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Kildahl AN, Helverschou SB. Post-traumatic stress disorder and experiences involving violence or sexual abuse in a clinical sample of autistic adults with intellectual disabilities: Prevalence and clinical correlates. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1075-1089. [PMID: 37609889 PMCID: PMC11067401 DOI: 10.1177/13623613231190948] [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: 08/24/2023]
Abstract
LAY ABSTRACT Post-traumatic stress disorder is a mental health disorder that may be triggered by the experience of events perceived as terrifying or overwhelming. Examples of such events include being the victim of violence or sexual abuse. Compared with other people, autistic people have increased risk of being exposed to violence or sexual abuse. In addition, autistic people may be more vulnerable to developing post-traumatic stress disorder following such exposure. However, knowledge is limited concerning the prevalence of experiences involving violence and sexual abuse, and post-traumatic stress disorder, in autistic people with co-occurring intellectual disabilities. Detection of these experiences, and identification of post-traumatic stress disorder, may be challenging in these individuals, and previous research indicates that post-traumatic stress disorder symptoms may be overlooked or misinterpreted. In this study, we examined prevalence of post-traumatic stress disorder, violence and sexual abuse in a clinical sample of 88 autistic adults with intellectual disabilities referred for mental health assessment. Only 3.4% were diagnosed with post-traumatic stress disorder, even if experiences involving violence (34.1%) or sexual abuse (17.0%) were common. Anxiety and affective disorders were common diagnoses among participants with these experiences. Controlling for autism characteristics, level of intellectual disability and communication skills, experiences of violence/sexual abuse were found to be associated with a measure of 'challenging' behaviours. These results indicate that potentially traumatic experiences are common in autistic adults with intellectual disabilities referred for mental health assessment, and that post-traumatic stress disorder may be under-recognised. The findings highlight the importance of trauma screening and post-traumatic stress disorder assessment, as well as the importance of trauma-informed care, in this population.
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Pugliese CE, Handsman R, You X, Anthony LG, Vaidya C, Kenworthy L. Probing heterogeneity to identify individualized treatment approaches in autism: Specific clusters of executive function challenges link to distinct co-occurring mental health problems. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241246091. [PMID: 38642028 DOI: 10.1177/13623613241246091] [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: 04/22/2024]
Abstract
LAY ABSTRACT Many autistic people struggle with mental health problems like anxiety, depression, inattention, and aggression, which can be challenging to treat. Executive function challenges, which impact many autistic individuals, may serve as a risk factor for mental health problems or make treating mental health conditions more difficult. While some people respond well to medication or therapy, others do not. This study tried to understand if there are different subgroups of autistic young people who may have similar patterns of executive function strengths and challenges-like flexibility, planning, self-monitoring, and emotion regulation. Then, we investigated whether executive function subgroups were related to mental health problems in autistic youth. We found three different types of executive function subgroups in autistic youth, each with different patterns of mental health problems. This helps us identify specific profiles of executive function strengths and challenges that may be helpful with identifying personalized supports, services, and treatment strategies for mental health conditions.
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Aymerich C, Pacho M, Catalan A, Yousaf N, Pérez-Rodríguez V, Hollocks MJ, Parellada M, Krebs G, Clark B, Salazar de Pablo G. Prevalence and Correlates of the Concurrence of Autism Spectrum Disorder and Obsessive Compulsive Disorder in Children and Adolescents: A Systematic Review and Meta-Analysis. Brain Sci 2024; 14:379. [PMID: 38672028 PMCID: PMC11048346 DOI: 10.3390/brainsci14040379] [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: 03/18/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD) are two common and impairing neurodevelopmental conditions with partial symptomatic overlap. The aim of this study is to systematically and meta-analytically examine the following: (i) the prevalence of an OCD diagnosis among young people with ASD, (ii) the prevalence of an ASD diagnosis among young people with OCD, and (iii) the clinical and therapeutic implications of such comorbidity. METHOD A multistep literature search was performed from database inception until 17 November 2023. This PRISMA/MOOSE-compliant systematic review, registered in PROSPERO (CRD42023480543), identified studies reporting on the prevalence, sociodemographic, psychopathologic, prognostic, and therapeutic correlates of OCD and ASD concurrence in children and adolescents. A quantitative meta-analysis with random effects was conducted to analyse the pooled prevalence of OCD among samples with a mean age of < 18 years old with ASD and the prevalence of ASD among individuals under 18 with OCD. Sensitivity analyses were performed to investigate the effect of diagnostic criteria and different continents. Meta-regression analyses were conducted to examine the effect of gender, age, IQ, and OCD severity scores. A narrative review of the clinical and therapeutical implications of the comorbidity was provided. RESULTS 42 studies were selected for the systematic review (SR), and 31 of them were also included in one of the meta-analyses. The pooled prevalence of OCD among ASD youth samples (n = 8916, mean age = 10.6 ± 1.6; 16.4% female) was 11.6% (95% confidence intervals [CI] = 6.9%; 18.8%), and the pooled prevalence of ASD among OCD children and adolescent samples (n = 6209, mean age = 14.1 ± 1.4; 45.7% female) was 9.5% (95% CI = 6.0%; 14.7%). Meta-regressions found a statistically higher prevalence of ASD among samples with a lower prevalence of females (β = -4.7; 95%CI = -8.6; -0.8). Children with both OCD and ASD present higher rates of functional impairment, psychopathology, and other comorbidities, compared to youth with either of the disorders alone. CONCLUSIONS OCD and ASD are highly concurrent conditions in youth, with symptomatic, prognostic, severity, and therapeutic implications. Future research should focus on conducting longitudinal cohort studies prospectively to determine development trajectories, along with randomized controlled trials to assess the efficacy of specific therapeutic interventions.
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Affiliation(s)
- Claudia Aymerich
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
- Biobizkaia Health Research Institute, Basque Country University, Basurto University Hospital, OSI Bilbao-Basurto, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 48903 Barakaldo, Spain
| | - Malein Pacho
- Biobizkaia Health Research Institute, Basque Country University, Basurto University Hospital, OSI Bilbao-Basurto, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 48903 Barakaldo, Spain
| | - Ana Catalan
- Biobizkaia Health Research Institute, Basque Country University, Basurto University Hospital, OSI Bilbao-Basurto, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 48903 Barakaldo, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
| | - Noorulain Yousaf
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Violeta Pérez-Rodríguez
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Matthew J. Hollocks
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
- Service for Complex Autism & Associated Neurodevelopmental Disorders, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Centro de Investigación en Red en Salud Mental (CIBERSAM), 28007 Madrid, Spain
| | - Georgina Krebs
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Bruce Clark
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Centro de Investigación en Red en Salud Mental (CIBERSAM), 28007 Madrid, Spain
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Neuhaus E, Santhosh M, Kresse A, Aylward E, Bernier R, Bookheimer S, Jeste S, Jack A, McPartland JC, Naples A, Van Horn JD, Pelphrey K, Webb SJ. Frontal EEG alpha asymmetry in youth with autism: Sex differences and social-emotional correlates. Autism Res 2023; 16:2364-2377. [PMID: 37776030 PMCID: PMC10840952 DOI: 10.1002/aur.3032] [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: 01/23/2023] [Accepted: 09/04/2023] [Indexed: 10/01/2023]
Abstract
In youth broadly, EEG frontal alpha asymmetry (FAA) associates with affective style and vulnerability to psychopathology, with relatively stronger right activity predicting risk for internalizing and externalizing behaviors. In autistic youth, FAA has been related to ASD diagnostic features and to internalizing symptoms. Among our large, rigorously characterized, sex-balanced participant group, we attempted to replicate findings suggestive of altered FAA in youth with an ASD diagnosis, examining group differences and impact of sex assigned at birth. Second, we examined relations between FAA and behavioral variables (ASD features, internalizing, and externalizing) within autistic youth, examining effects by sex. Third, we explored whether the relation between FAA, autism features, and mental health was informed by maternal depression history. In our sample, FAA did not differ by diagnosis, age, or sex. However, youth with ASD had lower total frontal alpha power than youth without ASD. For autistic females, FAA and bilateral frontal alpha power correlated with social communication features, but not with internalizing or externalizing symptoms. For autistic males, EEG markers correlated with social communication features, and with externalizing behaviors. Exploratory analyses by sex revealed further associations between youth FAA, behavioral indices, and maternal depression history. In summary, findings suggest that individual differences in FAA may correspond to social-emotional and mental health behaviors, with different patterns of association for females and males with ASD. Longitudinal consideration of individual differences across levels of analysis (e.g., biomarkers, family factors, and environmental influences) will be essential to parsing out models of risk and resilience among autistic youth.
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Affiliation(s)
- Emily Neuhaus
- Seattle Children’s Research Institute; Center on Child Health, Behavior & Development
- University of Washington Psychiatry & Behavioral Sciences
| | - Megha Santhosh
- Seattle Children’s Research Institute; Center on Child Health, Behavior & Development
| | - Anna Kresse
- Columbia University, Mailman School of Public Health
| | - Elizabeth Aylward
- Seattle Children’s Research Institute, Center for Integrative Brain Research
| | | | - Susan Bookheimer
- University of California Los Angeles School of Medicine, Dept. of Psychiatry & Biobehavioral Sciences
- University of California Los Angeles, Intellectual and Developmental Disabilities Research Center
| | - Shafali Jeste
- University of California Los Angeles School of Medicine, Dept. of Psychiatry & Biobehavioral Sciences
- University of California Los Angeles, Intellectual and Developmental Disabilities Research Center
| | | | | | | | - John D. Van Horn
- University of Virginia, Dept. of Psychology
- University of Virginia, School of Data Science
| | - Kevin Pelphrey
- University of Virginia, Dept. of Psychology
- University of Virginia, Dept. of Neurology, Brain Institute & School of Education & Human Development
| | - Sara Jane Webb
- Seattle Children’s Research Institute; Center on Child Health, Behavior & Development
- University of Washington Psychiatry & Behavioral Sciences
- University of Washington, Intellectual and Developmental Disabilities Research Center
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Shic F, Barney EC, Naples AJ, Dommer KJ, Chang SA, Li B, McAllister T, Atyabi A, Wang Q, Bernier R, Dawson G, Dziura J, Faja S, Jeste SS, Murias M, Johnson SP, Sabatos-DeVito M, Helleman G, Senturk D, Sugar CA, Webb SJ, McPartland JC, Chawarska K. The Selective Social Attention task in children with autism spectrum disorder: Results from the Autism Biomarkers Consortium for Clinical Trials (ABC-CT) feasibility study. Autism Res 2023; 16:2150-2159. [PMID: 37749934 PMCID: PMC11003770 DOI: 10.1002/aur.3026] [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: 02/16/2023] [Accepted: 08/25/2023] [Indexed: 09/27/2023]
Abstract
The Selective Social Attention (SSA) task is a brief eye-tracking task involving experimental conditions varying along socio-communicative axes. Traditionally the SSA has been used to probe socially-specific attentional patterns in infants and toddlers who develop autism spectrum disorder (ASD). This current work extends these findings to preschool and school-age children. Children 4- to 12-years-old with ASD (N = 23) and a typically-developing comparison group (TD; N = 25) completed the SSA task as well as standardized clinical assessments. Linear mixed models examined group and condition effects on two outcome variables: percent of time spent looking at the scene relative to scene presentation time (%Valid), and percent of time looking at the face relative to time spent looking at the scene (%Face). Age and IQ were included as covariates. Outcome variables' relationships to clinical data were assessed via correlation analysis. The ASD group, compared to the TD group, looked less at the scene and focused less on the actress' face during the most socially-engaging experimental conditions. Additionally, within the ASD group, %Face negatively correlated with SRS total T-scores with a particularly strong negative correlation with the Autistic Mannerism subscale T-score. These results highlight the extensibility of the SSA to older children with ASD, including replication of between-group differences previously seen in infants and toddlers, as well as its ability to capture meaningful clinical variation within the autism spectrum across a wide developmental span inclusive of preschool and school-aged children. The properties suggest that the SSA may have broad potential as a biomarker for ASD.
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Affiliation(s)
- Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Erin C. Barney
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Adam J. Naples
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kelsey J. Dommer
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Shou An Chang
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Beibin Li
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, Washington, USA
| | - Takumi McAllister
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Adham Atyabi
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Computer Science, University of Colorado - Colorado Springs, Colorado Springs, Colorado, USA
| | - Quan Wang
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Xi’an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi’an, China
| | - Raphael Bernier
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine, Seattle, Washington, USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - James Dziura
- Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Susan Faja
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Shafali Spurling Jeste
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, California, USA
- Division of Neurology, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Michael Murias
- Department of Medical Social Sciences, Northwestern University, Evanston, Illinois, USA
| | - Scott P. Johnson
- Department of Psychology, University of California Los Angeles, Los Angeles, California, USA
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - Gerhard Helleman
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Department of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Damla Senturk
- Department of Biostatistics, University of California Los Angeles, Los Angeles, California, USA
| | - Catherine A. Sugar
- Department of Biostatistics, University of California Los Angeles, Los Angeles, California, USA
| | - Sara Jane Webb
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine, Seattle, Washington, USA
| | - James C. McPartland
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Katarzyna Chawarska
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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6
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Berg LM, Gurr C, Leyhausen J, Seelemeyer H, Bletsch A, Schaefer T, Pretzsch CM, Oakley B, Loth E, Floris DL, Buitelaar JK, Beckmann CF, Banaschewski T, Charman T, Jones EJH, Tillmann J, Chatham CH, Bourgeron T, Murphy DG, Ecker C. The neuroanatomical substrates of autism and ADHD and their link to putative genomic underpinnings. Mol Autism 2023; 14:36. [PMID: 37794485 PMCID: PMC10552404 DOI: 10.1186/s13229-023-00568-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Autism spectrum disorders (ASD) are neurodevelopmental conditions accompanied by differences in brain development. Neuroanatomical differences in autism are variable across individuals and likely underpin distinct clinical phenotypes. To parse heterogeneity, it is essential to establish how the neurobiology of ASD is modulated by differences associated with co-occurring conditions, such as attention-deficit/hyperactivity disorder (ADHD). This study aimed to (1) investigate between-group differences in autistic individuals with and without co-occurring ADHD, and to (2) link these variances to putative genomic underpinnings. METHODS We examined differences in cortical thickness (CT) and surface area (SA) and their genomic associations in a sample of 533 individuals from the Longitudinal European Autism Project. Using a general linear model including main effects of autism and ADHD, and an ASD-by-ADHD interaction, we examined to which degree ADHD modulates the autism-related neuroanatomy. Further, leveraging the spatial gene expression data of the Allen Human Brain Atlas, we identified genes whose spatial expression patterns resemble our neuroimaging findings. RESULTS In addition to significant main effects for ASD and ADHD in fronto-temporal, limbic, and occipital regions, we observed a significant ASD-by-ADHD interaction in the left precentral gyrus and the right frontal gyrus for measures of CT and SA, respectively. Moreover, individuals with ASD + ADHD differed in CT to those without. Both main effects and the interaction were enriched for ASD-but not for ADHD-related genes. LIMITATIONS Although we employed a multicenter design to overcome single-site recruitment limitations, our sample size of N = 25 individuals in the ADHD only group is relatively small compared to the other subgroups, which limits the generalizability of the results. Also, we assigned subjects into ADHD positive groupings according to the DSM-5 rating scale. While this is sufficient for obtaining a research diagnosis of ADHD, our approach did not take into account for how long the symptoms have been present, which is typically considered when assessing ADHD in the clinical setting. CONCLUSION Thus, our findings suggest that the neuroanatomy of ASD is significantly modulated by ADHD, and that autistic individuals with co-occurring ADHD may have specific neuroanatomical underpinnings potentially mediated by atypical gene expression.
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Affiliation(s)
- Lisa M Berg
- Department of Child and Adolescent Psychiatry, University Hospital, Goethe University, Deutschordenstrasse 50, 60528, Frankfurt am Main, Germany.
- Brain Imaging Center, Goethe University, 60528, Frankfurt am Main, Germany.
- Department of Biosciences, Goethe University Frankfurt, 60438, Frankfurt am Main, Germany.
| | - Caroline Gurr
- Department of Child and Adolescent Psychiatry, University Hospital, Goethe University, Deutschordenstrasse 50, 60528, Frankfurt am Main, Germany
- Brain Imaging Center, Goethe University, 60528, Frankfurt am Main, Germany
| | - Johanna Leyhausen
- Department of Child and Adolescent Psychiatry, University Hospital, Goethe University, Deutschordenstrasse 50, 60528, Frankfurt am Main, Germany
- Brain Imaging Center, Goethe University, 60528, Frankfurt am Main, Germany
- Department of Biosciences, Goethe University Frankfurt, 60438, Frankfurt am Main, Germany
| | - Hanna Seelemeyer
- Department of Child and Adolescent Psychiatry, University Hospital, Goethe University, Deutschordenstrasse 50, 60528, Frankfurt am Main, Germany
- Brain Imaging Center, Goethe University, 60528, Frankfurt am Main, Germany
| | - Anke Bletsch
- Department of Child and Adolescent Psychiatry, University Hospital, Goethe University, Deutschordenstrasse 50, 60528, Frankfurt am Main, Germany
- Brain Imaging Center, Goethe University, 60528, Frankfurt am Main, Germany
| | - Tim Schaefer
- Fries Lab, Ernst Strüngmann Institute (ESI) for Neuroscience in Cooperation with Max Planck Society, 60528, Frankfurt, Germany
| | - Charlotte M Pretzsch
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, SE5 8AF, UK
| | - Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, SE5 8AF, UK
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, SE5 8AF, UK
| | - Dorothea L Floris
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
- Methods of Plasticity Research, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Christian F Beckmann
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Tobias Banaschewski
- Child and Adolescent Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Emily J H Jones
- Centre for Brain and Cognitive Development, Birkbeck, University of London, Malet Street, London, WC1E 7JL, UK
| | - Julian Tillmann
- F. Hoffmann-La Roche, Innovation Center Basel, Basel, Switzerland
| | - Chris H Chatham
- F. Hoffmann-La Roche, Innovation Center Basel, Basel, Switzerland
| | - Thomas Bourgeron
- Human Genetics and Cognitive Functions Unit, Institut Pasteur, Paris, France
| | - Declan G Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, SE5 8AF, UK
| | - Christine Ecker
- Department of Child and Adolescent Psychiatry, University Hospital, Goethe University, Deutschordenstrasse 50, 60528, Frankfurt am Main, Germany
- Brain Imaging Center, Goethe University, 60528, Frankfurt am Main, Germany
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, SE5 8AF, UK
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7
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László K, Vörös D, Correia P, Fazekas CL, Török B, Plangár I, Zelena D. Vasopressin as Possible Treatment Option in Autism Spectrum Disorder. Biomedicines 2023; 11:2603. [PMID: 37892977 PMCID: PMC10603886 DOI: 10.3390/biomedicines11102603] [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: 08/10/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Autism spectrum disorder (ASD) is rather common, presenting with prevalent early problems in social communication and accompanied by repetitive behavior. As vasopressin was implicated not only in salt-water homeostasis and stress-axis regulation, but also in social behavior, its role in the development of ASD might be suggested. In this review, we summarized a wide range of problems associated with ASD to which vasopressin might contribute, from social skills to communication, motor function problems, autonomous nervous system alterations as well as sleep disturbances, and altered sensory information processing. Beside functional connections between vasopressin and ASD, we draw attention to the anatomical background, highlighting several brain areas, including the paraventricular nucleus of the hypothalamus, medial preoptic area, lateral septum, bed nucleus of stria terminalis, amygdala, hippocampus, olfactory bulb and even the cerebellum, either producing vasopressin or containing vasopressinergic receptors (presumably V1a). Sex differences in the vasopressinergic system might underline the male prevalence of ASD. Moreover, vasopressin might contribute to the effectiveness of available off-label therapies as well as serve as a possible target for intervention. In this sense, vasopressin, but paradoxically also V1a receptor antagonist, were found to be effective in some clinical trials. We concluded that although vasopressin might be an effective candidate for ASD treatment, we might assume that only a subgroup (e.g., with stress-axis disturbances), a certain sex (most probably males) and a certain brain area (targeting by means of virus vectors) would benefit from this therapy.
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Affiliation(s)
- Kristóf László
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Dávid Vörös
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Pedro Correia
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Csilla Lea Fazekas
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Bibiána Török
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Imola Plangár
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Dóra Zelena
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
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8
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Carbone A, Dell'Aquila A. The Diagnosis of "Pervasive Developmental Disorder Not Otherwise Specified": A Systematic Literature Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050844. [PMID: 37238392 DOI: 10.3390/children10050844] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
(1) Background: The study deepens the diagnosis of "pervasive developmental disorder not otherwise specified" (PDD-NOS), a subthreshold diagnosis introduced in DSM-IV and then absorbed into the broader spectrum disorder of autism in DSM 5. The presence of people still attributed with a diagnosis of PDD-NOS can cause confusion in the understanding of this disorder, which is no longer present in the current diagnostic system. This review aims to gain a deeper understanding of the characteristics and boundaries of diagnosis, its use within the scientific community, and the long-term stability of that diagnosis. (2) Methods: The Prisma method was used to carry out the literature review; the scientific papers were selected using scientific search engines, including SCOPUS, PUBMED, and PsychINFO. Twenty-three articles were finally selected, and a meticulous reading was carried out in relation to the research questions. (3) Results: Four cross-cutting categories were identified: (1) diagnosis; (2) differential diagnosis; (3) prognosis; and (4) comorbidity. (4) Conclusions: Limits have emerged regarding the consistency, sensitivity, and the stability of PDD-NOS. The inclusion of this diagnosis within the broader autism spectrum disorder category coined in DSM-5 appears applicable.
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Affiliation(s)
- Agostino Carbone
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Asia Dell'Aquila
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Roma, Italy
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9
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Klein J, Kerns C, Hills K, Hogan A, Matherly S, Roberts J. Brief Report: Prevalence and Predictors of DSM-Specific and Distinct Anxiety in Cognitively Impaired Autistic Preschool Children. J Autism Dev Disord 2023:10.1007/s10803-023-05978-9. [PMID: 37039980 DOI: 10.1007/s10803-023-05978-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
Autistic individuals are twice as likely to meet criteria for anxiety than neurotypical children; yet we lack understanding of early presentations of anxiety in young autistic children, especially those with cognitive impairment. This study is the first to utilize an autism-specific anxiety diagnostic interview with 28 preschool cognitively impaired, autistic children and 18 neurotypical, age-matched controls. Results indicate that 64% of autistic children met criteria for DSM-specified or "other specified," herein referred to as "distinct," anxiety disorders; 32% met criteria for multiple anxiety disorders, with phobias occurring most often. Results indicate that anxiety is highly prevalent in cognitively-impaired, autistic preschool children, highlighting the need for developmentally-tailored assessment and treatment in early childhood.
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Affiliation(s)
- Jordan Klein
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Connor Kerns
- University of British Columbia, Vancouver, BC, Canada
| | - Kimberly Hills
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Abigail Hogan
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | | | - Jane Roberts
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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10
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Martinez K, Chlebowski C, Roesch S, Stadnick NA, Villodas M, Brookman-Frazee L. Psychometric Assessment of the Eyberg Child Behavior Inventory in Children with Autism in Community Settings. J Autism Dev Disord 2023; 53:1693-1705. [PMID: 35278165 PMCID: PMC9464797 DOI: 10.1007/s10803-022-05427-z] [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: 01/03/2022] [Indexed: 10/18/2022]
Abstract
The Eyberg Child Behavior Inventory (ECBI) is a frequently used measure to assess interfering behaviors in children and psychometric properties have recently been examined in children with autism spectrum disorder (ASD). There is a need to confirm the identified factors and examine the factor structure in a racially/ethnically diverse, community-based sample. The current study conducts a psychometric analysis of the ECBI in a sample of children with ASD receiving publicly-funded mental health services. Data were collected from 201 children with ASD ages 5-13 years (60% Hispanic/Latinx) participating in a community effectiveness trial. Confirmatory factor analysis indicated poor model fit using previously identified factors and a new four-factor solution was identified. Clinical and research implications of these findings are discussed.
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Affiliation(s)
- Kassandra Martinez
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
| | - Colby Chlebowski
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Scott Roesch
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Nicole A Stadnick
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
- University of California San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, La Jolla, CA, USA
| | - Miguel Villodas
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Lauren Brookman-Frazee
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
- University of California San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, La Jolla, CA, USA
- Rady Children's Hospital, San Diego, CA, USA
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11
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Dekker LP, van der Vegt EJM, Louwerse A, Visser K, van der Ende J, Maras A, Verhulst FC, Greaves-Lord K. Complementing or Congruent? Desired Characteristics in a Friend and Romantic Partner in Autistic versus Typically Developing Male Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1153-1167. [PMID: 36241943 PMCID: PMC10102130 DOI: 10.1007/s10508-022-02444-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 05/11/2023]
Abstract
Ideal friend and romantic partner characteristics related to self-perceived characteristics have been investigated in typically developing (TD) individuals, but not in individuals with autism spectrum disorder (ASD). Considering the autistic symptoms and challenges, investigating these concepts in autistic individuals is relevant. Given the lack of consensus, identity-first ("autistic person") and person-first ("person with autism") language are mixed throughout, to cover all preferences. This study explored (1) the association between self-perceived characteristics and desires in a friend/romantic partner, as well as (2) compare two groups (ASD and TD) in their desires for a friend/romantic partner. Two matched groups (ASD and TD) of 38 male adolescents (age 14-19 years) reported on the desire for nine characteristics (i.e., funny, popular, nice, cool, smart, trustworthy, good looking, similar interests, and being rich) in a friend/partner, and to what extent they felt they themselves possessed seven characteristics (i.e., funny, popular, nice, cool, smart, trustworthy, and good looking). Results showed both groups sought a friend and partner similar to themselves on intrinsic characteristics (e.g., trustworthiness), but less similar on extrinsic and social status characteristics (e.g., being less cool and popular). Particularly intrinsic characteristics, more than extrinsic and social status characteristics, were valued in both partners and friends, regardless of group. No significant differences were found between groups concerning to what extent characteristics were desired. Overall, adolescents with ASD desire similar characteristics as TD adolescents in their potential romantic partners and friends. There is some indication that the match between self-perception and desired characteristics is different.
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Affiliation(s)
- Linda P Dekker
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, Room T13-24, 3000 DR, Rotterdam, The Netherlands.
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands.
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands.
| | | | - Anneke Louwerse
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
| | - Kirsten Visser
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
- Youz Child and Adolescent Psychiatry, Team Sarr Autism Expertise Centre, Rotterdam, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Athanasios Maras
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
- Autism Team Northern-Netherlands of Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, The Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
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12
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Hermans RA, Ringeling LT, Liang K, Kloosterboer SM, de Winter BCM, Hillegers MHJ, Koch BCP, Dierckx B. The effect of therapeutic drug monitoring of risperidone and aripiprazole on weight gain in children and adolescents: the SPACe 2: STAR (trial) protocol of an international multicentre randomised controlled trial. BMC Psychiatry 2022; 22:814. [PMID: 36539734 PMCID: PMC9769061 DOI: 10.1186/s12888-022-04445-6] [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: 11/08/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Antipsychotic drugs are an important part of the treatment of irritability and aggression in children with an autism spectrum disorder (ASD). However, significant weight gain and metabolic disturbances are clinically relevant side effects of antipsychotic use in children. In the SPACe study, we showed positive correlations between both risperidone and aripiprazole plasma trough concentrations and weight gain over a 6-month period. The trial SPACe 2: STAR is designed as a follow-up study, in which we aim to research whether therapeutic drug monitoring in clinical practice can prevent severe weight gain, while retaining clinical effectiveness. METHODS SPACe 2: STAR is an international, multicentre, randomised controlled trial (RCT). One hundred forty children aged 6 to 18 who are about to start risperidone or aripiprazole treatment for ASD related behavioural problems will be randomised into one of two groups: a therapeutic drug monitoring (TDM) group, and a care as usual (CAU) group. Participants will be assessed at baseline and 4, 10, 24, and 52 weeks follow-up. In the TDM group, physicians will receive dosing advice based on plasma levels of risperidone and aripiprazole and its metabolites at 4 and 10 weeks. Plasma levels will be measured in dried blood spots (DBS). The primary outcome will be BMI z-score at 24 weeks after start of antipsychotic treatment. Among the secondary outcomes are effectiveness, metabolic laboratory measurements, levels of prolactin, leptin and ghrelin, extrapyramidal side effects, and quality of life. DISCUSSION This will be the first RCT evaluating the effect of TDM of antipsychotic drugs in children and adolescents. Thus, findings from SPACe 2: STAR will be of great value in optimising treatment in this vulnerable population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05146245. EudraCT number: 2020-005450-18. Sponsor protocol name: SPACe2STAR. Registered 8 June 2021. Protocol Version 6, Protocol date: 18 august 2022.
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Affiliation(s)
- Rebecca A. Hermans
- grid.5645.2000000040459992XDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, 3000 CB Rotterdam, PO Box 2060, the Netherlands ,grid.5645.2000000040459992XDepartment of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands ,grid.5645.2000000040459992XRotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Lisa T. Ringeling
- grid.5645.2000000040459992XDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, 3000 CB Rotterdam, PO Box 2060, the Netherlands ,grid.5645.2000000040459992XDepartment of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands ,grid.5645.2000000040459992XRotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Kajie Liang
- grid.5645.2000000040459992XDepartment of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands ,grid.5645.2000000040459992XRotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sanne M. Kloosterboer
- grid.5645.2000000040459992XDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, 3000 CB Rotterdam, PO Box 2060, the Netherlands
| | - Brenda C. M. de Winter
- grid.5645.2000000040459992XDepartment of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands ,grid.5645.2000000040459992XRotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Manon H. J. Hillegers
- grid.5645.2000000040459992XDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, 3000 CB Rotterdam, PO Box 2060, the Netherlands
| | - Birgit C. P. Koch
- grid.5645.2000000040459992XDepartment of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands ,grid.5645.2000000040459992XRotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Bram Dierckx
- grid.5645.2000000040459992XDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, 3000 CB Rotterdam, PO Box 2060, the Netherlands
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13
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Anxiety in Autism Spectrum Disorder: Clinical Characteristics and the Role of the Family. Brain Sci 2022; 12:brainsci12121597. [PMID: 36552057 PMCID: PMC9775263 DOI: 10.3390/brainsci12121597] [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: 10/14/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Anxiety Disorder (AD) is among the most common psychiatric comorbidity in children and adolescents with Autism Spectrum Disorder (ASD). Likewise, parental psychological distress (PPD) was linked to anxiety symptoms in children and adolescents with ASD. The aim of this study was to characterise, in a sample of children and adolescents with ASD, anxiety symptoms, the functional impairment associated and the presence of PPD. METHODS Participants were divided into three groups based on their diagnosis: children and adolescents with a diagnosis of ASD + AD, others with a diagnosis of AD but without a diagnosis of ASD, and others with a diagnosis of ASD but without a diagnosis of AD. RESULTS Group ASD + AD showed lower global functioning than Group ASD and Group AD. Generalised Anxiety Disorder, Separation Anxiety Disorder and Specific Phobias were more frequent in Group ASD + AD. Our findings also showed higher depressive symptoms in Group ASD + AD, both in the child and parent reports. Finally, parents of the Group ASD + AD revealed higher levels of PPD. CONCLUSIONS Our findings suggest that early assessment of AD with functional impairment associated with the role of PPD could define individualised treatments and consequently mean a better prognosis in children and adolescents with ASD and AD.
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14
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Carpenter KLH, Davis NO, Spanos M, Sabatos-DeVito M, Aiello R, Baranek GT, Compton SN, Egger HL, Franz L, Kim SJ, King BH, Kolevzon A, McDougle CJ, Sanders K, Veenstra-VanderWeele J, Sikich L, Kollins SH, Dawson G. Adaptive Behavior in Young Autistic Children: Associations with Irritability and ADHD Symptoms. J Autism Dev Disord 2022:10.1007/s10803-022-05753-2. [PMID: 36222990 PMCID: PMC10090229 DOI: 10.1007/s10803-022-05753-2] [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: 09/07/2022] [Indexed: 01/14/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) symptoms affect 40-60% of autistic children and have been linked to differences in adaptive behavior. It is unclear whether adaptive behavior in autistic youth is directly impacted by co-occurring ADHD symptoms or by another associated feature of both autism and ADHD, such as increased irritability. The current study examined relationships between irritability, ADHD symptoms, and adaptive behavior in 3- to 7-year-old autistic children. Results suggest that, after adjusting for co-occurring ADHD symptoms, higher levels of irritability are associated with differences in social adaptive behavior specifically. Understanding relationships between irritability, ADHD, and adaptive behavior in autistic children is critical because measures of adaptive behavior, such as the Vineland Scales of Adaptive Functioning, are often used as a proxy for global functioning, as well as for developing intervention plans and measuring outcomes as primary endpoints in clinical trials.
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Affiliation(s)
- Kimberly L H Carpenter
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Naomi O Davis
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Marina Spanos
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Rachel Aiello
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Grace T Baranek
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Scott N Compton
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | | | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Soo-Jeong Kim
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Bryan H King
- Department of Psychiatry and Behavioral Sciences, University of California at San Francisco, San Francisco, CA, USA
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | | | - Kevin Sanders
- Product Development Neuroscience, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Linmarie Sikich
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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15
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Thurman AJ, Dimachkie Nunnally A. Joint attention performance in preschool-aged boys with autism or fragile X syndrome. Front Psychol 2022; 13:918181. [PMID: 36003114 PMCID: PMC9393518 DOI: 10.3389/fpsyg.2022.918181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
Early development marks a period of rapid learning facilitated by children's natural curiosity about the people around them. In children with typical development, these early social attentional preferences set the foundation for learning about and from the surrounding world of people. Much of this learning happens using joint attention, the ability to coordinate attention between people and objects of mutual interest. It is well documented that decreased gaze use is commonly observed in individuals with autism and individuals with fragile X syndrome (FXS). Despite the growing body of research comparing phenotypic similarities between individuals with autism and individuals with FXS, no studies have directly compared joint attention performance between these groups. In the present study, we considered the similarities and differences in joint attention between preschool-aged boys with autism or FXS, and the relation between joint attention, language, and other phenotypic characteristics known to differ between boys with autism and boys with FXS. Although joint attention appeared similar, between-group differences emerged when controlling for the influence of age, non-verbal IQ, and autism symptom severity. Differences were also observed when considering how joint attention performance related to other aspects of the phenotype. For example, strong positive associations were observed between joint attention and language performance in boys with autism but not boys with FXS, even after controlling for non-verbal IQ. In contrast, the negative association between joint attention and anxiety symptom severity was significant and stronger in boys with FXS than in autism. These data offer preliminary insights into the similarities and differences between the autism and FXS phenotypes.
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Affiliation(s)
- Angela John Thurman
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States,Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, CA, United States,*Correspondence: Angela John Thurman,
| | - Amanda Dimachkie Nunnally
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States,Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, CA, United States
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16
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Tsuji Y, Imaizumi S, Sugawara M, Oiji A. Internalizing problems and suffering due to sensory symptoms in children and adolescents with and without autism spectrum disorder. Front Psychol 2022; 13:872185. [PMID: 35992424 PMCID: PMC9390977 DOI: 10.3389/fpsyg.2022.872185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/20/2022] [Indexed: 11/26/2022] Open
Abstract
Sensory symptoms are common in autism spectrum disorder (ASD). Previous studies have shown a positive correlation between sensory symptoms and internalizing problems; however, the role of the suffering due to sensory symptoms is not well understood. In the present study, we hypothesized that the relationship between sensory symptoms and internalizing problems in children is mediated by children’s and surrounding people’s suffering due to sensory symptoms. Parents of 113 students aged 6–15 years with and without ASD completed questionnaires about their children’s autistic traits, sensory symptoms, suffering due to sensory symptoms, and internalizing problems. The results showed that autistic traits and sensory symptoms were distributed as a continuum throughout children with and without ASD. Therefore, we investigated the relationship among variables in children with and without ASD attending regular classes. Structural equation modeling indicated that those who scored higher on sensory symptoms demonstrated greater suffering due to sensory symptoms as predictors of internalizing problems. Our findings provide evidence for developing a support system that specifically reduces suffering due to sensory symptoms, especially for students in regular classes.
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Affiliation(s)
- Yurika Tsuji
- Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
- *Correspondence: Yurika Tsuji,
| | - Shu Imaizumi
- Institute for Education and Human Development, Ochanomizu University, Tokyo, Japan
| | - Masumi Sugawara
- Faculty of Human Studies, Shirayuri University, Tokyo, Japan
| | - Arata Oiji
- Graduate School of Medical Science, Kitasato University, Kanagawa, Japan
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17
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Markiewicz-Gospodarek A, Górska A, Markiewicz R, Chilimoniuk Z, Czeczelewski M, Baj J, Maciejewski R, Masiak J. The Relationship between Mental Disorders and the COVID-19 Pandemic—Course, Risk Factors, and Potential Consequences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159573. [PMID: 35954930 PMCID: PMC9368061 DOI: 10.3390/ijerph19159573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/11/2022] [Accepted: 08/02/2022] [Indexed: 01/10/2023]
Abstract
In this review the authors discuss that COVID-19 has already had a direct impact on the physical health of many people and that it appears to have put at risk the mental health of large populations. In this review, we also discuss the relationship between mental disorders and the SARS-CoV-2 infection. We convey the disorders’ risk factors and the more serious mental disorder consequences of COVID-19. People with mental health disorders could be more susceptible to the emotional responses brought on by the COVID-19 epidemic. The COVID-19 pandemic may adversely influence the mental health of patients with already diagnosed mental disorders. For the aim of dealing better with the psychological problems of people afflicted by the COVID-19 pandemic, new psychological procedures are required.
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Affiliation(s)
| | - Aleksandra Górska
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Renata Markiewicz
- Department of Psychiatric Nursing, Medical University of Lublin, 18 Szkolna St., 20-124 Lublin, Poland
| | - Zuzanna Chilimoniuk
- Student Scientific Group, Department of Family Medicine, Medical University of Lublin, 6a (SPSK1) Langiewicza St., 20-032 Lublin, Poland
| | - Marcin Czeczelewski
- Department of Forensic Medicine, Medical University of Lublin, 8b Jaczewskiego St., 20-090 Lublin, Poland
| | - Jacek Baj
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Ryszard Maciejewski
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Jolanta Masiak
- II Department of Psychiatry and Psychiatric Rehabilitation, Medical University of Lublin, 1 Głuska (SPSK Nr 1) St., 20-059 Lublin, Poland
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18
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Tsuji Y, Matsumoto S, Saito A, Imaizumi S, Yamazaki Y, Kobayashi T, Fujiwara Y, Omori M, Sugawara M. Mediating role of sensory differences in the relationship between autistic traits and internalizing problems. BMC Psychol 2022; 10:148. [PMID: 35698105 PMCID: PMC9190171 DOI: 10.1186/s40359-022-00854-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/01/2022] [Indexed: 12/24/2022] Open
Abstract
Background Sensory differences are related to the autistic traits, and previous studies have shown a positive correlation between sensory differences and internalizing problems. In this study, we hypothesized that sensory differences and suffering due to sensory differences mediates the relationships between autistic traits and internalizing problems. Methods A total of 346 female Japanese university students completed questionnaires regarding their autistic traits, suffering due to sensory differences, and internalizing problems. Moreover, 114 participants completed a questionnaire related to sensory differences. Results Autistic traits were correlated with Low Registration and Sensation Avoiding. These sensory differences were also correlated with suffering due to sensory differences and internalizing problems. Moreover, path analysis indicated that the higher the suffering due to Low Registration and Sensation Avoiding was, the greater the internalizing problems in those who showed these sensory differences. Conclusions Female university students with serious suffering due to sensory differences may need support in managing their suffering and internalizing problems. Further research will help suggest support that these people require, at school and elsewhere. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00854-0.
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Affiliation(s)
- Yurika Tsuji
- Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo, Tokyo, Japan.
| | - Satoko Matsumoto
- Institute for Education and Human Development, Ochanomizu University, Bunkyo, Tokyo, Japan
| | - Aya Saito
- Faculty of Core Research, Ochanomizu University, Bunkyo, Tokyo, Japan
| | - Shu Imaizumi
- Institute for Education and Human Development, Ochanomizu University, Bunkyo, Tokyo, Japan
| | - Yoko Yamazaki
- Institute for Education and Human Development, Ochanomizu University, Bunkyo, Tokyo, Japan
| | | | - Yoko Fujiwara
- Faculty of Core Research, Ochanomizu University, Bunkyo, Tokyo, Japan.,Institute for Human Life Innovation, Ochanomizu University, Bunkyo, Tokyo, Japan
| | - Mika Omori
- Faculty of Core Research, Ochanomizu University, Bunkyo, Tokyo, Japan.,Graduate School of Arts and Letters, Tohoku University, Sendai, Miyagi, Japan
| | - Masumi Sugawara
- Faculty of Human Studies, Shirayuri University, Chofu, Tokyo, Japan
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Yang YJ, Chung KM. Pilot Randomized Control Trial of an App-Based CBT Program for Reducing Anxiety in Individuals with ASD without Intellectual Disability. J Autism Dev Disord 2022; 53:1331-1346. [PMID: 35689137 DOI: 10.1007/s10803-022-05617-9] [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: 05/13/2022] [Indexed: 10/18/2022]
Abstract
This study developed and tested the effectiveness of an app-based cognitive behavioral therapy (CBT) program in alleviating anxiety among adolescents and adults with autism without co-occurring intellectual disability. Thirty participants from 15 to 35 years old were randomly assigned to either the intervention or waitlist control group, and self- and caregiver proxy report questionnaires were administered, accompanied by direct behavior observation before and after the intervention period. There was a significant decrease in anxiety level, an increase in positive affect, and a decline in stereotypic behaviors, hyperactivity, noncompliance, and inappropriate speech in proxy reports for the intervention group, compared to the control group. A significant rise in passive response in the direct observation was also seen in the intervention group.
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Affiliation(s)
- Yoon Jung Yang
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
| | - Kyong-Mee Chung
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea.
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Brookman-Frazee L, Chlebowski C, Villodas M, Garland A, McPherson J, Koenig Y, Roesch S. The effectiveness of training community mental health therapists in an evidence-based intervention for ASD: Findings from a hybrid effectiveness-implementation trial in outpatient and school-based mental health services. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:678-689. [PMID: 34983251 PMCID: PMC10987077 DOI: 10.1177/13623613211067844] [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] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Publicly funded mental health services play an important role in caring for school-age children with autism spectrum disorder (ASD); however, therapists report a lack of specialized ASD training, which families identity as a barrier in obtaining mental health services for their children. An Individualized Mental Health Intervention for ASD (AIM HI) was developed in collaboration with community stakeholders to respond to identified needs of children and community therapists. The current study examined the effects of therapist training in AIM HI on the changes in therapist practice, including therapists' use of evidence-based intervention strategies in session. Data were collected from a study conducted in community outpatient and school based mental health programs randomly assigned to receive AIM HI therapist training or observation of routine care. Therapist and child clients were enrolled from participating programs. Therapists in AIM HI training received training and consultation for 6 months while delivering the AIM HI intervention to a participating client; therapists in usual care delivered routine care. Both groups of therapists video recorded psychotherapy sessions which were scored by trained raters. Differences between training groups were examined using multilevel modeling. Therapists trained in AIM HI were observed to use more extensive active teaching strategies with caregivers, engagement strategies with children, strategies promoting continuity of care, and had more structured sessions with more effective pursuit of caregiver and children skill teaching. Therapist licensure moderated some training outcomes.
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Affiliation(s)
| | | | | | | | | | - Yael Koenig
- San Diego County Behavioral Health Services, USA
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21
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Badgett NM, Sadikova E, Menezes M, Mazurek MO. Emergency Department Utilization Among Youth with Autism Spectrum Disorder: Exploring the Role of Preventive Care, Medical Home, and Mental Health Access. J Autism Dev Disord 2022; 53:2274-2282. [DOI: 10.1007/s10803-022-05503-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 11/25/2022]
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22
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László K, Kiss O, Vörös D, Mintál K, Ollmann T, Péczely L, Kovács A, Zagoracz O, Kertes E, Kállai V, László B, Hormay E, Berta B, Tóth A, Karádi Z, Lénárd L. Intraamygdaloid Oxytocin Reduces Anxiety in the Valproate-Induced Autism Rat Model. Biomedicines 2022; 10:biomedicines10020405. [PMID: 35203614 PMCID: PMC8962302 DOI: 10.3390/biomedicines10020405] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder affecting about 1.5% of children, and its prevalence is increasing. Anxiety is one of the most common comorbid signs of ASD. Despite the increasing prevalence, the pathophysiology of ASD is still poorly understood, and its proper treatment has not been defined yet. In order to develop new therapeutic approaches, the valproate- (VPA) induced rodent model of autism can be an appropriate tool. Oxytocin (OT), as a prosocial hormone, may ameliorate some symptoms of ASD. Methods: In the present study, we investigated the possible anxiolytic effect of intraamygdaloid OT on VPA-treated rats using the elevated plus maze test. Results: Our results show that male Wistar rats prenatally exposed to VPA spent significantly less time in the open arms of the elevated plus maze apparatus and performed significantly less head dips from the open arms. Bilateral OT microinjection into the central nucleus of the amygdala increased the time spent in the open arms and the number of head dips and reduced the anxiety to the healthy control level. An OT receptor antagonist blocked the anxiolytic effects of OT. The antagonist by itself did not influence the time rats spent in the open arms. Conclusions: Our results show that intraamygdaloid OT has anxiolytic effects in autistic rats.
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Affiliation(s)
- Kristóf László
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
- Correspondence: ; Tel.: +36-72-53624; Fax: +36-72-536244
| | - Orsolya Kiss
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Dávid Vörös
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Kitti Mintál
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Tamás Ollmann
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - László Péczely
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Anita Kovács
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Olga Zagoracz
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Erika Kertes
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Veronika Kállai
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Bettina László
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Edina Hormay
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Beáta Berta
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Attila Tóth
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
| | - Zoltán Karádi
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
- Szentágothai Center, Molecular Endocrinology and Neurophysiology Research Group, University of Pécs, 7624 Pécs, Hungary
| | - László Lénárd
- Medical School, Institute of Physiology, University of Pécs, 7624 Pécs, Hungary; (O.K.); (D.V.); (K.M.); (T.O.); (L.P.); (A.K.); (O.Z.); (E.K.); (V.K.); (B.L.); (E.H.); (B.B.); (A.T.); (Z.K.); (L.L.)
- Neuroscience Center, University of Pécs, 7624 Pécs, Hungary
- Szentágothai Center, Molecular Endocrinology and Neurophysiology Research Group, University of Pécs, 7624 Pécs, Hungary
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Chauhan G, Kumar G, Roy K, Kumari P, Thondala B, Kishore K, Panjwani U, Ray K. Hypobaric Hypoxia Induces Deficits in Adult Neurogenesis and Social Interaction via Cyclooxygenase-1/ EP1 Receptor Pathway Activating NLRP3 Inflammasome. Mol Neurobiol 2022; 59:2497-2519. [PMID: 35089581 DOI: 10.1007/s12035-022-02750-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/11/2022] [Indexed: 12/17/2022]
Abstract
Low oxygen environments, like hypobaric hypoxia (HH), are common nodes in a number of diseases characterized by neuroinflammation, which is detrimental to the structural and functional aspects of hippocampal circuitry. Hypoxic conditions lead to elevation of inflammasome-mediated inflammation that may contribute to cognitive deficits. However, a systematic investigation of the impact of inflammasome-mediated neuroinflammation on the components of neurogenic niche during HH remains to be elusive. Cerebral hypoxia was induced in adult male Sprague Dawley rats via decreasing partial pressure of oxygen. The effect of HH (1, 3, and 7 days at 25,000 ft) on social memory, anxiety, adult neurogenesis, and NLRP3- (NLR family pyrin domain containing 3) mediated neuroinflammation in the dentate gyrus (DG) was explored in detail. Furthermore, we explored the therapeutic efficacy of cyclooxygenase-1 inhibitor (valeryl salicylate, 5 mg/kg/day, i.p.) and EP1 receptor (EP1R) antagonist (SC19220, 1 mg/kg/day, i.p.) on HH-induced deficits. Seven days of HH exposure induced alteration in social and anxiety-like behavior along with perturbation in adult neurogenesis. Elevation in NLRP3, caspase-1, and IL-1β levels was observed during HH from day 1. A notable increase in the COX-1/EP1R pathway in activated glial cells in DG was evident during HH. COX-1 inhibitor and EP1R antagonist mitigated the detrimental effects of HH on social memory, adult neurogenesis via blunting NLRP3-mediated inflammation. Our data showed induction of the COX-1/EP1R pathway in the glial cells, which is detrimental to neurogenesis and social memory, opening up the possibility that the COX-1/EP1R pathway is a plausible target for inflammasome-related neurogenesis impairments.
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Affiliation(s)
- Garima Chauhan
- Neurophysiology Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Gaurav Kumar
- Neurophysiology Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Koustav Roy
- Neurophysiology Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Punita Kumari
- Neurophysiology Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Bhanuteja Thondala
- Neurophysiology Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Krishna Kishore
- Neurophysiology Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Usha Panjwani
- Neurophysiology Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Koushik Ray
- Neurophysiology Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi, 110054, India.
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Kim SK, McKay D, Cepeda SL, Schneider SC, Wood J, Storch EA. Assessment of improvement in anxiety severity for children with autism spectrum disorder: The matched correspondence analysis approach. J Psychiatr Res 2021; 145:175-181. [PMID: 34923358 PMCID: PMC9198104 DOI: 10.1016/j.jpsychires.2021.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/06/2021] [Accepted: 12/10/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Clinical trials typically involve random assignment to treatment conditions. However, random assignment does not guarantee a lack of systematic variation in the outcomes, and application of covariation methods for multiple dependent measures requires complicated assumptions that are often not met. METHODS This study employed matched correspondence analysis (CA) for controlling systematic variation and handling multiple outcomes. One hundred nine children with autism spectrum disorder (ASD) were assessed for anxiety symptom severity across four studies, where participants were randomly assigned to either cognitive behavioral therapy (CBT) or treatment as usual or waitlist (TAU/WT). Matched CA is designed to optimally scale only the differences between baseline and posttreatment, rendering the systematic baseline carryover effects irrelevant. RESULTS Differences in treatment efficacy were observed. CBT showed treatment efficacy on anxiety severity and anxiety-related impairment relative to TAU/WT, after the control of baseline carryover effects. CONCLUSION This study provides a way to control systematic variation between groups at the outset of treatment trials and is expected to provide a novel pathway to more proper assessment of treatment efficacy for children with ASD and anxiety.
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Affiliation(s)
- Se-Kang Kim
- Department of Psychology, Fordham University, USA.
| | - Dean McKay
- Department of Psychology, Fordham University, USA
| | - Sandra L Cepeda
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, USA
| | - Sophie C Schneider
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, USA
| | - Jeffrey Wood
- Department of Education, University of California, Los Angeles, USA
| | - Eric A Storch
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, USA
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Bilginer Ç, Yıldırım S, Törenek R, Özkaya AK. Patients with autism in the emergency department: cause of admissions and challenges. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:710-716. [PMID: 37547546 PMCID: PMC10402859 DOI: 10.1080/20473869.2021.2009996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 08/08/2023]
Abstract
Objective: This study aims to understand the presentations of autism spectrum disorder (ASD) patients in a tertiary hospital's emergency department (ED) in Turkey, and the difficulties of families face in the ED. Method: Clinical characteristics of ASD patients who presented to the ED between 1 January 2015 and 15 November 2020 were obtained by retrospective file review. The caregivers of the patients who had presented to the ED in 2020 were interviewed by a phone call. Results: There were 740 applications of 224 patients (192 boys, 32 girls). Almost half of the patients were between 0 and 5 years old. Respiratory problems were the most common cause of admissions in all age groups. The second common reasons for ED visits were gastrointestinal problems in 0-5 years old, traumatic injuries/poisoning in 6-12 years old, and epilepsy/syncope in 13-17 years old. Psychiatric problems were less common (2.7%) than other reasons for admission. The most challenging issue for children was "the crowded waiting area, and the long waiting period" and followed by "physical restraint imposed on the child," "noise," and "bright light." Conclusion: As the clinicians' awareness and use of more accurate diagnostic tools have increased, the ASD prevalence has gradually increased. To increase the quality of healthcare services for these patients, awareness studies and new interventions are needed.
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Affiliation(s)
- Çilem Bilginer
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Selman Yıldırım
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Rümeysa Törenek
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet Kağan Özkaya
- Department of Child Emergency, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Van Dyke MV, Guevara MVC, Wood KS, McLeod BD, Wood JJ. The Pediatric Autism Spectrum Therapy Observation System: Development, Psychometric Properties, and Sensitivity to Treatment. Child Psychiatry Hum Dev 2021; 52:1143-1153. [PMID: 33159632 PMCID: PMC8102645 DOI: 10.1007/s10578-020-01068-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2020] [Indexed: 10/23/2022]
Abstract
An observational coding system was developed to track clinical change in children with autism spectrum disorder (ASD) during psychotherapy. The Pediatric Autism Spectrum Therapy Observation System (PASTOS) consists of 23 items divided into 5 subscales and is used to rate child behaviors in individual psychotherapy sessions. Manual-based cognitive behavioral therapy session transcripts of 22 children diagnosed with ASD (IQ > 70) and a concurrent anxiety disorder (M = 9.41 years, SD = 1.56 years) enrolled in a randomized, controlled trial were coded. Results suggested that the PASTOS exhibited promising interrater reliability, internal consistency, convergent validity at post-treatment, and treatment sensitivity. The PASTOS may be a useful tool for studying process and outcome in psychotherapy research on children with ASD.
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Affiliation(s)
- Marilyn V Van Dyke
- Graduate School of Education and Information Studies, Division of Human Development and Psychology, University of California, Los Angeles, 405 Hilgard Ave., Los Angeles, CA, 90095, USA
| | - Maria V Cornejo Guevara
- Graduate School of Education and Information Studies, Division of Human Development and Psychology, University of California, Los Angeles, 405 Hilgard Ave., Los Angeles, CA, 90095, USA
| | - Karen S Wood
- Graduate School of Education and Information Studies, Division of Human Development and Psychology, University of California, Los Angeles, 405 Hilgard Ave., Los Angeles, CA, 90095, USA
| | - Bryce D McLeod
- Psychology Department, Virginia Commonwealth University, Richmond, USA
| | - Jeffrey J Wood
- Graduate School of Education and Information Studies, Division of Human Development and Psychology, University of California, Los Angeles, 405 Hilgard Ave., Los Angeles, CA, 90095, USA.
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Assessment and treatment of anxiety in children and adolescents with ASD: a systematic review. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-03-2021-0016] [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
The purpose of this study was to investigate the quality of current studies that assess and treat anxiety symptoms in children with autism spectrum disorder (ASD). More specifically the study aimed to answer the following questions: What are the qualities of the current studies using cognitive behavioral therapies (CBTs) to treat anxiety symptoms in children with ASD? Did studies make necessary modifications and adaptations to CBTs according to the evidence-based strategies and implement these versions of CBTs with precise fidelity? Were the selected measurements appropriate for assessing the anxiety symptoms in children with ASD?
Design/methodology/approach
A systematic review protocol was developed from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Moher et al., 2009). A rubric was adapted based on the CEC (Council for Exceptional Children; Cook, 2014) group comparison studies standards and the Evaluative Method for Determining EBP in Autism (Reichow et al., 2007). The 3-point Likert Scale (Chard et al., 2009) was adapted to score each study based on the rubric.
Findings
CBT is a first-line treatment with significant mixed results. Current studies use adapted versions of existing CBTs for children with ASD without reporting empirical evidence to these adaptations and changes. Reporting of the implementation fidelity is still an issue in the treatment of anxiety. Anxiety measurements that were designed for typically developing children failure to detect unusual anxiety symptoms in children with ASD.
Research limitations/implications
The first limitation of this study was including a variety of studies across CBT programs and types of anxiety symptoms. Types of anxiety and CBT treatments may require separate analyses with specific indicators. Due to the limited studies, reviews could not be analyzed across types of CBT programs. The second limitation was the types of studies. Most of the studies were pilot studies. Pilot studies might use various instruments and CBTs components for making selections to produce the best effects and results. The final limitation was the lack of examination of the data analysis process.
Originality/value
These findings are important because due to the variety of changes or adaptation to CBTs, inappropriate implementations and failure to detect unusual anxiety symptoms of children with ASD may cause significant differences in treatment responses and outcomes. The study demonstrated that the majority of the studies used adapted versions of existing CBTs without reporting empirical evidence for these adaptations and changes. The findings have shown that reporting of the implementation fidelity is still an issue. Moreover, the majority of studies had used anxiety measurements that were designed for typically developing children, not for children with ASD.
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Schwartzman BC. Mixed methods analysis of an exploratory apprenticeship model employment program for young adults with developmental disabilities. JOURNAL OF VOCATIONAL REHABILITATION 2021. [DOI: 10.3233/jvr-211156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Individuals with developmental disabilities experience lower employment, higher underemployment, and higher job switching rates than the general population. OBJECTIVE: The current study investigated: (1) the vocational and support experiences of individuals with developmental disabilities, and (2) the differences in participant outcomes between an apprenticeship-model employment program and the comparison group. METHODS: Qualitative and quantitative methods were used to assess outcomes and experiences of participants in the apprenticeship model employment program (N = 22) and a community-based “Job Club” (N = 11). Thematic analysis was used to analyze interview transcripts. Independent samples T-tests and paired samples T-tests were utilized to analyze within-group and between group differences. RESULTS: Parent interview data regarding past and current experiences of the participants in the apprenticeship model employment program suggest 6 major themes. Independent samples T-tests determined that the apprenticeship program participants were significantly less employed than the comparison group at pre-, then similarly employed as the comparison group at post-intervention. Within-group analyses determined that some aspects of participant confidence in their vocational skills and problem-solving skills significantly increased from pre- to post-intervention, according to parent report. CONCLUSIONS: The apprenticeship model of employment appears to be a promising model in need of further study with a larger sample size.
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Affiliation(s)
- Benjamin C. Schwartzman
- Graduate School of Education and Information Studies, Department of Human Development and Psychology, University of California Los Angeles, Los Angeles, CA, USA
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
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Guttentag S, Bishop S, Doggett R, Shalev R, Kaplan M, Dyson M, Cohen M, Lord C, Di Martino A. The utility of parent-report screening tools in differentiating autism versus attention-deficit/hyperactivity disorder in school-age children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:473-487. [PMID: 34219504 DOI: 10.1177/13623613211030071] [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: 11/17/2022]
Abstract
LAY ABSTRACT We tested the ability of a short, recently developed parent interview and two widely used parent-report questionnaires to discriminate school-age verbal children with autism spectrum disorder from those with attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHDw/oASD). These measures included the Autism Symptom Interview - School-Age, the Social Responsiveness Scale - 2nd Edition, and the Social Communication Questionnaire - Lifetime. The classification accuracy of all three parent screeners fell in the moderate range. Accuracy varied by instrument, and the Social Communication Questionnaire - Lifetime questionniare showed the highest accuracy. Children with autism spectrum disorder who were incorrectly classified by all parent screeners did not differ from those correctly classified in regard to demographics, intellectual abilities, nor in any specific clinical area beyond general parent concerns. These findings showed that there are valid screening options for assessing school-age verbal children with autism spectrum disorder versus ADHDw/oASD. They also underscore the need to assess multiple sources of information for increased accuracy.
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Affiliation(s)
- Sara Guttentag
- Child Mind Institute, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, USA.,Hassenfeld Children's Hospital at NYU Langone, USA
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30
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Mottron L. A radical change in our autism research strategy is needed: Back to prototypes. Autism Res 2021; 14:2213-2220. [PMID: 34077611 DOI: 10.1002/aur.2494] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/01/2021] [Accepted: 02/18/2021] [Indexed: 02/01/2023]
Abstract
The evolution of autism diagnosis, from its discovery to its current delineation using standardized instruments, has been paralleled by a steady increase in its prevalence and heterogeneity. In clinical settings, the diagnosis of autism is now too vague to specify the type of support required by the concerned individuals. In research, the inclusion of individuals categorically defined by over-inclusive, polythetic criteria in autism cohorts results in a population whose heterogeneity runs contrary to the advancement of scientific progress. Investigating individuals sharing only a trivial resemblance produces a large-scale type-2 error (not finding differences between autistic and dominant population) rather than detecting mechanistic differences to explain their phenotypic divergences. The dimensional approach of autism proposed to cure the disease of its categorical diagnosis is plagued by the arbitrariness of the dimensions under study. Here, we argue that an emphasis on the reliability rather than specificity of diagnostic criteria and the misuse of diagnostic instruments, which ignore the recognition of a prototype, leads to confound autism with the entire range of neurodevelopmental conditions and personality variants. We propose centering research on cohorts in which individuals are selected based on their expert judged prototypicality to advance the theoretical and practical pervasive issues pertaining to autism diagnostic thresholds. Reversing the current research strategy by giving more weight to specificity than reliability should increase our ability to discover the mechanisms of autism. LAY SUMMARY: Scientific research into the causes of autism and its mechanisms is carried out on large cohorts of people who are less and less different from the general population. This historical trend may explain the poor harvest of results obtained. Services and intervention are provided according to a diagnosis that now encompasses extremely different individuals. Last, we accept as a biological reality the constant increase over the years in the proportion of autistic people among the general population. These drifts are made possible by the attribution of a diagnosis of autism to people who meet vague criteria, rather than to people who experienced clinicians recognize as autistic. We propose to change our research strategy by focusing on the study of the latter, fewer in number, but more representative of the "prototype" of autism. To do this, it is necessary to clearly distinguish the population on which the research is carried out from that to which we provide support. People must receive services according to their needs, and not according to the clarity of their diagnosis.
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Affiliation(s)
- Laurent Mottron
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada.,CIUSSS-NIM Research Center, Rivière-des-Prairies, Mental Health Hospital, Montreal, Quebec, Canada
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31
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Including Children with Developmental Disabilities in the Equation During this COVID-19 Pandemic. J Autism Dev Disord 2021; 51:2155-2158. [PMID: 32816170 PMCID: PMC7438977 DOI: 10.1007/s10803-020-04670-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Amidst the ongoing novel Coronavirus disease pandemic, children with developmental disabilities warrant specific attention to minimise having disproportionate consequences. These children are especially vulnerable to the effects of the pandemic due to (1) Greater healthcare needs, (2) Dependency on community-based services and (3) Mental health concerns. Healthcare professionals, public health systems and the society needs to come together to advocate for these children by optimising access to healthcare and community intervention services, promoting mental well-being and caregiver welfare. The consequences of missed present-day opportunities might only be evident in the years to come in these children. Hence, despite the prolonged pandemic, with consequent limitations in availability of resources, children with developmental disabilities should continue to be supported.
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32
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Carruthers S, Taylor L, Sadiq H, Tripp G. The profile of pragmatic language impairments in children with ADHD: A systematic review. Dev Psychopathol 2021; 34:1-23. [PMID: 33973504 DOI: 10.1017/s0954579421000328] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This systematic review synthesizes the empirical literature examining pragmatic language in children diagnosed with attention-deficit/hyperactivity disorder (ADHD). Using a taxonomy of pragmatic language, we compared the pragmatic language profiles of children with ADHD to those of typically developing (TD) children and children with autism. Three databases were searched up to October 2019: PsychInfo; PubMed; and CSA Linguistics and Language Behavior Abstracts. We included 34 studies reporting on 2,845 children (ADHD = 1,407; TD = 1,058; autism = 380). Quality and risk of bias assessments included sample size and representativeness; measure reliability and validity; and missing data management. Children with ADHD were found to have higher rates of pragmatic difficulties than their TD peers. Specific difficulties were identified with inappropriate initiation, presupposition, social discourse, and narrative coherence. Children with ADHD appear to differ from those with autism in the degree of their pragmatic language impairments. General language skills contribute to, but do not explain, pragmatic difficulties in samples of children with ADHD. Though the extant evidence is limited, a preliminary profile of the pragmatic language impairments in children with ADHD is indicated. This supports a call for evidence-based interventions that include pragmatic language skills training.
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Affiliation(s)
- Sophie Carruthers
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lauren Taylor
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Hafiza Sadiq
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gail Tripp
- Okinawa Institute of Science and Technology, Graduate University, Okinawa, Japan
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33
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Taylor MJ, Ronald A, Martin J, Lundström S, Hosang GM, Lichtenstein P. Examining the association between childhood autistic traits and adolescent hypomania: a longitudinal twin study. Psychol Med 2021; 52:1-10. [PMID: 33827724 DOI: 10.1017/s0033291721000374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is evidence that autism spectrum disorders (ASDs) co-occur with bipolar disorder (BD) relatively frequently. Individuals with BD often report symptoms of mania and hypomania during adolescence, prior to the age of onset for BD. It is unknown whether these symptoms are associated with ASDs. We examined whether diagnoses of ASDs and autistic traits were associated with hypomania in a large, population-based Swedish twin sample. METHODS Parental structured interviews assessed autistic traits, and were used to assign screening diagnoses of ASDs, when twins were aged 9 or 12 (N = 13 533 pairs). Parents then completed questionnaires assessing hypomania when the twins were aged 15 and 18 (N = 3852 pairs at age 15, and 3013 pairs at age 18). After investigating the phenotypic associations between these measures, we used the classical twin design to test whether genetic and environmental influences on autistic traits influence variation in adolescent hypomania. RESULTS Autistic traits and ASD diagnoses in childhood were associated with elevated scores on the measures of adolescent hypomania. Twin analyses indicated that 6-9% of the variance in hypomania was explained by genetic influences that were shared with autistic traits in childhood. When repeating these analyses for specific autistic trait domains, we found a stronger association between social interaction difficulties and hypomania than for other autistic trait domains. CONCLUSIONS These results indicate a genetic link between autistic traits and hypomania in adolescence. This adds to the growing evidence base of genetic factors associated with ASDs showing links with psychiatric outcomes across childhood and into adulthood.
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Affiliation(s)
- Mark J Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Angelica Ronald
- Genes Environment Lifespan Laboratory, Department of Psychological Science, Centre for Brain and Cognitive Development, University of London, Birkbeck, UK
| | - Joanna Martin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
- Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
| | - Georgina M Hosang
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, UK
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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34
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Brookman-Frazee L, Chlebowski C, Villodas M, Roesch S, Martinez K. Training Community Therapists to Deliver an Individualized Mental Health Intervention for Autism Spectrum Disorder: Changes in Caregiver Outcomes and Mediating Role on Child Outcomes. J Am Acad Child Adolesc Psychiatry 2021; 60:355-366. [PMID: 32755632 DOI: 10.1016/j.jaac.2020.07.896] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 06/26/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study examines the impact of training therapists to deliver "An Individualized Mental Health Intervention for Autism Spectrum Disorder (ASD)" (AIM HI) for children with autism spectrum disorder on caregiver outcomes and the mediating role of changes in caregiver outcomes on child outcomes. METHOD Data were drawn from a cluster randomized trial conducted in 29 publicly funded mental health programs randomized to receive AIM HI training or usual care. Therapists were recruited from enrolled programs and child/caregiver participants enrolled from therapists' caseloads. Participants included 202 caregivers of children 5 to 13 years of age with autism spectrum disorder. Caregiver strain and sense of competence were assessed at baseline and 6 month postbaseline. Child behaviors were assessed at baseline and 6, 12, and 18 months postbaseline. Therapist delivery of evidence-based intervention strategies were assessed between baseline and 6 months. RESULTS A significant training effect was observed for caregiver sense of competence, with AIM HI caregivers reporting significantly greater improvement relative to usual care. There was no significant training effect for caregiver strain. Observer-rated therapist delivery of evidence-based interventions strategies over 6 months mediated training effects for sense of competence at 6 months. Changes in sense of competence from baseline to 6 months was associated with reduced child challenging behaviors at 6 months and mediated child outcomes at 12 and 18 months. CONCLUSION Combined with research demonstrating effectiveness of therapist AIM HI training on child outcomes, this study provides further evidence of the positive impact of training community therapists in the AIM HI intervention. CLINICAL TRIAL REGISTRATION INFORMATION Effectiveness and Implementation of a Mental Health Intervention for ASD (AIM HI); https://clinicaltrials.gov/; NCT02416323.
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Affiliation(s)
- Lauren Brookman-Frazee
- Child and Adolescent Services Research Center, San Diego, California; University of California, San Diego; Rady Children's Hospital, San Diego, California
| | - Colby Chlebowski
- Child and Adolescent Services Research Center, San Diego, California; University of California, San Diego.
| | - Miguel Villodas
- Child and Adolescent Services Research Center, San Diego, California; San Diego State University, California
| | | | - Kassandra Martinez
- Child and Adolescent Services Research Center, San Diego, California; University of California, San Diego; San Diego State University, California
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35
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Joshi G, Wilens T, Firmin ES, Hoskova B, Biederman J. Pharmacotherapy of attention deficit/hyperactivity disorder in individuals with autism spectrum disorder: A systematic review of the literature. J Psychopharmacol 2021; 35:203-210. [PMID: 33349107 DOI: 10.1177/0269881120972336] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To assess the empirical evidence for the treatment of attention deficit/hyperactivity disorder (ADHD) in populations with autism spectrum disorder (ASD). METHODS A systemic PubMed, PsychINFO, Embase, and Medline database search of peer-reviewed literature was conducted. Included in the review were controlled trials published in English with sample sizes ⩾10 participants examining the safety and efficacy of anti-ADHD medication in ASD populations. Data was extracted on relevant variables of study design, demographics, associated psychopathology, medication dose, efficacy, and tolerability. RESULTS Nine controlled trials met the inclusion and exclusion criteria: five with methylphenidate, three with atomoxetine, and one with guanfacine. Sample sizes ranged from 10 to 128 with 430 children participating across all the trials. In all the trials, treatment response was significantly superior to placebo. However, almost all trials assessed only hyperactivity, and most included only participants with intellectual disability with high levels of irritability. None of the trials distinguished agitation from hyperactivity. The response on hyperactivity for methylphenidate and atomoxetine was less than that observed in the neurotypical population; however, the response for guanfacine surpassed results observed in neurotypical populations. Treatment-emergent mood lability (i.e. mood dysregulation and mood-related adverse events) was frequently associated with methylphenidate and guanfacine treatments. Worse treatment outcomes were associated with individuals with lower intellectual capability compared with those with higher IQs. CONCLUSIONS here is a scarcity of controlled trials examining ADHD treatments in ASD populations, particularly in intellectually capable individuals with ASD and in adults. Response to ADHD medications in ASD were adversely moderated by the presence of intellectual disability and mood lability.
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Affiliation(s)
- Gagan Joshi
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, Boston, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston, USA.,Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Timothy Wilens
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, Boston, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston, USA.,Department of Psychiatry, Harvard Medical School, Boston, USA
| | - Elizabeth S Firmin
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, Boston, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston, USA
| | - Barbora Hoskova
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, Boston, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston, USA
| | - Joseph Biederman
- Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, Boston, USA.,Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston, USA.,Department of Psychiatry, Harvard Medical School, Boston, USA
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36
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Mingins JE, Tarver J, Waite J, Jones C, Surtees ADR. Anxiety and intellectual functioning in autistic children: A systematic review and meta-analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 25:18-32. [PMID: 33198481 PMCID: PMC8162138 DOI: 10.1177/1362361320953253] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Autistic children experience higher levels of anxiety than their peers. Making appropriate diagnoses of anxiety disorders and providing effective treatment for these children is particularly difficult. Inconsistent evidence suggests that levels of anxiety in autistic children are related to intellectual functioning. We provide the first meta-analysis of this evidence. A systematic search identified 49 papers for review. These papers included measures of anxiety and intelligence quotient in 18,430 autistic children. Studies employing correlations showed evidence of a significant relationship between intelligence quotient and anxiety in autistic children: children with higher intelligence quotient scored higher on measures of anxiety. Studies directly comparing groups of autistic children with and without intellectual disability also supported this conclusion. Most studies employing other designs also supported this finding. Employing a quality assessment framework identified common threats to validity. Many studies used measures of anxiety that were not validated across the samples they measure. This was most notable for those autistic children with an intellectual disability. It is vital that future research determines whether the identified relationship between intelligence quotient and anxiety reflects something important in the mechanism for anxiety in autistic children, or quantifies the lack of sensitivity of our measures of anxiety across different groups.
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Affiliation(s)
| | | | | | | | - Andrew DR Surtees
- University of Birmingham, UK
- Birmingham Children’s Hospital, UK
- Andrew DR Surtees, School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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37
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Bryant A, Guy J, Holmes J. The Strengths and Difficulties Questionnaire Predicts Concurrent Mental Health Difficulties in a Transdiagnostic Sample of Struggling Learners. Front Psychol 2020; 11:587821. [PMID: 33329246 PMCID: PMC7717974 DOI: 10.3389/fpsyg.2020.587821] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022] Open
Abstract
Children and adolescents with developmental problems are at increased risk of experiencing mental health problems. The Strengths and Difficulties Questionnaire (SDQ) is widely used as a screener for detecting mental health difficulties in these populations, but its use thus far has been restricted to groups of children with diagnosed disorders (e.g., ADHD). Transdiagnostic approaches, which focus on symptoms and soften or remove the boundaries between traditional categorical disorders, are increasingly adopted in research and practice. The aim of this study was to assess the potential of the SDQ to detect concurrent mental health problems in a transdiagnostic sample of children. The sample were referred by health and educational professionals for difficulties related to learning (N = 389). Some had one diagnosis, others had multiple, but many had no diagnoses. Parent-rated SDQ scores were significantly positively correlated with parent ratings of mental health difficulties on the Revised Child Anxiety and Depression Scale (RCADS). Ratings on the SDQ Emotion subscale significantly predicted the likelihood of having concurrent clinical anxiety and depression scores. Ratings on the Hyperactivity subscale predicted concurrent anxiety levels. These findings suggest the SDQ could be a valuable screening tool for identifying existing mental health difficulties in children recognized as struggling, as it can be in typically developing children and those with specific diagnoses.
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Affiliation(s)
- Annie Bryant
- Department of Clinical Psychology, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Jacalyn Guy
- Medical Research Council (MRC) Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Joni Holmes
- Medical Research Council (MRC) Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
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38
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Ramirez AC, Grebe SC, McNeel MM, Limon DL, Schneider SC, Berry LN, Goin-Kochel RP, Cepeda SL, Voigt RG, Salloum A, Storch EA. Parent-led, stepped-care cognitive-behavioral therapy for youth with autism and co-occurring anxiety: study rationale and method. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2020; 42:638-645. [PMID: 32520166 PMCID: PMC7678910 DOI: 10.1590/1516-4446-2020-0897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 03/01/2020] [Indexed: 11/21/2022]
Abstract
Anxiety disorders affect up to 50% of individuals with autism spectrum disorder (ASD) and are significantly impairing to the person affected, as well as to their loved ones. Cognitive-behavioral therapy (CBT) has been established as the gold-standard treatment for anxiety disorders among typically developing youth and adults, and demonstrates similar efficacy among youth with high-functioning autism (HFA). Many CBT interventions utilize a "full-package" treatment approach to treat co-occurring anxiety in youth with ASD. However, these service delivery systems are often therapist-intensive, costly, and impractical, thereby compromising full engagement and treatment adherence. This paper describes the design, rationale, and methodology of a study examining stepped-care CBT for youth with HFA and co-occurring anxiety - a clinical trial examining the efficacy of low-intensity, parent-led CBT as the first line of treatment and utilizing a more intensive, therapist-led intervention for nonresponders. The study will evaluate the potential benefits of stepped-care and parent-led therapist-assisted interventions, predictors of treatment response, and the economic value of using a stepped-care model. Implications for practice will be discussed.
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Affiliation(s)
- Ana C. Ramirez
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Autism Center, Texas Children’s Hospital, Houston, TX, USA
| | - Stacey C. Grebe
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Morgan M. McNeel
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Danica L. Limon
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Autism Center, Texas Children’s Hospital, Houston, TX, USA
| | - Sophie C. Schneider
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Leandra N. Berry
- Autism Center, Texas Children’s Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Robin P. Goin-Kochel
- Autism Center, Texas Children’s Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Sandra L. Cepeda
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Robert G. Voigt
- Autism Center, Texas Children’s Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Meyer Center for Developmental Pediatrics, Texas Children’s Hospital, Houston, TX, USA
| | - Alison Salloum
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Eric A. Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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39
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McCauley JB, Elias R, Lord C. Trajectories of co-occurring psychopathology symptoms in autism from late childhood to adulthood. Dev Psychopathol 2020; 32:1287-1302. [PMID: 32677592 PMCID: PMC7655668 DOI: 10.1017/s0954579420000826] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Given high rates of co-occurring conditions in youth and adults with autism spectrum disorder (ASD), it is critical to examine the developmental trajectories of these symptoms of psychopathology. Using data from a cohort of participants (n = 194), most of whom were first assessed for ASD in very early childhood, we investigated the trajectories of co-occurring depressive, anxiety, and attention-deficit hyperactivity disorder (ADHD) symptoms from late childhood to adulthood. Additionally, childhood predictors and adult outcomes associated with these symptom trajectories were examined. Using group-based trajectory modeling, we found two distinct classes of individuals exhibiting each of these co-occurring symptom patterns: one class exhibited fairly low symptoms across time, and one class with elevated symptoms with varied fluctuation across time (ADHD symptoms starting high but decreasing, anxiety symptoms high and stable, and depressive symptoms fluctuating but peaking at clinically significant levels in young adulthood). All high trajectory classes were associated with age 9 adaptive skills; verbal IQ predicted higher anxiety and depressive symptom classes. After accounting for verbal IQ, all high symptom trajectory classes were negative predictors of objective adult outcomes. These findings call for wide-ranging considerations of the needs of individuals across ability levels, autism symptoms, and behavioral and emotional challenges.
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Affiliation(s)
- James B McCauley
- Department of Psychiatry, University of California, Los Angeles, CA, USA
| | - Rebecca Elias
- Department of Psychiatry, University of California, Los Angeles, CA, USA
| | - Catherine Lord
- Department of Psychiatry, University of California, Los Angeles, CA, USA
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40
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Integrative analysis of shared genetic pathogenesis by autism spectrum disorder and obsessive-compulsive disorder. Biosci Rep 2020; 39:221433. [PMID: 31808517 PMCID: PMC6928520 DOI: 10.1042/bsr20191942] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/13/2019] [Accepted: 11/22/2019] [Indexed: 12/15/2022] Open
Abstract
Many common pathological features have been observed for both autism spectrum disorders (ASDs) and obsessive-compulsive disorder (OCD). However, no systematic analysis of the common gene markers associated with both ASD and OCD has been conducted so far. Here, two batches of large-scale literature-based disease–gene relation data (updated in 2017 and 2019, respectively) and gene expression data were integrated to study the possible association between OCD and ASD at the genetic level. Genes linked to OCD and ASD present significant overlap (P-value <2.64e-39). A genetic network of over 20 genes was constructed, through which OCD and ASD may exert influence on each other. The 2017-based analysis suggested six potential common risk genes for OCD and ASD (CDH2, ADCY8, APOE, TSPO, TOR1A, and OLIG2), and the 2019-based study identified two more genes (DISP1 and SETD1A). Notably, the gene APOE identified by the 2017-based analysis has been implicated to have an association with ASD in a recent study (2018) with DNA methylation analysis. Our results support the possible complex genetic associations between OCD and ASD. Genes linked to one disease are worth further investigation as potential risk factors for the other.
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41
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Mazurek MO, Harkins C, Menezes M, Chan J, Parker RA, Kuhlthau K, Sohl K. Primary Care Providers' Perceived Barriers and Needs for Support in Caring for Children with Autism. J Pediatr 2020; 221:240-245.e1. [PMID: 32143927 DOI: 10.1016/j.jpeds.2020.01.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/22/2019] [Accepted: 01/09/2020] [Indexed: 01/08/2023]
Abstract
A mixed methods approach was used to examine perspectives of 114 primary care providers regarding barriers and needs for support in caring for children with autism. The most common barriers related to lack of knowledge and resources for diagnosing and treating children with autism, and inadequate visit time and reimbursement.
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Affiliation(s)
- Micah O Mazurek
- Department of Human Services, Curry School of Education and Human Development, University of Virginia, Charlottesville, VA, USA.
| | - Christina Harkins
- Department of Human Services, Curry School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Michelle Menezes
- Department of Human Services, Curry School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - James Chan
- Biostatistics Center, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Robert A Parker
- Biostatistics Center, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Karen Kuhlthau
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kristin Sohl
- Department of Child Health, University of Missouri, Columbia, MO, USA
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42
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Hoch JD, Youssef AM. Predictors of Trauma Exposure and Trauma Diagnoses for Children with Autism and Developmental Disorders Served in a Community Mental Health Clinic. J Autism Dev Disord 2020; 50:634-649. [PMID: 31838644 PMCID: PMC6994449 DOI: 10.1007/s10803-019-04331-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Exposure to potentially traumatic events (PTEs), and trauma related diagnoses are poorly understood in autism spectrum disorders (ASD) and developmental disabilities (DD). The current study examined N = 7695 cases seen by a community mental health provider to compare exposure to PTEs and trauma-related diagnoses between children with ASD, children with DD, and children with other mental health diagnoses (e.g., depression). Predictors included demographics, exposure to negative life events, living situations, and subscales of the strengths and difficulties questionnaire (SDQ). Logistic regressions showed that diagnostic group, number and type of negative life events and locations lived, and SDQ subscale scores predicted trauma reports and trauma diagnoses. The findings suggest screener questions that may be useful across diagnostic groups.
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Affiliation(s)
- John D Hoch
- Fraser, 3333 University Ave SE, Minneapolis, MN, 55414, USA.
| | - Adriana M Youssef
- Institute for Translational Research in Children's Mental Health, University of Minnesota, 1100 Washington Avenue South, Minneapolis, MN, USA
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43
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Dekker LP, Visser K, van der Vegt EJM, Maras A, van der Ende J, Tick NT, Verhulst FC, Greaves-Lord K. Insight into Informant Discrepancies Regarding Psychosexual Functioning of Adolescents with and without Autism Spectrum Disorder. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2020; 30:487-501. [PMID: 31802571 DOI: 10.1111/jora.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The private nature of psychosexual functioning leads adolescents and their parents to have different perspectives, which highlights studying parent-child informant discrepancies in this domain. We investigated informant discrepancy in psychosexual functioning, using the self-report and parent report versions of the Teen Transition Inventory (TTI), of adolescents with autism spectrum disorder (ASD; 136 parent-child dyads) compared to adolescents from the general population (GP; 70 parent-child dyads). Significantly larger informant discrepancies exist in ASD dyads than GP dyads in most domains of psychosexual functioning, except for Body image, Sexual behavior, and Confidence in the future. It is important to use and pay attention to both informants, as discrepancies are relevant for both research and clinical practice regarding psychosexual functioning.
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Affiliation(s)
| | - Kirsten Visser
- Erasmus MC-Sophia
- Yulius, Organization for Mental Health
- Youz Child & Adolescent Psychiatry, Team Sarr Autism Expertise Centre
| | | | | | | | - Nouchka T Tick
- Yulius, Organization for Mental Health
- University Utrecht
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44
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Solish A, Klemencic N, Ritzema A, Nolan V, Pilkington M, Anagnostou E, Brian J. Effectiveness of a modified group cognitive behavioral therapy program for anxiety in children with ASD delivered in a community context. Mol Autism 2020; 11:34. [PMID: 32404180 PMCID: PMC7218559 DOI: 10.1186/s13229-020-00341-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 04/29/2020] [Indexed: 12/28/2022] Open
Abstract
Background Youth with autism spectrum disorder (ASD) experience high rates (approximately 50–79%) of comorbid anxiety problems. Given the significant interference and distress that excessive anxiety can cause, evidence-based intervention is necessary in order to reduce long-term negative effects. Cognitive behavioral therapy (CBT) has demonstrated efficacy for treating anxiety disorders across the lifespan, both in individual and group formats. Recently, modified CBT programs for youth with ASD have been developed, showing positive outcomes. To date, these modified CBT programs have primarily been evaluated in controlled research settings. Methods The current community effectiveness study investigated the effectiveness of a modified group CBT program (Facing Your Fears) delivered in a tertiary care hospital and across six community-based agencies providing services for youth with ASD. Data were collected over six years (N = 105 youth with ASD; ages 6–15 years). Results Hospital and community samples did not differ significantly, except in terms of age (hospital M = 10.08 years; community M = 10.87 years). Results indicated significant improvements in anxiety levels from baseline to post-treatment across measures, with medium effect sizes. An attempt to uncover individual characteristics that predict response to treatment was unsuccessful. Conclusions Overall, this study demonstrated that community implementation of a modified group CBT program for youth with ASD is feasible and effective for treating elevated anxiety.
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Affiliation(s)
- Abbie Solish
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada
| | - Nora Klemencic
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Child Development Institute, Toronto, ON, Canada
| | - Anne Ritzema
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Lighthouse Child & Adolescent Psychology, Ottawa, ON, Canada
| | - Vicki Nolan
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | | | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Jessica Brian
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada. .,Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada. .,Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
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45
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Stringer D, Kent R, Briskman J, Lukito S, Charman T, Baird G, Lord C, Pickles A, Simonoff E. Trajectories of emotional and behavioral problems from childhood to early adult life. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1011-1024. [PMID: 32191121 PMCID: PMC7521012 DOI: 10.1177/1362361320908972] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
LAY ABSTRACT Although mental health problems are common in autism, relatively little is known about their stability and the factors that influence their persistence or change over the life-course. To address this, we use data from the Special Needs and Autism Project (SNAP) cohort studied at three time-points from 12 to 23 years. Using the parent-reported Strengths and Difficulties Questionnaire (SDQ) domains of conduct, emotional, and ADHD symptoms, we evaluated the role of child, family, and contextual characteristics on these three trajectories. Symptoms decreased significantly over time for all three domains, but many participants still scored above the published disorder cutoffs. Individuals showed high levels of persistence. Higher initial adaptive function and language levels predicted a greater decline in conduct and ADHD symptoms. In contrast, higher language functioning was associated with higher levels of emotional symptoms, as was lower levels of autism symptom severity and higher parental education. Those with higher neighborhood deprivation had higher initial conduct problems but a steeper decline over time. Our findings highlight that it may be possible to accurately predict mental health trajectories over this time period, which could help parents and carers in planning and help professionals target resources more efficiently.
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Affiliation(s)
| | | | | | | | | | | | - Catherine Lord
- UCLA Semel Institute for Neuroscience
and Human Behavior, USA
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46
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Thurman AJ, Hoyos Alvarez C. Language Performance in Preschool-Aged Boys with Nonsyndromic Autism Spectrum Disorder or Fragile X Syndrome. J Autism Dev Disord 2020; 50:1621-1638. [PMID: 30783899 PMCID: PMC6699941 DOI: 10.1007/s10803-019-03919-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In the present study, language performance on standardized assessments (e.g., overall verbal performance, receptive and expressive vocabulary) and spontaneous language produced in play was compared between preschool-aged boys with autism spectrum disorder (nASD, n = 25) and boys with fragile X syndrome (FXS, n = 16). At the group-level, we observed weaknesses in the language skills of boys with nASD relative to those with FXS (e.g., when considering raw score performance, standard score performance relative to nonverbal cognitive skills, frequency of talk in play), after controlling for nonverbal IQ and ASD symptom severity. Moreover, although individually most children in both groups demonstrated language delays relative to CA-expectations, language delays relative to nonverbal level-expectations were more common in boys with nASD.
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Affiliation(s)
- Angela John Thurman
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, USA.
- MIND Institute, University of California Davis, Sacramento, USA.
| | - Cesar Hoyos Alvarez
- MIND Institute, University of California Davis, Sacramento, USA
- Department of Spanish and Portuguese, University of California Davis, Sacramento, USA
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47
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Haruvi-Lamdan N, Horesh D, Zohar S, Kraus M, Golan O. Autism Spectrum Disorder and Post-Traumatic Stress Disorder: An unexplored co-occurrence of conditions. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:884-898. [PMID: 32245333 DOI: 10.1177/1362361320912143] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
LAY ABSTRACT People with Autism Spectrum Disorder show an increased risk of experiencing traumatic events, particularly social victimization. However, Autism Spectrum Disorder and Post-Traumatic Stress Disorder co-occurrence was hardly studied. We examined exposure to traumatic life events and Post-Traumatic Stress Disorder symptoms in adults with Autism Spectrum Disorder vs typical adults. Two groups took part in this study: Twenty-five adults with Autism Spectrum Disorder and 25 typical adults of similar age and male to female ratio. Participants completed questionnaires on potentially traumatic life events of social and non-social nature, as well as on Post-Traumatic Stress Disorder symptoms related to their most distressing event. Participants also filled out an autism traits questionnaire. Results showed a higher Post-Traumatic Stress Disorder rate in the Autism Spectrum Disorder group (32%) compared with the typical group (4%). Individuals with Autism Spectrum Disorder reported more Post-Traumatic Stress Disorder symptoms, particularly re-experiencing and increased physiological arousal, compared with typical adults, although the latter was elevated only in females with Autism Spectrum Disorder. Participants with Autism Spectrum Disorder, especially females, reported more negative life events, particularly social events, than typical adults. Sixty percent of Autism Spectrum Disorder participants, but only 20% of typical participants, chose a social event as their most distressing event. Individuals with Autism Spectrum Disorder who were also suspected as having Post-Traumatic Stress Disorder (based on their questionnaires) presented poorer social skills compared with those with Autism Spectrum Disorder alone. Results indicate that individuals with Autism Spectrum Disorder are more susceptible to trauma and Post-Traumatic Stress Disorder, particularly due to social stressors. Females with Autism Spectrum Disorder may be especially vulnerable to Post-Traumatic Stress Disorder.
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Affiliation(s)
| | - Danny Horesh
- Bar-Ilan University, Israel.,New York University, USA.,Autism Treatment & Research Center, Association for Children at Risk, Israel
| | | | | | - Ofer Golan
- Bar-Ilan University, Israel.,Autism Treatment & Research Center, Association for Children at Risk, Israel.,University of Cambridge, UK
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48
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Mazurek MO, Stobbe G, Loftin R, Malow BA, Agrawal MM, Tapia M, Hess A, Farmer J, Cheak-Zamora N, Kuhlthau K, Sohl K. ECHO Autism Transition: Enhancing healthcare for adolescents and young adults with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:633-644. [PMID: 31581793 DOI: 10.1177/1362361319879616] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2024]
Abstract
Transition-age youth and young adults with autism spectrum disorder have complex healthcare needs, yet the current healthcare system is not equipped to adequately meet the needs of this growing population. Primary care providers lack training and confidence in caring for youth and young adults with autism spectrum disorder. The current study developed and tested an adaptation of the Extension for Community Healthcare Outcomes model to train and mentor primary care providers (n = 16) in best-practice care for transition-age youth and young adults with autism spectrum disorder. The Extension for Community Healthcare Outcomes Autism Transition program consisted of 12 weekly 1-h sessions connecting primary care providers to an interdisciplinary expert team via multipoint videoconferencing. Sessions included brief didactics, case-based learning, and guided practice. Measures of primary care provider self-efficacy, knowledge, and practice were administered pre- and post-training. Participants demonstrated significant improvements in self-efficacy regarding caring for youth/young adults with autism spectrum disorder and reported high satisfaction and changes in practice as a result of participation. By contrast, no significant improvements in knowledge or perceived barriers were observed. Overall, the results indicate that the model holds promise for improving primary care providers' confidence and interest in working with transition-age youth and young adults with autism spectrum disorder. However, further refinements may be helpful for enhancing scope and impact on practice.
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Affiliation(s)
| | | | | | | | | | | | - Amy Hess
- Nationwide Children's Hospital, USA
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Kim SK, McKay D, Ehrenreich-May J, Wood J, Storch EA. Assessing treatment efficacy by examining relationships between age groups of children with autism spectrum disorder and clinical anxiety symptoms: Prediction by correspondence analysis. J Affect Disord 2020; 265:645-650. [PMID: 31787421 PMCID: PMC7042046 DOI: 10.1016/j.jad.2019.11.107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/09/2019] [Accepted: 11/22/2019] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Autism spectrum disorders (ASD) are neurodevelopmental in nature and are frequently accompanied by anxiety. To fully assess treatment efficacy, we examined rates of anxiety symptom change by age groups following either cognitive behavioral therapy (CBT) or treatment as usual (TAU). METHODS One hundred sixty-three children with ASD and ASD-related anxiety symptoms were randomly assigned to either CBT or TAU. Utilizing prediction by correspondence analysis (CA), we evaluated the age effect (defined in three groups; ages 6-9, 10-12, and 13-16) and the changes in correlations between age and anxiety severity levels over the course of treatment. RESULTS Significantly greater anxiety symptom reduction was associated with CBT compared with TAU across the three age groups. Of particular note, the children ages 10-12 who received CBT showed the greatest improvement compared to all other groups. Late childhood, prior to adolescence, showed the best response to CBT for anxiety in ASD. DISCUSSION These findings suggest that treatment programs need to more closely address developmental factors within narrower bands of age groups. The present results are limited in their generalization to the CBT efficacy for a specific age band (ages 10-12). Longitudinal investigations are recommended to confirm whether the similar age group children who receive CBT experience the greatest benefit in reducing their ASD-related anxiety symptoms.
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Affiliation(s)
- Se-Kang Kim
- Fordham University, New York City, NY, United States.
| | | | | | - Jeffery Wood
- University of California, Los Angeles, CA, United States
| | - Eric A Storch
- Baylor College of Medicine, Houston, TX, United States
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50
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Family-Centered Cognitive Behavioral Therapy for Anxiety in Very Young Children with Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:3905-3920. [PMID: 32146598 DOI: 10.1007/s10803-020-04446-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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