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Yu T, Ma Z, Zhang Y. How does parental rearing patterns of children in upper primary school impact social withdrawal? A mediating effect of emotional regulation. Front Psychol 2024; 15:1382104. [PMID: 39035090 PMCID: PMC11258026 DOI: 10.3389/fpsyg.2024.1382104] [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: 02/06/2024] [Accepted: 06/18/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction The present study endeavors to elucidate the impact of emotional regulation and parental rearing patterns on the social development of children in the upper grades of primary school. A burgeoning body of literature suggests that these factors significantly influence children's social adaptation and emotional well-being, yet a comprehensive examination of these relationships is warranted. Methods Employing a cross-sectional design, this investigation utilized the Egna Minnen Beträffande Uppfostran (EMBU), Emotional Regulation Questionnaire for Children (ERQC), and Child Behavioural Issues Scale (CBCL) to assess a sample of 276 pupils across grades 4-6. The selection of these instruments allowed for a multifaceted evaluation of the constructs of interest. Results A pronounced disparity in parental rearing practices, emotional regulation capabilities, and levels of social withdrawal was observed among the different grades, with grade 5 exhibiting the most pronounced effects. Parental emotional warmth demonstrated a significant positive correlation with children's emotional regulation abilities, while punitive, rejecting, and preferential behaviors were inversely correlated. The study established that parental rearing practices indirectly influence social withdrawal through the mediating role of children's emotional regulation, underscoring the complexity of this relationship. Conclusion The results underscore the salient role of parental rearing and emotional regulation in the social development of children. The study contributes to the existing literature by providing a nuanced understanding of the mechanisms through which parenting styles and emotional competencies interplay to affect social withdrawal. Implications for educational practices and future research directions are discussed.
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Affiliation(s)
- Tao Yu
- School of Educational Science, Shenyang Normal University, Shenyang, China
| | - Zhengyu Ma
- Shenyang Seventh Middle School, Shenyang, China
| | - Yu Zhang
- School of Art and Information Engineering, Dalian University of Technology, Dalian, China
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Burghart M, Sahm AHJ, Schmidt S, Bulla J, Mier D. Understanding empathy deficits and emotion dysregulation in psychopathy: The mediating role of alexithymia. PLoS One 2024; 19:e0301085. [PMID: 38718018 PMCID: PMC11078418 DOI: 10.1371/journal.pone.0301085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/09/2024] [Indexed: 05/12/2024] Open
Abstract
Psychopathy is a severe personality disorder marked by a wide range of emotional deficits, including a lack of empathy, emotion dysregulation, and alexithymia. Previous research has largely examined these emotional impairments in isolation, ignoring their influence on each other. Thus, we examined the concurrent interrelationship between emotional impairments in psychopathy, with a particular focus on the mediating role of alexithymia. Using path analyses with cross-sectional data from a community sample (N = 315) and a forensic sample (N = 50), our results yielded a statistically significant mediating effect of alexithymia on the relationship between psychopathy and empathy (community and forensic) and between psychopathy and emotion dysregulation (community). Moreover, replacing psychopathy with its three dimensions (i.e., meanness, disinhibition, and boldness) in the community sample revealed that boldness may function as an adaptive trait, with lower levels of alexithymia counteracting deficits in empathy and emotion dysregulation. Overall, our findings indicate that psychopathic individuals' limited understanding of their own emotions contributes to their lack of empathy and emotion dysregulation. This underscores the potential benefits of improving emotional awareness in the treatment of individuals with psychopathy.
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Affiliation(s)
- Matthias Burghart
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Alexander H. J. Sahm
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Sergej Schmidt
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Jan Bulla
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Daniela Mier
- Department of Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
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O'Connor RA, Doherty M, Ryan-Enright T, Gaynor K. Perspectives of autistic adolescent girls and women on the determinants of their mental health and social and emotional well-being: A systematic review and thematic synthesis of lived experience. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:816-830. [PMID: 38145308 DOI: 10.1177/13623613231215026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
LAY ABSTRACT Difficulties with mental health and low levels of well-being are more common among autistic girls and women than non-autistic people, but we do not fully understand why. Research does not focus enough on what autistic girls and women could tell us about this. This review aims to summarise the studies where autistic girls and women explain things that affect their mental health and well-being to help us understand how to prevent these difficulties from developing. Three research databases were searched to find possibly relevant studies. There were 877 studies found, which two researchers screened according to particular criteria. They found 52 studies that could be included in this review. One researcher evaluated the quality of these studies and extracted the key information from them. This review summarises the views of 973 autistic girls and women aged between 13 and 70+. The findings from the 52 studies were analysed, and we found many factors that affect the mental health and well-being of autistic girls and women. These factors fall into two categories: (1) difficulties living in a world not designed for autistic people and (2) the impact of stigma due to being autistic.
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Affiliation(s)
- Rachel Ag O'Connor
- School of Psychology, University College Dublin, Republic of Ireland
- Health Service Executive, Republic of Ireland
| | - Mary Doherty
- Brighton and Sussex Medical School, Brighton, UK
- Our Lady's Hospital, Navan, Republic of Ireland
| | - Theresa Ryan-Enright
- School of Psychology, University College Dublin, Republic of Ireland
- Health Service Executive, Republic of Ireland
| | - Keith Gaynor
- School of Psychology, University College Dublin, Republic of Ireland
- DETECT, Early Intervention Service, Blackrock, Republic of Ireland
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Sun F, Wang F, Hu X, Xue J, Zheng S, Su J, Lu Q. Alexithymia and negative emotions among nursing students: a moderated mediation model. BMC Nurs 2024; 23:167. [PMID: 38459516 PMCID: PMC10921665 DOI: 10.1186/s12912-024-01832-0] [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: 01/03/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
Nursing students, who comprise a high percentage of China's college students, experience many psychological problems; however, few studies explored the mechanisms underlying these problems. This cross-sectional study explored the relationships and mechanisms of depression, anxiety, stress, and narrative disorders in senior nursing students. Questionnaires were administered to 380 senior nursing students in Hubei Province using the Sociodemographic Questionnaire, Toronto Alexithymia-20 Scale, Perceived Social Support Scale, 10-Item Connor-Davidson Resilience Scale, and Depression-Anxiety-Stress Scale. After controlling for sociodemographic variables, Hayes' PROCESS macros were used to test how psychological resilience moderates the relationships among narrative disorders, negative affect, and perceived social support. Bootstrap confidence intervals tested for indirect effects. Correlation analyses revealed that alexithymia was correlated significantly positively with depression-anxiety-stress (r = 0.57, 0.56, and 0.58, resp.) and significantly negatively with perceived social support (r = 0-0.46). Psychological resilience was correlated significantly negatively with alexithymia (r=-0.39) and depression-anxiety-stress (r=-0.31, -0.30, and-0.32, resp.) but significantly positively with perceived social support(r = 0.50). Perceived social support was correlated significantly negatively with depression-anxiety-stress (r=-0.33, -0.34, and - 0.42 resp.). Stress was correlated significantly positively with anxiety and depression (r = 0.81 and 0.77, resp.). Psychological resilience was a partial mediator between depression and dysphoria (β=-0.08, p < 0.05). Dysphoria directly predicted anxiety (β = 0.31) and stress (β = 0.37); moreover,alexithymia predicted depression not only directly but also through the mediating effect of psychological resilience. Therefore, educators and clinical administrators must promote and recognise negative emotions among nursing students to help ensure the nursing workforce's stability.
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Affiliation(s)
- Feifei Sun
- Department of Nursing, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Fang Wang
- Xianning Vocational Technical College, 437100, Xianning, Hubei, China
| | - Xiaojing Hu
- Department of Nursing, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Jiaomei Xue
- Society and Law School, Shandong Women's University, Changqing University Science and Technology Park, No. 2399, University Road, 25030, Jinan, Shandong, China
| | - Shangkun Zheng
- Human Resources Department, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Jing Su
- Editorial Board, Journal of Shandong First Medical University, No. 6699 Qingdao Road, Huaiyin District, 250000, Jinan, China
| | - Qinghua Lu
- Department of Infection Management, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China.
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Riedelbauch S, Gaigg SB, Thiel T, Roessner V, Ring M. Examining a model of anxiety in autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:565-579. [PMID: 37329157 PMCID: PMC10913331 DOI: 10.1177/13623613231177777] [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] [Indexed: 06/18/2023]
Abstract
ABSTRACT Anxiety disorders commonly occur in autism. Existing studies implicate intolerance of uncertainty, alexithymia, sensory processing differences and emotion regulation difficulties as influencing factors of anxiety in autism. To date, a few studies have considered the combination of these factors within the same sample. This study used structural equation modelling to test the prediction that intolerance of uncertainty and emotion regulation constitute more direct causes of anxiety in autism that mediate the influences of sensory processing difference and alexithymia as more sequential contributing factors. Autistic (n = 86) and non-autistic adults (n = 100) completed a battery of self-report questionnaires. Only when applied to each group separately, the broad predictions of the model were confirmed for the autistic group following data-driven additions of paths between sensory processing difference and anxiety and alexithymia implying that sensory processing difference contribute indirectly as well as directly to individual differences in anxiety. For the non-autistic group, model fit could only be achieved after removing autism-related traits and sensory processing differences as predictors of anxiety. These results suggest that aetiology and expression of anxiety in autism partially overlap with what is observed in the general population except that sensory processing differences appear to play a relatively unique role in the context of autism.
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Affiliation(s)
- Saskia Riedelbauch
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | | | - Tobias Thiel
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Melanie Ring
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
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Shiraishi N, Sakata M, Toyomoto R, Yoshida K, Luo Y, Nakagami Y, Tajika A, Suga H, Ito H, Sumi M, Muto T, Ichikawa H, Ikegawa M, Watanabe T, Sahker E, Uwatoko T, Noma H, Horikoshi M, Iwami T, Furukawa TA. Three types of university students with subthreshold depression characterized by distinctive cognitive behavioral skills. Cogn Behav Ther 2024; 53:207-219. [PMID: 38008940 DOI: 10.1080/16506073.2023.2288557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 11/15/2023] [Indexed: 11/28/2023]
Abstract
Subthreshold depression impairs young people's quality of life and places them at greater risk of developing major depression. Cognitive behavioral therapy (CBT) is an evidence-based approach for addressing such depressive states. This study identified subtypes of university students with subthreshold depression and revealed discrete profiles of five CBT skills: self-monitoring, cognitive restructuring, behavioral activation, assertive communication, and problem solving. Using data from the Healthy Campus Trial (registration number: UMINCTR-000031307), a hierarchical clustering analysis categorized 1,080 students into three clusters: Reflective Low-skilled, Non-reflective High-skilled, and Non-reflective Low-skilled students. Non-reflective Low-skilled students were significantly more depressed than other students (p < .001). The severity of depression seemed to be related to the combination of self-monitoring skills and other CBT skills. Considering the high prevalence of poor self-monitoring skills in persons with autism, the most severe depression was observed in the significant association between Non-reflective Low-skilled students and autistic traits (p = .008). These findings suggest that subthreshold depression can be categorized into three subtypes based on CBT skill profiles. The assessment of autistic traits is also suggested when we provide CBT interventions for Non-reflective Low-skilled students.
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Affiliation(s)
- Nao Shiraishi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Masatsugu Sakata
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Rie Toyomoto
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Kazufumi Yoshida
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Yan Luo
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Yukako Nakagami
- Department of Health Service, Kyoto University, Kyoto, Japan
| | - Aran Tajika
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | | | - Hiroshi Ito
- Department of Medical Service Center, Ritsumeikan University, Kyoto, Japan
| | - Michihisa Sumi
- Department of Medical Service Center, Ritsumeikan University, Kyoto, Japan
| | - Takashi Muto
- Department of Psychology, Doshisha University, Kyoto, Japan
| | - Hiroshi Ichikawa
- Department of Medical Life Systems, Doshisha University, Kyoto, Japan
| | - Masaya Ikegawa
- Department of Medical Life Systems, Doshisha University, Kyoto, Japan
| | - Takafumi Watanabe
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Ethan Sahker
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
- Medical Education Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Teruhisa Uwatoko
- Department of Psychiatry, Kyoto University Hospital, Kyoto, Japan
| | - Hisashi Noma
- Department of Data Science, The Institute of Statistical Mathematics, Tokyo, Japan
| | - Masaru Horikoshi
- Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Taku Iwami
- Department of Health Service, Kyoto University, Kyoto, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
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Bieczek D, Ściślicka A, Bobowska A, Tomsia F, Wilczyński KM, Janas-Kozik M. Relationship of autistic traits and the severity of fear of the COVID-19 pandemic in the general population. Front Psychiatry 2024; 15:1260444. [PMID: 38469032 PMCID: PMC10925681 DOI: 10.3389/fpsyt.2024.1260444] [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: 07/17/2023] [Accepted: 02/07/2024] [Indexed: 03/13/2024] Open
Abstract
Background The aim of the study was to investigate the level of fear of the COVID-19 pandemic and to detect a possible correlation between the autistic traits and the level of fear and to learn about other factors that may affect the level of fear. Methods The study utilised a questionnaire and was conducted online in the period from 16.02.2021 to 11.06.2021. The test group consisted of 214 respondents with an average age of 23.78 years (95%CI: 22.48 - 25.08; max: 61, min: 14) from the general population. The study used The Autism-Spectrum Quotient (AQ) questionnaire to assess the degree of autistic traits in the general population and The Fear of COVID-19 Scale, which was used to assess the level of fear of COVID-19. Results Among the respondents, 9 people scored ≥32 on the AQ test and were considered to have a high degree of autistic traits. In multiple regression (R2 = 0.1, p<0.0001), a positive relationship between the severity of fear of COVID-19 and the autistic traits (p=0.01) and age (p<0.001) was obtained. Additionally, a second multiple regression (R2 = 0.1, p<0.000001) including the subscales of AQ was performed and a positive relationship between the severity of fear of COVID-19 and the difficulties in attention switching (p=0.0004) and age (p=0.00001) was obtained. Conclusion People with higher autistic traits present greater fear of the COVID-19 pandemic. We suggest that it might be caused by cognitive stiffness and disorders in emotions regulation, according to the literature. The elderly also present higher levels of fear. The other variables did not affect the level of fear of the COVID-19 pandemic.
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Affiliation(s)
- Dominika Bieczek
- Students’ Scientific Society, Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, Katowice, Poland
| | - Adrianna Ściślicka
- Students’ Scientific Society, Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Bobowska
- Students’ Scientific Society, Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, Katowice, Poland
| | - Filip Tomsia
- Students’ Scientific Society, Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Maria Wilczyński
- Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, Katowice, Poland
- Department of Psychiatry and Psychotherapy of Developmental Age, John Paul’s II Pediatric Center, Sosnowiec, Poland
| | - Małgorzata Janas-Kozik
- Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, Katowice, Poland
- Department of Psychiatry and Psychotherapy of Developmental Age, John Paul’s II Pediatric Center, Sosnowiec, Poland
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Morie KP, Lord KA, Diefenbach GJ, Basuchoudhary O, Lewis S, Assaf M. Subscales of alexithymia show unique pathways through reappraisal and suppression to anxiety, depression and stress. J Affect Disord 2024; 347:445-452. [PMID: 38007105 PMCID: PMC10842914 DOI: 10.1016/j.jad.2023.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/26/2023] [Accepted: 11/13/2023] [Indexed: 11/27/2023]
Abstract
The goal of this work was to explore associations of constituent factors of alexithymia on mental health and potential mediating effects of emotion regulation strategies, specifically suppression and reappraisal. Data were collected through the crowd-sourcing platform Amazon Mechanical Turk (MTURK). Three hundred seventy-seven individuals completed questionnaires related to distress (Depression Anxiety Stress Scales [DASS]), emotion regulation (Emotion Regulation Questionnaire [ERQ]) and Alexithymia (Bermond-Vorst Alexithymia Questionnaire [BVAQ]). Three mediation models were constructed for depression, anxiety and stress, with BVAQ subscales (verbalizing, identifying, emotionalizing, fantasizing, and analyzing) as predictors and ERQ subscales (suppression and reappraisal) as mediators. Results indicated 37.3 % variance in depression, 25.2 % variance in anxiety, and 35.3 % variance in stress was explained by each model. Direct associations revealed emotionalizing and fantasizing were negatively associated with depression, anxiety, and stress, while verbalizing was additionally associated with depression, identifying was additionally associated with anxiety, and all four BVAQ subscales were associated with stress. BVAQ subscales demonstrated negative associations with reappraisal and positive associations with suppression that mediated anxiety and depression. However, suppression did not mediate relationships between BVAQ subscales with stress. Findings support the importance of examining multiple factors of alexithymia and associations with emotion regulation strategies and distress.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA.
| | - Kayla A Lord
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Anxiety Disorders Center, The Institute of Living, Hartford, CT 06106, USA
| | - Gretchen J Diefenbach
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Anxiety Disorders Center, The Institute of Living, Hartford, CT 06106, USA
| | - Oishani Basuchoudhary
- Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, CT 06106, USA
| | - Stephanie Lewis
- Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, CT 06106, USA
| | - Michal Assaf
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, CT 06106, USA
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9
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Hasani J, Emadi Chashmi SJ, Zakiniaeiz Y, Potenza MN. Psychometric properties of the Persian version of the cognitive emotion regulation questionnaire-short (CERQ-P-short): Reliability, validity, factor structure, treatment sensitivity, and measurement invariance. J Psychiatr Res 2024; 170:1-10. [PMID: 38096672 PMCID: PMC11131131 DOI: 10.1016/j.jpsychires.2023.11.011] [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] [Received: 02/23/2023] [Revised: 10/26/2023] [Accepted: 11/15/2023] [Indexed: 02/02/2024]
Abstract
AIMS This study aimed to examine the psychometric properties of a widely-used measure of emotion regulation, the short version of the Cognitive Emotion Regulation Questionnaire (CERQ-short), in the Persian language (CERQ-P-short) among Iranian populations. METHODS The CERQ-P-short was administered to 1825 participants (female = 974) including 436 adolescents, 834 adults from the general population, 45 patients each with generalized anxiety and obsessive-compulsive disorders, an additional 30 patients each with generalized anxiety and obsessive-compulsive disorders receiving treatment, 45 patients with substance use disorders (SUDs) and an additional 360 adult psychiatric patients. We tested reliability, factor structure, measurement invariance, convergent and discriminant validity, and treatment sensitivity (i.e., intervention response) by age, sex, and diagnostic group. The Depression Anxiety Stress Scale-21 was also administered. RESULTS Cronbach's alpha coefficient and test-retest coefficients suggested good reliability. Fit indices suggested that the 9-factor CERQ-P-Short model was good across groups. The CERQ-P-Short showed good measurement invariance in all four models (configural, metric, scalar, and strict) in all groups. Both adaptive and maladaptive cognitive emotion-regulation strategies demonstrated convergent and discriminant validity. Finally, treatment sensitivity of the CERQ-P-Short scale before and after the completion of treatment sessions was suggested for patients with generalized anxiety and obsessive-compulsive disorders. CONCLUSIONS While the present study has some limitations, it represents a significant contribution because it supports CERQ-P-Short scales usefulness, validity, and reliability in the general population and among psychiatric patients. The results of the current study can be beneficial to the both clinicians and researchers.
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Affiliation(s)
- Jafar Hasani
- Department of Clinical Psychology, Kharazmi University, Tehran, Iran.
| | | | - Yasmin Zakiniaeiz
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience, The Child Study Center and the Wu Tsai Institute, Yale University and Yale University School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA
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10
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Slater H, Yin Z, Walsh CG. Characterization of Adult Patients with Autism Spectrum Disorder that Use Patient Portal. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2024; 2023:1267-1276. [PMID: 38222351 PMCID: PMC10785869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Patients with autism spectrum disorder (ASD) access healthcare frequently, yet little is known about their interactions with patient portals. To describe adults with ASD using patient portal, we conducted regression analyses of visit history, demographics, co-occurring conditions and diagnoses, and patient portal use to determine factors most indicative of whether a patient 1) has sent at least one message (via patient or proxy) and 2) has at least one message sent on their behalf via a proxy account after they turned 18 years old. The 2,412-person cohort had 996 (41.3%) patients who had sent at least one message on their account with 129 (5.3%) of patients having at least one proxy message. This study found that adults with ASD are less likely to use messaging functionality and more likely to have a message sent via proxy than other patient populations. Comorbid mental illness was correlated with using messaging functionality.
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Affiliation(s)
- Hannah Slater
- Vanderbilt University Medical Center, Nashville, TN USA
| | - Zhijun Yin
- Vanderbilt University Medical Center, Nashville, TN USA
| | - Colin G Walsh
- Vanderbilt University Medical Center, Nashville, TN USA
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Tse WS, Pochwat B, Szewczyk B, Misztak P, Bobula B, Tokarski K, Worch R, Czarnota-Bojarska M, Lipton SA, Zaręba-Kozioł M, Bijata M, Wlodarczyk J. Restorative effect of NitroSynapsin on synaptic plasticity in an animal model of depression. Neuropharmacology 2023; 241:109729. [PMID: 37797736 DOI: 10.1016/j.neuropharm.2023.109729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/07/2023]
Abstract
In the search for new options for the pharmacological treatment of major depressive disorder, compounds with a rapid onset of action and high efficacy but lacking a psychotomimetic effect are of particular interest. In the present study, we evaluated the antidepressant potential of NitroSynapsin (NS) at behavioural, structural, and functional levels. NS is a memantine derivative and a dual allosteric N-methyl-d-aspartate receptors (NMDAR) antagonist using targeted delivery by the aminoadamantane of a warhead nitro group to inhibitory redox sites on the NMDAR. In a chronic restraint stress (CRS) mouse model of depression, five doses of NS administered on three consecutive days evoked antidepressant-like activity in the chronically stressed male C57BL/6J mice, reversing CRS-induced behavioural disturbances in sucrose preference and tail suspension tests. CRS-induced changes in morphology and density of dendritic spines in cerebrocortical neurons in the medial prefrontal cortex (mPFC) were also reversed by NS. Moreover, CRS-induced reduction in long-term potentiation (LTP) in the mPFC was found to be prevented by NS based on the electrophysiological recordings. Our study showed that NS restores structural and functional synaptic plasticity and reduces depressive behaviour to the level found in naïve animals. These results preliminarily revealed an antidepressant-like potency of NS.
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Affiliation(s)
- Wing Sze Tse
- Laboratory of Cell Biophysics, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur Str. 3, 02-093 Warsaw, Poland
| | - Bartłomiej Pochwat
- Laboratory of Cell Biophysics, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur Str. 3, 02-093 Warsaw, Poland; Department of Neurobiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland
| | - Bernadeta Szewczyk
- Department of Neurobiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland
| | - Paulina Misztak
- Department of Neurobiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; Department of Medicine and Surgery, University of Milano-Bicocca, 20-900, Monza, Italy
| | - Bartosz Bobula
- Department of Physiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland
| | - Krzysztof Tokarski
- Department of Physiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland
| | - Remigiusz Worch
- Laboratory of Cell Biophysics, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur Str. 3, 02-093 Warsaw, Poland
| | - Marta Czarnota-Bojarska
- Laboratory of Cell Biophysics, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur Str. 3, 02-093 Warsaw, Poland
| | - Stuart A Lipton
- Neurodegeneration New Medicines Center and Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037, United States; Department of Neurosciences, University of California, School of Medicine, La Jolla, San Diego, CA 92093, United States
| | - Monika Zaręba-Kozioł
- Laboratory of Cell Biophysics, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur Str. 3, 02-093 Warsaw, Poland
| | - Monika Bijata
- Laboratory of Cell Biophysics, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur Str. 3, 02-093 Warsaw, Poland.
| | - Jakub Wlodarczyk
- Laboratory of Cell Biophysics, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur Str. 3, 02-093 Warsaw, Poland.
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12
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Josyfon E, Spain D, Blackmore C, Murphy D, Oakley B. Alexithymia in Adult Autism Clinic Service-Users: Relationships with Sensory Processing Differences and Mental Health. Healthcare (Basel) 2023; 11:3114. [PMID: 38132004 PMCID: PMC10742835 DOI: 10.3390/healthcare11243114] [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: 10/26/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Mental health difficulties commonly co-occur with autism, especially in autistic people accessing clinic services, impacting substantially on quality-of-life. Alexithymia (difficulty describing/identifying feelings) and sensory processing differences are prevalent traits in autism that have been associated with depression/anxiety in autistic community samples. However, it is important to better understand interrelationships between these traits in clinical populations to improve identification of service-user needs. In this study, 190 autistic adults (65.3% male), seen in a tertiary autism clinic, completed self-report measures of alexithymia (20-item Toronto Alexithymia Scale), sensory processing differences (Adolescent/Adult Sensory Profile) and depression/anxiety (Hospital Anxiety and Depression Scale). Multiple linear regression models and mediation analyses were used to examine associations between alexithymia, sensory processing differences, and depression/anxiety severity. Across the sample, 66.3% of individuals (N = 126) were classified as alexithymic (score ≥ 61). Total alexithymia and difficulty describing/identifying feelings were significantly associated with depression severity (β = 0.30-0.38, highest p < 0.002), and difficulty identifying feelings was significantly associated with anxiety severity (β = 0.36, p < 0.001). Sensory processing differences were also significantly associated with depression severity (β = 0.29, p = 0.002) and anxiety severity across all models (β = 0.34-0.48, highest p < 0.001) Finally, difficulty describing/identifying feelings partially mediated the relationships between sensory processing differences and both depression/anxiety severity. Overall, these results highlight that interventions adapted for and targeting emotional awareness and sensory-related uncertainty may improve mental health outcomes in autistic service-users.
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Affiliation(s)
- Emily Josyfon
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Debbie Spain
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Charlotte Blackmore
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
- Sackler Institute for Translational Neurodevelopment, King’s College London, De Crespigny Park, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust (SLaM), London SE5 8AZ, UK
| | - Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
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13
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Galvin J, Howes A, Richards G. Longitudinal Associations Between Autistic Traits, Self-compassion, Anxiety and Depression in Autistic and Non-autistic Adults Without Intellectual Disability. J Autism Dev Disord 2023:10.1007/s10803-023-06157-6. [PMID: 37874475 DOI: 10.1007/s10803-023-06157-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE Previous cross-sectional research suggests self-compassion may mediate associations between autistic traits and mental health in autistic and non-autistic adults. However, no research to date has examined these relationships longitudinally. In this study, we used a cross-lagged panel analysis to examine correlations over time between autistic traits, self-compassion, and anxiety/depression. METHODS Participants were from the UK and included autistic (n = 228 at T1, n = 156 at T2, and n = 165 at T3) and non-autistic adults (n = 228 at T1, n = 122 at T2, and n = 124 at T3) without intellectual disability. Participants were recruited through an online participation platform and completed demographics, the Autism Spectrum Quotient (AQ), the Self-Compassion Scale (SCS), and the Hospital Anxiety and Depression Scale (HADS) at baseline (T1), 6 months (T2), and 12 months (T3). RESULTS In the autistic sample, negative correlations were observed between self-compassion and subsequent anxiety/depression across all models and timepoints, and these relationships were not reciprocal (i.e., earlier depression and anxiety did not predict future self-compassion). In the non-autistic sample, the findings generally suggested bi-directional relationships between self-compassion and anxiety/depression. In both groups, an indirect pathway between T1 autistic traits and T3 anxiety/depression via T2 self-compassion was confirmed. CONCLUSION Considering the high prevalence of anxiety and depression among autistic people, and that self-compassion can be cultivated through practice, these findings suggest that self-compassion could be a useful therapeutic target to promote mental health in the autistic population.
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Affiliation(s)
- John Galvin
- Department of Psychology, University of Warwick, Coventry, UK.
| | - Abby Howes
- Norwich Medical School, University of East Anglia, East Of England, UK
| | - Gareth Richards
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
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14
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Bemmouna D, Weiner L. Linehan's biosocial model applied to emotion dysregulation in autism: a narrative review of the literature and an illustrative case conceptualization. Front Psychiatry 2023; 14:1238116. [PMID: 37840783 PMCID: PMC10570453 DOI: 10.3389/fpsyt.2023.1238116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
Emotion dysregulation (ED) is a transdiagnostic difficulty prevalent in autism spectrum condition (ASC). Importantly, recent research has suggested that ED is involved in self-harm and suicidality. Pre-existing models on the etiology of ED in ASC focus mainly on biological factors to ASC features, such as sensory sensitivities, poor flexibility, and sensitivity to change. However, although psychosocial factors seem to play a role in the emergence of ED in ASC as well (e.g., childhood maltreatment and camouflaging), there is a lack of a comprehensive model conceptualizing biosocial factors involved in ED in autistic people. Linehan's biosocial model (1993) is one of the leading etiological models of ED in borderline personality disorder (BPD). It conceptualizes ED as emerging from transactions between a pre-existing emotional vulnerability in the child and an invalidating developmental environment. Beyond its clinical relevance, Linehan's model has gathered empirical evidence supporting its pertinence in BPD and in other psychiatric disorders. Although ASC and BPD are two distinct diagnoses, because they may share ED, Linehan's biosocial model might be useful for understanding the development of ED in ASC. Hence, this article aims to provide an application and extension of Linehan's model to conceptualize ED in ASC. To do so, we conducted a narrative review of the literature on ED and its underlying factors in ASC from a developmental perspective. To investigate the pertinence of the biosocial model applied to ED in autistic people, we were interested on data on (i) ED and its behavioral correlates in ASC, in relation to the biosocial model, (ii) the potential biological and psychosocial correlates of ED in ASC and (iii) the overlapping difficulties in ASC and BPD. Finally, to assess the pertinence of the model, we applied it to the case of an autistic woman presenting with ED and suicidal behaviors. Our review and application to the case of an autistic woman suggest that ED in ASC encompasses factors related to both biological and psychosocial risk factors as conceptualized in the BPD framework, although in both domains ASC-specific factors might be involved.
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Affiliation(s)
- Doha Bemmouna
- Faculté de Psychologie, Université de Strasbourg, Strasbourg, France
| | - Luisa Weiner
- Faculté de Psychologie, Université de Strasbourg, Strasbourg, France
- Département de Psychiatrie Adulte, Hôpitaux Universitaires de Strasbourg, Strasbourg, Alsace, France
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15
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Dell’Osso L, Massoni L, Battaglini S, De Felice C, Nardi B, Amatori G, Cremone IM, Carpita B. Emotional dysregulation as a part of the autism spectrum continuum: a literature review from late childhood to adulthood. Front Psychiatry 2023; 14:1234518. [PMID: 37791135 PMCID: PMC10544895 DOI: 10.3389/fpsyt.2023.1234518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
The concept of emotional dysregulation (ED) has recently gained interest in the scientific literature and is commonly defined as the inability to use the modulatory mechanisms involved in emotion regulation, resulting in a functioning meaningfully below the baseline. Even though the data available are still limited, an increasing number of studies have hypothesized a promoting role for some of the core features of autism spectrum disorder (ASD) in the development of ED, in particular being repetitive behaviors, social difficulties and alexythimia. In this framework, the purpose of this study was to review the literature that is currently available about presence and correlates of ED in young adults with autism spectrum conditions as well as to offer some insights about possible implications for illness trajectories. The data reported seems to point to a shared etiology between ED and repetitive/restricted ASD symptoms, with perseveration features serving as the foundation for the inability to control one's emotions. In this context, a neurodevelopmental basis for ED could be consistent with the transnosographic conceptualization of ASD, which hypothesizes a potential neurodevelopmental basis for several psychiatric disorders, whose autistic traits would be the phenotypical presentation.
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Affiliation(s)
| | | | | | | | | | | | | | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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16
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Oakley B, Boatman C, Doswell S, Dittner A, Clarke A, Ozsivadjian A, Kent R, Judd A, Baldoza S, Hearn A, Murphy D, Simonoff E. Molehill Mountain feasibility study: Protocol for a non-randomised pilot trial of a novel app-based anxiety intervention for autistic people. PLoS One 2023; 18:e0286792. [PMID: 37406026 PMCID: PMC10321642 DOI: 10.1371/journal.pone.0286792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/23/2023] [Indexed: 07/07/2023] Open
Abstract
Up to 50% of autistic people experience co-occurring anxiety, which significantly impacts their quality of life. Consequently, developing new interventions (and/ or adapting existing ones) that improve anxiety has been indicated as a priority for clinical research and practice by the autistic community. Despite this, there are very few effective, evidence-based therapies available to autistic people that target anxiety; and those that are available (e.g., autism adapted Cognitive Behavioural Therapy; CBT) can be challenging to access. Thus, the current study will provide an early-stage proof of concept for the feasibility and acceptability of a novel app-based therapeutic approach that has been developed with, and adapted for, autistic people to support them in managing anxiety using UK National Institute for Health and Care Excellence (NICE) recommended adapted CBT approaches. This paper describes the design and methodology of an ethically approved (22/LO/0291) ongoing non-randomised pilot trial that aims to enrol approximately 100 participants aged ≥16-years with an existing autism diagnosis and mild-to-severe self-reported anxiety symptoms (trial registration NCT05302167). Participants will be invited to engage with a self-guided app-based intervention-'Molehill Mountain'. Primary (Generalised Anxiety Disorder Assessment, Hospital Anxiety and Depression Scale) and secondary outcomes (medication/ service use and Goal Attainment Scaling) will be assessed at baseline (Week 2 +/- 2), endpoint (Week 15 +/- 2) and three follow-ups (Weeks 24, 32 and 41 +/- 4). Participants will also be invited to complete an app acceptability survey/ interview at the study endpoint. Analyses will address: 1) app acceptability/ useability and feasibility (via survey/ interview and app usage data); and 2) target population, performance of outcome measures and ideal timing/ duration of intervention (via primary/ secondary outcome measures and survey/ interview)-with both objectives further informed by a dedicated stakeholder advisory group. The evidence from this study will inform the future optimisation and implementation of Molehill Mountain in a randomised-controlled trial, to provide a novel tool that can be accessed easily by autistic adults and may improve mental health outcomes.
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Affiliation(s)
- Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Camberwell, London, United Kingdom
| | - Charlotte Boatman
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Camberwell, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Camberwell, London, United Kingdom
| | - Sophie Doswell
- National Adult ADHD and ASD Psychology Service (NAAAPS), Behavioural & Developmental Psychiatry, Monks Orchard House, Bethlem Royal Hospital, Beckenham, Kent, United Kingdom
| | - Antonia Dittner
- National Adult ADHD and ASD Psychology Service (NAAAPS), Behavioural & Developmental Psychiatry, Monks Orchard House, Bethlem Royal Hospital, Beckenham, Kent, United Kingdom
| | | | - Ann Ozsivadjian
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Camberwell, London, United Kingdom
| | - Rachel Kent
- Michael Rutter Centre for Children & Young People, Maudsley Hospital, London, United Kingdom
| | | | | | | | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Camberwell, London, United Kingdom
- Sackler Institute for Translational Neurodevelopment, King’s College London, Denmark Hill, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Camberwell, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
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17
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Kurtz MR, Kana RK, Rivera DL, Newman SD. The role of the broader autism phenotype in anxiety and depression in college-aged adults. Front Psychiatry 2023; 14:1187298. [PMID: 37342174 PMCID: PMC10278885 DOI: 10.3389/fpsyt.2023.1187298] [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: 03/15/2023] [Accepted: 05/16/2023] [Indexed: 06/22/2023] Open
Abstract
The current study examines the relationship between the presence of autistic traits and anxiety and mood disorders in young adults from different racial groups. A representative sample from a predominately white university (2,791 non-Hispanic White (NHW) and 185 Black students) completed the broad autism phenotype questionnaire (BAPQ), a measure of depression (Patient Health Questionnaire, PHQ-9), and anxiety (Generalized Anxiety Disorder, GAD-7). Statistical Package for Social Sciences (SPSS) was used to perform two multiple regression analyses to determine the association between race, BAPQ score and anxiety and depression symptoms. The current study found a stronger association between autistic traits had depression and anxiety symptoms in Black participants than did NHW participants. These findings underscore the association between autistic traits and anxiety and depression in Black communities, and the need for further studies on this topic area. Additionally, it highlights the importance of improving access to mental health care for this population.
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Affiliation(s)
- McKayla R. Kurtz
- Department of Psychology, Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Rajesh K. Kana
- Department of Psychology, Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Daphne L. Rivera
- Department of Psychology, Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
| | - Sharlene D. Newman
- Department of Psychology, Center for Innovative Research in Autism, The University of Alabama, Tuscaloosa, AL, United States
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
- Alabama Life Research Institute, The University of Alabama, Tuscaloosa, AL, United States
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18
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Bonete S, Molinero C, Ruisanchez D. Emotional Dysfunction and Interoceptive Challenges in Adults with Autism Spectrum Disorders. Behav Sci (Basel) 2023; 13:bs13040312. [PMID: 37102826 PMCID: PMC10136046 DOI: 10.3390/bs13040312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/26/2023] [Accepted: 03/31/2023] [Indexed: 04/08/2023] Open
Abstract
People with autism spectrum disorder (ASD) frequently show impaired sensory processing in different senses, including the interoceptive system. Recent findings suggest that interoception is a fundamental component of emotional experience and that impaired interoception is associated with alexithymia. This study aims to explore the association and interrelation between interoceptive confusion, alexithymia, and the capacity for emotional regulation among a sample of 33 adults with ASD compared to a control group of 35 adults with neurotypical development and its mutual impact. The participants answered a series of questionnaires addressing these three variables. The results showed (1) significant differences between the groups in all dimensions, with dysfunctional emotional regulation, impaired interoception, and alexithymia in the ASD group, (2) significant correlations between interoceptive confusion, emotional clarity, and alexithymia in the ASD group but only positive correlations between interoceptive confusion and alexithymia in the CG, and (3) that emotional clarity, alexithymia, and autism explain 61% of the variance in interoceptive confusion. These results are in line with previous studies and suggest that training interoceptive ability may enhance emotional clarity and reduce alexithymia among those diagnosed with ASD, with significant implications in the planning of treatment.
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Affiliation(s)
- Saray Bonete
- Department of Psychology, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
| | - Clara Molinero
- Department of Psychology, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
| | - Daniela Ruisanchez
- Department of Psychology, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
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19
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Zamani S, Hasani J, Hatami M, Tadros E. Emotion Dysregulation and Alexithymia within Marital Burnout through an Emotion-Focused Therapy Lens. JOURNAL OF COUPLE & RELATIONSHIP THERAPY 2023. [DOI: 10.1080/15332691.2023.2165206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Solaleh Zamani
- Department of Clinical Psychology, Kharazmi University of Tehran, Tehran, Iran
| | - Jafar Hasani
- Department of Clinical Psychology, Kharazmi University of Tehran, Tehran, Iran
| | - Mohammad Hatami
- Department of Clinical Psychology, Kharazmi University of Tehran, Tehran, Iran
| | - Eman Tadros
- IMFT, Governors State University, University Park, Illinois, USA
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20
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Ben Hassen N, Molins F, Garrote-Petisco D, Serrano MÁ. Emotional regulation deficits in autism spectrum disorder: The role of alexithymia and interoception. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 132:104378. [PMID: 36410287 DOI: 10.1016/j.ridd.2022.104378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/28/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to analyze emotional regulation, alexithymia and interoception in a group of people diagnosed with ASD (n = 27), a normative population with a technical academic training (n = 30), and another group with a humanities/health training (n = 20). Results showed significantly higher scores in alexithymia and emotional regulation problems, and lower scores in interoception in the ASD group. Also, alexithymia was found to correlate with emotional regulation, which was found to be significant in all three groups. In addition, interoception correlated negatively with alexithymia in the ASD group. Finally, the scores of the group with the technical training were closer to those of the ASD group compared to the humanities/health group.
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Affiliation(s)
- Nour Ben Hassen
- Department of Psychobiology, Universitat de València, Av. Blasco Ibáñez, 13, 46010 Valencia, Spain
| | - Francisco Molins
- Department of Psychobiology, Universitat de València, Av. Blasco Ibáñez, 13, 46010 Valencia, Spain
| | | | - Miguel Ángel Serrano
- Department of Psychobiology, Universitat de València, Av. Blasco Ibáñez, 13, 46010 Valencia, Spain.
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21
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Thapar A, Livingston LA, Eyre O, Riglin L. Practitioner Review: Attention-deficit hyperactivity disorder and autism spectrum disorder - the importance of depression. J Child Psychol Psychiatry 2023; 64:4-15. [PMID: 35972029 PMCID: PMC10087979 DOI: 10.1111/jcpp.13678] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
Young people with neurodevelopmental disorders, such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), show high rates of mental health problems, of which depression is one of the most common. Given that depression in ASD and ADHD is linked with a range of poor outcomes, knowledge of how clinicians should assess, identify and treat depression in the context of these neurodevelopmental disorders is much needed. Here, we give an overview of the latest research on depression in young people with ADHD and ASD, including possible mechanisms underlying the link between ADHD/ASD and depression, as well as the presentation, assessment and treatment of depression in these neurodevelopmental disorders. We discuss the implications for clinicians and make recommendations for critical future research in this area.
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Affiliation(s)
- Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Lucy A Livingston
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Olga Eyre
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
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22
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Albahri AS, Zaidan AA, AlSattar HA, A. Hamid R, Albahri OS, Qahtan S, Alamoodi AH. Towards physician's experience: Development of machine learning model for the diagnosis of autism spectrum disorders based on complex
T
‐spherical fuzzy‐weighted zero‐inconsistency method. Comput Intell 2022. [DOI: 10.1111/coin.12562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ahmed S. Albahri
- Informatics Institute for Postgraduate Studies (IIPS) Iraqi Commission for Computers and Informatics (ICCI) Baghdad Iraq
| | - Aws A. Zaidan
- Faculty of Engineering and IT The British University in Dubai Dubai United Arab Emirates
| | - Hassan A. AlSattar
- Department of Business Administration, College of Administrative Sciences The University of Mashreq Baghdad Iraq
| | - Rula A. Hamid
- Informatics Institute for Postgraduate Studies (IIPS) Iraqi Commission for Computers and Informatics (ICCI) Baghdad Iraq
| | - Osamah S. Albahri
- Computer Techniques Engineering Department Mazaya University College Nasiriyah Iraq
| | - Sarah Qahtan
- Department of Computer Center, College of Health and Medical Techniques Middle Technical University Baghdad Iraq
| | - Abdulla H. Alamoodi
- Department of Computing, Faculty of Arts, Computing and Creative Industry Universiti Pendidikan Sultan Idris Tanjung Malim Malaysia
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23
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Barros F, Figueiredo C, Soares SC. Autism traits dimensionality and multivariate relationship with alexithymia and anxiety in the general population. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 131:104361. [PMID: 36240538 DOI: 10.1016/j.ridd.2022.104361] [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: 04/18/2022] [Revised: 10/01/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Autism is characterized by social and non-social alterations observed beyond the clinical diagnosis. Research analyzing the expression of autism traits in the general population helps to unravel the relationship between autism dimensions and other associated variables, such as alexithymia and anxiety. The Autism-Spectrum Quotient (AQ) was developed to assess autism traits in the general population; however, inconsistent results regarding its dimensionality have emerged. AIMS This study aimed to extend evidence about the AQ measurement model, and explore the multivariate relationship between autism traits, alexithymia, and trait anxiety. METHODS 292 adults of the general population were recruited. An Exploratory Factor Analysis and Confirmatory Factor Analysis were performed to assess the factorial structure of AQ. A path analysis was carried out to explore the relationship between autism traits, alexithymia, and trait anxiety. RESULTS The results supported a three-factor model of AQ. The path analysis model showed evidence of a significant role of alexithymia as a mediator of the relationship between autism traits and anxiety. CONCLUSIONS AND IMPLICATIONS The present study provides empirical support for a three-factor model of AQ in the general population. The association between autism traits, alexithymia, and anxiety dimensions highlights the multidimensional nature of these variables and the need to account for their distinct impact on autism-related variables.
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Affiliation(s)
- Filipa Barros
- William James Center for Research (WJCR), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal; Center for Health Technology and Services Research (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.
| | - Cláudia Figueiredo
- Science and Engineer Education Group (SEE), Centre for Mechanical Engineering and Automation (TEMA), Department of Mechanical Engineering, University of Aveiro, Aveiro, Portugal; Research Unit on Governance, Competitiveness and Public Policies (GOVCOPP), University of Aveiro, Aveiro, Portugal.
| | - Sandra C Soares
- William James Center for Research (WJCR), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.
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Lee KS, Murphy J, Catmur C, Bird G, Hobson H. Furthering the language hypothesis of alexithymia: An integrated review and meta-analysis. Neurosci Biobehav Rev 2022; 141:104864. [PMID: 36087760 DOI: 10.1016/j.neubiorev.2022.104864] [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: 05/20/2022] [Revised: 08/26/2022] [Accepted: 09/04/2022] [Indexed: 11/27/2022]
Abstract
Alexithymia, including the inability to identify and express one's own feelings, is a subclinical condition responsible for some of the socioemotional symptoms seen across a range of psychiatric conditions. The language hypothesis of alexithymia posits a language-mediated disruption in the development of discrete emotion concepts from ambiguous affective states, exacerbating the risk of developing alexithymia in language-impaired individuals. To provide a critical evaluation, a systematic review and meta-analysis of 29 empirical studies of language functioning in alexithymia was performed. A modest association was found between alexithymia and multi-domain language deficits (r = -0.14), including structural language, pragmatics, and propensity to use emotional language. A more theoretically-relevant subsample analysis comparing alexithymia levels in language-impaired and typical individuals revealed larger effects, but a limited number of studies adopted this approach. A synthesis of 11 emotional granularity studies also found an association between alexithymia and reduced emotional granularity (r = -0.10). Language impairments seem to increase the risk of alexithymia. Heterogeneous samples and methods suggest the need for studies with improved alexithymia assessments.
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Affiliation(s)
- Ka Shu Lee
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, United Kingdom; Yale Child Study Center, Yale School of Medicine, United States.
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Caroline Catmur
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, United Kingdom
| | - Geoffrey Bird
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, United Kingdom
| | - Hannah Hobson
- Department of Psychology, University of York, United Kingdom
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Albahri AS, Hamid RA, Zaidan AA, Albahri OS. Early automated prediction model for the diagnosis and detection of children with autism spectrum disorders based on effective sociodemographic and family characteristic features. Neural Comput Appl 2022. [DOI: 10.1007/s00521-022-07822-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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26
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Leung CNW, Tsang B, Huang DH, Chan RWS. Building Self-Efficacy in Parenting Adult Children With Autistic Spectrum Disorder: An Initial Investigation of a Two-Pronged Approach in Role Competence. Front Psychol 2022; 13:841264. [PMID: 35941955 PMCID: PMC9355802 DOI: 10.3389/fpsyg.2022.841264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/01/2022] [Indexed: 12/05/2022] Open
Abstract
Previous studies on parenting adult children with ASD were scarce, and their intervention protocols mainly were derived from established work with children. Development of an applicable adult-oriented protocol and demonstration of its effectiveness is warranted. The present study outlined the development and evaluation of Core Autism Parenting Skills (CAPS), which targets to enhance parenting self-efficacy (PSE) intervention for adult children with ASD by addressing two intervention goals in parallel: acquisition of parenting skills and cultivating positive attributes. In CAPS, PSE is operationalised into four parent roles: to observe, reinforce, empathise, and accompany, each with requisite attributes, skills, and prescribed training. Twenty-seven parents with adult children with ASD (aged 16-37) were recruited. They completed measures assessing their PSE, competence in the four parent roles, and emotional well-being at pre-training, post-training and 2-month follow-up. The intervention was well-received by the participants and reported significant improvements in PSE, parent role competence at post-training and 2-month follow-up. The applicability of PSE and parent role competence in constructing effective parenting intervention for adult children with ASD was supported.
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Falter-Wagner CM, Bloch C, Burghof L, Lehnhardt FG, Vogeley K. Autism traits outweigh alexithymia traits in the explanation of mentalising performance in adults with autism but not in adults with rejected autism diagnosis. Mol Autism 2022; 13:32. [PMID: 35804399 PMCID: PMC9264711 DOI: 10.1186/s13229-022-00510-9] [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: 03/18/2022] [Accepted: 06/13/2022] [Indexed: 12/19/2022] Open
Abstract
Background Pronounced alexithymia traits have been found in autism spectrum disorder (ASD) and recent research has been carving out the impact alexithymia traits might have on mentalising deficits associated with ASD. Method In this cross-sectional study, a large representative referral population for diagnostic examination for possible ASD (n = 400) was screened for clinical alexithymia with a German version of the Reading the Mind in the Eyes test (RME). In contrast to previous attempts to carve out the impact of alexithymia traits on mentalising deficits though, we employed dominance analysis to account for the correlation between predictors. The relative relationship between alexithymia traits and autism traits with RME performance was investigated in the group of individuals with confirmed ASD diagnosis (N = 281) and compared to the clinical referral sample in which ASD was ruled out (N = 119). Results Dominance analysis revealed autism traits to be the strongest predictor for reduced mentalising skills in the ASD sample, whereas alexithymia contributed significantly less. In the sample of individuals with ruled out diagnosis, autism traits were the strongest predictor, but alexithymia traits were in sum equally associated to mentalising, with the External-Oriented Thinking subscale as an important predictor of this association. Limitations It needs to be considered that the cross-sectional study design does not allow for causal inference. Furthermore, mentalising is a highly facetted capacity and measurements need to reduce this complexity into simple quantities which limits the generalizability of results. Discussion While alexithymia traits should be considered for their mental health importance, they do not dominate the explanation of reduced mentalising skills in individuals with ASD, but they might do to a larger degree in individuals with ruled out ASD. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-022-00510-9.
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Affiliation(s)
- Christine M Falter-Wagner
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU Munich, Nussbaumstr. 7, 80336, Munich, Germany.
| | - Carola Bloch
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU Munich, Nussbaumstr. 7, 80336, Munich, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lana Burghof
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Fritz-Georg Lehnhardt
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany
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28
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Clasby B, Mirfin‐Veitch B, Blackett R, Kedge S, Whitehead E. Responding to neurodiversity in the courtroom: A brief evaluation of environmental accommodations to increase procedural fairness. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2022; 32:197-211. [PMID: 35932097 PMCID: PMC9540328 DOI: 10.1002/cbm.2239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/20/2022] [Indexed: 06/15/2023]
Abstract
Recent research has highlighted that a high prevalence of young adults who have various forms of neurodivergence come into contact with the criminal justice system. Currently, many courts are not designed to respond to neurological differences often seen in young people who engage with them. The aim of this study was to identify ways to make locality courts more accessible, engaging, and ultimately more responsive to neurodivergence. A panel of neurodivergence specialists reviewed the general district courtroom environment of a new specialised young adult list court in Aotearoa New Zealand to identify potential barriers to accessibility and to highlight areas for improvement. The methodology involved naturalistic observation of a typical morning in the courtroom. We identified a series of recommendations with the potential to improve the court experience and increase access to justice for neurodivergent young adults. This study identified specific need for neurodiversity education and screening within the court environment.
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Affiliation(s)
- Betony Clasby
- Department of Sociological StudiesThe University of SheffieldSheffieldUK
- Murdoch Children’s Research InstituteMelbourneAustralia
- Donald Beasley InstituteDunedinNew Zealand
| | - Brigit Mirfin‐Veitch
- Donald Beasley InstituteDunedinNew Zealand
- Centre for Postgraduate Nursing StudiesUniversity of OtagoDunedinNew Zealand
| | - Rose Blackett
- Registered Psychologist, Dyslexia Foundation of New ZealandChristchurchNew Zealand
| | - Sally Kedge
- The University of AucklandAucklandNew Zealand
| | - Esther Whitehead
- PGDipLitEdMassey UniversityPalmerston NorthNew Zealand
- Advocate and AdvisoryNeurodiversity Community of PracticeAko AotearoaThrivableNew Zealand
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29
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Oakley BFM, Jones EJH, Crawley D, Charman T, Buitelaar J, Tillmann J, Murphy DG, Loth E. Alexithymia in autism: cross-sectional and longitudinal associations with social-communication difficulties, anxiety and depression symptoms. Psychol Med 2022; 52:1458-1470. [PMID: 33028432 PMCID: PMC9226426 DOI: 10.1017/s0033291720003244] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 08/14/2020] [Accepted: 08/20/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Alexithymia (difficulties in identifying and describing emotion) is a transdiagnostic trait implicated in social-emotional and mental health problems in the general population. Many autistic individuals experience significant social-communication difficulties and elevated anxiety/depression and alexithymia. Nevertheless, the role of alexithymia in explaining individual variability in the quality/severity of social-communication difficulties and/or anxiety and depression symptoms in autism remains poorly understood. METHODS In total, 337 adolescents and adults (autism N = 179) were assessed for alexithymia on the Toronto Alexithymia Scale and for social-communication difficulties, anxiety and depression symptoms. A total of 135 individuals (autism N = 76) were followed up 12-24 months later. We used regression models to establish cross-sectional and longitudinal associations between alexithymia, social-communication difficulties, anxiety and depression symptoms. RESULTS Autistic individuals reported significantly higher alexithymia than comparison individuals (p < 0.001, r effect size = 0.48), with 47.3% of autistic females and 21.0% of autistic males meeting cut-off for clinically relevant alexithymia (score ⩾61). Difficulties in describing feelings were particularly associated with current self-reported social-communication difficulties [p < 0.001, β = 0.57, 95% confidence interval (CI) 0.44-0.67] and predicted later social-communication difficulties (p = 0.02, β = 0.43, 95% CI 0.07-0.82). Difficulties in identifying feelings were particularly associated with current anxiety symptom severity (p < 0.001, β = 0.54, 95% CI 0.41-0.77) and predicted later anxiety (p = 0.01; β = 0.31, 95% CI 0.08-0.62). CONCLUSIONS Our findings suggest that difficulties in identifying v. describing emotion are associated with differential clinical outcomes in autism. Psychological therapies targeting emotional awareness may improve social-communication and anxiety symptoms in autism, potentially conferring long-term benefits.
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Affiliation(s)
- Bethany F. M. Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Emily J. H. Jones
- Centre for Brain & Cognitive Development, Birkbeck, University of London, London WC1E 7HX, UK
| | - Daisy Crawley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust (SLaM), London, UK
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behaviour, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Reiner Postlaan 12, Nijmegen, The Netherlands
| | - Julian Tillmann
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Applied Psychology: Health, Development, Enhancement, and Intervention, University of Vienna, Vienna, Austria
| | - Declan G. Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust (SLaM), London, UK
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
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Jure R. The “Primitive Brain Dysfunction” Theory of Autism: The Superior Colliculus Role. Front Integr Neurosci 2022; 16:797391. [PMID: 35712344 PMCID: PMC9194533 DOI: 10.3389/fnint.2022.797391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/19/2022] [Indexed: 11/20/2022] Open
Abstract
A better understanding of the pathogenesis of autism will help clarify our conception of the complexity of normal brain development. The crucial deficit may lie in the postnatal changes that vision produces in the brainstem nuclei during early life. The superior colliculus is the primary brainstem visual center. Although difficult to examine in humans with present techniques, it is known to support behaviors essential for every vertebrate to survive, such as the ability to pay attention to relevant stimuli and to produce automatic motor responses based on sensory input. From birth to death, it acts as a brain sentinel that influences basic aspects of our behavior. It is the main brainstem hub that lies between the environment and the rest of the higher neural system, making continuous, implicit decisions about where to direct our attention. The conserved cortex-like organization of the superior colliculus in all vertebrates allows the early appearance of primitive emotionally-related behaviors essential for survival. It contains first-line specialized neurons enabling the detection and tracking of faces and movements from birth. During development, it also sends the appropriate impulses to help shape brain areas necessary for social-communicative abilities. These abilities require the analysis of numerous variables, such as the simultaneous evaluation of incoming information sustained by separate brain networks (visual, auditory and sensory-motor, social, emotional, etc.), and predictive capabilities which compare present events to previous experiences and possible responses. These critical aspects of decision-making allow us to evaluate the impact that our response or behavior may provoke in others. The purpose of this review is to show that several enigmas about the complexity of autism might be explained by disruptions of collicular and brainstem functions. The results of two separate lines of investigation: 1. the cognitive, etiologic, and pathogenic aspects of autism on one hand, and two. the functional anatomy of the colliculus on the other, are considered in order to bridge the gap between basic brain science and clinical studies and to promote future research in this unexplored area.
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31
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Davidson D, Morales D. Associations Between Autism Symptomatology, Alexithymia, Trait Emotional Intelligence, and Adjustment to College. Front Psychol 2022; 13:813450. [PMID: 35572317 PMCID: PMC9096698 DOI: 10.3389/fpsyg.2022.813450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
It has been asserted that the socio-emotional challenges associated with autism spectrum disorder (ASD) may be explained, in part, by the higher rates of alexithymia in individuals with autism. Alexithymia refers to difficulties in identifying one's own emotional states and describing those states to others. Thus, one goal of the present study was to examine levels of alexithymia in relation to ASD symptomatology and trait emotion intelligence (EI). Trait EI is a multifaceted concept that captures emotional competencies and behavioral dispositions A second goal was to assess whether alexithymia, ASD symptomatology and trait EI served as significant predictors of adjustment to college, including academic, social, and personal-emotional adjustment. In addition to keeping with the spectrum nature of autism, our research strategy allowed us to capture those students who may not have received a formal diagnosis of ASD but report symptoms that can be indicative of ASD. This includes women, who are less likely to receive a diagnosis of ASD even when ASD symptomatology is present. The results of the study showed that students reporting higher levels of ASD symptomatology also reported significantly higher levels of alexithymia and lower trait emotional intelligence (trait EI) than those with less or no symptomatology. Alexithymia was also negatively related to trait EI, and both alexithymia and ASD symptomatology were found to be significant predictors of trait EI. However, only trait EI was a significant predictor of adjustment to college and only for social adjustment. These findings suggest that support programs that develop trait EI skills may improve the college experience for students with ASD, regardless of alexithymia or ASD symptomatology.
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Affiliation(s)
- Denise Davidson
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
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32
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Mason D, Happé F. The role of alexithymia and autistic traits in predicting quality of life in an online sample. RESEARCH IN AUTISM SPECTRUM DISORDERS 2022; 90:None. [PMID: 35116075 PMCID: PMC8763252 DOI: 10.1016/j.rasd.2021.101887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Autistic people tend to report poorer Quality of Life (QOL) than comparison groups, though some studies do report more optimistic findings. Higher autistic traits are also related to poorer QOL. However, the role of alexithymia in this relationship has not been explored. METHOD A total of 163 participants (N = 53 autistic and N = 111 comparison) consented to take part; however, 30 participants were excluded due to missing data (who did not differ from those who were retained on age, gender, education, employment, or living status), leaving a final sample of 133 (N = 42 Autistic and 91 Comparison participants). Demographic information (including age, gender) was collected, alongside self-report measures of autistic traits, mental health, alexithymia, and QOL. We estimated regression models based on pre-registered analysis, and we conducted exploratory network analyses. RESULTS Alexithymic traits did not predict QOL when controlling for covariates. Depression significantly predicted Physical, Psychological, and Social QOL. When examining the impact of just alexithymic traits and autistic traits, both were significantly associated with Physical and Psychological QOL. For participants with a low depression score, the correlation between alexithymia and QOL was strong; suggesting that depression occludes the association between alexithymia and QOL. Network analyses suggested that depression and anxiety exert direct effects on Physical and Psychological QOL, whereas alexithymia scores may influence Physical QOL via autistic traits. CONCLUSION In sum, depression is a pervasive negative predictor of multiple QOL domains. The role of alexithymia in predicting QOL dimensionally and categorically was not ruled out, given our exploratory analyses, we suggest that interventions which target alexithymia may positively impact QOL for those who score low on depressive symptoms.
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Affiliation(s)
- David Mason
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, UK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, UK
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Moore HL, Brice S, Powell L, Ingham B, Freeston M, Parr JR, Rodgers J. The Mediating Effects of Alexithymia, Intolerance of Uncertainty, and Anxiety on the Relationship Between Sensory Processing Differences and Restricted and Repetitive Behaviours in Autistic Adults. J Autism Dev Disord 2021; 52:4384-4396. [PMID: 34643864 PMCID: PMC9508023 DOI: 10.1007/s10803-021-05312-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/23/2022]
Abstract
Distress caused by sensory processing differences for autistic individuals may be reduced by repetitive behaviours (RRB), including repetitive motor (RMB) and insistence on sameness (ISB) behaviours. Intolerance of uncertainty (IU) and anxiety mediate the relationship between sensory processing and RRB in autistic children. We replicated this model in autistic adults, extending it to include alexithymia. Serial mediation, using data from 426 autistic adults, identified significant direct effects from sensory processing to RMB and ISB, and indirect effects through alexithymia-IU-anxiety for RMB, and IU alone, and alexithymia-IU for ISB. Different mechanisms may underpin RMB and ISB. Alexithymia alongside, IU and anxiety, should be considered when understanding the relationship between sensory processing and RRB, and when offering interventions to support autistic people.
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Affiliation(s)
- Heather L Moore
- School of Psychology, 4.28, Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE2 4DR, UK.
| | - Samuel Brice
- Population Health Sciences Institute, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Level 3, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK.,Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Newcastle Upon Tyne, NE3 1XT, UK
| | - Lauren Powell
- School of Psychology, 4.28, Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE2 4DR, UK
| | - Barry Ingham
- Population Health Sciences Institute, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Level 3, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK.,Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Newcastle Upon Tyne, NE3 1XT, UK
| | - Mark Freeston
- School of Psychology, 4.28, Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE2 4DR, UK
| | - Jeremy R Parr
- Population Health Sciences Institute, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Level 3, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK.,Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Newcastle Upon Tyne, NE3 1XT, UK
| | - Jacqui Rodgers
- Population Health Sciences Institute, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Level 3, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK
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Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study. J Autism Dev Disord 2021; 52:4337-4354. [PMID: 34626285 PMCID: PMC8501315 DOI: 10.1007/s10803-021-05317-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 12/14/2022]
Abstract
Self-harm and suicidal behaviors are prevalent among autistic adults without intellectual disability (ID). Emotion dysregulation (ED), the difficulty in modulating emotions, has been identified as an important risk factor. Dialectical behavior therapy (DBT) has been proved effective to treat ED in disorders other than autism spectrum disorder. Our study aimed at assessing the feasibility, acceptability and preliminary efficacy of DBT in seven autistic adults without ID exhibiting self-harm and/or suicidal behaviors linked to severe ED. Our results suggest that DBT is feasible and highly acceptable to autistic adults without ID. Additionally, mean scores on the Difficulties in Emotion Regulation Scale decreased significantly post-treatment and at 4-month follow-up, suggesting that DBT might be efficacious in reducing ED in this population.
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Aslam AR, Altaf MAB. A 10.13µJ/Classification 2-Channel Deep Neural Network Based SoC for Negative Emotion Outburst Detection of Autistic Children. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2021; 15:1039-1052. [PMID: 34543203 DOI: 10.1109/tbcas.2021.3113613] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
An electroencephalogram (EEG)-based non-invasive 2-channel neuro-feedback SoC is presented to predict and report negative emotion outbursts (NEOB) of Autistic patients. The SoC incorporates area-and-power efficient dual-channel Analog Front-End (AFE), and a deep neural network (DNN) emotion classification processor. The classification processor utilizes only the two-feature vector per channel to minimize the area and overfitting problems. The 4-layers customized DNN classification processor is integrated on-sensor to predict the NEOB. The AFE comprises two entirely shared EEG channels using sampling capacitors to reduce the area by 30%. Moreover, it achieves an overall integrated input-referred noise, NEF, and crosstalk of 0.55 µVRMS, 2.71, and -79 dB, respectively. The 16 mm2 SoC is implemented in 0.18 um 1P6M, CMOS process and consumes 10.13 μJ/classification for 2 channel operation while achieving an average accuracy of >85% on multiple emotion databases and real-time testing.
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Jean FA, Jouni A, Bouvard MP, Camelot G, Beggiato A, Scheid I, Gaman A, Bouquet C, Ly-Le Moal M, Houenou J, Delorme R, Leboyer M, Amestoy A. Overlap of anxiety, depression, irritability and aggressiveness in autism spectrum disorder: an exploratory study using cluster analysis. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-08-2020-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to explore the overlap between symptoms of depression, anxiety, irritability and aggressiveness in autism spectrum disorder (ASD), to measure specific and idiosyncratic emotional responses.
Design/methodology/approach
A total of 42 high functioning adolescents and adults, between 12 and 39 years old, meeting the diagnostic and statistical manual of mental disorders – 5 criteria for ASD were selected from the InFoR Autism cohort. Data were analyzed in an exploratory way using Hill and Smith and K-medoids cluster analysis.
Findings
The authors found an aggregation of anxiety, depression, aggressive behaviors and irritability. Cluster analysis was maximized for two groups with 17 and 25 participants, respectively. The first group was characterized by high levels of symptoms of irritability, aggressiveness, hyperactivity and intermediate levels of anxiety and depression. In the first group, participants had significantly higher levels of autistic symptoms considering the social responsiveness scale and repetitive behavior scale-revised scales (relatives’ reports) suggesting that a particular group of subjects with a high level of ASD specific symptoms may express anxiety and depression in a specific way based on externalizing behaviors in addition to the common mood and anxiety symptoms.
Research limitations/implications
Improved understanding of the aggregation of externalized symptoms with symptoms of anxiety and mood disorders in ASD should lead to a better understanding of the underlying mechanisms related to emotion dysregulation in ASD.
Practical implications
Improved knowledge of the symptoms could lead to enhanced detection of psychiatric comorbidities in ASD.
Originality/value
The study was based on a transdiagnostic approach of psychiatric symptoms in individuals with ASD. Aggregation and clustering analysis was used to explore naive patterns of these psychiatric symptoms.
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Williams ZJ, Gotham KO. Improving the measurement of alexithymia in autistic adults: a psychometric investigation of the 20-item Toronto Alexithymia Scale and generation of a general alexithymia factor score using item response theory. Mol Autism 2021; 12:56. [PMID: 34376227 PMCID: PMC8353782 DOI: 10.1186/s13229-021-00463-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/31/2021] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Alexithymia, a personality trait characterized by difficulties interpreting emotional states, is commonly elevated in autistic adults, and a growing body of literature suggests that this trait underlies several cognitive and emotional differences previously attributed to autism. Although questionnaires such as the 20-item Toronto Alexithymia Scale (TAS-20) are frequently used to measure alexithymia in the autistic population, few studies have investigated the psychometric properties of these questionnaires in autistic adults, including whether differential item functioning (I-DIF) exists between autistic and general population adults. METHODS This study is a revised version of a previous article that was retracted due to copyright concerns (Williams and Gotham in Mol Autism 12:1-40). We conducted an in-depth psychometric analysis of the TAS-20 in a large sample of 743 cognitively able autistic adults recruited from the Simons Foundation SPARK participant pool and 721 general population controls enrolled in a large international psychological study. The factor structure of the TAS-20 was examined using confirmatory factor analysis, and item response theory was used to generate a subset of the items that were strong indicators of a "general alexithymia" factor. Correlations between alexithymia and other clinical outcomes were used to assess the nomological validity of the new alexithymia score in the SPARK sample. RESULTS The TAS-20 did not exhibit adequate model fit in either the autistic or general population samples. Empirically driven item reduction was undertaken, resulting in an 8-item general alexithymia factor score (GAFS-8, with "TAS" no longer referenced due to copyright) with sound psychometric properties and practically ignorable I-DIF between diagnostic groups. Correlational analyses indicated that GAFS-8 scores, as derived from the TAS-20, meaningfully predict autistic trait levels, repetitive behaviors, and depression symptoms, even after controlling for trait neuroticism. The GAFS-8 also presented no meaningful decrement in nomological validity over the full TAS-20 in autistic participants. LIMITATIONS Limitations of the current study include a sample of autistic adults that was majority female, later diagnosed, and well educated; clinical and control groups drawn from different studies with variable measures; only 16 of the TAS-20 items being administered to the non-autistic sample; and an inability to test several other important psychometric characteristics of the GAFS-8, including sensitivity to change and I-DIF across multiple administrations. CONCLUSIONS These results indicate the potential of the GAFS-8 to robustly measure alexithymia in both autistic and non-autistic adults. A free online score calculator has been created to facilitate the use of norm-referenced GAFS-8 latent trait scores in research applications (available at https://asdmeasures.shinyapps.io/alexithymia ).
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Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN 37232 USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN USA
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Understanding Oneself to Understand Others: The Role of Alexithymia and Anxiety in the Relationships Between Autistic Trait Dimensions and Empathy. J Autism Dev Disord 2021; 52:1971-1983. [PMID: 34041681 DOI: 10.1007/s10803-021-05086-6] [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] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
People on the autism spectrum may have difficulty inferring others' emotions (cognitive empathy), but may share another's emotions (affective empathy) and exhibit heightened personal distress. The present study examined independent autistic trait dimensions (social difficulties and restricted/repetitive behaviours) and the roles alexithymia and trait anxiety have in explaining this profile of empathy. Results from the general population (n = 301) revealed that pronounced social difficulties and not restricted/repetitive behaviours related to reduced cognitive and affective empathy, and heightened personal distress. However, both dimensions, through alexithymia and anxiety, indirectly influenced empathy. Surprisingly, while the dimensions indirectly improved affective empathy, pronounced social difficulties directly reduced affective empathy. This study motivates a nuanced model of empathy by including autistic trait dimensions, anxiety, and alexithymia.
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Investigating the Relationship between Autistic Traits, Ruminative Thinking, and Suicidality in a Clinical Sample of Subjects with Bipolar Disorder and Borderline Personality Disorder. Brain Sci 2021; 11:brainsci11050621. [PMID: 34066194 PMCID: PMC8151773 DOI: 10.3390/brainsci11050621] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Previous literature reported in both subjects with Borderline personality disorder (BPD) and Bipolar disorder (BD) higher levels of autistic traits, linked to a greater suicidality risk. The aim of this study was to evaluate and compare the presence of autistic traits in a sample of individuals with BD or BPD, with a specific focus on suicidality. (2) Methods: We recruited two clinical samples of subjects (BPD and BD) and a control group without a diagnosis according to DSM-5 (CTL). Subjects were assessed with the AdAS Spectrum, the RRS and, for evaluating suicidality, the MOODS-SR. (3) Results: The CTL group showed significantly lower scores of both BD and BPD on AdAS Spectrum, RRS, and suicidality scores. BPD subjects showed significantly lower scores than BD ones in most of AdAS Spectrum domain scores. Correlation and regression analyses highlighted specific patterns of association among AdAS Spectrum domains, RRS, and suicidality in each clinical group. (4) Conclusions: Both BPD and BD individuals show greater levels of autistic traits, which seem to be distributed in a continuum featuring the highest levels among BD subjects. In both disorders, higher autistic traits were linked to suicidal tendencies, although with different patterns of association between BD and BPD subjects.
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Abstract
Individuals with autism experience substantially higher rates of mood problems compared to the general population, which contribute to reduced quality of life and increased mortality through suicide. Here, we reviewed evidence for the clinical presentation, aetiology and therapeutic approaches for mood problems in autism. We identified a lack of validated tools for accurately identifying mood problems in individuals with autism, who may present with 'atypical' features (e.g. severe irritability). Risk factors for mood problems in autism appear to be largely overlapping with those identified in the general population, including shared genetic, environmental, cognitive, physiological/neurobiological mechanisms. However, these mechanisms are exacerbated directly/indirectly by lived experiences of autism, including increased vulnerability for chronic stress - often related to social-communication difficulties(/bullying) and sensory sensitivities. Lastly, current therapeutic approaches are based on recommendations for primary mood disorders, with little reference to the neurobiological/cognitive differences associated with autism. Thus, we recommend: 1) the development and validation of (objective) tools to identify mood problems in autism and measure therapeutic efficacy; 2) an interactive approach to investigating aetiologies in large-scale longitudinal studies, integrating different levels of analysis (e.g. cognitive, neurobiological) and lived experience; 3) testing potential treatments through high-quality (e.g. sufficiently powered, blinded) clinical trials, specifically for individuals with autism.
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Affiliation(s)
- Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, UK
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, UK
| | - Declan G Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, UK.,South London and Maudsley NHS Foundation Trust (SLaM), London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, UK
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McVey AJ, Schiltz HK, Coffman M, Antezana L, Magnus B. A Preliminary Psychometric Analysis of the Difficulties with Emotion Regulation Scale (DERS) Among Autistic Adolescents and Adults: Factor Structure, Reliability, and Validity. J Autism Dev Disord 2021; 52:1169-1188. [PMID: 33886035 DOI: 10.1007/s10803-021-05018-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 12/01/2022]
Abstract
Emotion dysregulation is common among autistic people, yet few measures have received psychometric evaluation in this population. We examined the factor structure, reliability, and validity of a commonly-used measure of emotion dysregulation, the Difficulties with Emotion Regulation Scale (DERS), in a sample of 156 autistic adolescents and adults. Data were drawn from the NIH National Database for Autism Research (NDAR) and an author's existing dataset. Results demonstrated that the factor structure generally conformed to the original 6-factor model, with modifications. Reliability analyses revealed good-to-excellent internal consistencies. Validity analyses indicated that the DERS was positively associated with measures of anxiety, depression, and alexithymia. Our findings provide preliminary evidence for the utility of the DERS in a small autistic sample, with minor modifications.
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Affiliation(s)
- Alana J McVey
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada. .,Department of Psychology, Marquette University, Milwaukee, WI, USA.
| | | | - Marika Coffman
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.,Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Ligia Antezana
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Brooke Magnus
- Department of Psychology, Marquette University, Milwaukee, WI, USA.,Department of Psychology and Neuroscience, Boston College, Chestnut Hill, MA, USA
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Williams ZJ, Gotham KO. Improving the measurement of alexithymia in autistic adults: a psychometric investigation and refinement of the twenty-item Toronto Alexithymia Scale. Mol Autism 2021; 12:20. [PMID: 33653400 PMCID: PMC7971146 DOI: 10.1186/s13229-021-00427-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/19/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Alexithymia, a personality trait characterized by difficulties interpreting one's own emotional states, is commonly elevated in autistic adults, and a growing body of literature suggests that this trait underlies a number of cognitive and emotional differences previously attributed to autism, such as difficulties in facial emotion recognition and reduced empathy. Although questionnaires such as the twenty-item Toronto Alexithymia Scale (TAS-20) are frequently used to measure alexithymia in the autistic population, few studies have attempted to determine the psychometric properties of these questionnaires in autistic adults, including whether differential item functioning (I-DIF) exists between autistic and general population adults. METHODS We conducted an in-depth psychometric analysis of the TAS-20 in a large sample of 743 verbal autistic adults recruited from the Simons Foundation SPARK participant pool and 721 general population controls enrolled in a large international psychological study (the Human Penguin Project). The factor structure of the TAS-20 was examined using confirmatory factor analysis, and item response theory was used to further refine the scale based on local model misfit and I-DIF between the groups. Correlations between alexithymia and other clinical outcomes such as autistic traits, anxiety, and quality-of-life were used to assess the nomological validity of the revised alexithymia scale in the SPARK sample. RESULTS The TAS-20 did not exhibit adequate global model fit in either the autistic or general population samples. Empirically driven item reduction was undertaken, resulting in an eight-item unidimensional scale (TAS-8) with sound psychometric properties and practically ignorable I-DIF between diagnostic groups. Correlational analyses indicated that TAS-8 scores meaningfully predict autistic trait levels, anxiety and depression symptoms, and quality of life, even after controlling for trait neuroticism. LIMITATIONS Limitations of the current study include a sample of autistic adults that was overwhelmingly female, later-diagnosed, and well-educated; clinical and control groups drawn from different studies with variable measures; and an inability to test several other important psychometric characteristics of the TAS-8, including sensitivity to change and I-DIF across multiple administrations. CONCLUSIONS These results indicate the potential of the TAS-8 as a psychometrically robust tool to measure alexithymia in both autistic and non-autistic adults. A free online score calculator has been created to facilitate the use of norm-referenced TAS-8 latent trait scores in research applications (available at http://asdmeasures.shinyapps.io/TAS8_Score ).
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Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN 37232 USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN USA
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Rumball F, Antal K, Happé F, Grey N. Co-occurring mental health symptoms and cognitive processes in trauma-exposed ASD adults. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 110:103836. [PMID: 33453693 DOI: 10.1016/j.ridd.2020.103836] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/24/2020] [Accepted: 12/12/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Mental health problems are common amongst adults with an Autism Spectrum Disorder (ASD). Stressful and traumatic life events can trigger or exacerbate symptoms of anxiety, depression and PTSD. In the general population, transdiagnostic processes such as suppression and perseverative thinking are associated with responses to trauma and mental health symptoms. AIMS This study explored the relationships between thought suppression, perseverative thinking and symptoms of depression, anxiety and PTSD in ASD adults who reported exposure to a range of DSM-5 and non-DSM-5 traumatic events. METHODS 59 ASD adults completed a series of online self-report questionnaires measuring trauma, transdiagnostic cognitive processes, and mental health symptoms. RESULTS Probable PTSD rarely occurred in isolation and was associated with depression and anxiety symptoms in trauma-exposed ASD adults. All cognitive processes and mental health symptoms were positively associated with one another, regardless of whether the trauma met DSM-5 PTSD Criterion A. When accounting for both cognitive processes, only thought suppression significantly predicted PTSD and anxiety symptoms, while only perseverative thinking significantly predicted depression symptoms. CONCLUSIONS AND IMPLICATIONS These preliminary results suggest that different cognitive processes more strongly affect anxiety/PTSD versus depression symptom severity in trauma-exposed ASD adults, although co-occurring symptoms are common. Implications for assessment, treatment and future research are discussed.
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Affiliation(s)
- Freya Rumball
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience - PO80, De Crespigny Park, Denmark Hill, London, SE5 8AF, United Kingdom.
| | - Kinga Antal
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience - PO80, De Crespigny Park, Denmark Hill, London, SE5 8AF, United Kingdom
| | - Francesca Happé
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience - PO80, De Crespigny Park, Denmark Hill, London, SE5 8AF, United Kingdom
| | - Nick Grey
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience - PO80, De Crespigny Park, Denmark Hill, London, SE5 8AF, United Kingdom; Sussex Partnership NHS Foundation Trust, United Kingdom
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44
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Bloch C, Burghof L, Lehnhardt FG, Vogeley K, Falter-Wagner C. Alexithymia traits outweigh autism traits in the explanation of depression in adults with autism. Sci Rep 2021; 11:2258. [PMID: 33500523 PMCID: PMC7838249 DOI: 10.1038/s41598-021-81696-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 01/08/2021] [Indexed: 01/13/2023] Open
Abstract
When contemplating the alarming depression rates in adults with autism spectrum disorder (ASD), there is a need to find factors explaining heightened symptoms of depression. Beyond the impact of autism traits, markedly increased levels of alexithymia traits should be considered as a candidate for explaining why individuals with ASD report higher levels of depressive symptoms. Here, we aim to identify the extent to which autism or alexithymia traits indicate depressive symptoms in ASD and whether the pattern of association are specific to ASD. Data of a large (N = 400) representative clinical population of adults referred to autism diagnostics have been investigated and split by cases with a confirmed ASD diagnosis (N = 281) and cases with a ruled out ASD diagnosis (N = 119). Dominance analysis revealed the alexithymia factor, difficulties in identifying feelings, as the strongest predictor for depressive symptomatology in ASD, outweighing autism traits and other alexithymia factors. This pattern of prediction was not specific to ASD and was shared by clinical controls from the referral population with a ruled out ASD diagnosis. Thus, the association of alexithymia traits with depression is not unique to ASD and may constitute a general psychopathological mechanism in clinical samples.
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Affiliation(s)
- Carola Bloch
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany. .,Department of Psychiatry and Psychotherapy, Medical Faculty, LMU Munich, Nussbaumstr. 7, 80336, Munich, Germany.
| | - Lana Burghof
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Fritz-Georg Lehnhardt
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Institute of Neuroscience and Medicine (INM3), Research Center Jülich, Leo-Brandt-Str, 52428, Jülich, Germany
| | - Christine Falter-Wagner
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU Munich, Nussbaumstr. 7, 80336, Munich, Germany.,Department of Psychology, University of Cologne, Gronewaldstr. 2, 50931, Cologne, Germany
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45
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Ohtani T, Matsuo K, Sutoh C, Oshima F, Hirano Y, Wakabayashi A, Shimizu E. Reduced Brain Activation in Response to Social Cognition Tasks in Autism Spectrum Disorder with and without Depression. Neuropsychiatr Dis Treat 2021; 17:3015-3024. [PMID: 34611402 PMCID: PMC8487275 DOI: 10.2147/ndt.s327608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/04/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE In clinical settings, diagnosing comorbid depression in individuals with autism spectrum disorder (ASD) is often difficult. Neuroimaging studies have reported reduced activation of frontal and temporal regions during emotional face recognition task (EFRT) in ASD and depression. However, to the best of our knowledge, no study has examined differences in frontotemporal activation during EFRT between ASD with and without comorbid depression. We aimed to compare the frontotemporal hemodynamic responses to the EFRT in ASD with and without depression and to find clues to help in discriminating the characteristics between them. PATIENTS AND METHODS In 24 drug-naïve young adults with ASD (12 with depression [ASD-Dep(+)] and 12 without depression [ASD-Dep(-)]) and 12 with typical development (TD), frontotemporal hemodynamic responses during an EFRT were measured using functional near-infrared spectroscopy (fNIRS). RESULTS The ASD groups showed reduced activation during EFRT than the TD group in the right ventrolateral prefrontal cortex (VLPFC). Moreover, the ASD-Dep(+) group showed reduced activation during EFRT than the ASD-Dep(-) group in the right anterior temporal cortex (aTC), and reduced activation than the TD group in the left VLPFC. CONCLUSION The observed results might reflect reduced regional activation in ASD and ASD with comorbid depression.
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Affiliation(s)
- Toshiyuki Ohtani
- Safety and Health Organization, Chiba University, Chiba, Japan.,Research Center for Child Mental Development, Chiba University, Chiba, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Koji Matsuo
- Department of Psychiatry, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Chihiro Sutoh
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine and School of Medicine, Chiba University, Chiba University, Chiba, Japan
| | - Fumiyo Oshima
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Akio Wakabayashi
- Department of Psychology,Graduate School of Humanities, Chiba University, Chiba, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan.,Department of Cognitive Behavioral Physiology, Graduate School of Medicine and School of Medicine, Chiba University, Chiba University, Chiba, Japan
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Albantakis L, Brandi ML, Zillekens IC, Henco L, Weindel L, Thaler H, Schliephake L, Timmermans B, Schilbach L. Alexithymic and autistic traits: Relevance for comorbid depression and social phobia in adults with and without autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:2046-2056. [PMID: 32662285 PMCID: PMC7543015 DOI: 10.1177/1362361320936024] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
LAY ABSTRACT Adults with autism often develop mental health problems such as depression and social phobia. The reasons for this are still unclear. Many studies found that alexithymia plays an important role in mental health problems like depression. People with alexithymia have difficulties identifying and describing their emotions. Almost every second person with autism has alexithymia. Therefore, we explored in this study whether alexithymia is linked to worse mental health in autistic people. We looked at two common diagnoses, depression and social phobia. We found that alexithymia increased symptoms of depression, while autistic traits increased symptoms of social phobia. Our results suggest that alexithymia and autistic traits can increase the risk of mental health problems. An early assessment could help prevent mental health problems and improve quality of life.
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Affiliation(s)
- Laura Albantakis
- Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | | | - Imme Christina Zillekens
- Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Lara Henco
- Max Planck Institute of Psychiatry, Munich, Germany
- Graduate School of Systemic Neurosciences, Muenich, Germany
| | | | - Hanna Thaler
- Max Planck Institute of Psychiatry, Munich, Germany
| | | | | | - Leonhard Schilbach
- Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
- LVR-Klinikum Duesseldorf/Kliniken der Heinrich-Heine-Universitaet Duesseldorf, Germany
- Ludwig-Maximilian-University, Munich, Germany
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47
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Howes A, Richards G, Galvin J. A Preliminary Investigation Into the Relationship Between Autistic Traits and Self-Compassion. Psychol Rep 2020; 124:1988-1997. [PMID: 32903137 DOI: 10.1177/0033294120957244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Self-compassion refers to the extension of kindness to oneself when faced with feelings of inadequacies, shortcomings or failures. It is possible that individuals high in autistic traits may encounter difficulties with self-compassion, and this could be particularly pronounced due to the social challenges they might face. To explore this potential relationship, we recruited university students and members of the general population to an online survey (n = 176). Participants completed measures on demographics, autistic traits, and self-compassion. We found that autistic traits were indeed negatively correlated with self-compassion in both males and females. Interestingly, a comparison of the slopes showed significantly stronger relationships in males compared to females for the negative (but not the positive) subscales of the self-compassion scale. Although speculative at this point, it is possible that self-compassion acts as a mediator between autistic traits and psychopathology. With this in mind, further work is warranted to determine whether self-compassion could be a target for therapeutic intervention.
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Affiliation(s)
- Abby Howes
- Department of Psychology, Birmingham City University, UK.,Department of Psychology, Birmingham City University, UK
| | - Gareth Richards
- School of Psychology, Faculty of Medical Sciences, Newcastle University, UK; Autism Research Centre, Department of Psychiatry, University of Cambridge, UK.,Department of Psychology, Birmingham City University, UK
| | - John Galvin
- Department of Psychology, Birmingham City University, UK
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Morie KP, Zhai ZW, Potenza MN, Mayes LC. Alexithymia, Emotion-Regulation Strategies, and Traumatic Experiences in Prenatally Cocaine-Exposed Young Adults. Am J Addict 2020; 29:492-499. [PMID: 32436341 DOI: 10.1111/ajad.13056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/01/2020] [Accepted: 04/23/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Exposure to early-life trauma may lead to maladaptive characteristics such as alexithymia, and thus to poorer emotional regulation. This relationship may also be influenced by exposure to substances prenatally. We hypothesized that increased alexithymia would be seen in those with prenatal cocaine exposure (PCE). Additionally, we hypothesized that early-life trauma would be associated with alexithymia, and that alexithymia would be associated with poor emotional reappraisal and emotional suppression. METHODS A moderated mediation model was developed to examine whether the hypothesized indirect relationship between trauma and emotional reappraisal through alexithymia was different in young adults with and without PCE (Total N = 57). Thirty-seven young adults with PCE and 20 with no such exposure, all of whom were members of a longitudinal cohort, were recruited for the study, and data concerning childhood trauma, alexithymia, and emotional regulation were collected. Intercorrelations were performed between the scores on each measure and moderated mediation models were constructed separately with emotional neglect or emotional abuse as the independent variable and emotional reappraisal or emotional suppression as the dependent variable. RESULTS PCE status was associated with alexithymia, and alexithymia mediated the relationship between emotional neglect and emotional reappraisal in individuals with PCE but not those without. DISCUSSION AND CONCLUSIONS The data suggest that alexithymia is a mechanism underlying poor use of emotional reappraisal in PCE individuals. SCIENTIFIC SIGNIFICANCE Individuals with early-life trauma and substance exposure may represent a vulnerable population, and alexithymia may play a key role in the development of emotional regulation skills in this population. (Am J Addict 2020;29:492-499).
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Zu Wei Zhai
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychology, Middlebury College, Middlebury, Vermont
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Child Study Center, Yale University School of Medicine, New Haven, Connecticut.,Connecticut Mental Health Center, New Haven, Connecticut.,Connecticut Council on Problem Gambling, Wethersfield, Connecticut.,Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Linda C Mayes
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut.,Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychology, Yale University School of Medicine, New Haven, Connecticut
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Giannotti M, de Falco S, Venuti P. Alexithymia, Not Autism Spectrum Disorder, Predicts Perceived Attachment to Parents in School-Age Children. Front Psychol 2020; 11:332. [PMID: 32256425 PMCID: PMC7090142 DOI: 10.3389/fpsyg.2020.00332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/12/2020] [Indexed: 11/27/2022] Open
Abstract
Alexithymia is defined as a limited ability in the cognitive processing of emotions. Literature suggested its negative influence on interpersonal relationship, documenting elevated alexithymia in individuals with Autism Spectrum Disorder (ASD) compared to control groups. However, the study of alexithymia in school-age children with ASD remains largely unexplored as well as its effect on specific child socioemotional outcomes such as quality of attachment relationships. This study examines alexithymia and perceived attachment to parents in twenty-four children with ASD (without intellectual disability) and 24 typically developing (TD) children (mean age 10 years) using the self-reported Alexithymia Questionnaire for Children (AQC) and the Inventory of Parent and Peer Attachment (IPPA). Measures of family SES as well as child intelligence were collected. Data revealed that ASD children showed higher levels of Alexithymia compared to TD group. In addition, 21% of participants with ASD exceed alexithymia categorical cut-off. By contrast, no difference emerged in the perception of attachment to parents. Moreover, alexithymia, but not ASD status, was found to predictive of child perception of attachment to parents. We observed no significant effect of child age and verbal IQ. Our findings showed that alexithymia was more common in children with ASD, whereas attachment was similar between groups. Difficulties in identifying and describing one's own feelings may hinder the construction of a positive representation of parent-child attachment relationship regardless of child clinical status. Thus, alexithymia seems to play a key role on the way school-age children with and without ASD perceive their relationship with their parents.
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Affiliation(s)
- Michele Giannotti
- Department of Psychology and Cognitive Sciences, University of Trento, Trento, Italy
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Hugo M, Hedegaard J. Inclusion through folk high school in Sweden - the experience of young adult students with high-functioning autism. Disabil Rehabil 2020; 43:2805-2814. [PMID: 31996055 DOI: 10.1080/09638288.2020.1717651] [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: 10/25/2022]
Abstract
PURPOSE The purpose of this study is to provide a description of the learning environment at Folk High School for participants with high-functioning autism and to examine their learning experience at Folk High School. METHODS A qualitative interview study was conducted with 21 participants who were enrolled at Folk High School which had been adapted to suit young adults with high-functioning autism. The interviews were analysed by means of a thematic content analysis which resulted in the identification of 6 themes related to learning experiences at Folk High School. RESULTS The participants enjoyed themselves and felt secure at Folk High School. They felt that they and their academic endeavours were suitably recognised, acknowledged, and understood. They reported that the teaching was suitably adapted for them and they felt that they could succeed in their studies. A frequent report that they made concerned their experience of clear structures in the teaching process and its predictability. The participants stated that Folk High School has the ability to satisfy each participant's needs, which entailed lower levels of perceived stress than what they had experienced in their previous schooling. The participants experienced personal development during their time at Folk High School. CONCLUSIONS Folk High School, and its special character, is able to successfully satisfy the needs of participants with high-functioning autism. Many of the participants, for the first time in their lives, experienced a sense of inclusion in an educational system and felt that they could succeed in their studies. However, there exists a risk that they become institutionalised, which entails that the participants function well primarily in Folk High School's safe and caring environment.Implications for rehabilitationA supportive environment including both formal and social learning is paramount for people with high-functioning autism.Individually adapted teaching that is structured and predictable improve the conditions under which they can focus on their studies and enjoy academic success.The teachers' relational competence and ability to show interest in each individual are crucial.Social- and special-pedagogic competencies need to co-exist so as to improve learning conditions.Internship/workplace training can provide an important social learning experience for participants, as they learn about themselves and others and as they develop their social competence.To practice living on one's own is a significant challenge, but it can create opportunities to learn about one's self and to develop a sense of responsibility and other social skills.
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Affiliation(s)
- Martin Hugo
- School of Education and Communication, Jonkoping University, Jonkoping, Sweden
| | - Joel Hedegaard
- School of Education and Communication, Jonkoping University, Jonkoping, Sweden
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