating Inventory Executive Functions (BRIEF: Gioia et al. in Behavior rating inventory of executive function. Psychological Assessment Resources, Odesse 2000), and examined the association with autism severity. Inhibition problems were mostly found in the youngest group (6- to 8-year-olds), whereas problems with planning where more evident for 12- to 14-year-olds as compared to 9- to 11-year-olds. In a subsample of participants meeting the ADOS ASD cut-off criteria the age related differences in planning were absent, while problems with cognitive flexibility were less apparent in 15- to 18-year-olds, compared to 9- to 11-, and 12- to 14-year olds. EF problems surpassing the clinical cutoff were only observed in 20% (planning) to 51% (cognitive flexibility) of the children and adolescents, and no relation was found with ASD symptom severity. This underlines the heterogeneous nature of ASD.
Collapse
Affiliation(s)
- Sanne F W M van den Bergh
- Autism Clinic, Research and Development, Dr. Leo Kannerhuis, Houtsniplaan 1, 6865 XZ, Doorwerth, The Netherlands,
| | | | | | | | | |
Collapse
|
65
|
Mito H, Matsuura N, Mukai K, Yanagisawa Y, Nakajima A, Motoyama M, Arikawa A, Yamanishi K, Matsunaga H. The impacts of elevated autism spectrum disorder traits on clinical and psychosocial features and long-term treatment outcome in adult patients with obsessive-compulsive disorder. Compr Psychiatry 2014; 55:1526-33. [PMID: 24957957 DOI: 10.1016/j.comppsych.2014.05.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Revised: 05/12/2014] [Accepted: 05/12/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND While a close relation between obsessive-compulsive disorder (OCD) and autism spectrum disorder (ASD) has been pointed out, there are few studies that have investigated whether highly elevated ASD traits may have significant impacts on clinical and psychosocial features as well as long-term treatment outcome in adult OCD patients. METHODS We assessed ASD traits using the Autism Spectrum Quotient (AQ) in 81 Japanese patients with OCD. The relation between degree of ASD traits and clinical and psychosocial variables and the 48-week treatment outcomes was analyzed in the subjects. RESULTS A substantial proportion of the subjects showed higher ASD traits (35%) with more severe depressive or pervasive anxiety status, and social impairments and lower QOL compared to other OCD individuals. However, elevated ASD traits may exert rather smaller impact on the OCD phenomenology along with on the long-term treatment outcome than expected. CONCLUSIONS Elevated ASD traits may further emphasize the general psychopathological and socio-dysfunctional features rather than clinical aspects associated with OCD. Co-existing depressive or anxious symptom severity may further exacerbate the core-deficits related to ASD pathology. Thus the assessment of ASD traits should be important for understanding the clinical and psychosocial features and treatment responses in OCD patients.
Collapse
Affiliation(s)
- Hironori Mito
- Department of Neuropsychiatry, Hyogo College of Medicine, Nisinomiya, Japan; Zinmeikai Hospital, Nishinomiya, Japan
| | - Naomi Matsuura
- Graduate School of Education, Tokyo University of Social Welfare, Aichi, Japan
| | - Keiitiro Mukai
- Department of Neuropsychiatry, Hyogo College of Medicine, Nisinomiya, Japan
| | | | - Akihiro Nakajima
- Department of Neuropsychiatry, Hyogo College of Medicine, Nisinomiya, Japan
| | - Mikuni Motoyama
- Department of Neuropsychiatry, Hyogo College of Medicine, Nisinomiya, Japan
| | - Ayako Arikawa
- Department of Neuropsychiatry, Hyogo College of Medicine, Nisinomiya, Japan
| | - Kyosuke Yamanishi
- Department of Neuropsychiatry, Hyogo College of Medicine, Nisinomiya, Japan
| | - Hisato Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, Nisinomiya, Japan.
| |
Collapse
|
66
|
Neely L, Rispoli M, Gerow S, Ninci J. Effects of Antecedent Exercise on Academic Engagement and Stereotypy During Instruction. Behav Modif 2014; 39:98-116. [DOI: 10.1177/0145445514552891] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Antecedent physical exercise has emerged as a potentially promising treatment for reducing challenging behavior and increasing academic behavior in individuals with autism spectrum disorder (ASD). The purpose of this study was to evaluate the effects of physical exercise conducted prior to instructional sessions (antecedent physical exercise) on academic engagement and stereotypy during instructional sessions for two children diagnosed with ASD. Functional analysis results suggested stereotypy was maintained by automatic reinforcement for both participants. A multielement design was employed to evaluate academic engagement and stereotypy during instructional sessions following randomly sequenced conditions involving either (a) no antecedent exercise, (b) brief durations of antecedent exercise, or (c) antecedent exercise that continued until the participant engaged in a systematically determined behavioral indicator of satiation. Both participants demonstrated higher levels of academic engagement and reduced levels of stereotypy during the instructional sessions which followed antecedent physical exercise that continued until behavioral indicators of satiation occurred. This study replicates previous research suggesting that individuals with ASD may benefit from physical exercise prior to academic instruction and further suggests that the duration of antecedent exercise may be optimally individualized based on behavioral indicators of satiation.
Collapse
|
67
|
The Relationship Between Autistic Traits and Social Anxiety, Worry, Obsessive–Compulsive, and Depressive Symptoms: Specific and Non-specific Mediators in a Student Sample. J Autism Dev Disord 2014; 45:858-72. [DOI: 10.1007/s10803-014-2238-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
68
|
Ruzzano L, Borsboom D, Geurts HM. Repetitive Behaviors in Autism and Obsessive–Compulsive Disorder: New Perspectives from a Network Analysis. J Autism Dev Disord 2014; 45:192-202. [DOI: 10.1007/s10803-014-2204-9] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
69
|
Abstract
Obsessive compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) are two of the most common neuropsychiatric diseases in paediatric populations. The high comorbidity of ADHD and OCD with each other, especially of ADHD in paediatric OCD, is well described. OCD and ADHD often follow a chronic course with persistent rates of at least 40–50 %. Family studies showed high heritability in ADHD and OCD, and some genetic findings showed similar variants for both disorders of the same pathogenetic mechanisms, whereas other genetic findings may differentiate between ADHD and OCD. Neuropsychological and neuroimaging studies suggest that partly similar executive functions are affected in both disorders. The deficits in the corresponding brain networks may be responsible for the perseverative, compulsive symptoms in OCD but also for the disinhibited and impulsive symptoms characterizing ADHD. This article reviews the current literature of neuroimaging, neurochemical circuitry, neuropsychological and genetic findings considering similarities as well as differences between OCD and ADHD.
Collapse
|
70
|
Selles RR, Arnold EB, Phares V, Lewin AB, Murphy TK, Storch EA. Cognitive-behavioral therapy for anxiety in youth with an autism spectrum disorder: A follow-up study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2014; 19:613-21. [DOI: 10.1177/1362361314537912] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cognitive-behavioral therapy for anxiety in youth with an autism spectrum disorder appears efficacious; however, maintenance of treatment gains has not yet been studied. Using a sample of 32 youth who had benefited at least minimally from a past trial of cognitive-behavioral therapy for anxiety in autism spectrum disorder, this study assessed anxiety symptoms in youth 10–26 months following treatment completion. Compared to baseline, follow-up scores were associated with large effects for treatment. Relative to post-treatment, a small effect for return in symptoms was present and significantly fewer individuals were rated as responders at follow-up. Future studies should investigate factors associated with poor treatment maintenance and modifications or additions to treatment that may help maintain treatment gains.
Collapse
|
71
|
Comorbid Psychopathology in Autism Spectrum Disorder. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2014. [DOI: 10.1007/s40489-014-0012-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
72
|
Autism and Anxiety: Overlap, Similarities, and Differences. HANDBOOK OF AUTISM AND ANXIETY 2014. [DOI: 10.1007/978-3-319-06796-4_6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
73
|
|
74
|
Scahill L, Dimitropoulos A, McDougle CJ, Aman MG, Feurer ID, McCracken JT, Tierney E, Pu J, White S, Lecavalier L, Hallett V, Bearss K, King B, Arnold LE, Vitiello B. Children's Yale-Brown obsessive compulsive scale in autism spectrum disorder: component structure and correlates of symptom checklist. J Am Acad Child Adolesc Psychiatry 2014; 53:97-107.e1. [PMID: 24342389 PMCID: PMC3999641 DOI: 10.1016/j.jaac.2013.09.018] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 08/30/2013] [Accepted: 10/14/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Repetitive behaviors in autism spectrum disorders (ASD) range from motor stereotypy to immersion in restricted interests. The modified Children's Yale-Brown Obsessive Compulsive Scale for children with autism spectrum disorder (CYBOCS-ASD) includes a Symptom Checklist (behavior present or absent) and 5 severity scales (Time Spent, Interference, Distress, Resistance and Control). METHOD We assembled CYBOCS-ASD data from 3 Research Units on Pediatric Psychopharmacology Autism Network trials to explore the component structure of repetitive behaviors in children with ASD. Raters trained to reliability conducted the CYBOCS-ASD in 272 medication-free subjects. Fifteen Symptom Checklist items were endorsed for less than 5% of the sample and were dropped. Principal component analysis was used to explore the clustering of 23 checklist items. Component scores computed for each subject were correlated with other measures. We also examined the distribution of severity scales. RESULTS The subjects (229 boys and 43 girls; mean age = 7.8 ± 2.6 years) met criteria for an ASD; half were intellectually disabled. The PCA resulted in a 5-component solution to classify repetitive behaviors (34.4% of the variance): hoarding and ritualistic behavior; sensory and arranging behavior; sameness and self-injurious behavior; stereotypy; restricted interests. Sensory and arranging and stereotypy components were associated with lower adaptive functioning (Pearson r = 0.2-0.3; p < .003). The resistance scale showed little variation, with more than 60% of the sample with the highest score. CONCLUSIONS Rarely endorsed items can be dropped from the Checklist. The resistance item does not appear to be relevant for children with ASD.
Collapse
|
75
|
Neil N, Sturmey P. Assessment and Treatment of Obsessions and Compulsions in Individuals with Autism Spectrum Disorders: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2013. [DOI: 10.1007/s40489-013-0006-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
76
|
Paula-Pérez I. Differential diagnosis between obsessive compulsive disorder and restrictive and repetitive behavioural patterns, activities and interests in autism spectrum disorders. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.rpsmen.2012.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
77
|
Kerns CM, Kendall PC. The presentation and classification of anxiety in autism spectrum disorder. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/cpsp.12009] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
78
|
Paula-Pérez I. Differential diagnosis between obsessive compulsive disorder and restrictive and repetitive behavioural patterns, activities and interests in autism spectrum disorders. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2012; 6:178-86. [PMID: 23084795 DOI: 10.1016/j.rpsm.2012.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 07/06/2012] [Accepted: 07/29/2012] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The obsessive compulsive disorder (OCD) and the restricted and repetitive patterns of behavior, interests and activities inherent to autism spectrum disorders (ASD) share a number of features that can make the differential diagnosis between them extremely difficult and lead to erroneous overdiagnosis of OCD in people with autism. DEVELOPMENT In both cases there may appear to have a fixation on routine, ritualized patterns of verbal and nonverbal behavior, resistance to change, and highly restrictive interests, which becomes a real challenge for differentiating rituals, stereotypes and adherence to routines in ASD from obsessions and compulsions in OCD. This article provides key points to clarify this differential diagnosis through the analysis of emotional valence, content, function and psychological theories that explain the obsessions and compulsions in OCD, and the desire for sameness, stereotyped movements and limited interest in autism. CONCLUSION The terms "obsession" and "compulsion" should no longer be used when referring to patterns of behavior, interests or restricted and repetitive activities in autism due to syntonic characteristics, low perception of personal responsibility and low neutralizing efforts. Treatment focuses on changing the environment, the use of socio-communicative compensatory strategies and behavioral modification techniques to improve cognitive and behavioral flexibility. When there is comorbidity between, exposure behavioral and response prevention techniques are then used, followed by others of more cognitive orientation if necessary.
Collapse
Affiliation(s)
- Isabel Paula-Pérez
- Trastornos de Conducta del Departamento de Métodos de Investigación y Diagnóstico en Educación, Universidad de Barcelona, Barcelona, España; Posgrado «Diagnóstico e Intervención en los Trastornos del Espectro Autista», Universidad de Barcelona, Barcelona, España.
| |
Collapse
|
79
|
Ollington N, Green VA, O'Reilly MF, Lancioni GE, Didden R. Functional analysis of insistence on sameness in an 11-year old boy with Asperger syndrome. Dev Neurorehabil 2012; 15:154-9. [PMID: 22494085 DOI: 10.3109/17518423.2012.662660] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To identify the functional properties of insistence on sameness associated with autism spectrum disorders. METHOD An 11-year-old boy with Asperger syndrome was observed during play where scenarios (mistakes, misplaced items, interrupted activity) were created to correspond with parent-reported scenarios where the child would insist on sameness. The extent of problem behaviour was observed under four functional assessment conditions (restore environment, tangible, attention, escape), according to a multi-element design. RESULTS The results showed an interaction between the scenario type and type of functional assessment condition. Problem behaviour appeared to have a restorative function related to correcting a mistake, an attention function related to attempting to recruit help in finding a missing item and a tangible function suggesting an attempt to regain access to the materials and activity. CONCLUSION Problem behaviours related to insistence on sameness may be motivated by different consequences depending on the scenario created.
Collapse
|
80
|
Meyza KZ, Defensor EB, Jensen AL, Corley MJ, Pearson BL, Pobbe RLH, Bolivar VJ, Blanchard DC, Blanchard RJ. The BTBR T+ tf/J mouse model for autism spectrum disorders-in search of biomarkers. Behav Brain Res 2012; 251:25-34. [PMID: 22958973 DOI: 10.1016/j.bbr.2012.07.021] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 07/11/2012] [Accepted: 07/12/2012] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorders (ASD) form a common group of neurodevelopmental disorders appearing to be under polygenic control, but also strongly influenced by multiple environmental factors. The brain mechanisms responsible for ASD are not understood and animal models paralleling related emotional and cognitive impairments may prove helpful in unraveling them. BTBR T+ tf/J (BTBR) mice display behaviors consistent with the three diagnostic categories for ASD. They show impaired social interaction and communication as well as increased repetitive behaviors. This review covers much of the data available to date on BTBR behavior, neuroanatomy and physiology in search for candidate biomarkers, which could both serve as diagnostic tools and help to design effective treatments for the behavioral symptoms of ASD.
Collapse
Affiliation(s)
- Ksenia Z Meyza
- Pacific Biosciences Research Center, University of Hawaii, 1993 East-west Road, Honolulu, HI 96822, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
81
|
LeMonda BC, Holtzer R, Goldman S. Relationship between executive functions and motor stereotypies in children with Autistic Disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2012; 6:1099-1106. [PMID: 23637708 PMCID: PMC3638958 DOI: 10.1016/j.rasd.2012.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study reports on the relationship between motor stereotypies and impairments in executive functions (EF) in children with Autistic Disorder (AD) and in children with Developmental Language Disorders (DLD). We hypothesized that low EF performance would predict higher frequency and longer durations of stereotypies in the AD group only. Twenty-two children (age range = 7-9 years, 6 months, girls = 5) with AD were recruited from a longitudinal multi-site study and compared to twenty-two non-autistic children with DLD (age range = 7-9 years, 6 months, girls = 5). The two groups were matched on non-verbal IQ and demographic characteristics. Frequency and duration of stereotypies were coded from videotaped semi-structured play sessions. EF measures included the Wisconsin Card Sorting Task (WCST) Categories, Wechsler Intelligence Scale for Children-Revised (WISC-R) Mazes, and Stanford-Binet Fourth Edition (SB-IV) Matrices. The scores for frequency and duration of stereotypies were higher in the AD group. Separate linear regressions revealed that group status, EF, and their interactions predict stereotypies. Specifically, lower EF scores predicted higher frequencies and longer durations of stereotypies in the AD group only. Analyses controlled for age, gender, and parent education. Findings suggest that in AD, EF impairments and stereotypies may be linked to shared brain pathways.
Collapse
Affiliation(s)
- Brittany C. LeMonda
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Road, Bronx, NY 10461, United States
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Road, Bronx, NY 10461, United States
- Department of Neurology, Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10461, United States
| | - Sylvie Goldman
- Department of Neurology, Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10461, United States
- Department of Pediatrics, Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10461, United States
| |
Collapse
|
82
|
Mazzone L, Ruta L, Reale L. Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges. Ann Gen Psychiatry 2012; 11:16. [PMID: 22731684 PMCID: PMC3416662 DOI: 10.1186/1744-859x-11-16] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 05/10/2012] [Indexed: 11/10/2022] Open
Abstract
Several psychiatric conditions, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS) and High Functioning Autism (HFA). In this review we examine the interplay between psychiatric comorbidities and AS/HFA. In particular, we will focus our attention on three main issues. First, we examine which psychiatric disorders are more frequently associated with AS/HFA. Second, we review which diagnostic tools are currently available for clinicians to investigate and diagnose the associated psychiatric disorders in individuals with AS/HFA. Third, we discuss the challenges that clinicians and researchers face in trying to determine whether the psychiatric symptoms are phenotypic manifestations of AS/HFA or rather they are the expression of a distinct, though comorbid, disorder. We will also consider the role played by the environment in the manifestation and interpretation of these symptoms. Finally, we will propose some strategies to try to address these issues, and we will discuss therapeutic implications.
Collapse
Affiliation(s)
- Luigi Mazzone
- Child Neuropsychiatry Unit, Department of Neuroscience, I,R,C,C,S, Children's Hospital, Bambino Gesù, Rome, Italy.
| | | | | |
Collapse
|
83
|
Anxiety and repetitive behaviours in autism spectrum disorders and williams syndrome: a cross-syndrome comparison. J Autism Dev Disord 2012; 42:175-80. [PMID: 21424863 DOI: 10.1007/s10803-011-1225-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Children with autism spectrum disorder or Williams syndrome are vulnerable to anxiety. The factors that contribute to this risk remain unclear. This study compared anxiety in autism spectrum disorder and Williams syndrome and examined the relationship between repetitive behaviours and anxiety. Thirty-four children with autism and twenty children with Williams syndrome were assessed with measures of anxiety and repetitive behaviours. Children with autism had higher levels of anxiety. Within the autism sample higher levels of repetitive behaviours were associated with more anxiety. This was not replicated in the Williams syndrome sample, indicating a differential role for restricted and repetitive behaviours in relation to anxiety. Understanding the links between repetitive behaviours and anxiety is essential for effective intervention.
Collapse
|
84
|
Boyd BA, McDonough SG, Bodfish JW. Evidence-based behavioral interventions for repetitive behaviors in autism. J Autism Dev Disord 2012; 42:1236-48. [PMID: 21584849 PMCID: PMC3709868 DOI: 10.1007/s10803-011-1284-z] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Restricted and repetitive behaviors (RRBs) are a core symptom of autism spectrum disorders (ASD). There has been an increased research emphasis on repetitive behaviors; however, this research primarily has focused on phenomenology and mechanisms. Thus, the knowledge base on interventions is lagging behind other areas of research. The literature suggests there are evidence-based practices to treat "lower order" RRBs in ASD (e.g., stereotypies); yet, there is a lack of a focused program of intervention research for "higher order" behaviors (e.g., insistence on sameness). This paper will (a) discuss barriers to intervention development for RRBs; (b) review evidence-based interventions to treat RRBs in ASD, with a focus on higher order behaviors; and (c) conclude with recommendations for practice and research.
Collapse
Affiliation(s)
- Brian A Boyd
- Division of Occupational Science and Occupational Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, CB# 7122, Bondurant Hall, Chapel Hill, NC 27599-7120, USA.
| | | | | |
Collapse
|
85
|
Carrasco M, Volkmar FR, Bloch MH. Pharmacologic treatment of repetitive behaviors in autism spectrum disorders: evidence of publication bias. Pediatrics 2012; 129:e1301-10. [PMID: 22529279 PMCID: PMC3340598 DOI: 10.1542/peds.2011-3285] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The goal of this study was to examine the efficacy of serotonin receptor inhibitors (SRIs) for the treatment of repetitive behaviors in autism spectrum disorders (ASD). METHODS Two reviewers searched PubMed and Clinicaltrials.gov for randomized, double-blind, placebo-controlled trials evaluating the efficacy of SRIs for repetitive behaviors in ASD. Our primary outcome was mean improvement in ratings scales of repetitive behavior. Publication bias was assessed by using a funnel plot, the Egger's test, and a meta-regression of sample size and effect size. RESULTS Our search identified 5 published and 5 unpublished but completed trials eligible for meta-analysis. Meta-analysis of 5 published and 1 unpublished trial (which provided data) demonstrated a small but significant effect of SRI for the treatment of repetitive behaviors in ASD (standardized mean difference: 0.22 [95% confidence interval: 0.07-0.37], z score = 2.87, P < .005). There was significant evidence of publication bias in all analyses. When Duval and Tweedie's trim and fill method was used to adjust for the effect of publication bias, there was no longer a significant benefit of SRI for the treatment of repetitive behaviors in ASD (standardized mean difference: 0.12 [95% confidence interval: -0.02 to 0.27]). Secondary analyses demonstrated no significant effect of type of medication, patient age, method of analysis, trial design, or trial duration on reported SRI efficacy. CONCLUSIONS Meta-analysis of the published literature suggests a small but significant effect of SRI in the treatment of repetitive behaviors in ASD. This effect may be attributable to selective publication of trial results. Without timely, transparent, and complete disclosure of trial results, it remains difficult to determine the efficacy of available medications.
Collapse
Affiliation(s)
- Melisa Carrasco
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, Michigan 48109-2215, USA.
| | - Fred R. Volkmar
- Child Study Center and Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Michael H. Bloch
- Child Study Center and Department of Psychiatry, Yale University, New Haven, Connecticut
| |
Collapse
|
86
|
Ellegood J, Henkelman RM, Lerch JP. Neuroanatomical Assessment of the Integrin β3 Mouse Model Related to Autism and the Serotonin System Using High Resolution MRI. Front Psychiatry 2012; 3:37. [PMID: 22557981 PMCID: PMC3337465 DOI: 10.3389/fpsyt.2012.00037] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 04/09/2012] [Indexed: 12/02/2022] Open
Abstract
The integrinβ3 (ITGβ3) gene has been associated with both autism and the serotonin system. The purpose of this study was to examine the volumetric differences in the brain of an ITGβ3 homozygous knockout mouse model compared with a corresponding wild-type mouse using high resolution magnetic resonance imaging and detailed statistical analyses. The most striking difference found was an 11% reduction in total brain volume. Moreover, 32 different regions were found to have significantly different relative volumes (percentage total brain volume) in the ITGβ3 mouse. A number of interesting differences relevant to autism were discovered including a smaller corpus callosum volume and bilateral decreases in the hippocampus, striatum, and cerebellum. Relative volume increases were also found in the frontal and parieto-temporal lobes as well as in the amygdala. Particularly intriguing were the changes in the lateral wings of the dorsal raphe nuclei since that nucleus is so integral to the development of many different brain regions and the serotonin system in general.
Collapse
Affiliation(s)
- Jacob Ellegood
- Mouse Imaging Centre, Hospital for Sick Children Toronto, ON, Canada
| | | | | |
Collapse
|
87
|
Edwards MJ, Lang AE, Bhatia KP. Stereotypies: A critical appraisal and suggestion of a clinically useful definition. Mov Disord 2011; 27:179-85. [PMID: 22161914 DOI: 10.1002/mds.23994] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mark J Edwards
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK
| | | | | |
Collapse
|
88
|
Abstract
Individual differences in the expression of autism complicate research on the nature and treatment of this disorder. In the Modifier Model of Autism (Mundy et al. 2007), we proposed that individual differences in autism may result not only from syndrome specific causal processes, but also from variability in generic, non-syndrome specific modifier processes that affect the social and emotional development of all people. One study supporting this model found that measures of resting anterior EEG asymmetry, a measure reflecting complex brain processes associated with generic individual differences in approach and avoidance motivation, may help explain differences in the expression of autism in children without intellectual disabilities (Sutton et al. 2005). In the current study, we partially replicated the observation that children with autism who exhibited a pattern of left frontal EEG asymmetry tended to display milder levels of social symptoms, although in the current sample this pattern applied only to HFA children with relatively lower verbal IQs. New observations indicated that left frontal EEG asymmetry was also associated with retrospective parent reports of significantly later age of onset of symptoms, but also higher levels of self-reported outward expressions of anger as well as symptoms of obsessive compulsive disorder in school-age higher functioning children with ASD. Therefore, the results of this study provide a new and fully independent set of observations, which indicate that individual differences in anterior EEG asymmetry may significantly moderate the expression and developmental course of autism. This observation may have clinical implications for identifying meaningful diagnostic sub-groups among children with autism.
Collapse
|
89
|
Gjevik E, Eldevik S, Fjæran-Granum T, Sponheim E. Kiddie-SADS reveals high rates of DSM-IV disorders in children and adolescents with autism spectrum disorders. J Autism Dev Disord 2011; 41:761-9. [PMID: 20824493 PMCID: PMC3094530 DOI: 10.1007/s10803-010-1095-7] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Prevalence of current comorbid DSM-IV disorders was assessed in a special school population of children and adolescents with ASD (N = 71, age 6.0-17.9 years), representing all cognitive levels and main ASD subgroups. Symptoms were assessed through parent interview and association to child characteristics was explored. Seventy-two percent was diagnosed with at least one comorbid disorder. Anxiety disorders (41%) and attention deficit/hyperactivity disorder (31%) were most prevalent. Obsessive-compulsive disorder was more common in older children, and oppositional defiant disorder/conduct disorder more prevalent in pervasive developmental disorder, not otherwise specified. Our results show high rates of comorbid DSM-IV disorders and underscore the importance of such evaluation in children ASD. However, diagnostic challenges are present and future research on the diagnostic validity of comorbid psychiatric disorders is needed.
Collapse
Affiliation(s)
- Elen Gjevik
- Division of Mental Health and Addiction, Oslo University Hospital, P.O. Box 26, 0319, Vinderen, Oslo, Norway.
| | | | | | | |
Collapse
|
90
|
Boyd BA, Woodard CR, Bodfish JW. Feasibility of exposure response prevention to treat repetitive behaviors of children with autism and an intellectual disability: a brief report. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2011; 17:196-204. [PMID: 21975037 DOI: 10.1177/1362361311414066] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is a lack of evidence-based behavioral therapies or pharmacotherapies to treat repetitive behaviors found in autism. Effective behavioral therapies are needed to counter any negative consequences these behaviors may have on the child's early learning and socialization. The purpose of this proof-of-principle study was to test the feasibility of modifying exposure response prevention, an evidence-based strategy for obsessive-compulsive disorder, to treat the repetitive behaviors found in autism. Five school-aged participants (ages 5-11) diagnosed with an autism spectrum disorder participated in the study. Our preliminary findings suggest it is feasible, and potentially efficacious, to modify standard exposure response prevention to treat the specific forms of repetitive behaviors found in individuals with autism and comorbid intellectual disabilities. A larger clinical trial is needed to substantiate these preliminary findings.
Collapse
Affiliation(s)
- Brian A Boyd
- Division of Occupational Science and Occupational Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7120, USA.
| | | | | |
Collapse
|
91
|
Ghanizadeh A, Moeini Y. Are parent-reported repetitive and restricted behaviours associated with psychological problems in pre-school-aged children? J Psychiatr Ment Health Nurs 2011; 18:608-13. [PMID: 21848595 DOI: 10.1111/j.1365-2850.2011.01710.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study surveys the association of restricted and repetitive behaviours in pre-school children with their emotional and behavioural problems. Parents of 504 pre-school children selected by cluster sampling participated and filled in the questionnaires including repetitive and restricted behaviour (RRB) scale and the Strengths and Difficulties Questionnaire. The parents reported repetitive and restrictive behaviours are gender-related in pre-school-aged children. Hyperactivity and emotional problems are significantly in association with all the four types of repetitive and restrictive behaviours. Prosocial problems score is in association with 'reaction to change' subscale score. Children with higher scores of conduct problems have higher rates of 'sensorimotor stereotypies', 'reaction to change' and 'modulation insufficiency'. Pre-school children with a higher rate of RRBs are more hyperactive and have more emotional problems than those with lower rates of RRBs. Conduct problems are more common in children with 'sensorimotor stereotypies', 'reaction to change' and 'modulation insufficiency' problems. Repetitive and restricted behaviours are associated with mental health problems in pre-school-aged children.
Collapse
Affiliation(s)
- A Ghanizadeh
- Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Hafez Hospital, Shiraz, Iran.
| | | |
Collapse
|
92
|
Spiker MA, Lin CE, Van Dyke M, Wood JJ. Restricted interests and anxiety in children with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2011; 16:306-20. [DOI: 10.1177/1362361311401763] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A preoccupation with restricted interests (RI) is a core symptom of autism spectrum disorders (ASD). Engagement in RI is commonly observed in this population and impacts social, adaptive, and emotional functioning. The presence of anxiety disorders and overlap in symptom expression with RI, such as obsessive compulsive disorder (OCD), in children with ASD suggests a possible link between anxiety and the RI manifestation. RI play a multidimensional role in ASD and have been described as being expressed in multiple forms, such as fact collection or the enactment of RI through play. However, there is little research exploring in more detail the possible relationship between RI expression and anxiety. To explore the association between RI expression and anxiety, the current study examined the association between the various modes of RI expression and anxiety disorder symptoms in 68 elementary-aged children diagnosed with high-functioning ASD. Findings indicated that symbolic enactment of RI in the form of play, rather than information collection or time engaged in RI, was significantly linked with the increased presence and severity of anxiety symptoms. The conceptualization of RI as possible maladaptive coping responses to negative emotional experiences is discussed.
Collapse
|
93
|
Mack H, Fullana MA, Russell AJ, Mataix-Cols D, Nakatani E, Heyman I. Obsessions and compulsions in children with Asperger's syndrome or high-functioning autism: a case-control study. Aust N Z J Psychiatry 2010; 44:1082-8. [PMID: 20973622 DOI: 10.3109/00048674.2010.515561] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare the clinical characteristics and symptom severity of children with obsessive disorder (OCD) plus autism spectrum disorders (ASD) with those of children with OCD plus Tourette's syndrome (TS) or OCD alone. METHOD Children with OCD and ASD (OCD/ASD) (n = 12, mean age = 14.33, range: 12-18) were compared to children with OCD and TS (OCD/TS) (n = 12, mean age = 13.92, range: 9-17) and children with OCD-alone (OCD) (n = 12, mean age = 12.92, range: 9-17) on measures of obsessive-compulsive (OC) symptom frequency, severity, interference and other clinical variables. RESULTS Patients from the OCD/ASD group rated their OC symptoms as equally distressing, time consuming and contributing to a similar level of interference in functioning as patients in the OCD/TS and OCD groups. The types of symptoms were similar across groups but patients with OCD/TS reported greater frequency of ordering and arranging compulsions, and a trend towards more sexual obsessions. Patients with OCD/ASD reported more peer relationship problems compared with the other two groups. CONCLUSIONS Children with ASD may experience a similar level of impairment from OC symptoms as children with TS plus OCD and children with OCD only. It is suggested that it is useful to establish both diagnoses given that obsessions and compulsions may respond to treatment, and their alleviation may improve functioning in children on the autism spectrum.
Collapse
|
94
|
Wood JJ, Gadow KD. Exploring the nature and function of anxiety in youth with autism spectrum disorders. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.1468-2850.2010.01220.x] [Citation(s) in RCA: 180] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
95
|
Glutamate transporter gene (SLC1A1) single nucleotide polymorphism (rs301430) and repetitive behaviors and anxiety in children with autism spectrum disorder. J Autism Dev Disord 2010; 40:1139-45. [PMID: 20155310 DOI: 10.1007/s10803-010-0961-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Investigated association of single nucleotide polymorphism (SNP) rs301430 in glutamate transporter gene (SLC1A1) with severity of repetitive behaviors (obsessive-compulsive behaviors, tics) and anxiety in children with autism spectrum disorder (ASD). Mothers and/or teachers completed a validated DSM-IV-referenced rating scale for 67 children with autism spectrum disorder. Although analyses were not significant for repetitive behaviors, youths homozygous for the high expressing C allele had more severe anxiety than carriers of the T allele. Allelic variation in SLC1A1 may be a biomarker for or modifier of anxiety symptom severity in children with ASD, but study findings are best conceptualized as tentative pending replication with larger independent samples.
Collapse
|
96
|
Gadow KD, DeVincent CJ, Pisarevskaya V, Olvet DM, Xu W, Mendell N, Finch SJ, Hatchwell E. Parent-child DRD4 genotype as a potential biomarker for oppositional, anxiety, and repetitive behaviors in children with autism spectrum disorder. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:1208-14. [PMID: 20600463 PMCID: PMC2939241 DOI: 10.1016/j.pnpbp.2010.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Revised: 06/21/2010] [Accepted: 06/22/2010] [Indexed: 01/26/2023]
Abstract
The primary objective of the present study was to examine whether a combination of parent-child DRD4 genotypes results in more informative biomarkers of oppositional, separation anxiety, and repetitive behaviors in children with autism spectrum disorder (ASD). Based on prior research indicating the 7-repeat allele as a potential risk variant, participants were sorted into one of four combinations of parent-child genotypes. Owing to the possibility of parent-of-origin effects, analyses were conducted separately for mother-child (MC) and father-child (FC) dyads. Mothers completed a validated DSM-IV-referenced rating scale. Partial eta-squared (ηp(2)) was used to determine the magnitude of group differences: 0.01-0.06=small, 0.06-0.14=moderate, and >0.14=large. Analyses indicated that children in MC dyads with matched genotypes had the least (7-/7-) and most (7+/7+) severe mother-rated oppositional-defiant (ηp(2)=0.11) and separation anxiety (ηp(2)=0.19) symptoms. Conversely, youths in FC dyads with matched genotypes had the least (7-/7-) and most (7+/7+) severe obsessive-compulsive behaviors (ηp(2)=0.19) and tics (ηp(2)=0.18). Youths whose parents were both noncarriers had less severe tics than peers with at least one parental carrier, and the effect size was large (ηp(2)=0.16). There was little evidence that noncarrier children were rated more severely by mothers who were carriers versus noncarriers. Transmission Disequilibrium Test analyses provided preliminary evidence for undertransmission of the 2-repeat allele in youths with more severe tics (p=0.02). Parent genotype may be helpful in constructing prognostic biomarkers for behavioral disturbances in ASD; however, findings are tentative pending replication with larger, independent samples.
Collapse
Affiliation(s)
- Kenneth D. Gadow
- Correspondence: Kenneth D. Gadow, Ph.D., Department of Psychiatry, Putnam Hall, South Campus State University of New York, Stony Brook, NY 11794-8790, Phone: (631) 632-8858, FAX: (631) 632-8953
| | - Carla J. DeVincent
- Department of Pediatrics, State University of New York at Stony Brook, Stony Brook, NY 11794-8788, Phone: (631) 632-3042, FAX: (631) 632-3021,
| | | | - Doreen M. Olvet
- Zucker Hillside Hospital, Psychiatry Research, North Shore – Long Island Jewish Health System, Glen Oaks, NY 11004,
| | - Wenjie Xu
- Department of Applied mathematics and Statistics, Stony Brook University, Stony Brook, NY 11794-8088,
| | - Nancy Mendell
- Department of Applied mathematics and Statistics, Stony Brook University, Stony Brook, NY 11794-8088,
| | - Stephen J. Finch
- Department of Applied mathematics and Statistics, Stony Brook University, Stony Brook, NY 11794-8088,
| | - Eli Hatchwell
- Department of Pathology, Director of the Genomics Core Facility and Associate Professor, HSC-T8, Room 053, Stony Brook University, Stony Brook, NY 11794-8088, Phone: 631-444-1206, FAX: 631-444-3129,
| |
Collapse
|
97
|
Anholt GE, Cath DC, van Oppen P, Eikelenboom M, Smit JH, van Megen H, van Balkom AJLM. Autism and ADHD symptoms in patients with OCD: are they associated with specific OC symptom dimensions or OC symptom severity? J Autism Dev Disord 2010; 40:580-9. [PMID: 20039111 PMCID: PMC2855859 DOI: 10.1007/s10803-009-0922-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and ASD symptoms. OCD patients showed increased ADHD and autism symptom frequencies, OCD + ADHD patients reporting more autism symptoms (particularly attention switching and social skills problems) than OCD − ADHD patients. Attention switching problems were most significant predictors of OC symptom dimensions (except hoarding) and of symptom severity. Hoarding was not associated with elevated autism scale scores, but with inattention. In conclusion, attention switching problems may reflect both symptom overlap and a common etiological factor underlying ASD, ADHD and OCD.
Collapse
Affiliation(s)
- Gideon E. Anholt
- Department of Psychiatry and Institute for Extramural Medicine, VU-University Medical Centre, Amsterdam, The Netherlands
| | - Danielle C. Cath
- Outpatient Clinic for Anxiety Disorders, GGZ-inGeest, Amsterdam, The Netherlands
- Department of Clinical and Health Psychology, Utrecht University/Altrecht, Anxiety Outpatient Program, Utrecht, The Netherlands
- Altrecht Anxiety Outpatient Program, Mimosastraat 2-4, 3551 DC Utrecht, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry and Institute for Extramural Medicine, VU-University Medical Centre, Amsterdam, The Netherlands
- Outpatient Clinic for Anxiety Disorders, GGZ-inGeest, Amsterdam, The Netherlands
| | - Merijn Eikelenboom
- Department of Psychiatry and Institute for Extramural Medicine, VU-University Medical Centre, Amsterdam, The Netherlands
| | - Johannes H. Smit
- Department of Psychiatry and Institute for Extramural Medicine, VU-University Medical Centre, Amsterdam, The Netherlands
| | | | - Anton J. L. M. van Balkom
- Department of Psychiatry and Institute for Extramural Medicine, VU-University Medical Centre, Amsterdam, The Netherlands
- Outpatient Clinic for Anxiety Disorders, GGZ-inGeest, Amsterdam, The Netherlands
| |
Collapse
|
98
|
Stein DJ, Grant JE, Franklin ME, Keuthen N, Lochner C, Singer HS, Woods DW. Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM-V. Depress Anxiety 2010; 27:611-26. [PMID: 20533371 DOI: 10.1002/da.20700] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In DSM-IV-TR, trichotillomania (TTM) is classified as an impulse control disorder (not classified elsewhere), skin picking lacks its own diagnostic category (but might be diagnosed as an impulse control disorder not otherwise specified), and stereotypic movement disorder is classified as a disorder usually first diagnosed in infancy, childhood, or adolescence. ICD-10 classifies TTM as a habit and impulse disorder, and includes stereotyped movement disorders in a section on other behavioral and emotional disorders with onset usually occurring in childhood and adolescence. This article provides a focused review of nosological issues relevant to DSM-V, given recent empirical findings. This review presents a number of options and preliminary recommendations to be considered for DSM-V: (1) Although TTM fits optimally into a category of body-focused repetitive behavioral disorders, in a nosology comprised of relatively few major categories it fits best within a category of motoric obsessive-compulsive spectrum disorders, (2) available evidence does not support continuing to include (current) diagnostic criteria B and C for TTM in DSM-V, (3) the text for TTM should be updated to describe subtypes and forms of hair pulling, (4) there are persuasive reasons for referring to TTM as "hair pulling disorder (trichotillomania)," (5) diagnostic criteria for skin picking disorder should be included in DSM-V or in DSM-Vs Appendix of Criteria Sets Provided for Further Study, and (6) the diagnostic criteria for stereotypic movement disorder should be clarified and simplified, bringing them in line with those for hair pulling and skin picking disorder.
Collapse
Affiliation(s)
- Dan J Stein
- Department of Psychiatry, University of Cape Town, Rondebosch, Cape Town, South Africa.
| | | | | | | | | | | | | |
Collapse
|
99
|
Validating the Repetitive Behavior Scale-Revised in Young Children with Autism Spectrum Disorder. J Autism Dev Disord 2010; 40:1521-30. [DOI: 10.1007/s10803-010-1012-0] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
100
|
Ruta L, Mugno D, D'Arrigo VG, Vitiello B, Mazzone L. Obsessive-compulsive traits in children and adolescents with Asperger syndrome. Eur Child Adolesc Psychiatry 2010; 19:17-24. [PMID: 19557496 DOI: 10.1007/s00787-009-0035-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Accepted: 05/26/2009] [Indexed: 11/30/2022]
Abstract
The objective of this study is to examine the occurrence and characteristic features of obsessive-compulsive behaviours in children and adolescents with Asperger syndrome (AS), with respect to a matched obsessive compulsive disorder group (OCD) and a typically developing control group (CG). For this purpose, 60 subjects (20 OCD; 18 AS; 22 CG), aged 8-15 years, matched for age, gender and IQ were compared. AS and OCD patients were diagnosed according to the DSM-IV-TR criteria. The Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule were used to assist in the AS diagnosis; the WISC-R was administered to assess IQ. Obsessive and compulsive symptoms were evaluated by using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). None of the AS children received a formal diagnosis of OCD. The AS group presented significantly higher frequencies of Hoarding obsessions and Repeating, Ordering and Hoarding compulsions compared to CG. The OCD group, in turn, reported significantly higher frequencies of Contamination and Aggressive obsessions and Checking compulsions compared to both the AS group and CG. As expected, the OCD group displayed a higher severity of symptoms (Moderate level of severity) than did the AS group (Mild level of severity). Finally, in our sample, neither the OCD group nor the AS group demonstrated a completely full awareness of the intrusive, unreasonable and distressing nature of symptoms, and the level of insight did not differ between the OCD group and CG, although an absence of insight was observed in the AS group. Children with AS showed higher frequencies of obsessive and compulsive symptoms than did typically developing children, and these features seem to cluster around Hoarding behaviours. Additionally, different patterns of symptoms emerged between the OCD and AS groups. Finally, in our sample, the level of insight was poor in both the OCD and the AS children. Further research should be conducted to better understand the characteristics of repetitive thoughts and behaviours in autism spectrum disorders, and to clarify the underlying neurobiological basis of these symptoms.
Collapse
Affiliation(s)
- Liliana Ruta
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Catania, 95123 Catania, Italy.
| | | | | | | | | |
Collapse
|