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Pryke-Hobbes A, Davies J, Heasman B, Livesey A, Walker A, Pellicano E, Remington A. The workplace masking experiences of autistic, non-autistic neurodivergent and neurotypical adults in the UK. PLoS One 2023; 18:e0290001. [PMID: 37672533 PMCID: PMC10482295 DOI: 10.1371/journal.pone.0290001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/31/2023] [Indexed: 09/08/2023] Open
Abstract
Masking entails hiding or concealing one's traits during social interactions. Research suggests that masking is particularly common for autistic people, though many non-autistic people also conceal aspects of their identity. Existing research has identified the key motivations and consequences of masking. No research to date, however, has considered how this might be affected by the social context in which masking is employed. This study compared the masking experiences of 285 autistic, 88 non-autistic neurodivergent and 99 neurotypical adults within a context in which masking is expected to be highly prevalent, namely the workplace. We used reflexive thematic analysis to explore the motivations, consequences, and contextual differences of workplace masking compared to other social contexts. Workplace masking was considered by participants in all three groups to be an adaptive response to a range of socially grounded workplace challenges and was usually employed as a strategy to safeguard against the threat of negative social and employment outcomes. Our non-autistic neurodivergent and autistic participants, however, reported experiencing unique pressures to mask, given the limited understanding of neurodiversity in workplaces and society more broadly. These findings have important implications for the wider masking literature and for workplace practice.
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Affiliation(s)
- Amber Pryke-Hobbes
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Jade Davies
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Brett Heasman
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Adam Livesey
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Amy Walker
- Neurodiversity Works, London, United Kingdom
| | | | - Anna Remington
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
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Hotez E, Hudson S. Expanding on "Screening, Diagnosis, and Intervention for Autism: Experiences of Black and Multiracial Families Seeking Care" to Support BIPOC Autistic Postsecondary Students. J Autism Dev Disord 2023; 53:3717-3721. [PMID: 37178427 DOI: 10.1007/s10803-023-06001-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Emily Hotez
- Department of General Internal Medicine / Health Services Research, University of California, Los Angeles (UCLA), David Geffen School of Medicine, 911 Broxton Ave, Los Angeles, CA, 90095, USA.
| | - Shanice Hudson
- Hood Medicine Initiative, Inc, Indianapolis, IN, 46205, P.O. Box 55458, USA
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Gates JA, McNair ML, Richards JK, Lerner MD. Social Knowledge & Performance in Autism: A Critical Review & Recommendations. Clin Child Fam Psychol Rev 2023; 26:665-689. [PMID: 37544969 PMCID: PMC10613329 DOI: 10.1007/s10567-023-00449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
Autistic social challenges have long been assumed to arise from a lack of social knowledge ("not knowing what to do"), which has undergirded theory and practice in assessment, treatment, and education. However, emerging evidence suggests these differences may be better accounted for by difficulties with social performance ("doing what they may know"). This distinction has important implications for research, practice, policy, and community support of autistic people. This review examines the theoretical and clinical implications and empirical status of the knowledge-performance distinction in autism. Current evidence suggests that social knowledge deficits are neither definitional nor reliably related to outcomes in autism. Prioritizing social knowledge, then, may produce unanticipated, problematic consequences in terms of accuracy of assessment, intervention effectiveness, and promotion of stigma. It may also yield unrealistic expectations around the value of knowledge for autistic people and their families, yielding important ethical considerations. Conversely, recent evidence highlights performance-related factors as being especially promising for better modeling and addressing social challenges in autism. Prioritizing performance, then, may offer new directions for assessment, substantially different intervention opportunities, and novel methods of inclusion and affirmation. This review touches upon each of these domains and implications, integrates these developments with broader models of social competence in youth, and provides direction for future research and practice regarding social competence in autism.
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Affiliation(s)
| | | | | | - Matthew D Lerner
- Stony Brook University, Stony Brook, USA.
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA.
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Cassidy S, McLaughlin E, McGranaghan R, Pelton M, O'Connor R, Rodgers J. Is camouflaging autistic traits associated with defeat, entrapment, and lifetime suicidal thoughts? Expanding the Integrated Motivational Volitional Model of Suicide. Suicide Life Threat Behav 2023; 53:572-585. [PMID: 37129164 DOI: 10.1111/sltb.12965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/23/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION The current study explored whether camouflaging autistic traits is associated with defeat and entrapment and lifetime suicidal thoughts, as predicted by the Integrated Volitional Model of Suicide (IMV model). METHODS 180 UK undergraduate students (76.7% female 18-67 years) completed a cross-sectional online survey from February 5 to March 23, 2020, including self-report measures of defeat and entrapment (SDES), autistic traits (AQ-10), depression (PHQ-9), anxiety (GAD-7), camouflaging autistic traits (CAT-Q), and lifetime suicidal thoughts and behaviors (SBQ-R item 1). RESULTS After controlling for age, gender, current depression, and anxiety symptoms, autistic traits accounted for significantly more of the variance in defeat and entrapment (1.1%), and camouflaging accounted for a further 3.2% of the variance. The association between autistic traits and lifetime suicidality was significantly mediated by camouflaging, defeat, and entrapment. After controlling for age, gender, current depression, and anxiety symptoms, defeat and entrapment (but not camouflaging) accounted for significantly more variance in lifetime suicidal thoughts. The interaction between camouflaging, defeat and entrapment predicted significantly less variance in lifetime suicidal thoughts than either variable alone. CONCLUSION Results suggest that camouflaging autistic traits is a transdiagnostic risk factor for lifetime suicidality, relevant to the defeat and entrapment constructs of the IMV model.
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Affiliation(s)
- Sarah Cassidy
- School of Psychology, University of Nottingham, Nottingham, UK
| | | | | | - Mirabel Pelton
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Rory O'Connor
- School of Psychology, University of Glasgow, Glasgow, UK
| | - Jacqui Rodgers
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
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Abstract
The sex difference in the prevalence of autism spectrum disorder (ASD) may be magnified by sex differences on diagnostic measures. The current study compared autistic males and females on items on the gold-standard diagnostic measure, the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). In a sample of 8-to-17-year old autistic individuals from research (n = 229) and clinical settings (n = 238), females were less likely to show atypicalities on most items related to social-communication behaviors and on total and subscale scores. When controlling for overall intensity of symptomatology, no sex differences survived statistical corrections. Diagnostic criteria and/or gold-standard assessments may be less sensitive to female presentations of ASD and/or autistic females may exhibit fewer or less intense behaviors characteristic of ASD.
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Affiliation(s)
- Hannah M Rea
- Psychiatry & Behavioral Science Department, University of Washington, Seattle, WA, 98195, USA
| | - Roald A Øien
- UiT-The Arctic University of Norway, PB 6060, 9037, Tromsø, Norway
- Child Study Center, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Frederick Shic
- Center On Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, 98105, USA
- Department of Pediatrics, University of Washington, Seattle, WA, 98195, USA
| | - Sara Jane Webb
- Psychiatry & Behavioral Science Department, University of Washington, Seattle, WA, 98195, USA
- Center On Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, 98105, USA
| | - Allison B Ratto
- Children's National Medical Center, 15245 Shady Grove Road, Suite 350, Rockville, MD, 20850, USA.
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Bureau R, Riebel M, Weiner L, Coutelle R, Dachez J, Clément C. French Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). J Autism Dev Disord 2023:10.1007/s10803-023-06048-w. [PMID: 37349595 DOI: 10.1007/s10803-023-06048-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE Autistic camouflaging is a collection of strategies used to hide autistic characteristics. It can have serious consequences on autistic people's mental health and needs to be addressed and measured in clinical practice. The purpose of this study is to evaluate the psychometric properties of the French adaptation of the Camouflaging Autistic Traits Questionnaire. METHODS 1227 participants (744 autistic, 483 non-autistic) answered the French version of the CAT-Q in an online survey or on paper. Confirmatory factor analysis, measurement invariance testing, internal consistency analysis (McDonald's ω), and convergent validity with the DASS-21 depression subscale were conducted. Test-rest reliability was assessed on a sample of 22 autistic volunteers using intraclass correlation coefficient. RESULTS A good fit was found for the original three-factor structure as well as a good internal consistency, excellent test-retest reliability and highly significant convergent validity. Measurement invariance testing indicates however that the meaning behind items is different for autistic vs. non-autistic people. CONCLUSION The French version of the CAT-Q can be used in clinical settings to assess camouflaging behaviors and intent to camouflage. Further research is needed to clarify the camouflage construct and whether reported measurement noninvariance are due to cultural differences or a true difference in what camouflaging might mean for non-autistic people.
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Affiliation(s)
- Raven Bureau
- Université de Strasbourg, Laboratoire Interuniversitaire en Sciences de l'Education et de la Formation, LISEC UR 2310, Strasbourg, France.
- GIS Autisme et TND, Strasbourg's Teams, Strasbourg, France.
| | - Marie Riebel
- Université de Strasbourg, Laboratoire de Psychologie des Cognitions, LPC UR 4440, Strasbourg, France
| | - Luisa Weiner
- Université de Strasbourg, Laboratoire de Psychologie des Cognitions, LPC UR 4440, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Pôle de Psychiatrie, Santé Mentale et Addictologie, 1 place de l'hôpital, Strasbourg, 67000, France
| | - Romain Coutelle
- Hôpitaux Universitaires de Strasbourg, Service de psychiatrie de l'enfant et de l'adolescent, 1 place de l'hôpital, Strasbourg, 67000, France
- Centre d'excellence STRAS&ND, Strasbourg, France
- GIS Autisme et TND, Strasbourg's Teams, Strasbourg, France
| | | | - Céline Clément
- Université de Strasbourg, Laboratoire Interuniversitaire en Sciences de l'Education et de la Formation, LISEC UR 2310, Strasbourg, France
- Centre d'excellence STRAS&ND, Strasbourg, France
- GIS Autisme et TND, Strasbourg's Teams, Strasbourg, France
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Hoare E, Reyes J, Olive L, Willmott C, Steer E, Berk M, Hall K. Neurodiversity in elite sport: a systematic scoping review. BMJ Open Sport Exerc Med 2023; 9:e001575. [PMID: 37342788 PMCID: PMC10277550 DOI: 10.1136/bmjsem-2023-001575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/23/2023] Open
Abstract
The objective of this systematic scoping review is to understand the extent and scope of evidence regarding neurodiversity in elite sport. This systematic scoping review considered epidemiological studies, com mentary and viewpoints papers, systematic review and meta-analyses, and any intervention or clinical treatment, management and practice studies in relation to neurodiversity in elite sport. Case studies and grey literature were ineligible for review. Neurodivergence included neurodevelopmental disorders such as autism spectrum disorder, attention-deficit hyperactivity disorder (ADHD) and specific learning disorders. Elite sport was defined as Olympic, Paralympic, national, international, professional and semiprofessional sport. The final 23 studies included in this review comprised 10 observational studies, 4 systematic/narrative reviews, 6 commentary/position statements and 3 qualitative studies. The literature reflected a major focus on ADHD as a risk factor for concussion and prognosis for postconcussion recovery. Further, there was a focus on the medical management of ADHD, regarding adherence to sporting antidoping regulations. One study focused on the experience of autism in athletes in elite sport settings through qualitative interviews. One study focused on anxiety disorders in elite athletes, with ADHD emerging as a major risk factor. There is a strong rationale for future research to build on the evidence for neurodiversity in elite sport to foster supportive and inclusive elite sporting environments.
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Affiliation(s)
- Erin Hoare
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Australian Football League, Melbourne, Victoria, Australia
| | - Jonathan Reyes
- Australian Football League, Melbourne, Victoria, Australia
- Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, VIC, Australia
| | - Lisa Olive
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
- Orygen, National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- Centre of Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Catherine Willmott
- Australian Football League, Melbourne, Victoria, Australia
- Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, VIC, Australia
| | - Emma Steer
- Clinical and Educational and Developmental Psychologist, Melbourne, Victoria, Australia
| | - Michael Berk
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
- Orygen, National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- Centre of Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Kate Hall
- Australian Football League, Melbourne, Victoria, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
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McAuliffe C, Walsh RJ, Cage E. " My whole life has been a process of finding labels that fit": A Thematic Analysis of Autistic LGBTQIA+ Identity and Inclusion in the LGBTQIA+ Community. AUTISM IN ADULTHOOD 2023; 5:127-138. [PMID: 37346993 PMCID: PMC10280209 DOI: 10.1089/aut.2021.0074] [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: 11/13/2022]
Abstract
Background Being nonheterosexual and noncisgender appears to be more common among autistic people. This intersection of identities is often stigmatized in research and society. However, we know that community involvement can protect against negative mental health outcomes associated with being a minority; researchers found this effect in separate studies examining participation in the autistic and Lesbian, Gay, Bisexual, Trans, Queer, Intersex, Asexual plus other gender and sexual orientation-based identity (LGBTQIA+) communities. This study examined how autistic LGBTQIA+ individuals navigate their multiple marginalized identities and the LGBTQIA+ community. Methods Twelve autistic LGBTQIA+ people from the United Kingdom took part in semistructured interviews. Questions focused on identity and community. We analyzed the interviews using reflexive thematic analysis. Results We identified four overarching themes-Identity (Re)Development, Navigating Authenticity, Exclusion from Community Spaces, and Creating Change. Participants viewed accessing a community of similar others as a means of increasing understanding, self-knowledge, and self-acceptance. We identified several barriers to inclusion, including accessibility and gatekeeping. Participants discussed strategies to combat these obstacles, such as the creation of intersectional community spaces and activism and representation as a means of increasing autism understanding. Conclusions This study suggests that similar to other marginalized groups, autistic LGBTQIA+ individuals are motivated to engage in communities relevant to their identities. However, community spaces for autistic LGBTQIA+ are often inaccessible due to social, sensory, and identity-based barriers. Participants highlighted autism understanding as a barrier to coming out both in community and noncommunity settings. This suggests that improving autism acceptance and understanding is crucial to achieve accessible, intersectional, and inclusive community spaces.
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Affiliation(s)
| | - Reubs J. Walsh
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
- Centre for Applied Transgender Studies, Chicago, Illinois, USA
| | - Eilidh Cage
- Department of Psychology, University of Stirling, Stirling, Scotland
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Sunagawa M. How much of my true self can i show? social adaptation in autistic women: a qualitative study. BMC Psychol 2023; 11:144. [PMID: 37138313 PMCID: PMC10155366 DOI: 10.1186/s40359-023-01192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 04/26/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Social adaptation is often aimed at supporting autistic people, yet its specific goals may not include their actual perspectives. That is, the state of adaptation is judged based on the standards and values of non-autistic people. This qualitative study focused on autistic women's perceptions of social adaptation and examined their lived experiences in daily life, as adaptive behaviors have often been reported as a "female autism phenotype." METHODS Semi-structured interviews were conducted face-to-face with ten autistic women aged 28-50 years (M = 36.7; standard SD = 7.66). The analysis was conducted based on the grounded theory approach. RESULTS Two core perceptions were identified: maintaining stable relationships and fulfilling social roles based on past experiences of "maladaptation." The participants sought adaptations within a reasonable range and adjusted their balance with society to maintain stability in their daily lives. CONCLUSION The findings indicated that autistic women's perceptions of adaptation were based on the accumulation of past negative experiences. Further harmful efforts should be prevented. Support for autistic people to make their own choices in life is also important. Moreover, autistic women need a place where they can be themselves and be accepted as they are. This study showed the importance of changing the environment rather than modifying autistic people to adapt to a society.
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Affiliation(s)
- Mebuki Sunagawa
- Department of Psychology, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo, 112- 8610, Japan.
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Hotez E, Rava J, Russ S, Ware A, Halfon N. Using a life course health development framework to combat stigma-related health disparities for individuals with intellectual and/or developmental disability (I/DD). Curr Probl Pediatr Adolesc Health Care 2023; 53:101433. [PMID: 37867057 DOI: 10.1016/j.cppeds.2023.101433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
In the U.S., 1 in 6 children has an intellectual and/or developmental disability (I/DD). This population experiences a multitude of negative health outcomes across the life course, relative to the general population. Stigma-the social devaluation of individuals with certain characteristics, identities, or statuses within interpersonal, educational, healthcare, and policy contexts-is a potentially preventable contributor to health disparities. To date, existing approaches for addressing and preventing stigma are limited to discrete and siloed interventions that often fail to address the lifelong, cumulative impacts of the specific types of stigma experienced by the I/DD population. In the current paper, we describe three elements of Life Course Health Development (LCHD)-a novel translational framework that draws on evidence from biology, sociology, epidemiology, and psychology-that healthcare providers can use to prevent stigma-related health disparities and improve outcomes for individuals with I//DDs. We discuss the utility of targeting prevention to sensitive periods; prioritizing interventions for the most damaging types of stigmas; and leveraging supports from multiple service systems and sectors. By incorporating evidence from life course science into efforts to address stigma-related health disparities, providers can more effectively and strategically prevent and combat stigma-related health disparities for the I/DD population in childhood and across the life course.
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Affiliation(s)
- Emily Hotez
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine / Health Services Research, 911 Broxton Ave, Los Angeles, CA, 90095, United States; University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States.
| | - Julianna Rava
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine / Health Services Research, 911 Broxton Ave, Los Angeles, CA, 90095, United States; University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States
| | - Shirley Russ
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine / Health Services Research, 911 Broxton Ave, Los Angeles, CA, 90095, United States; University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States
| | - Allysa Ware
- Family Voices, 110 Hartwell Avenue, Lexington, MA, 02421, United States
| | - Neal Halfon
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, United States; Department of Public Policy, UCLA Luskin School of Public Affairs, Los Angeles, CA, United States
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Friedman S, Noble R, Archer S, Gibson J, Hughes C. Respite and connection: Autistic adults' reflections upon nature and well-being during the Covid-19 pandemic. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:13623613231166462. [PMID: 37113030 PMCID: PMC10140763 DOI: 10.1177/13623613231166462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
LAY ABSTRACT The Covid-19 pandemic and associated lockdowns provided opportunities to spend time in nature, with many people reporting that this benefitted their well-being. However, existing research from the pandemic period has focused on the way general populations experienced nature; less is known about how autistic people used nature to support their well-being during the pandemic. We created a survey that invited autistic adults living in the United Kingdom to reply to text box questions. A total of 127 people responded to our survey; we analysed their responses using a method called reflexive thematic analysis and developed themes based on patterns among all the responses. We developed two themes: respite in nature and connecting amid widespread disconnection. For some autistic adults during the pandemic, nature provided physical distance from others or from crowded homes, which helped them reduce their stress. In addition, some participants felt more psychologically connected to nature itself during the pandemic, while for others, nature served as a way of connecting with others during a potentially isolating time. These findings are important for autistic people and their families and carers who may want to seek out nature-based activities to support well-being in the wake of the pandemic.
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Secci I, Petigas L, Cuenod A, Klauser P, Kapp C, Novatti A, Armando M. Case report: Treatment-resistant depression, multiple trauma exposure and suicidality in an adolescent female with previously undiagnosed Autism Spectrum Disorder. Front Psychiatry 2023; 14:1151293. [PMID: 37181890 PMCID: PMC10169628 DOI: 10.3389/fpsyt.2023.1151293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
High rates of co-occurring depression are commonly reported in youth with Autism Spectrum Disorder (ASD), especially in individuals without intellectual disability (ID). Depression in ASD undermines adaptive behavior and is associated with a higher risk of suicidality. Females with ASD may be particularly vulnerable due to their greater use of camouflaging strategies. Indeed, in comparison to males, ASD is underdiagnosed in females, despite higher rates of internalizing symptoms and suicidality. Trauma exposure may also play a role in the development of depressive symptoms in this population. Moreover, evidence for effective treatments of depression in autistic youth are lacking, with ASD individuals frequently experiencing low efficacy and side effects. We present the case of an adolescent female with previously undiagnosed ASD without ID, admitted for active suicidal plans and a treatment-resistant depression (TRD), occurred after a COVID-19 lockdown in the context of cumulative exposure to stressful life events. Comprehensive clinical assessments performed at intake confirmed severe depression with suicidality. Intensive psychotherapy and different changes in medications were carried out (SSRI, SNRI, SNRI + NaSSA, SNRI + aripiprazole), all of which were ineffective, with persistent suicidal thoughts, often requiring intensive individual monitoring. The patient was finally successfully treated with lithium augmentation of fluoxetine, with no side effects. During hospitalization she was also evaluated by an ASD specialized center, where a diagnosis of ASD was made according to the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) scores, as well as to clinical judgment of a senior psychiatrist. The present case report shows that clinicians should not overlook undiagnosed autism as a possible cause of TRD, especially in females without ID, where higher rates of under diagnosis may be in part related to their greater use of camouflage. It also suggests that ASD underdiagnosis and resulting unmet needs may be involved in vulnerability to stressful experiences, depression, and suicidality. Furthermore, it shows the complexity of providing care to TRD in youth with autism, suggesting that an augmentation therapy with lithium, a commonly recommended therapeutic strategy for refractory depression in typically developing samples, may also be effective in this population.
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Affiliation(s)
- Ilaria Secci
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland
| | - Lucie Petigas
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland
| | - Alexandra Cuenod
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland
- Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Paul Klauser
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland
| | - Carole Kapp
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland
| | - Audrey Novatti
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland
| | - Marco Armando
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and the University of Lausanne, Lausanne, Switzerland
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Alaghband-rad J, Hajikarim-Hamedani A, Motamed M. Camouflage and masking behavior in adult autism. Front Psychiatry 2023; 14:1108110. [PMID: 37009119 PMCID: PMC10060524 DOI: 10.3389/fpsyt.2023.1108110] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/17/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionAutism spectrum disorder (ASD) is characterized by persistent deficits in social communication and social interaction across multiple contexts. Social camouflaging was first shown to be a characteristic of autistic persons, who actively try to disguise and compensate for their autism features in social contexts in an effort to socially blend in better. Recently, an increasing, though still insufficient, number of studies has been conducted on the concept of camouflage; however, different aspect of it, from psychopathology and etiology to its complications and consequences, are not clearly defined. We aimed to systematically review the existing literature on camouflage in autistic adults to describe the correlates of camouflage, motivations for exhibiting camouflage behavior, and the potential impacts of camouflage on the mental health of autistic individuals.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guidelines to conduct a systematic review. The databases of PubMed and Scopus, and PsycInfo were searched for eligible studies. Studies were published between January 1st, 1980, to April 1st, 2022.ResultsWe included 16 articles, of which four studies were qualitative and 11 were quantitative. One study used a mix method. The assessment tools used for camouflage, the correlates of camouflage including autism severity, gender, age, cognitive profile and neuroanatomical correlates, reasons for camouflage and the impacts of camouflaging behavior on mental health are discussed in this review.DiscussionIn synthesizing the literature, we conclude that camouflage seems to be more common among females who report more autistic symptoms themselves. There may also be some differences between men and women in reasons of exhibiting it and its neuroanatomical correlates. Further research is needed as to why this phenomenon is more prevalent in females with implications for gender related cognitive and neuroanatomical differences. Effects of camouflage on mental health and daily life measures of individuals such as employment, university graduation, relationship, financial status, and quality of life should be studied with more details in future studies.
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Affiliation(s)
- Javad Alaghband-rad
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mahtab Motamed
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Mahtab Motamed,
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Measuring Social Camouflaging in Individuals with High Functioning Autism: A Literature Review. Brain Sci 2023; 13:brainsci13030469. [PMID: 36979279 PMCID: PMC10046375 DOI: 10.3390/brainsci13030469] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
In the recent years, growing attention has been paid to the use of camouflaging strategies by adult populations suffering from autism spectrum disorder (ASD) with milder manifestations and without intellectual impairment, which may lead to a delay in diagnosis or even a misdiagnosis. In fact, high-functioning ASD individuals were reported to be more aware of their communication difficulties and were more likely make considerable efforts to adjust their behavior to conventional rules of non-autistic individuals, learning to imitate other non-ASD individuals. Moreover, females reported a higher frequency of camouflaging strategies, suggesting a role of camouflaging in the gender gap of the ASD diagnosis. Although camouflaging strategies can sometimes grant a better level of adjustment, even resulting in a hyper-adaptive behavior, they are also often correlated with negative mental health consequences due to the long-term stress associated with continuous attempts to adapt in day-to-day life. In this framework, the aim of the present work was to review the available studies that assessed the presence and correlates of camouflaging strategies in individuals with ASD. Although the literature available on the topic is still scarce, some interesting correlations between camouflaging and anxious and depressive symptoms, as well as suicidality, were highlighted. In particular, the controversial and sometime opposite thoughts and results about camouflaging may be clarified and integrated in light of a dimensional approach to psychopathology.
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Heyworth M, Brett S, den Houting J, Magiati I, Steward R, Urbanowicz A, Stears M, Pellicano E. "I'm the Family Ringmaster and Juggler": Autistic Parents' Experiences of Parenting During the COVID-19 Pandemic. AUTISM IN ADULTHOOD 2023; 5:24-36. [PMID: 36941857 PMCID: PMC10024268 DOI: 10.1089/aut.2021.0097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Little is known about autistic parenthood. The literature that exists suggests that autistic parents can find it difficult to manage the everyday demands of parenting and domestic life. While emerging research has also highlighted more positive parenting experiences, greater understanding of autistic parenthood is needed. Objective This study sought to understand autistic parents' parenting experiences during the initial phase of the COVID-19 pandemic. Methods Thirty-five Australian autistic parents (95% women) of autistic children (aged 4-25 years) took part in semi-structured interviews designed to elicit their experiences of life during lockdown. We used reflexive thematic analysis using an inductive (bottom-up) approach to identify patterned meanings within the data set. Results Autistic parents repeatedly spoke of how the lockdown brought some initial relief from the intensity of their usual lives caring for their children. Nevertheless, most autistic parents felt that the "cumulative stress" of trying to juggle everything during lockdown proved very challenging, which eventually took its toll on parents' mental health. Parents were aware that they needed support but found it difficult to reach out to their usual social supports (including autistic friends) for help, and formal supports were virtually nonexistent. Consequently, they felt "very much forgotten." Nevertheless, they described how their connections with their children grew stronger over lockdown as they focused on nurturing their children's "mental health ahead of everything else." Conclusions Our analysis shows how challenging conventional life can be for autistic parents. Parenting requires grappling with a distinctive set of demands, which are usually partially manageable through the informal supports many autistic parents draw upon. The relative absence of informal supports during the pandemic, however, left them reliant on more formal supports, which were not forthcoming. Research is urgently needed to identify the most effective formal supports for autistic parents, ideally in partnership with autistic parents themselves.
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Affiliation(s)
- Melanie Heyworth
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Reframing Autism, Sydney, Australia
| | - Simon Brett
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Jacquiline den Houting
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Iliana Magiati
- School of Psychological Science, University of Western Australia, Perth, Australia
| | | | | | - Marc Stears
- Sydney Policy Lab, University of Sydney, Sydney, Australia
| | - Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
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Harkins C, Menezes M, Sadikova E, Mazurek M. Friendship and Anxiety/Depression Symptoms in Boys With and Without Autism Spectrum Disorder. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:119-133. [PMID: 36807479 DOI: 10.1352/1944-7558-128.2.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 05/17/2022] [Indexed: 06/18/2023]
Abstract
The transition to adolescence may be a challenging time for individuals with autism spectrum disorder (ASD). This developmental period is marked by increased social demands and increasing anxiety and depression symptoms for many individuals with autism. As both of these factors may compound social difficulties and impact friendship experiences, this study explored the relations among autism symptom severity, internalizing symptoms, and friendship experiences in boys with and without ASD (with IQ > 75). Results showed that internalizing symptoms predicted quantity of close friendships in the ASD group. Given the observed relationship between internalizing symptoms and friendship experiences, social skills intervention programs should address possible internalizing symptoms associated with establishing/maintaining social relationships and perceived friendship quality.
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Affiliation(s)
- Christina Harkins
- Christina Harkins, Michelle Menezes, Eleonora Sadikova, and Micah Mazurek, The University of Virginia School of Education and Human Development
| | - Michelle Menezes
- Christina Harkins, Michelle Menezes, Eleonora Sadikova, and Micah Mazurek, The University of Virginia School of Education and Human Development
| | - Eleonora Sadikova
- Christina Harkins, Michelle Menezes, Eleonora Sadikova, and Micah Mazurek, The University of Virginia School of Education and Human Development
| | - Micah Mazurek
- Christina Harkins, Michelle Menezes, Eleonora Sadikova, and Micah Mazurek, The University of Virginia School of Education and Human Development
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67
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Milner V, Colvert E, Mandy W, Happé F. A comparison of self-report and discrepancy measures of camouflaging: Exploring sex differences in diagnosed autistic versus high autistic trait young adults. Autism Res 2023; 16:580-590. [PMID: 36490366 PMCID: PMC10946751 DOI: 10.1002/aur.2873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
Camouflaging describes masking or compensating for autistic traits and/or related difficulties. Some evidence suggests autistic females camouflage more than autistic males, potentially contributing to delayed or missed diagnosis. Studies predominantly adopt self-report measures of camouflaging, potentially reflecting a person's intent to camouflage without accurately measuring effectiveness (i.e., success in fulfilling the intended effect of minimizing the appearance of autistic traits) of camouflaging. Discrepancy scores between underlying cognitive difficulties (e.g., theory of mind) and observed autistic traits (henceforth camoToM ), or between self-reported autistic traits and observed autistic traits (henceforth camoSRS ), may provide a more accurate measure of camouflaging effectiveness. Three measures of camouflaging administered to autistic males (n = 46) and females (n = 40), and adults with equally high levels of autistic traits but no diagnosis (n = 45 males, n = 43 females) recruited from a large population-based sample were compared. Self-report measures of camouflaging were significantly correlated with camoSRS scores only. Both discrepancy scores were correlated with each other. Adults with high autistic traits, but no diagnosis, had higher discrepancy camouflaging scores than diagnosed adults, but self-reported scores were similar. Diagnosed females scored higher than diagnosed males across all camouflaging measures, but no sex difference occurred in the high trait group. This might indicate that autistic females have higher intentions and greater effectiveness when camouflaging, compared with autistic males. For camoSRS only, high trait males scored significantly higher than diagnosed males; no group difference occurred for females. These results suggest that, despite all participants intending to camouflage to some extent, effective camouflaging as measured by discrepancy scores is higher in undiagnosed high autistic trait individuals. One interpretation is that effective camouflaging reduces the likelihood of autism diagnosis in males and females with high autistic traits.
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Affiliation(s)
- Victoria Milner
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Emma Colvert
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - William Mandy
- Research Department of Clinical, Educational, and Health PsychologyUniversity College LondonLondonUK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
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68
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Doran JD, McCrary SG, Morrison BM, Hiruma LS, Chan DV. View of the Work Community and Vocational Rehabilitation Services Among Adults With Autism Spectrum Disorder. REHABILITATION COUNSELING BULLETIN 2023. [DOI: 10.1177/00343552231155217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Many adults diagnosed with autism spectrum disorder (ASD) face challenges in establishing and maintaining employment. These difficulties may be related to ASD symptomology or employer attitudes; however, vocational rehabilitation (VR) can provide employment-related resources. This study sought to understand how adults with ASD view their integration into workplace communities and VR services. Qualitative data were collected from 24 adults with ASD, and analysis identified themes surrounding the importance of workplace contributions, interesting work, and positive workplace relationships contributing to feeling integrated into the workplace community. Responses were also examined for perspectives on the role of VR in supporting workplace integration. Findings indicate the importance of attending to individual employment preferences and the need for long-term VR follow-along services to explore opportunities for employment growth. Implications and future recommendations for research and practice are also discussed.
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Affiliation(s)
- Julie D. Doran
- The University of North Carolina-Chapel Hill, USA
- East Carolina University, Greenville, NC, USA
| | | | | | | | - Dara V. Chan
- The University of North Carolina-Chapel Hill, USA
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69
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Monahan JL, Freedman B, Singh V, Kalb L, Edmondson C. Initial Validation of the Counseling Center Assessment of Psychological Symptoms-62 for the Autistic College Population. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2023. [DOI: 10.1080/07481756.2023.2170246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
| | - Brian Freedman
- University of Delaware Center for Disabilities Studies, Newark, DE, USA
| | - Vini Singh
- Kennedy Krieger Institute, Baltimore, MD, USA
| | - Luke Kalb
- Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cassidy Edmondson
- University of Delaware Center for Disabilities Studies, Newark, DE, USA
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Horgan F, Kenny N, Flynn P. A systematic review of the experiences of autistic young people enrolled in mainstream second-level (post-primary) schools. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:526-538. [PMID: 35757990 DOI: 10.1177/13623613221105089] [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: 02/02/2023]
Abstract
LAY ABSTRACT Internationally, more autistic pupils are being educated in mainstream schools. Some people have voiced concerns that this policy roll-out is happening before examining the effective outcomes for autistic students. Concerns have also been expressed regarding a lack of the voices of autistic pupils themselves within research and policy. This study was undertaken in order to gather literature that explores the views and experiences of autistic young people in relation to their mainstream school placement at the secondary level. This study aims to summarise the existing literature and provide a new, more complete account of the school experiences of this cohort. After an extensive search, 33 studies were identified by the authors as meeting a set of inclusion criteria. All of the studies included in this review elicited the views and perspectives of at least one autistic young person regarding their mainstream secondary school placement. Upon carefully analysing these studies, the authors developed three key themes as follows: 'Demands of mainstream placements', 'Social participation' and 'Impacts on the student'. Our analysis revealed that for many autistic young people, mainstream school is a complex and demanding social environment. Further research that prioritises the voices and perspectives of this cohort is essential as inclusive policy and practice continues to develop.
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71
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Milner V, Mandy W, Happé F, Colvert E. Sex differences in predictors and outcomes of camouflaging: Comparing diagnosed autistic, high autistic trait and low autistic trait young adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:402-414. [PMID: 35652328 PMCID: PMC9902997 DOI: 10.1177/13623613221098240] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Many autistic people use strategies that help them adapt in social situations and hide behaviours that may seem different to non-autistic individuals - this is called camouflaging. Camouflaging may help autistic people fit in socially; however, it might also lead to poorer well-being. It has been suggested that autistic females camouflage more than autistic males. This article explored differences between males and females who have an autism diagnosis, have characteristics of autism but no diagnosis and those with few autistic characteristics. It is important to include these groups as camouflaging may make it more difficult to get an autism diagnosis and therefore make it less likely a person will receive support. We found that autistic women camouflaged more than all other groups. The group with few autistic characteristics (males and females) camouflaged the least. Loneliness was found to be a possible reason for camouflaging for the diagnosed autistic group only. In terms of outcomes related to camouflaging, it was found that those who camouflaged most had a lower quality of life; this was true of all groups. This tells us that there may be different reasons to camouflage, and different outcomes related to camouflaging for those with many characteristics of autism (including those with a diagnosis), and those with few. It is important that clinicians, teachers, parents and other stakeholders are aware of the negative outcomes associated with camouflaging so that more support can be provided for those who need it.
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72
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Finding the Proportion of Females with Autistic Spectrum Disorder Who Develop Anorexia Nervosa, the True Prevalence of Female ASD and Its Clinical Significance. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020272. [PMID: 36832401 PMCID: PMC9955974 DOI: 10.3390/children10020272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023]
Abstract
It appears that up to 80% of females with autistic spectrum disorder (ASD) have not been diagnosed by the age of 18. This translates to a prevalence of about 5-6%, and if true, has serious implications for female mental health. One way of finding the true value is to use Bayes' Theorem with a comorbid condition as a more easily recognizable flag. An obvious choice is anorexia nervosa (AN), but it transpires that the proportion of women with ASD who develop AN is unknown. This study uses published data in novel ways to provide two methods of estimating a range for this variable, and gives a median value of 8.3% for AN in ASD and, with four other methods, a median prevalence of 6% for female ASD. The clinical implications of the diagnosis and management of ASD and its comorbidities are discussed and, as an example, a solution is provided for the rate of ASD in symptomatic generalized joint hypermobility. It is probable that one in six women with a mental health condition is autistic.
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73
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S DeThorne L, Gerlach-Houck H. Resisting Ableism in School-Based Speech-Language Therapy: An Invitation to Change. Lang Speech Hear Serv Sch 2023; 54:1-7. [PMID: 36630730 DOI: 10.1044/2022_lshss-22-00139] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Laura S DeThorne
- Department of Speech, Language, & Hearing Sciences, Western Michigan University, Kalamazoo
| | - Hope Gerlach-Houck
- Department of Speech, Language, & Hearing Sciences, Western Michigan University, Kalamazoo
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74
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Hannon B, Mandy W, Hull L. A comparison of methods for measuring camouflaging in autism. Autism Res 2023; 16:12-29. [PMID: 36424824 PMCID: PMC10099783 DOI: 10.1002/aur.2850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 10/31/2022] [Indexed: 11/26/2022]
Abstract
Interest in social camouflaging has led to a multiplicity of measurement methods of uncertain validity. This two-part investigation first used a systematic review ("Study 1") to identify and appraise methods used to quantify camouflaging of autistic traits, using the Consensus-based Standards for the Selection of Health Status Measurement Instruments checklist. A total of 16 distinct measurement tools were identified; all are in the preliminary phases of psychometric evaluation. The systematic review highlighted: (1) the need for parent-report tools which specifically measure camouflaging; and (2) a lack of studies looking at associations between different methods of camouflaging, which limits understanding of their validity. "Study 2" aimed to begin to address these gaps in knowledge. We created a parent-report version of the Camouflaging Autistic Traits Questionnaire (CAT-Q) and evaluated its concurrent validity in autistic young people by examining associations with the self-report CAT-Q and a discrepancy measure. Discriminant validity was investigated by comparing all three methods of measuring camouflaging to a measure of social skills, to test whether they assess a construct distinct from social ability. The self- and parent-report CAT-Q were significantly related (r = 0.47, 95% CI = 0.24-0.65), and were related weakly (r = 0.20, 95% CI = -0.06 to 0.43) and strongly (r = 0.46, 95% CI = 0.23-0.64), respectively, to the discrepancy approach. No measure was associated with social skills. Improving the psychometric properties of these methods, and introducing a novel parent-report measure, may help selection of appropriate methods in future research and integration into clinical practice.
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Affiliation(s)
- Benjamin Hannon
- Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - William Mandy
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Laura Hull
- Department of Clinical, Educational & Health Psychology, University College London, London, UK.,Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Petrolini V, Rodríguez-Armendariz E, Vicente A. Autistic camouflaging across the spectrum. NEW IDEAS IN PSYCHOLOGY 2023. [DOI: 10.1016/j.newideapsych.2022.100992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Crompton CJ, Hallett S, Axbey H, McAuliffe C, Cebula K. 'Someone like-minded in a big place': Autistic young adults' attitudes towards autistic peer support in mainstream education. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:76-91. [PMID: 35249357 PMCID: PMC9806484 DOI: 10.1177/13623613221081189] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
LAY ABSTRACT Autistic young people may struggle in mainstream schools and feel disconnected from their peers and their school. We know that autistic adults can benefit from spending time with other autistic people, but we don't know if this is the case for younger autistic people. We conducted interviews with 13 autistic young adults in the United Kingdom who recently left mainstream schooling. We asked them if they would have been interested in being involved in autistic peer support when they were at school, and if so, what that peer support should look like. Results indicated that autistic young people were enthusiastic about the idea of peer support. They thought it was important that peer support was flexible to suit their needs at different times, as well as inclusive, positive, and embracing neurodiversity. They also discussed the potential benefits and difficulties of having a peer support system within a school setting. This adds to the growing body of research on the potential benefits of autistic-autistic interactions on autistic people's well-being and sense of belonging. Findings can be used to help design pilot peer support projects in schools that can be tested to see how effective they are.
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Affiliation(s)
- Catherine J Crompton
- University of Edinburgh, UK,Catherine J Crompton, The Centre for
Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh
Hospital, Morningside Terrace, Edinburgh EH10 5HF, UK.
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Oredipe T, Kofner B, Riccio A, Cage E, Vincent J, Kapp SK, Dwyer P, Gillespie-Lynch K. Does learning you are autistic at a younger age lead to better adult outcomes? A participatory exploration of the perspectives of autistic university students. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:200-212. [PMID: 35404160 DOI: 10.1177/13623613221086700] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
LAY ABSTRACT People learn they are autistic at different ages. We wanted to know if telling kids they are autistic earlier helps them feel better about their lives when they grow up. We are a team of autistic and non-autistic students and professors. Seventy-eight autistic university students did our online survey. They shared how they found out they were autistic and how they felt about being autistic. They also shared how they feel about their lives now. Around the same number of students learned they were autistic from doctors and parents. Students who learned they were autistic when they were younger felt happier about their lives than people who learned they were autistic when they were older. Students who learned they were autistic when they were older felt happier about being autistic when they first found out than people who did not have to wait as long. Our study shows that it is probably best to tell people they are autistic as soon as possible. The students who did our study did not think it was a good idea to wait until children are adults to tell them they are autistic. They said that parents should tell their children they are autistic in ways that help them understand and feel good about who they are.
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Affiliation(s)
- Tomisin Oredipe
- College of Staten Island, The City University of New York, USA
| | - Bella Kofner
- College of Staten Island, The City University of New York, USA
| | - Ariana Riccio
- The Graduate Center, The City University of New York, USA
| | | | | | | | | | - Kristen Gillespie-Lynch
- College of Staten Island, The City University of New York, USA.,The Graduate Center, The City University of New York, USA
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78
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Bertoux M. Cognizione sociale. Neurologia 2022. [DOI: 10.1016/s1634-7072(22)47091-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Autistic traits and camouflaging behaviors: a cross-sectional investigation in a University student population. CNS Spectr 2022; 27:740-746. [PMID: 34505557 DOI: 10.1017/s1092852921000808] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Increasing research is stressing the importance of identifying autistic traits (ATs) in clinical and general populations. University students may be a group at higher risk for the presence of ATs. Recently, specific attention has been paid to camouflaging strategies used by subjects in the autism spectrum in order to cope with the social environment. The aim of this work was to evaluate the prevalence of ATs and camouflaging behaviors in a population of University students. METHODS Subjects were requested to anonymously fill out through an online form the Adult Autism Subthreshold Spectrum and the Camouflaging AT Questionnaire. RESULTS ATs were more represented among males and among students of specific fields of study. Camouflaging behaviors were significantly more frequent among subjects with more severe autism spectrum symptoms, without differences depending from sex. CONCLUSIONS Our study confirms the strong association between ATs and camouflaging behaviors and the relationship between ATs, sex, and specific fields of study.
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80
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Mahony C, O'Ryan C. A molecular framework for autistic experiences: Mitochondrial allostatic load as a mediator between autism and psychopathology. Front Psychiatry 2022; 13:985713. [PMID: 36506457 PMCID: PMC9732262 DOI: 10.3389/fpsyt.2022.985713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
Molecular autism research is evolving toward a biopsychosocial framework that is more informed by autistic experiences. In this context, research aims are moving away from correcting external autistic behaviors and toward alleviating internal distress. Autism Spectrum Conditions (ASCs) are associated with high rates of depression, suicidality and other comorbid psychopathologies, but this relationship is poorly understood. Here, we integrate emerging characterizations of internal autistic experiences within a molecular framework to yield insight into the prevalence of psychopathology in ASC. We demonstrate that descriptions of social camouflaging and autistic burnout resonate closely with the accepted definitions for early life stress (ELS) and chronic adolescent stress (CAS). We propose that social camouflaging could be considered a distinct form of CAS that contributes to allostatic overload, culminating in a pathophysiological state that is experienced as autistic burnout. Autistic burnout is thought to contribute to psychopathology via psychological and physiological mechanisms, but these remain largely unexplored by molecular researchers. Building on converging fields in molecular neuroscience, we discuss the substantial evidence implicating mitochondrial dysfunction in ASC to propose a novel role for mitochondrial allostatic load in the relationship between autism and psychopathology. An interplay between mitochondrial, neuroimmune and neuroendocrine signaling is increasingly implicated in stress-related psychopathologies, and these molecular players are also associated with neurodevelopmental, neurophysiological and neurochemical aspects of ASC. Together, this suggests an increased exposure and underlying molecular susceptibility to ELS that increases the risk of psychopathology in ASC. This article describes an integrative framework shaped by autistic experiences that highlights novel avenues for molecular research into mechanisms that directly affect the quality of life and wellbeing of autistic individuals. Moreover, this framework emphasizes the need for increased access to diagnoses, accommodations, and resources to improve mental health outcomes in autism.
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Affiliation(s)
| | - Colleen O'Ryan
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
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81
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Bertilsdotter Rosqvist H, Hultman L, Hallqvist J. Knowing and accepting oneself: Exploring possibilities of self-awareness among working autistic young adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221137428. [DOI: 10.1177/13623613221137428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Autistic people have historically been described as incapable of developing a deeper sense of self-awareness, and autistic understandings of self-awareness have been largely disregarded. The aim of this study is to explore the way young autistic adults try to understand their functionality and who they are, or to develop their sense of self-awareness, in work and in private life contexts. In 12 qualitative interviews conducted with four autistic adults without learning difficulties, we identified a rich set of reflections on knowing and accepting oneself. The overarching theme of self-knowledge has three subthemes: learning from previous experiences, learning about oneself by securing the support of others, and understanding and accepting autistic functionality. The strategy of self-knowledge was used by these young adults to help them achieve functional lives in the work and private domains. Our results show that young autistic adults both actively explore and develop their self-awareness. We suggest that it is important for practitioners and employers working with autistic individuals to engage with their journeys of self-awareness as a vital part of understanding and supporting them. Lay abstract When researchers and professionals talk about autism, they commonly point out problems and risks with autism or being autistic. Several interventions are based on the idea of the problems and risks of autism. Another way of talking about autism is to point out autistic people’s strengths and strategies which they use to handle barriers and problems in their lives in order to live good lives on their own terms. In this article, the researchers explore how autistic young adults formulate their own difficulties, strengths and support needs in order to get right support from support people. To be able to formulate this, autistic people need to get to know oneself and one’s own way of functioning. Autistic own self-knowledge must be central when formal support people, such as social workers, formulate support and interventions aimed at helping autistic people, in order for the support/intervention to be helpful.
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82
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Keates N, Waldock KE, Dewar E. Tensions Between Autistic Sociality, Communication, and Social Skills Research: A Response to Bambara (2022) and Camarata (2022). JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4346-4350. [PMID: 36256585 DOI: 10.1044/2022_jslhr-22-00331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE The purpose of this letter to the editor is to further elucidate the arguments Keates (2022) and Beechey (2022) stated in their letters to the editor. Both Bambara (2022) and Camarata (2022) pose comments that require clarifying the original arguments, particularly regarding power and autistic sociality, which we feel will provide further clarity to this highly significant and growing topic within autism research. CONCLUSION We recommend teaching not autistic people but rather non-autistic individuals about autistic sociality, in order to lower the burden on autistic interlocutors in cross-neurotype interactions and socialization (as per previous literature, Bottema-Beutel et al., 2018). We provide recommendations to address difficulties in cross-neurotype interactions-for example, bridging the neurotype gap through practice or psychosocial interventions for acceptance of autistic people and their system of interpretation, as per Jones et al. (2021).
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Affiliation(s)
- Nathan Keates
- Tizard Centre, University of Kent, Canterbury, United Kingdom
| | | | - Eleanor Dewar
- Tizard Centre, University of Kent, Canterbury, United Kingdom
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83
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Ferenc K, Płatos M, Byrka K, Król ME. Looking through rainbow-rimmed glasses: Taking neurodiversity perspective is related to subjective well-being of autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221135818. [DOI: 10.1177/13623613221135818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Finding new ways of supporting the well-being of autistic adults is an essential goal for research and practice. We tested the predictive value of attitudes towards autism (as neurodiversity or as a disorder) and identification with other autistic people, on the psychological distress and self-esteem of autistic adults ( n = 109). Adopting a neurodiversity attitude not only predicted higher self-esteem but also served as a protective factor against the negative impact of identification with other autistic people on psychological distress. These findings show that clinicians should be sensitive to the way autistic people understand autism and the extent to which they identify with the autism community, as these factors relate to their well-being. Lay abstract Autistic adults experience a high level of distress. Finding new ways to support their well-being is an important goal for researchers and clinicians. We assessed the way autistic adults view their autism, as a disorder or as a type of mind (neurodiversity), and the level they integrate with other autistic people, and we checked how those factors contribute to their well-being. People who see autism rather as a type of mind than as a disorder had higher self-esteem. People who view themselves as more similar to other autistic people felt more stressed, but this result was not accurate for people who view autism as a type of mind. Clinicians should be sensitive to the way autistic people understand autism and to what extent they identify with the autism community, because it may relate to their well-being.
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Affiliation(s)
- Kinga Ferenc
- SWPS University of Social Sciences and Humanities, Poland
| | - Mateusz Płatos
- University of Warsaw, Poland
- Association for Social Innovation ‘Mary and Max’, Poland
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84
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O’Connor RA, van den Bedem N, Blijd-Hoogewys EM, Stockmann L, Rieffe C. Friendship quality among autistic and non-autistic (pre-) adolescents: Protective or risk factor for mental health? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:2041-2051. [PMID: 35068188 PMCID: PMC9597130 DOI: 10.1177/13623613211073448] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Autistic young people are often misunderstood by non-autistic young people, and this can lead to difficulties in their friendships. We know that friendship is very important for our mental health. For non-autistic young people, having good friendships is linked to better mental health and having problems in friendship can cause mental health problems. This study aimed to compare the positive and negative features of friendship that autistic non-autistic young people experience. The study also aimed to understand if having positive or negative friendship features is related to signs of mental health problems (anxiety and depression). 306 young people aged 9-16 took part in this study. These were 86 autistic boys, 18 autistic girls, 91 non-autistic boys and 111 non-autistic girls. The findings of this study showed that autistic young people have less positive friendship features than non-autistic young people. For all young people in the study, having more positive friendship features was related to fewer signs of depression, while having more negative friendship features was related to more signs of depression. Just for autistic girls, having more positive friendship features was related to more signs of anxiety. These findings show that support is needed to help autistic young people have more positive friendships. For example, by teaching non-autistic young people how to be supportive friends to their autistic peers.
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Affiliation(s)
| | | | | | | | - Carolien Rieffe
- Leiden University, The
Netherlands
- University College London, UK
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85
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Schuck RK, Tagavi DM, Baiden KMP, Dwyer P, Williams ZJ, Osuna A, Ferguson EF, Jimenez Muñoz M, Poyser SK, Johnson JF, Vernon TW. Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework. J Autism Dev Disord 2022; 52:4625-4645. [PMID: 34643863 PMCID: PMC9508016 DOI: 10.1007/s10803-021-05316-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 12/25/2022]
Abstract
Proponents of autism intervention and those of the neurodiversity movement often appear at odds, the former advocating for intensive treatments and the latter arguing that autism must be accepted as a form of diversity. The history of behavioral intervention has understandably outraged many in the Autistic community, though many still value supports focused on quality of life. This commentary argues that Naturalistic Developmental Behavioral Interventions (NDBIs) hold promise for bridging the gap between early intervention and the neurodiversity movement. However, we recognize NDBIs have much room to grow and suggest multiple strategies for improvement. We believe these updates are not only feasible for clinicians and researchers to implement but will ultimately lead to improved quality of life for Autistic individuals.
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Affiliation(s)
- Rachel K Schuck
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA.
| | - Daina M Tagavi
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Kaitlynn M P Baiden
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Patrick Dwyer
- Department of Psychology, University of California, Davis, Davis, CA, USA
- Center for Mind and Brain, University of California, Davis, Davis, CA, USA
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
| | - Anthony Osuna
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Emily F Ferguson
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Maria Jimenez Muñoz
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Samantha K Poyser
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | | | - Ty W Vernon
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
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86
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Pellicano E, Fatima U, Hall G, Heyworth M, Lawson W, Lilley R, Mahony J, Stears M. A capabilities approach to understanding and supporting autistic adulthood. NATURE REVIEWS PSYCHOLOGY 2022; 1:624-639. [PMID: 36090460 PMCID: PMC9443657 DOI: 10.1038/s44159-022-00099-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/28/2022]
Abstract
There is little comprehensive research into autistic adulthood, and even less into the services and supports that are most likely to foster flourishing adult autistic lives. This limited research is partly because autism is largely conceived as a condition of childhood, but this focus of research has also resulted from the orthodox scientific approach to autism, which conceptualizes autistic experience almost entirely as a series of biologically derived functional deficits. Approaching autism in this way severely limits what is known about this neurodevelopmental difference, how research is conducted and the services and supports available. In this Review, we adopt an alternative research strategy: we apply Martha Nussbaum’s capabilities approach, which focuses on ten core elements of a thriving human life, to research on autistic adulthood. In doing so, we identify areas where autistic adults thrive and where they often struggle, and highlight issues to which researchers, clinicians and policymakers should respond. The resulting picture is far more complex than conventional accounts of autism imply. It also reveals the importance of engaging autistic adults directly in the research process to make progress towards genuinely knowing autism and supporting flourishing autistic lives. The focus on functional deficits in conventional autism research constrains understanding of autistic lives. In this Review, Pellicano et al. appraise research on autistic adulthood through a capabilities lens to identify areas where autistic adults thrive, and where more research and services are needed to enhance their quality of life.
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87
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Cage E, Cranney R, Botha M. Brief Report: Does Autistic Community Connectedness Moderate the Relationship Between Masking and Wellbeing? AUTISM IN ADULTHOOD 2022; 4:247-253. [PMID: 36606159 PMCID: PMC9645674 DOI: 10.1089/aut.2021.0096] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Masking involves blending in or covering a stigmatized identity, to avoid discrimination and to "pass" within society. Autistic people often report masking, both intentionally and unintentionally, to get by in social situations. Autistic people who report high rates of masking also tend to experience poorer mental health. It is important we understand whether there are variables that can protect against the negative effects of masking. One such potential variable is autistic community connectedness (ACC)-being part of and belonging to the autistic community. Past research suggests there are benefits for autistic people socially connecting with other autistic people. We investigated whether ACC could moderate the relationship between masking and wellbeing. Methods One hundred ninety-six autistic people completed an online survey including measures of ACC, masking, and mental wellbeing. We used moderation analysis to test whether ACC acted as a buffer between masking and wellbeing. Results Higher self-reported masking related to poorer mental wellbeing. Higher ACC related to more positive wellbeing. Higher ACC correlated with more masking. However, there was no interaction effect, and ACC did not moderate the relationship between masking and wellbeing. Conclusions Although ACC did relate to more positive mental wellbeing overall, it did not moderate the negative relationship between masking and wellbeing. If masking relates to the prejudice faced by autistic people, those with greater attachment to the autistic community may also be more aware of discrimination against their community. Furthermore, autistic people who are more connected might experience a higher salience of masking when moving between autistic and nonautistic settings. Tackling prejudice toward autistic people is critical in helping to reduce the negative effects associated with masking, and we must endeavor to change perceptions and increase inclusion of autistic people.
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Affiliation(s)
- Eilidh Cage
- Department of Psychology, University of Stirling, Stirling, Scotland
| | - Rebekah Cranney
- Department of Psychology, University of Stirling, Stirling, Scotland
| | - Monique Botha
- Department of Psychology, University of Stirling, Stirling, Scotland
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88
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Trundle G, Jones KA, Ropar D, Egan V. The forensic implications of camouflaging: a study into victimisation and offending associated with autism and pathological demand avoidance. ADVANCES IN AUTISM 2022. [DOI: 10.1108/aia-02-2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to investigate the influence of social camouflaging on victimisation and offending in relation to autism and pathological demand avoidance (PDA) traits. Camouflaging aims to overcome or conceal difficulties in social and communication skills. Autistic individuals report camouflaging in response to threat and being verbally and physically assaulted when they have not camouflaged. Thus, camouflaging could be associated with victimisation. Camouflaging could also impact on specialist support available to an individual, potentially increasing the risk of victimisation or offending.
Design/methodology/approach
Cross-sectional study was conducted using 220 participants from the general population who completed online questionnaires measuring victimisation and offending, autism and PDA traits, camouflaging and symptoms of depression and anxiety.
Findings
Correlational analysis found positive associations between camouflaging and victimisation, and camouflaging and lifetime offending. Greater camouflaging and PDA traits predicted greater offending, whereas greater autism traits predicted fewer offending behaviours. While correlated, camouflaging was not significantly predictive of victimisation. Victimisation was predicted by symptoms of depression and PDA traits.
Originality/value
To the best of the authors’ knowledge, this study is the first to consider camouflaging as an influencing factor on offending and victimisation in autistic and PDA individuals.
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89
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Frigaux A, Vacant C, Evrard R. Le devenir autiste au féminin : difficultés diagnostiques et ressources subjectives. Une revue de littérature. EVOLUTION PSYCHIATRIQUE 2022. [DOI: 10.1016/j.evopsy.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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90
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Feldman M, Hamsho N, Blacher J, Carter AS, Eisenhower A. Predicting peer acceptance and peer rejection for autistic children. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Melanie Feldman
- TEACCH Autism Program School of Medicine, University of North Carolina Chapel Hill North Carolina USA
| | - Narmene Hamsho
- Department of Psychology University of Massachusetts Boston Massachusetts USA
| | - Jan Blacher
- Graduate School of Education University of California Riverside California USA
| | - Alice S. Carter
- Department of Psychology University of Massachusetts Boston Massachusetts USA
| | - Abbey Eisenhower
- Department of Psychology University of Massachusetts Boston Massachusetts USA
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91
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Bemmouna D, Weibel S, Kosel M, Hasler R, Weiner L, Perroud N. The utility of the autism-spectrum quotient to screen for autism spectrum disorder in adults with attention deficit/hyperactivity disorder. Psychiatry Res 2022; 312:114580. [PMID: 35523029 DOI: 10.1016/j.psychres.2022.114580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022]
Abstract
The co-occurrence of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) has been reported to be highly prevalent in adults. However, very few studies have assessed the usefulness of screening instruments to detect this co-occurrence, particularly when screening for ASD in the context of ADHD. Our study aimed at assessing the utility of the autism-spectrum quotient (AQ) as a screening tool of ASD in a sample of 153 adults referred for ADHD assessment. Our results showed that the AQ is of limited use in this context as its positive predictive value was low (47%). Particularly, the more severe the attentional deficits the more likely individuals with ADHD were to be misclassified as having a co-occurring ASD based on the AQ. However, the "imagination" subscale of the AQ was able to discriminate those who met ASD criteria from those who did not, suggesting that targeting imagination impairments might be useful when assessing for the ADHD+ASD co-occurrence in clinical settings.
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Affiliation(s)
- Doha Bemmouna
- Department of Psychology, University of Strasbourg, 12 Rue Goethe, Strasbourg 67000, France.
| | - Sébastien Weibel
- Inserm U1114, 1 Place de l'Hôpital, Strasbourg 67000, France; Psychiatry Department, University Hospitals of Strasbourg, 1 Place de l'Hôpital, Strasbourg 67000, France
| | - Markus Kosel
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospital of Geneva, 20 rue de Lausanne, Geneva 1201, Switzerland
| | - Roland Hasler
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospital of Geneva, 20 rue de Lausanne, Geneva 1201, Switzerland
| | - Luisa Weiner
- Department of Psychology, University of Strasbourg, 12 Rue Goethe, Strasbourg 67000, France; Psychiatry Department, University Hospitals of Strasbourg, 1 Place de l'Hôpital, Strasbourg 67000, France
| | - Nader Perroud
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospital of Geneva, 20 rue de Lausanne, Geneva 1201, Switzerland
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92
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Ai W, Cunningham WA, Lai MC. Reconsidering autistic ‘camouflaging’ as transactional impression management. Trends Cogn Sci 2022; 26:631-645. [DOI: 10.1016/j.tics.2022.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 12/12/2022]
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93
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Dwyer P. The Neurodiversity Approach(es): What Are They and What Do They Mean for Researchers? Hum Dev 2022; 66:73-92. [PMID: 36158596 PMCID: PMC9261839 DOI: 10.1159/000523723] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/22/2021] [Indexed: 08/31/2023]
Abstract
This paper presents the concepts of "neurodiversity" and the "neurodiversity approaches" towards disability and discusses how confusion regarding the meaning of these concepts exacerbates debate and conflict surrounding the neurodiversity approaches. For example, some claim the neurodiversity approaches focus solely on society and deny contributions of individual characteristics to disability (a controversial stance), whereas this paper joins other literature in acknowledging the contributions of both individual and society to disability. This paper also addresses other controversies related to neurodiversity, such as uncertainty regarding the scope of the approaches - to whom do they apply? - and their implications for diagnostic categories. Finally, it provides recommendations for developmental researchers who wish to carry out neurodiversity-aligned research: scholars are urged to study both individual neurodivergent people and the contexts around them; to consider both strengths and weaknesses; to recognize their own biases; and to listen to and learn from neurodivergent people.
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Affiliation(s)
- Patrick Dwyer
- Center for Mind and Brain, University of California at Davis, Davis, California, USA
- Department of Psychology, University of California at Davis, Davis, California, USA
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94
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Mantzalas J, Richdale AL, Dissanayake C. A conceptual model of risk and protective factors for autistic burnout. Autism Res 2022; 15:976-987. [PMID: 35416430 DOI: 10.1002/aur.2722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/25/2022] [Accepted: 03/22/2022] [Indexed: 12/28/2022]
Abstract
Early qualitative research indicates that autistic burnout is commonly experienced by autistic people and is associated with significant, negative consequences for their mental health, wellbeing, and quality of life, including suicidality. Findings to date suggest that factors associated with being autistic and the widespread lack of autism awareness and acceptance within society contribute to the onset and recurrence of autistic burnout. Based on autistic adults' descriptions of their lived experiences, a Conceptual Model of Autistic Burnout (CMAB) is proposed, which describes a series of hypothesized relationships between identified risk and protective factors that may contribute to, or buffer against, autistic burnout. The theoretical framework for the CMAB is based on the Social-Relational model of disability and neurodiversity paradigm, and the Job Demands-Resources model of burnout, and Conservation of Resources theory. The CMAB offers a holistic perspective for understanding individual, social, and environmental factors that can influence autistic burnout via various direct and indirect pathways. Autistic burnout research is in its infancy and the CMAB provides a foundation for future investigations about this condition. LAY SUMMARY: Although many autistic people describe experiencing autistic burnout, there has been little research on this topic. Based on descriptions of autistic peoples' lived experiences, we developed a conceptual model to explore how various risk and protective factors may interact to contribute to, or prevent, autistic burnout.
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Affiliation(s)
- Jane Mantzalas
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
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95
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Keates N. A Letter to the Editor Regarding Bambara et al. (2021), "Using Peer Supports to Encourage Adolescents With Autism Spectrum Disorder to Show Interest in Their Conversation Partners". JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1600-1603. [PMID: 35263555 DOI: 10.1044/2022_jslhr-22-00028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this letter is to address interpretations regarding Bambara et al.'s (2021) study and help resolve potential for further missteps within this line of research. CONCLUSION There is clear value in teaching skills that are wanted by autistic people. The primary issue within the article is that it does not acknowledge the double empathy problem and is constructed based on only a neurotypical system of interpretation or communication style. What is being promoted is to address skills autistic participants request.
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Affiliation(s)
- Nathan Keates
- Tizard Centre, University of Kent, Canterbury, Kent, United Kingdom
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96
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Cooper M, Gale K, Langley K, Broughton T, Massey TH, Hall NJ, Jones CRG. Neurological consultation with an autistic patient. Pract Neurol 2022; 22:120-125. [PMID: 34625468 DOI: 10.1136/practneurol-2020-002856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/04/2022]
Abstract
Autism is a neurodevelopmental condition with a very heterogeneous presentation. Autistic people are more likely to have unmet healthcare needs, making it essential that healthcare professionals are 'autism-aware'. In this article, we provide an overview of how autism presents and use case studies to illustrate how a neurological consultation in an outpatient clinic environment could prove challenging for a autistic person. We suggest how to improve communication with autistic patients in clinic and highlight the importance of a patient-centred and flexible approach.
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Affiliation(s)
- Miriam Cooper
- Neurodevelopmental Service, Cwm Taf Morgannwg University Health Board, Merthyr Tydfil, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Katherine Gale
- Neurodevelopmental Service, Cwm Taf Morgannwg University Health Board, Merthyr Tydfil, UK
| | - Kate Langley
- School of Psychology, Cardiff University, Cardiff, UK
| | - Thomas Broughton
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Thomas H Massey
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | | | - Catherine R G Jones
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, UK
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Montanari M, Martella G, Bonsi P, Meringolo M. Autism Spectrum Disorder: Focus on Glutamatergic Neurotransmission. Int J Mol Sci 2022; 23:ijms23073861. [PMID: 35409220 PMCID: PMC8998955 DOI: 10.3390/ijms23073861] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/16/2022] Open
Abstract
Disturbances in the glutamatergic system have been increasingly documented in several neuropsychiatric disorders, including autism spectrum disorder (ASD). Glutamate-centered theories of ASD are based on evidence from patient samples and postmortem studies, as well as from studies documenting abnormalities in glutamatergic gene expression and metabolic pathways, including changes in the gut microbiota glutamate metabolism in patients with ASD. In addition, preclinical studies on animal models have demonstrated glutamatergic neurotransmission deficits and altered expression of glutamate synaptic proteins. At present, there are no approved glutamatergic drugs for ASD, but several ongoing clinical trials are currently focusing on evaluating in autistic patients glutamatergic pharmaceuticals already approved for other conditions. In this review, we provide an overview of the literature concerning the role of glutamatergic neurotransmission in the pathophysiology of ASD and as a potential target for novel treatments.
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Affiliation(s)
- Martina Montanari
- Laboratory of Neurophysiology and Plasticity, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (M.M.); (G.M.)
- Department of Systems Neuroscience, University Tor Vergata, 00133 Rome, Italy
| | - Giuseppina Martella
- Laboratory of Neurophysiology and Plasticity, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (M.M.); (G.M.)
| | - Paola Bonsi
- Laboratory of Neurophysiology and Plasticity, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (M.M.); (G.M.)
- Correspondence: (P.B.); (M.M.)
| | - Maria Meringolo
- Laboratory of Neurophysiology and Plasticity, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (M.M.); (G.M.)
- Correspondence: (P.B.); (M.M.)
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98
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Radulski EM. Conceptualising Autistic Masking, Camouflaging, and Neurotypical Privilege: Towards a Minority Group Model of Neurodiversity. Hum Dev 2022. [DOI: 10.1159/000524122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Autistic masking and camouflaging—concealing Autistic traits to ‘pass’ as non-Autistic—is linked to negative developmental consequences including stress, mental illness, identity loss, and suicidality. Recent psychological literature on masking and camouflaging seeks to urgently address these issues—yet overlooks relevant sociological research. This study uses Sara Ahmed and Frantz Fanon’s work on masking, alongside Judith Butler’s concept of performativity, to formulate distinct sociological definitions for Autistic masking and camouflaging. I offer a qualitative Critical Discourse Analysis of 2018’s #TakeTheMaskOff Neurodiversity Activism campaign, alongside psychology masking/camouflaging literature, to question the social drivers of masking and camouflaging. Autism is widely understood as an ‘Invisible’ Disability. However, I found that the necessity of masking and camouflaging to avoid discrimination renders Autistic people a ‘Visible Neurominority Group’. Proposing a new Minority Group Model of Neurodiversity, I argue that Neurotypical hegemony, invisibility, and majority group privilege are key social drivers of masking and camouflaging.
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99
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Turnock A, Langley K, Jones CR. Understanding Stigma in Autism: A Narrative Review and Theoretical Model. AUTISM IN ADULTHOOD 2022; 4:76-91. [PMID: 36605561 PMCID: PMC8992913 DOI: 10.1089/aut.2021.0005] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The experience of stigma by autistic people is relatively understudied, despite contributing to a range of poor outcomes and having an overarching impact on well-being. The current review of the literature synthesizes research to determine what is currently known and presents a theoretical model of autism stigma. Autism stigma is primarily influenced by a public and professional understanding of autism in combination with interpretation of visible autistic traits. Moderating factors include the quality and quantity of contact with autistic people, cultural factors, sex and gender, individual differences, and diagnostic disclosure. Stigma can reduce well-being as well as increase the presence of camouflaging behaviors, which mask autistic traits. Caregivers of autistic people can experience stigma by association, that is, affiliate stigma, which can impact their own well-being. A variety of interventions and approaches to reduce stigma are discussed, including "autism friendly" spaces, positive media representation, educational and psychosocial training for the public and professionals, as well as cultural and systemic shifts that foster inclusivity and recognize neurodiversity.
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Affiliation(s)
- Alice Turnock
- School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, United Kingdom
| | - Kate Langley
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Catherine R.G. Jones
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom.,Address correspondence to: Catherine R.G. Jones, PhD, School of Psychology, Cardiff University, Park Place, Cardiff CF10 3AT, United Kingdom
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100
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Harmens M, Sedgewick F, Hobson H. The Quest for Acceptance: A Blog-Based Study of Autistic Women's Experiences and Well-Being During Autism Identification and Diagnosis. AUTISM IN ADULTHOOD 2022; 4:42-51. [PMID: 36605564 PMCID: PMC8992923 DOI: 10.1089/aut.2021.0016] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Although studies have found that autism is underdiagnosed in women and that autistic women have poorer well-being outcomes than men, less is known about autistic women's experiences with self-identification or diagnosis or how they feel such experiences affect their mental health. Methods We explored autistic women's experiences of coming to recognize and understand themselves as autistic. We used data collected from blogs written by autistic women about their diagnostic or self-identification experiences. We were particularly interested in well-being, and how this contributed to, was affected by, and interacted with the identification and diagnostic process. We used thematic analysis to explore and document experiences described in blogs from 20 blogsites (representing the views of 23 autistic women). Results Acceptance was a central issue. We developed themes of self-understanding and self-acceptance, being understood and accepted by others (including peers, clinicians, and others in the autism community), and the exhaustion resulting from trying to be accepted and be understood. These issues arose both when going through the diagnostic process, and after receiving a formal diagnosis. Conclusions Diagnosis and identification may have both positive and negative effects on autistic women's well-being, with women often describing difficulties after diagnosis as stemming from facing male stereotypes of autism. We consider the implications of our findings for clinicians, researchers, and those who work with autistic women.
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Affiliation(s)
- Miriam Harmens
- Department of Psychology, University of York, Heslington, York, United Kingdom
| | | | - Hannah Hobson
- Department of Psychology, University of York, Heslington, York, United Kingdom.,Address correspondence to: Hannah Hobson, DPhil, Department of Psychology, University of York, YO10 5DD York, United Kingdom
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