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Green CC, Smith J, Bent CA, Chetcuti L, Uljarević M, Benson PR, Hudry K. Predictors of Change in Wellbeing and Mental Health of Parents of Autistic Pre-Schoolers. J Autism Dev Disord 2024:10.1007/s10803-024-06471-7. [PMID: 39060704 DOI: 10.1007/s10803-024-06471-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 07/28/2024]
Abstract
Parenting is a rewarding experience but is not without its challenges. Parents of Autistic children face additional challenges, and as a result can experience lower levels of wellbeing and more mental health problems (i.e., depression, anxiety, stress). Previous studies have identified concurrent correlates of wellbeing and mental health. However, few have investigated predictors of subsequent wellbeing and mental health, or of change over time, among parents of pre-school aged autistic children. We examined child-, parent-, and family/sociodemographic factors associated with change in parents' mental health and wellbeing across three timepoints (spanning approximately one year) among 53 parents of Autistic pre-schoolers (M = 35.48, SD = 6.36 months. At each timepoint, parents reported lower wellbeing and greater mental health difficulties compared to normative data. There was no significant group-level change over time in parent outcomes. However, individual variability in short-term (~ 5 months) wellbeing and mental health change was predicted by a combination of child- and parent-related factors, while variability in medium-term (~ 10 months) change was predicted by parent factors alone. Parents' description of their child and their relationship predicted change in both wellbeing and mental health. Furthermore, participating in a parent-mediated intervention (available to a subgroup) was a significant predictor of change in wellbeing. Our findings highlight potentially modifiable factors (e.g., learning healthier coping strategies) that may positively impact both short- and medium-term change in parental outcomes.
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Affiliation(s)
- Cherie C Green
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Jodie Smith
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Catherine A Bent
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Lacey Chetcuti
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Stanford Autism Centre, Department of Psychiatry and Behavioural Sciences, Child and Adolescent Psychiatry, School of Medicine, Stanford University, Stanford, CA, USA
- Telethon Kids Institute, WA, Nedlands, Australia
| | - Mirko Uljarević
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
- Stanford Autism Centre, Department of Psychiatry and Behavioural Sciences, Child and Adolescent Psychiatry, School of Medicine, Stanford University, Stanford, CA, USA
| | - Paul R Benson
- Department of Sociology, University of Massachusetts, Boston, USA
| | - Kristelle Hudry
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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Soto EF, Orantes D, Russo N, Antshel KM. Autism and sexual and gender minority identity in college students: Examination of self-reported rates, functional outcomes, and treatment engagement. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1519-1539. [PMID: 38551171 DOI: 10.1177/13623613241236228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
LAY ABSTRACT Autistic individuals and those who identify with a sexual and/or gender minority are both at risk for various mental health concerns and related impairments. However, the connection between autism and sexual and/or gender minorities and mental health and functional outcomes is not clear. Here, we provide evidence of these connections by analyzing data from a large nationally representative dataset from the American College Health Association-National College Health Assessment III. We found that autistic college students who identify with both sexual and gender minorities reported the highest rates of stress, academic, and mental health concerns including suicidality when compared with autistic college students with or without a sexual and/or gender minority. In addition, college students with at least two identities, such as autism and a sexual minority identity or both a sexual and gender minority identity, reported the next highest rates of concern. These findings affirm the need for mental healthcare providers to consider the intersections of a sexual and gender minority identities in non-autistic and, especially, in autistic college students to develop and provide better support and resources.
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Bal VH, Mournet AM, Glascock T, Shinall J, Gunin G, Jadav N, Zhang H, Brennan E, Istvan E, Kleiman EM. The emotional support plan: Feasibility trials of a brief, telehealth-based mobile intervention to support coping for autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:932-944. [PMID: 37497873 DOI: 10.1177/13623613231186035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
LAY ABSTRACT Autistic adults may have difficulty coping during stressful periods, which could make them more vulnerable to depression and anxiety. We designed the emotional support plan (ESP) to help autistic people find ways to cope in stressful situations. Thirty-six autistic adults created an ESP and answered questions about their opinions of the ESP. Most autistic adults found the ESP to have a positive impact on them and many would recommend the ESP to another person. Feedback from autistic adults suggested ways that we might test the ESP in future studies. Overall, autistic adults in this study found the ESP to be useful and a worthwhile intervention to study more in the future. While more research is clearly needed, we hope that the brief nature of the ESP will make it helpful for autistic people who are trying to handle negative feelings during stressful life events.
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Affiliation(s)
| | | | | | | | | | - Nikita Jadav
- Rutgers, The State University of New Jersey, USA
| | - Henry Zhang
- Rutgers, The State University of New Jersey, USA
| | | | - Emily Istvan
- Rutgers, The State University of New Jersey, USA
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Greenwood E, Cooklin A, Barbaro J, Miller C. Autistic patients' experiences of the hospital setting: A scoping review. J Adv Nurs 2024; 80:908-923. [PMID: 37743597 DOI: 10.1111/jan.15880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/25/2023] [Accepted: 09/10/2023] [Indexed: 09/26/2023]
Abstract
AIM To explore the factors that affect the experiences of autistic patients in the hospital setting. DESIGN A scoping review. DATA SOURCES A systematic literature search using the databases CINAHL, Medline and Google Scholar was undertaken in September 2021 and updated in January 2023. This review is based on the methodological framework of Arksey and O'Malley (International Journal of Social Research Methodology, 8(1):19-32, 2005), which was further refined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS Autistic patients, as well as their families and healthcare staff, face several barriers that can impact their healthcare experiences within hospital settings. Of 211 articles screened, 30 were eligible and included. Through our review, we identified two main themes. The first theme, 'challenges to hospital experiences', includes four sub-themes: (1) communication, (2) a mismatch between the needs for autistic patients and the hospital environment, (3) challenges related to parents' experiences and (4) challenges related to hospital systems. The second theme, 'facilitators that improve hospital experiences', includes three sub-themes: (1) provision of care pathways, (2) partnership between parents and experts and (3) facilitators to improve hospital systems. By understanding these themes, we can work to address the barriers that autistic patients and their families face, while leveraging the facilitators to improve their hospital experiences. CONCLUSION It is critical to understand the experiences of autistic patients in the hospital setting because they present a substantial risk of hospital admission due to their associated acute to chronic health conditions. Additionally, nurses and other medical staff must understand the unique hospital experiences and challenges of autistic patients to improve care and facilitate better hospital experiences. This review further highlights the crucial need to adopt a collaborative and inclusive approach between autistic patients, their families and healthcare staff. To achieve this, co-design initiatives that incorporate the perspectives and lived experiences of the autistic community are necessary. By placing autistic voices at the forefront of these initiatives, it is hoped that changes are meaningful, relevant and can be sustained. IMPACT Understanding the unique hospital experiences and challenges of autistic patients can improve their quality of life and well-being by reducing stress and anxiety during hospitalization, leading to better health outcomes and potentially shorter hospital stays. It can also promote a more positive view of healthcare among autistic individuals, encouraging them to seek medical care when needed and have broader societal impacts such as reducing healthcare costs and improving the overall health and well-being of the population. Autistic patients present a substantial risk of hospital admission due to their associated acute to chronic conditions. Nurses and other medical staff must understand the unique hospital experiences and challenges of autistic patients to improve care and facilitate better hospital experiences. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Elly Greenwood
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Amanda Cooklin
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Charne Miller
- Department of Nursing, School of Health Sciences, University of Melbourne Affiliated with School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
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Jodra M, García-Villamisar D. Protective factors against the emotional impact of the pandemic in adults with autism spectrum disorders (ASD) and intellectual disability (ID). Sci Rep 2024; 14:4341. [PMID: 38383720 PMCID: PMC10882043 DOI: 10.1038/s41598-024-55049-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/20/2024] [Indexed: 02/23/2024] Open
Abstract
The pandemic has had very negative effects on the mental health of the population, especially in people with autism spectrum disorders (ASD) and intellectual disability (ID). We analyzed whether social communication, quality of life, and anxiety explain changes in the emotional impact of the pandemic in 60 adults with ASD and ID. Correlations between the study variables were analyzed and subsequently a multiple regression analysis was performed. The results show that communication writing, leisure and well-being index, explain 31% of the dependent variable. The well-being index (PWI) contributes significantly to improving the fit of the model, as indicated by β value. The remaining variables, communication writing and leisure socialization, do not contributed significantly to improving the fit of the model. Quality of life is the only variable that can explain changes in the emotional impact of the pandemic in the study population. This finding should guide future psychoeducational interventions and services for adults.
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Affiliation(s)
- Marina Jodra
- Department of Personality, Evaluation and Clinical Psychology, Universidad Complutense de Madrid, Rector Royo Villanova s/n, Ciudad Universitaria, 28040, Madrid, Spain.
- Asociación Nuevo Horizonte, Las Rozas, Madrid, Spain.
| | - Domingo García-Villamisar
- Department of Personality, Evaluation and Clinical Psychology, Universidad Complutense de Madrid, Rector Royo Villanova s/n, Ciudad Universitaria, 28040, Madrid, Spain
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Realpe AX, Mills N, Beasant L, Douglas S, Kenny L, Rai D. Lockdown Experiences and Views on Future Research Participation of Autistic Adults in the UK During the First 6 Months of the COVID-19 Pandemic. AUTISM IN ADULTHOOD 2023; 5:301-310. [PMID: 37663442 PMCID: PMC10468553 DOI: 10.1089/aut.2022.0027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background The COVID-19 pandemic resulted in large-scale public health restrictions and lockdowns across many countries. There is an increasing literature on the varied impact of such lockdowns in autistic adults. However, there is very little research on how the pandemic and related public health measures may impact the willingness of autistic people in engaging and taking part in research. The aim of this qualitative study was to explore autistic adults' experiences of the COVID-19 lockdown and how the pandemic may affect future research participation. Methods We conducted in-depth interviews with 31 autistic adults between March and July 2020. Transcripts were analyzed thematically within a critical realism framework. Results Participants identified positive aspects of lockdown such as enjoying the lack of social pressures and using their well-developed skills for dealing with uncertainty. Autistic people also shared challenges of adjusting to lockdown, for example, rapid change in daily routines. While hopeful about the freedom gained from easing restrictions, participants were concerned about the inconsistent communication and application of rules during the transition out of lockdown. This may have exacerbated already rising mental health issues among autistic people. The participants viewed research participation and engagement with increased relevance during the pandemic and welcomed efforts to conduct research using online methods of communication. Conclusion The COVID-19 lockdown had a varied effect in the lives and routines of autistic people. However, health care providers and researchers need to be mindful of rising mental health issues in the aftermath of the pandemic, especially for people who were already vulnerable. The response to the pandemic may have offered opportunities for innovation in research processes enabling more autistic people to engage with research and making studies more inclusive.
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Affiliation(s)
- Alba X. Realpe
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Nicola Mills
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Lucy Beasant
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Lorcan Kenny
- Autistica UK Charity, London, United Kingdom
- Learning Disability and Autism Programme, NHS England & NHS Improvement, London, United Kingdom
| | - Dheeraj Rai
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Avon and Wiltshire Partnership NHS Mental Health Trust, Bath, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
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Wolff B, Franco VR, Magiati I, Pestell CF, Glasson EJ. Psychosocial and neurocognitive correlates of suicidal thoughts and behaviours amongst siblings of persons with and without neurodevelopmental conditions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104566. [PMID: 37441861 DOI: 10.1016/j.ridd.2023.104566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/24/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE Siblings of individuals with neurodevelopmental conditions (NDCs) have greater incidence of neuropsychiatric diagnoses and neurocognitive difficulties compared to siblings of persons without NDCs. Despite suicidality being labelled a global health crisis (WHO, 2014) and NDC siblings experiencing risk factors implicated in suicidality, no previous studies examined suicidality amongst adolescent and young adult siblings of persons with NDCs. Our study aimed to bridge this gap. METHOD The present study used Bayesian analyses and risk classification models to examine individual and environmental risk factors associated with suicidal thoughts and behaviours amongst siblings of persons with and without NDCs (n = 267; 132 NDC, 135 control group, mean age 20.61, range 14-27, 76.40% female, 76.78% White Caucasian), as measured using self-report survey data and remote self-administered cognitive tests. RESULTS NDC siblings had higher rates of current nonsuicidal self-injury (NSSI; 18.94% versus 14.07%, δ = -0.32), suicidal ideation (25.76% versus 8.89%, δ = -0.40) and history of suicide attempts (18.18% versus 4.44%, δ = -0.43) compared to controls. Classification models using boosting and random forest demonstrated adequate performance: positive predictive value 0.86-0.91, negative predictive value 0.81-0.90, false negative rates 0.11-0.24. Cognitive inflexibility, alexithymia, inattention, bullying, depression, NSSI, and eating or psychotic disorder history had the highest relative importance in predicting lifetime suicidality. Poorer executive functioning (measured by the Wisconsin Card Sorting Task, Sustained Attention to Response Task, Stop Signal Task, and N-Back 2-back task) was strongly correlated with suicidality. CONCLUSIONS Screening for proximal and modifiable risk factors is critical to inform suicidal behaviour intervention and prevention programs for at-risk siblings.
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Affiliation(s)
- Brittany Wolff
- School of Psychological Science, The University of Western Australia, Perth, Australia; Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia.
| | | | - Iliana Magiati
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Carmela F Pestell
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Emma J Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia; Discipline of Psychiatry, Medical School, The University of Western Australia, Perth, WA, Australia
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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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Barlattani T, D'Amelio C, Capelli F, Mantenuto S, Rossi R, Socci V, Stratta P, Di Stefano R, Rossi A, Pacitti F. Suicide and COVID-19: a rapid scoping review. Ann Gen Psychiatry 2023; 22:10. [PMID: 36932453 PMCID: PMC10020759 DOI: 10.1186/s12991-023-00441-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/03/2023] [Indexed: 03/19/2023] Open
Abstract
There is considerable interest in exploring effects of coronavirus disease 2019 (COVID-19) pandemic on mental health. Suicide is one of the leading causes of mortality worldwide and changes in daily life brought by the pandemic may be additional risk factors in people with pre-existing mental disorders. This rapid PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) scoping review aims to identify and analyze current evidence about the relation between COVID-19 pandemic outbreak, along with COVID-19 disease and severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection, and suicide in individuals with previously diagnosed mental disorders. First, we conducted a comprehensive review of the literature, then proceeded to discuss findings in a narrative way. Tables were constructed and articles sorted according to the studies' methodologies. 53 papers were eventually identified as eligible, among which 33 are cross-sectional studies, 9 are longitudinal studies, and 11 studies using other methodologies. Despite suffering from a mental disorder is a risk factor for suicidal behavior per se, the advent of COVID-19 pandemic may exacerbate this relation. Nevertheless, data addressing a clear correlation between suicidal behavior and the pandemic outbreak are still controversial. Longitudinal analysis using validated suicide scales and multicenter studies could provide deeper insight and knowledge about this topic.
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Affiliation(s)
- Tommaso Barlattani
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy.
| | - Chiara D'Amelio
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Francesco Capelli
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Simonetta Mantenuto
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
| | - Valentina Socci
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Paolo Stratta
- Department of Mental Health Sulmona-Avezzano-L'Aquila, ASL 1, Abruzzo, Italy
| | - Ramona Di Stefano
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
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Shakeshaft A, Blakey R, Kwong ASF, Riglin L, Davey Smith G, Stergiakouli E, Tilling K, Thapar A. Mental-health before and during the COVID-19 pandemic in adults with neurodevelopmental disorders. J Psychiatr Res 2023; 159:230-239. [PMID: 36753897 PMCID: PMC9885110 DOI: 10.1016/j.jpsychires.2023.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 01/11/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
The COVID-19 pandemic negatively impacted mental health globally. Individuals with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), are at elevated risk of mental health difficulties. We investigated the impact of the pandemic on anxiety, depression and mental wellbeing in adults with NDDs using data from the Avon Longitudinal Study of Parents and Children (n = 3058). Mental health data were collected pre-pandemic (age 21-25) and at three timepoints during the pandemic (ages 27-28) using the Short Mood and Feelings Questionnaire, Generalized Anxiety Disorder Assessment-7, and Warwick Edinburgh Mental Wellbeing Scale. ADHD and ASD were defined using validated cut-points of the Strengths and Difficulties Questionnaire and Autism Spectrum Quotient, self-reported at age 25. We used multi-level mixed-effects models to investigate changes in mental health in those with elevated ADHD/ASD traits compared to those without. Prevalences of depression, anxiety and poor mental wellbeing were higher at all timepoints (pre-pandemic and during pandemic) in those with ADHD and ASD compared to those without. Anxiety increased to a greater extent in those with ADHD (β = 0.8 [0.2,1.4], p = 0.01) and ASD (β = 1.2 [-0.1,2.5], p = 0.07), while depression symptoms decreased, particularly in females with ASD (β = -3.1 [-4.6,-1.5], p = 0.0001). On average, mental wellbeing decreased in all, but to a lesser extent in those with ADHD (β = 1.3 [0.2,2.5], p = 0.03) and females with ASD (β = 3.0 [0.2,5.9], p = 0.04). To conclude, anxiety disproportionately increased in adults with NDDs during the pandemic, however, the related lockdowns may have provided a protective environment for depressive symptoms in the same individuals.
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Affiliation(s)
- Amy Shakeshaft
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Wolfson Centre for Young People's Mental Health, Cardiff University, UK
| | - Rachel Blakey
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Alex S F Kwong
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Division of Psychiatry, University of Edinburgh, UK
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Wolfson Centre for Young People's Mental Health, Cardiff University, UK
| | - George Davey Smith
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Evie Stergiakouli
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Kate Tilling
- Population Health Sciences and MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; Wolfson Centre for Young People's Mental Health, Cardiff University, UK.
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A systematic review of predictors of suicidal thoughts and behaviors among autistic adults: Making the case for the role of social connection as a protective factor. Clin Psychol Rev 2023; 99:102235. [PMID: 36459876 DOI: 10.1016/j.cpr.2022.102235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/21/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022]
Abstract
Autistic adults are a high-risk population for suicidal thoughts and behaviors (STBs). Accordingly, this systematic review aims to review the prevalence of STBs among autistic adults, review the risk and protective factors for STBs in autistic adults, and formulate a disorder-specific conceptualization of risk in this population. We systematically searched PsycINFO and Google Scholar for all studies published prior to March 28th, 2022. We included empirical articles focused on autistic adults, ages 18 years and older, reporting on suicide-related outcomes. In total, 45 peer-reviewed empirical articles were included in the current systematic review. The most frequently studied factors in relation to suicide risk among autistic adults were interpersonal constructs (42.4% of total studies looking at risk/protective factors) and depressive symptoms (36.4% of total studies looking at risk/protective factors). We conclude by summarize two key content areas: exploring social and interpersonal constructs and better understanding the role of depressive symptoms in autism. As researchers continue to explore STBs among autistic adults, it will be necessary to addressing the overreliance on autistic symptoms instead of autism diagnoses, measurement issues of STBs, and a need for treatment adaptations.
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Barriers to healthcare and their relationship to well-being and social support for autistic adults during COVID-19. Prim Health Care Res Dev 2022; 23:e79. [PMID: 36515013 PMCID: PMC9817085 DOI: 10.1017/s1463423622000755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM The present study aimed to investigate barriers to healthcare and their relationships to social and emotional well-being and intersectional inequalities for autistic adults during COVID-19 restrictions in the UK. BACKGROUND Autistic adults experience severe health inequalities and report more barriers to accessing health services compared to other both disabled and non-disabled populations. The COVID-19 pandemic has impacted many areas of society that may have increased vulnerability of autistic people to social and health inequalities, including delivery of healthcare from in-person to remote methods. METHOD One hundred twenty-eight autistic adults who lived in the UK took part in an online survey. Measures included the Barriers to Healthcare Checklist (Short Form) and PROMIS outcome measure bank to assess emotional well-being and social support. Participants rated their agreement with items, retrospectively considering three different points of the trajectory of COVID-19 restrictions: before COVID-19, during the first lockdown in spring 2020, and in the month prior to taking the survey during autumn 2020. They completed a follow-up survey six months later to continue to assess change as restrictions in the UK were eased. FINDINGS The average number of barriers to healthcare showed no significant change between all four time points. However, the nature of barriers to healthcare changed at the point of lockdown and persisted beyond the easing of COVID-19 restrictions. Barriers to healthcare were associated with some social and emotional well-being variables and demographic groups including gender, education and presence of additional disabilities. The findings may help to identify areas to target to improve access to both remote and in-person health systems for autistic people as modes of delivery continue to change over time.
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Muniandy M, Richdale AL, Lawson LP. Coping-resilience profiles and experiences of stress in autistic adults. Autism Res 2022; 15:2149-2166. [PMID: 36114687 PMCID: PMC9826183 DOI: 10.1002/aur.2817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/01/2022] [Indexed: 01/11/2023]
Abstract
Emerging studies allude to high stress in autistic adults. Considering the detrimental impact of stress on health outcomes, examining individual resources which may influence the extent to which stress is experienced (e.g., coping and resilience) is vital. Using a person-focused approach, this study aimed to identify coping-resilience profiles, and examine their relations to general perceived stress and daily hassles in a sample of autistic adults (N = 86; aged 19-74 years). Cluster analysis identified four coping-resilience profiles (i.e., high cope/ low resilience, low cope/ high resilience, engage cope/ high resilience, and disengage cope/ low resilience). The high cope/ low resilience and disengage cope/ low resilience groups had significantly higher general perceived stress than the remaining groups. No significant group differences were noted in relation to daily hassles. Jointly addressing coping and resilience may be beneficial on the perceived stress experienced in autistic adults. The use of coping-resilience profiles may also allow for the personalization of stress management and support options in the autistic adult population.
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Affiliation(s)
- Melanie Muniandy
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityBundooraVictoriaAustralia,Cooperative Research Centre for Living with Autism (Autism CRC), The University of QueenslandBrisbaneAustralia
| | - Amanda L. Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityBundooraVictoriaAustralia,Cooperative Research Centre for Living with Autism (Autism CRC), The University of QueenslandBrisbaneAustralia
| | - Lauren P. Lawson
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityBundooraVictoriaAustralia,Cooperative Research Centre for Living with Autism (Autism CRC), The University of QueenslandBrisbaneAustralia
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Hedley D, Batterham PJ, Bury SM, Clapperton A, Denney K, Dissanayake C, Fox P, Frazier TW, Gallagher E, Hayward SM, Robinson J, Sahin E, Trollor J, Uljarević M, Stokes MA. The Suicidal Ideation Attributes Scale-Modified (SIDAS-M): Development and preliminary validation of a new scale for the measurement of suicidal ideation in autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:1115-1131. [PMID: 36237153 DOI: 10.1177/13623613221131234] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Autistic people may be at higher risk of suicidal behavior than people in the general population. Suicidal behavior may include thinking about suicide or attempting to end one's own life by suicide. It is important to identify autistic people who may be thinking about suicide. People who are at risk of suicidal behavior can be identified by asking questions about whether they have been thinking about suicide. A specially designed questionnaire, or screening instrument, can help someone ask the best questions to find out if someone has been thinking about suicide. This information can help to identify supports to be put in place to prevent suicidal behavior, such as a suicide attempt. However, autistic people may interpret questions differently than non-autistic people. It is important to use screening tools that have been designed with, and for autistic people. In this study, we examined the Suicidal Ideation Attributes Scale (SIDAS). The SIDAS is an existing tool that was developed to screen for suicidal thinking in the general population. We modified SIDAS for use with autistic adults. We involved autistic people in the process of modifying SIDAS. We called the modified instrument the SIDAS-M. The results of our study showed SIDAS-M may be useful for screening for suicidal thinking in autistic adults who do not have an intellectual disability.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Jo Robinson
- The University of Melbourne, Australia.,Orygen, Australia
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15
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Lew-Koralewicz A. Psychosocial Functioning and the Educational Experiences of Students with ASD during the COVID-19 Pandemic in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159468. [PMID: 35954828 PMCID: PMC9368499 DOI: 10.3390/ijerph19159468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 12/16/2022]
Abstract
Due to their individual developmental and learning needs, adolescents with autism spectrum disorder (ASD) benefit from a variety of educational, medical, and therapeutic services. During the COVID-19 pandemic, these services were discontinued or significantly reduced, which may have resulted in increased difficulties in coping with various areas of life. The purpose of this study was to explore how the pandemic affected the psychosocial and educational functioning of students with ASD. A qualitative, problem-focused interview method was used. The obtained material was subjected to interpretive phenomenological analysis. The study involved 10 secondary school students diagnosed with ASD. The assessment of the effects of the pandemic on the functioning of people with ASD is inconclusive. The respondents noted both negative and positive effects of lockdown. On the positive side, they were able to spend time with their family, isolate themselves from difficult social relationships and feel better. Among the negative effects, adolescents point to difficulties in emotional functioning—increased levels of stress and anxiety, as well as increased feelings of loneliness and difficulties with online education. The study showed the varied experiences of young people with autism during the pandemic, highlighting the significant need to support some of them in terms of their emotional, social and educational functioning.
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Fridell A, Norrman HN, Girke L, Bölte S. Effects of the Early Phase of COVID-19 on the Autistic Community in Sweden: A Qualitative Multi-Informant Study Linking to ICF. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1268. [PMID: 35162290 PMCID: PMC8835079 DOI: 10.3390/ijerph19031268] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/13/2022] [Accepted: 01/15/2022] [Indexed: 02/04/2023]
Abstract
While the COVID-19 pandemic is ongoing, early outcome studies indicate severe and pervasive global effects of the pandemic and associated measures to prevent the spread of the virus. General population studies, as well as insight into the outcomes for particular groups, will be necessary in order to mitigate potentially long-term effects as well as to prepare for future epidemics or pandemics. The pandemic conditions have been marked by rapid and abrupt changes and unpredictability which are circumstances that leave the autistic population particularly vulnerable to adverse outcomes following the distinctive features of the diagnosis. Studies are only beginning to delineate the outcomes of the global autism community and the present study adds to these findings by providing a local, multi-perspective, qualitative analysis of the lived experiences of the Swedish autism community. In this study, autistic youth and adults, caregivers of autistic individuals, as well as representatives of Swedish interest organizations were interviewed. Thematic analysis was performed on the population as a whole and patterns of results were formalized according to the International Classification of Function, Disability and Health (ICF-CY). Participants report wide-ranging adverse outcomes of the pandemic relating to mental health and access to support, participation in daily activities and socialization, education, and work as well as parental resources. However, participants also report positive outcomes relating to a reduction in specific social and everyday demands, and normalization of lived experiences. Additionally, interviews outlined some strategies used to cope during pandemic conditions. Implications of these findings are discussed.
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Affiliation(s)
- Anna Fridell
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 113 30 Stockholm, Sweden; (H.N.N.); (L.G.); (S.B.)
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm,118 61 Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia
| | - Hjalmar Nobel Norrman
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 113 30 Stockholm, Sweden; (H.N.N.); (L.G.); (S.B.)
| | - Linda Girke
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 113 30 Stockholm, Sweden; (H.N.N.); (L.G.); (S.B.)
- Department of Psychology, Developmental Psychology, Uppsala University, 751 05 Uppsala, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 113 30 Stockholm, Sweden; (H.N.N.); (L.G.); (S.B.)
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm,118 61 Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia
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