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Halvorsen MB, Kildahl AN, Kaiser S, Axelsdottir B, Aman MG, Helverschou SB. Applicability and Psychometric Properties of General Mental Health Assessment Tools in Autistic People: A Systematic Review. J Autism Dev Disord 2024:10.1007/s10803-024-06324-3. [PMID: 38613595 DOI: 10.1007/s10803-024-06324-3] [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] [Accepted: 03/15/2024] [Indexed: 04/15/2024]
Abstract
In recent years, there has been a proliferation of instruments for assessing mental health (MH) among autistic people. This study aimed to review the psychometric properties of broadband instruments used to assess MH problems among autistic people. In accordance with the PRISMA guidelines (PROSPERO: CRD42022316571) we searched the APA PsycINFO via Ovid, Ovid MEDLINE, Ovid Embase and the Web of Science via Clarivate databases from 1980 to March 2022, with an updated search in January 2024, to identify very recent empirical studies. Independent reviewers evaluated the titles and abstracts of the retrieved records (n = 11,577) and full-text articles (n = 1000). Data were extracted from eligible studies, and the quality of the included papers was appraised. In all, 164empirical articles reporting on 35 instruments were included. The review showed variable evidence of reliability and validity of the various instruments. Among the instruments reported in more than one study, the Aberrant Behavior Checklist had consistently good or excellent psychometric evidence. The reliability and validity of other instruments, including: the Developmental Behavior Checklist, Emotion Dysregulation Inventory, Eyberg Child Behavior Inventory, Autism Spectrum Disorder-Comorbid for Children Scale, and Psychopathology in Autism Checklist, were less documented. There is a need for a greater evidence-base for MH assessment tools for autistic people.
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Affiliation(s)
- Marianne Berg Halvorsen
- Department of Pediatric Rehabilitation, University Hospital of North Norway, P.O. Box 2, 9038, Tromsø, Norway.
| | - Arvid Nikolai Kildahl
- NevSom Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo University Hospital, Oslo, Norway
- Intellectual Disabilities/Autism, Regional Section Mental Health, Oslo University Hospital, Oslo, Norway
| | - Sabine Kaiser
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU North), UiT The Arctic University of Norway, Tromsø, Norway
| | - Brynhildur Axelsdottir
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Michael G Aman
- Ohio State University, Columbus, OH, USA
- Nisonger Center, University Center for Excellence in Developmental Disabilities, Ohio State University, Columbus, OH, USA
| | - Sissel Berge Helverschou
- NevSom Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo University Hospital, Oslo, Norway
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Suvarna V, Farrell L, Adams D, Emerson LM, Paynter J. Parenting Practices and Externalizing Behaviors in Autistic Children: A Systematic Literature Review. Clin Child Fam Psychol Rev 2024; 27:235-256. [PMID: 38407761 PMCID: PMC10920481 DOI: 10.1007/s10567-024-00467-6] [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: 01/28/2024] [Indexed: 02/27/2024]
Abstract
There is limited recent research on the association between parenting practices and externalizing behaviors in autistic children. To address this gap, the current systematic review examined the associations between parenting practices and externalizing behaviors in autistic children, along with the mediating and moderating effects of parent and child variables (PROSPERO registration number CRD42022268667). Study inclusion criteria were (1) Peer-reviewed journals, (2) Participants included parents of autistic children and their children, (3) Quantitative measures of both parenting practices or behaviors/style and child externalizing behaviors, (4) Cross-sectional or longitudinal studies only, and (5) Studies published in English. Study exclusion criteria were: (1) Qualitative studies, (2) Published in a language other than English, (3) Participants included non-human participants, (4) Participants that did not include parents and their autistic children as participants or did not report this group separately, (5) Systematic review and meta-analyses, and (6) No quantitative measures of parenting practices and/or child externalizing behaviors. Quality appraisal and risk of bias were conducted using the McMaster Tool and results were synthesized in Covidence and Excel. Thirty studies were included in the review. Results demonstrated that mindful parenting was associated with fewer or lower levels of externalizing behaviors; positive parenting practices had non-significant associations with externalizing behaviors; specific parenting practices had differing associations with externalizing behaviors; and negative parenting practices were associated with higher levels of externalizing behaviors. We are unable to draw causal relationships due to focus on cross-sectional and longitudinal articles only. The potential for future research to target specific parent practices to support children's externalizing behaviors is discussed.
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Affiliation(s)
- Vedanta Suvarna
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia.
| | - Lara Farrell
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
| | - Dawn Adams
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Mt Gravatt, QLD, Australia
| | - Lisa-Marie Emerson
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Jessica Paynter
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
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Ellison KS, Jarzabek E, Jackson SLJ, Naples A, McPartland JC. Brief Report: Exploratory Evaluation of Clinical Features Associated with Suicidal Ideation in Youth with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:803-810. [PMID: 35616816 DOI: 10.1007/s10803-022-05575-2] [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: 04/13/2022] [Indexed: 11/26/2022]
Abstract
There has been a heightened awareness of an increased risk of suicidality among individuals with autism spectrum disorder (ASD) due to high rates of suicidal ideation (SI) in this population (11-66%). The current study investigated the rate of parent-endorsed SI and associated clinical features in 48 youths with ASD (Age; M: 12.97 years, SD: 2.33). SI was endorsed in 18.75% of participants. Youth with SI exhibited significantly higher levels of affective problems, externalizing problems, feelings of humiliation and rejection, and symptoms related to perfectionism. Results indicate that co-occurring mental health problems are associated with suicidal ideation and provide relevant targets for psychotherapeutic intervention. This preliminary study in a modest sample suggests the value of further research in larger samples to replicate and generalize these findings.
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Affiliation(s)
- Kimberly S Ellison
- Child Study Center, School of Medicine, Yale University, 40 Temple Street, Suite 6A2, New Haven, CT, 06520, USA
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA, 70803, USA
| | - Elzbieta Jarzabek
- Child Study Center, School of Medicine, Yale University, 40 Temple Street, Suite 6A2, New Haven, CT, 06520, USA
| | - Scott L J Jackson
- Child Study Center, School of Medicine, Yale University, 40 Temple Street, Suite 6A2, New Haven, CT, 06520, USA
- Office of Assessment and Analytics, Southern Connecticut State University, 501 Crescent Street, New Haven, CT, 06515, USA
| | - Adam Naples
- Child Study Center, School of Medicine, Yale University, 40 Temple Street, Suite 6A2, New Haven, CT, 06520, USA
| | - James C McPartland
- Child Study Center, School of Medicine, Yale University, 40 Temple Street, Suite 6A2, New Haven, CT, 06520, USA.
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Orm S, Wood J, Corbett B, Fjermestad K. Suicidal Risk Behaviors in Adolescents With Rare Neurodevelopmental Disorders: The Role of Sex, Autistic Traits, and Mental Health Difficulties. J Pediatr Psychol 2023; 48:852-860. [PMID: 37553221 PMCID: PMC10857814 DOI: 10.1093/jpepsy/jsad051] [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: 01/18/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE Autistic traits are associated with mental health difficulties and risk of suicidal risk behaviors among adolescents. Little is known about how autistic traits affect the mental health of adolescents with rare neurodevelopmental disorders (RNDs). The aim of this study was to investigate the relationship between autistic traits, mental health difficulties, and suicidal risk behaviors in adolescents with RNDs. METHODS Parents (N = 93) completed the Child Behavior Checklist, Social Communication Questionnaire, and Social Responsiveness Scale about their adolescent (Mage = 13.1, SD = 2.3, 62.4% females) with an RND (e.g., sex chromosome aneuploidies, Fragile X syndrome, 22q11.2 deletion syndrome). The data were analyzed with hierarchical logistic regression analysis. RESULTS The prevalence of suicidal risk behaviors (16.1%) was similar to that reported among autistic youth and was higher among boys than girls. More autistic traits were associated with suicidal risk behaviors in bivariate analysis. In multivariate analysis, more anxiety/depressive symptoms were associated with more suicidal risk behaviors and externalizing problems associated with suicidal risk behaviors beyond autistic traits and anxiety/depressive symptoms. CONCLUSION Adolescents with RNDs are at risk of suicidal risk behaviors, especially those with higher levels of autistic traits, anxiety/depressive symptoms, and externalizing problems. Assessment of autistic traits, mental health difficulties, and suicide risk may be indicated for adolescents with RNDs to determine if corresponding intervention is needed.
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Affiliation(s)
- Stian Orm
- Division of Mental Health Care, Innlandet Hospital Trust, Norway
- Frambu Resource Center for Rare Disorders, Norway
| | - Jeffrey Wood
- Department of Education, University of California, USA
| | - Blythe Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, USA
| | - Krister Fjermestad
- Frambu Resource Center for Rare Disorders, Norway
- Department of Psychology, University of Oslo, Norway
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Andersen PN, Orm S, Fossum IN, Øie MG, Skogli EW. Adolescence internalizing problems as a mediator between autism diagnosis in childhood and quality of life in emerging adults with and without autism: a 10-year longitudinal study. BMC Psychiatry 2023; 23:149. [PMID: 36894901 PMCID: PMC9996871 DOI: 10.1186/s12888-023-04635-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Individuals with autism tend to have a reduced quality of life across their lifespan. This reduced quality of life may be a result of autism traits, mental distress, and poor person/environment fit. In this longitudinal study, we looked at the role of adolescence internalizing and externalizing problems in mediating the relationship between having an autism diagnosis from childhood and perceived quality of life as emerging adults. METHODS A total of 66 participants in a group of emerging adults with autism (mean age 22.2 years), and without autism (mean age 20.9 years) were assessed in three assessment waves (T1 at 12 years, T2 at 14 years, and T3 at 22 years of age). Parents filled out the Child Behavior Checklist at T2 and participants filled out the Perceived Quality of Life Questionnaire at T3. Total and indirect effects were tested in serial mediation analysis. RESULTS The results showed that internalizing problems fully mediated the association between childhood autism diagnosis and the quality of life in emerging adulthood, while externalizing problems did not. CONCLUSION Our findings suggest that attention to adolescent internalizing problems is important to improve the later quality of life for emerging adults with autism.
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Affiliation(s)
- Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Holsetgata, Norway.
| | - Stian Orm
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingrid Nesdal Fossum
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway.,Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Erik Winther Skogli
- Department of Psychology, Inland Norway University of Applied Sciences, Holsetgata, Norway.,Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
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Cleary M, West S, McLean L, Hunt GE, Hungerford C, Kornhaber R. A Scoping Review of Autism and the Way It Changes the Presentation of Suicidal Thoughts and Behavior Compared to the General Population. Issues Ment Health Nurs 2022; 44:282-301. [PMID: 36279193 DOI: 10.1080/01612840.2022.2132329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Autism spectrum conditions are a group of neurodevelopmental conditions that carries an array of co-occurring diagnoses, including a heightened risk of suicide attempts and suicide. This scoping review examined primary research focusing on autism and suicidality, to understand what is currently known on the topic, including how autism changes the presentation of suicidal thoughts and behavior; and to assess the suicide awareness and prevention education programs currently available for autistic people, their families, and health professionals and support workers. A comprehensive search (November 2021) across Scopus, PubMed and CINAHL identified 39 articles from 38 studies. Three themes emerged, with five subthemes. 1. The prevalence of suicidality in autistic people; 2. The presentation of suicidality in autistic people, including (a) risk of suicidality; (b) gender, age, employment and education; (c) co-occurring psychiatric conditions; (d) autism traits and social communication; (e) intellectual disability; and 3. Autism-specific approaches to suicidal thoughts, behavior and prevention. Findings were mixed, including conflicting evidence on the risk of autism and suicidality, and limited evidence of resources related to autism-specific suicide awareness or information, and education or prevention programs.
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Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, New South Wales, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, New South Wales, Australia
| | - Loyola McLean
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.,Consultation-Liaison Psychiatry, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Westmead Psychotherapy Program for Complex Traumatic Disorders, Western Sydney Local Health District, Parramatta, New South Wales, Australia.,The Western Clinical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Glenn E Hunt
- Speciality of Psychiatry, Concord Clinical School, The University of Sydney, Concord West, New South Wales, Australia
| | - Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, New South Wales, Australia.,School of Health, Federation University, Mt Helen, Victoria, Australia
| | - Rachel Kornhaber
- School of Nursing, University of Tasmania, Sydney, New South Wales, Australia
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Hymas R, Badcock JC, Milne E. Loneliness in Autism and Its Association with Anxiety and Depression: A Systematic Review with Meta-Analyses. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00330-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract
Objectives
This systematic review aimed to quantify differences in loneliness levels between autistic and neurotypical samples and investigate the association between loneliness and mental health in autistic individuals.
Methods
Three meta-analyses were conducted. Studies were methodologically appraised using established tools.
Results
Overall, 39 studies were included. The majority of these achieved moderate methodological quality ratings. The primary meta-analysis (N = 23) found autistic samples reported higher loneliness compared with neurotypical samples (Hedges’ g = .89). The meta-analyses on the associations between loneliness and anxiety (N = 14) and depression (N = 11) in autistic samples found significant pooled correlations (r = .29 and r = .48, respectively).
Conclusions
This review highlights numerous limitations within current autism and loneliness research. Nevertheless, loneliness in autism merits targeted clinical and research attention.
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