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Kim SY, Lecavalier L. Evaluating the Use of Self-reported Measures in Autistic Individuals in the Context of Psychiatric Assessment: A Systematic Review. J Autism Dev Disord 2021; 52:4355-4374. [PMID: 34643862 DOI: 10.1007/s10803-021-05323-y] [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: 10/02/2021] [Indexed: 11/24/2022]
Abstract
The current review examined the use of self-report measures in autistic individuals in the context of psychiatric assessments. It focused on inter-rater agreement, internal consistency, test-retest reliability, and criterion validity with clinical diagnoses. It also gathered information on constructs measured, the nature of the samples, and the quality of the studies. Thirty-six out of 10,557 studies met inclusion criteria. We found that the majority of studies (1) targeted young people with average or above average cognitive abilities, (2) measured anxiety symptoms, and (3) evaluated parent-child agreement. More studies are needed on individuals with lower cognitive abilities, adults, and other constructs. Studies assessing criterion validity and test-retest reliability are also needed.
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Affiliation(s)
- Soo Youn Kim
- Nisonger Center, The Ohio State University, 1581 Dodd Drive, Columbus, OH, 43210, USA
| | - Luc Lecavalier
- Nisonger Center, The Ohio State University, 1581 Dodd Drive, Columbus, OH, 43210, USA.
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2
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Nathanson EW, Rispoli KM. School Psychologists’ Assessment Practices for Students with Co-Occurring Anxiety and Autism Spectrum Disorder. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2021. [DOI: 10.1080/15377903.2021.1941468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Emma W. Nathanson
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, Michigan, USA
| | - Kristin M. Rispoli
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, Michigan, USA
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Simpson K, Adams D, Ambrose K, Keen D. "My cheeks get red and my brain gets scared": A computer assisted interview to explore experiences of anxiety in young children on the autism spectrum. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103940. [PMID: 33765519 DOI: 10.1016/j.ridd.2021.103940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Anxiety symptoms are common in children on the autism spectrum and may be present at an early age. While a multi-informant approach is considered best practice in the assessment of anxiety, self-reports from young children on the autism spectrum are rarely included. AIMS The aim of this study was to utilise a computer-assisted interview procedure incorporating visual prompts to elicit the viewpoints of children about their experiences of anxiety. METHODS AND PROCEDURES Ten children aged 5-8 years who were diagnosed on the autism spectrum completed the interview. Directed content analysis was used to explore the data generated in the interview. OUTCOMES AND RESULTS A wide range of situations that trigger anxiety, and responses to anxiety, were reported across the participant group. These responses may be unrecognised as anxiety by others. The children provided positive feedback on the use of the computer-assisted interview. CONCLUSIONS AND IMPLICATIONS The child's own self-report can inform parents and professionals of the situations which make them more or less anxious and the behaviours that they use to communicate their anxiety in that specific situation. The use of a computer-assisted interview may be an effective method to support self-report of anxiety-related experiences for young children on the autism spectrum.
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Affiliation(s)
- Kate Simpson
- Autism Centre of Excellence, Arts Education and Law, Griffith University, QLD, Australia; Griffith Institute for Educational Research, Griffith University, QLD, Australia.
| | - Dawn Adams
- Autism Centre of Excellence, Arts Education and Law, Griffith University, QLD, Australia; Griffith Institute for Educational Research, Griffith University, QLD, Australia.
| | - Kathryn Ambrose
- Autism Centre of Excellence, Arts Education and Law, Griffith University, QLD, Australia; Griffith Institute for Educational Research, Griffith University, QLD, Australia.
| | - Deb Keen
- Autism Centre of Excellence, Arts Education and Law, Griffith University, QLD, Australia; Griffith Institute for Educational Research, Griffith University, QLD, Australia.
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Bitsika V, Heyne DA, Sharpley CF. Is Bullying Associated with Emerging School Refusal in Autistic Boys? J Autism Dev Disord 2021; 51:1081-1092. [PMID: 32705395 DOI: 10.1007/s10803-020-04610-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The experience of being bullied is widespread among autistic youth. Relatively little empirical work has been done on the relationship between the bullying of these youth and school refusal (SR). This study of 67 school-age autistic boys (M = 11.7 years, SD = 2.3 years) examined several factors that may contribute to SR. Data regarding boys' age, generalised anxiety disorder (GAD), major depressive disorder (MDD), key ASD diagnostic criteria, and frequency of being bullied were collected. Results indicated that, while boys displaying emerging SR also had significantly higher GAD and MDD than boys without emerging SR, only the frequency of being bullied made a significant contribution to emerging SR. Implications for prevention and treatment of SR among autistic youth are discussed.
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Affiliation(s)
- Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, 2350, Australia
| | - David A Heyne
- Leiden University Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, 2350, Australia.
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Pazuniak M, Pekrul SR. Obsessive-Compulsive Disorder in Autism Spectrum Disorder Across the Lifespan. Psychiatr Clin North Am 2020; 43:745-758. [PMID: 33127006 DOI: 10.1016/j.psc.2020.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Obsessive-compulsive disorder is a relatively common disorder seen in autism spectrum disorder across the lifespan. Many obsessive-compulsive disorder symptoms can present similarly to the core features of autism spectrum disorder and it is often difficult to differentiate between obsessive-compulsive disorder and stereotypic behaviors or restricted interests in autism spectrum disorder. However, there are differences between the 2 disorders. This article is a review of the current literature with the goal of helping the clinician to diagnose and treat obsessive-compulsive disorder in a patient with autism spectrum disorder.
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Affiliation(s)
- Markian Pazuniak
- Department of Child and Adolescent Psychiatry, University of Maryland Medical Center, 701 West Pratt Street, 2nd Floor, Baltimore, MD 21201, USA
| | - Scott R Pekrul
- Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204, USA.
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Abstract
Obsessive-compulsive disorder is a relatively common disorder seen in autism spectrum disorder across the lifespan. Many obsessive-compulsive disorder symptoms can present similarly to the core features of autism spectrum disorder and it is often difficult to differentiate between obsessive-compulsive disorder and stereotypic behaviors or restricted interests in autism spectrum disorder. However, there are differences between the 2 disorders. This article is a review of the current literature with the goal of helping the clinician to diagnose and treat obsessive-compulsive disorder in a patient with autism spectrum disorder.
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Bitsika V, Arnold WM, Sharpley CF. Cluster analysis of autism spectrum disorder symptomatology: Qualitatively distinct subtypes or quantitative degrees of severity of a single disorder? RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 76:65-75. [PMID: 29579688 DOI: 10.1016/j.ridd.2018.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 03/08/2018] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
The decision to collapse several related disorders into a single diagnosis of Autism Spectrum Disorder (ASD) generated significant controversy and debate. There has been mixed evidence as to whether various ASD subtypes are qualitatively distinct or if they exist on a spectrum of symptom severity. The present study conducted a two-step cluster analysis of major ASD symptoms in a sample of 147 young males with ASD aged between 6yr and 18yr with IQ > 70. Results indicated that a two-cluster solution (high and low severity of ASD symptomatology) was reliable and valid. Further, the construct of challenging behaviour was not a necessary component of the two-cluster solution, verifying the new conceptualisation of ASD. Further replication of these findings with other subsets of individuals with ASD is needed.
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Affiliation(s)
- Vicki Bitsika
- Centre for Autism Spectrum Disorder, Bond University, Robina, Queensland, 4229, Australia
| | - Wayne M Arnold
- Centre for Autism Spectrum Disorder, Bond University, Robina, Queensland, 4229, Australia
| | - Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, 2351, New South Wales, Australia.
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Anxiety-related symptomatology in young children on the autism spectrum. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 23:350-358. [DOI: 10.1177/1362361317734692] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Anxiety symptomatology is frequently reported in autistic children, and the prevalence of anxiety disorder is estimated at around 40%. However, most studies have focused upon children of age 8 years or above, so little is known about early signs of anxiety in younger children with autism. This study sought to describe anxiety-related symptomatology in 95 5- to 6-year-old autistic children using the Anxiety Scale for Children with Autism Spectrum Disorder. Wide variability was found in levels of symptomatology with the most frequently reported items within the ‘uncertainty’ subscale and the least frequently reported items in the ‘anxious arousal’ subscale. Comparisons of those with scores less than or greater than 70 on adaptive behaviour suggests some influence of ability on presentation of anxiety-related symptomatology.
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Jiujias M, Kelley E, Hall L. Restricted, Repetitive Behaviors in Autism Spectrum Disorder and Obsessive-Compulsive Disorder: A Comparative Review. Child Psychiatry Hum Dev 2017; 48:944-959. [PMID: 28281020 DOI: 10.1007/s10578-017-0717-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This review paper critically examines literature regarding restricted and repetitive behaviors (RRBs) in Autism Spectrum Disorder (ASD) and Obsessive-Compulsive Disorder (OCD). The similar behavioral profiles of these disorders presents the potential for confusion regarding diagnoses and intervention efforts. As such, this review highlights the similarities and differences between RRBs in ASD and OCD. The developmental trajectories of RRBs are presented, followed by an exploration of three constructs implicated in RRB manifestation: anxiety, executive functioning, and sensory phenomena. While RRBs tend to develop with some similarity in both disorders, the differing role of anxiety highlights important distinctions between ASD and OCD. We urge researchers and clinicians to think critically about the dimensions that affect RRB presentation. Future research should use this review as a starting point to further elucidate the differences between RRBs in these two populations.
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Affiliation(s)
- Marina Jiujias
- Psychology Department, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Elizabeth Kelley
- Psychology Department, Queen's University, Kingston, ON, K7L 3N6, Canada. .,Queen's University, Humphrey Hall Room 351, 62 Arch Street, Kingston, ON, K7L 3N6, Canada.
| | - Layla Hall
- Psychology Department, Queen's University, Kingston, ON, K7L 3N6, Canada
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Bitsika V, Sharpley CF. The association between parents' ratings of ASD symptoms and anxiety in a sample of high-functioning boys and adolescents with Autism Spectrum Disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 63:38-45. [PMID: 28259062 DOI: 10.1016/j.ridd.2017.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 02/16/2017] [Accepted: 02/20/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND The relationship between symptoms of Autism Spectrum Disorder (ASD) and Generalised Anxiety Disorder (GAD) is complex and sometimes confounding. However, exploration of that relationship has significant potential to assist in treatment or avoidance of GAD by identifying ASD-related behaviours as 'targets' for intervention with anxious children as well as for preventative treatments that could be implemented into daily routines before children become anxious. To further understanding of this relationship, the association between parent-ratings of their sons' ASD symptoms and GAD symptoms was investigated in two samples of boys with high-functioning ASD. METHODS Parents of a sample of 90 pre-adolescent (M age=8.8yr) and 60 adolescent males (M age=14.6yr) completed the Social Responsiveness Scale (SRS) and the GAD subscale of the Child and Adolescent Symptom Inventory (CASI-4 GAD) about their sons. RESULTS Pre-adolescents had significantly higher SRS scale scores than adolescents. For pre-adolescents, high levels of tension in social situations were associated with 3.5-times greater likelihood of having GAD; for adolescents, experiencing difficulty in changes in routine was associated with a 10-fold increase in risk of GAD. CONCLUSIONS In addition to focussing upon GAD itself, preventative and treatment options aimed at reducing GAD or its risk might profitably recognise and focus upon these two aspects of ASD that are different across the two age groups but each of which was significantly associated with GAD severity and prevalence in this study.
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Affiliation(s)
- Vicki Bitsika
- Centre for Autism Spectrum Disorders, Bond University, University Drive, Robina, Queensland 4229, Australia.
| | - Christopher F Sharpley
- Brain-Behaviour Research Group, Queen Elizabeth Drive, University of New England, Armidale, New South Wales 2351 Australia.
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van Steensel FJA, Heeman EJ. Anxiety Levels in Children with Autism Spectrum Disorder: A Meta-Analysis. JOURNAL OF CHILD AND FAMILY STUDIES 2017; 26:1753-1767. [PMID: 28680259 PMCID: PMC5487760 DOI: 10.1007/s10826-017-0687-7] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescence.
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Affiliation(s)
- Francisca J. A. van Steensel
- Child Development and Education, University of Amsterdam, Research priority area Yield, Nieuwe Achtergracht 127, 1018 WS Amsterdam, Netherlands
| | - Emma J. Heeman
- De Opvoedpoli B.V., Dorpstraat 145, 2712 AG Zoetermeer, Netherlands
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Bitsika V, Sharpley CF, Mills R. How are Sensory Features associated with seven anxiety disorders in boys with Autism Spectrum Disorder? Int J Dev Neurosci 2016; 50:47-54. [PMID: 26975191 DOI: 10.1016/j.ijdevneu.2016.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/08/2016] [Accepted: 03/09/2016] [Indexed: 12/28/2022] Open
Abstract
The association between Sensory Features (SF) and seven anxiety disorders was investigated using self-reports and parental reports about 140 young males with an Autism Spectrum Disorder (ASD). Although there were significant correlations between SF and self- and parent-ratings of some of the seven anxiety disorders, overall, SF was found to have an inconsistent association across the seven anxiety disorders and this was also found for the 8 symptoms of Generalised Anxiety Disorder. These data challenge the practice of assessing SF and anxiety via global measures and argue for individualized disorder-specific assessments to develop more effective diagnoses and treatments for the effects of SF.
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Affiliation(s)
- Vicki Bitsika
- Centre for Autism Spectrum Disorders, Bond University, University Drive, Robina, Queensland 4229, Australia
| | - Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Queen Elizabeth Drive, Armidale 2351, New South Wales, Australia.
| | - Richard Mills
- Centre for Autism Spectrum Disorders, Bond University, University Drive, Robina, Queensland 4229, Australia; Department of Psychology, University of Bath, Bath, UK
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Sharpley CF, Bitsika V, Andronicos NM, Agnew LL. Is afternoon cortisol more reliable than waking cortisol in association studies of children with an ASD? Physiol Behav 2016; 155:218-23. [PMID: 26717863 DOI: 10.1016/j.physbeh.2015.12.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/16/2015] [Accepted: 12/20/2015] [Indexed: 12/28/2022]
Abstract
Salivary cortisol may be used as a biomarker of stress and anxiety in children with an Autism Spectrum Disorder (ASD) and is particularly valuable in studies of the association between stress-related cortisol concentrations and other factors such as comorbid disorders or aspects of the ASD phenotype. Although protocols for the collection of cortisol shortly after waking are often based on the assumption of the presence of a diurnal rhythm in cortisol, that rhythm may not be as reliable in children with an ASD as in non-ASD children. Alternatively, collecting cortisol during the afternoon may represent a more reliable procedure with less inter-participant variability.
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Affiliation(s)
- Christopher F Sharpley
- Centre for Autism Spectrum Disorders, Bond University, Robina, Queensland, Australia; Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
| | - Vicki Bitsika
- Centre for Autism Spectrum Disorders, Bond University, Robina, Queensland, Australia
| | - Nicholas M Andronicos
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
| | - Linda L Agnew
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
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