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Alhuzimi TE. Saudi parents' perspectives of the factors influencing the quality of life of their children with autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 152:104799. [PMID: 39002204 DOI: 10.1016/j.ridd.2024.104799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/03/2024] [Accepted: 07/09/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Research indicates that the deficits in social communication and the repetitive, restrictive behaviour of persons with Autistic Spectrum Disorder (ASD) can pose challenges to their functioning in different Quality of Life (QoL) domains, leading to lower levels of life satisfaction. Evidence also indicates that various social and family factors, such as the support received in the community/environment and the composition of the family, could impact the QoL of persons with ASD. AIM To study the factors influencing the QoL of children with ASD in the Kingdom of Saudi Arabia (KSA) by investigating the perspectives of their parents. METHOD Questionnaires were completed by 110 parents who had a child with ASD. The questionnaire included the 96-item KidsLife-ASD scale to capture parents' perspectives regarding the difficulties experienced by their child, the ASD support received by their families, and the QoL of the child. The data obtained from the questionnaire were statistically analysed using IBM SPSS software. RESULTS The difficulties experienced by children with ASD and aspects of the support (services and interventions, and challenges) they receive are factors that influence the QoL of children with ASD in the KSA. Moreover, the number of children in the family, the birth order of child with ASD, and the severity of ASD symptoms are factors that influence parents' perceptions of their children's difficulties, family ASD support, and the child's QoL. CONCLUSIONS Saudi parents who have one child with ASD believed that the QoL of their child was high and confirmed that the difficulties experienced by the child and the support received by the family were factors which influenced the QoL of a child with ASD.
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Affiliation(s)
- Talal E Alhuzimi
- Department of Special Education, College of Education, King Saud University, Riyadh, Saudi Arabia.
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Stecher C, Pagni BA, Cloonan S, Vink S, Hill E, Ogbeama D, Delaney S, Braden BB. App-based meditation habits maintain reductions in depression symptoms among autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1487-1502. [PMID: 37837362 DOI: 10.1177/13623613231200679] [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: 10/16/2023]
Abstract
LAY ABSTRACT Existing research has identified an increased risk of depression among autistic adults, which can negatively impact their adaptive functioning abilities and socioeconomic outcomes. Mobile app-based meditation is a feasible, accessible, and effective self-care solution for depression among neurotypical adults, but there is limited evidence for the long-term benefits of app-based meditation among autistic adults. Habits are a key behavioral strategy for maintaining behavior change, and anchoring is one effective habit formation intervention that has yet to be tested among autistic adults. This study demonstrates that it is both feasible and effective to integrate the anchoring habit formation strategy into an app-based meditation intervention for establishing meditation habits among autistic adults. In addition, the study shows that app-based meditation habits were successful at maintaining reductions in depressive symptoms over 6 months. These results demonstrate the power of anchoring-based habit formation interventions for establishing healthy habits among autistic adults, which offers a promising behavioral intervention technique for establishing other healthy habits among autistic adults. The study also shows that app-based meditation habits are an effective long-term self-care solution for managing depressive symptoms among autistic adults that should be used by mental health providers and policymakers. Future research should test this combined anchoring and app-based meditation intervention technique among larger samples of autistic adults and over longer durations to better understand the mechanisms underlying the success of this intervention.
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Li X, Gao W, Yu J, Mao Y, Gu H, Li F, Ren D. Mental Health and Quality of Life in Chronic Kidney Disease Patients with Mild-to-Moderate Depression: A Retrospective Cohort Study of Mindfulness-Based Stress Reduction Therapy. ACTAS ESPANOLAS DE PSIQUIATRIA 2024; 52:138-148. [PMID: 38622007 PMCID: PMC11015819 DOI: 10.62641/aep.v52i2.1600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Chronic kidney disease (CKD) patients may experience pessimism, and even despair, due to long-term nature of the condition, which increases the risk of depression. Mindfulness-based stress reduction (MBSR) can relieve depression. This retrospective cohort study aimed to investigate the effects of MBSR on mental health and quality of life in CKD patients with mild-to-moderate depression, so as to provide guidance for clinical nursing programs. METHODS The clinical data of 100 CKD patients with mild-to-moderate depression who were treated in Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences from January 2021 to March 2023 were retrospectively analyzed. Based on nursing method received, the patients were divided into the conventional group (conventional management) and the MBSR group (MBSR therapy was implemented in addition to conventional management). After matching, there were 35 cases in each group. The scores for the self-rating depression scale (SDS), Connor-Davidson Resilience Scale (CD-RISC), Five-factor Mindfulness Questionnaire (FFMQ), Pittsburgh Sleep Quality Index (PSQI), and 36-item Short Form Health Survey (SF-36) were compared between the two groups. RESULTS After management, the SDS and PSQI scores of the MBSR group were lower than those of the conventional group, and the CD-RISC, FFMQ and SF-36 scores were higher than those of the conventional group (p < 0.05). CONCLUSION MBSR can improve the mental health, sleep quality, and quality of life of CKD patients with mild-to-moderate depression, and improve psychological resilience and mindfulness.
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Affiliation(s)
- Xiumei Li
- Nephrology Internal Department, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, 201800 Shanghai, China
| | - Wei Gao
- Emergency Department, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, 201800 Shanghai, China
| | - Jie Yu
- Nephrology Internal Department, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, 201800 Shanghai, China
| | - Yanling Mao
- Nephrology Internal Department, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, 201800 Shanghai, China
| | - Haihong Gu
- Nephrology Internal Department, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, 201800 Shanghai, China
| | - Fang Li
- Nephrology Internal Department, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, 201800 Shanghai, China
| | - Dongmei Ren
- Nursing Department, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, 201800 Shanghai, China
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Agius H, Luoto AK, Backman A, Eriksdotter C, Jayaram-Lindström N, Bölte S, Hirvikoski T. Mindfulness-based stress reduction for autistic adults: A feasibility study in an outpatient context. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:403-414. [PMID: 37190953 PMCID: PMC10851647 DOI: 10.1177/13623613231172809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
LAY ABSTRACT Autistic adults report high stress levels and difficulties dealing with everyday stressors. Mindfulness-based stress reduction groups aim to help regulate stress responses. We asked 50 autistic adults, without intellectual disability, to participate in a study of mindfulness-based stress reduction. The group program was made accessible through clear group leader communication and good program predictability, as well as reduced exposure to disturbing sensory stimuli. The mindfulness and yoga based exercises from the original mindfulness-based stress reduction program were included. The participants were positive and would even recommend an autistic friend to participate in a mindfulness-based stress reduction group. They reported that mindfulness-based stress reduction could lower symptoms of stress and improved stress coping. We still need to investigate these effects further in larger studies. The findings of this work show that mindfulness-based stress reduction groups can be adapted for autistic adults and that the participants overall were positive to the intervention and the group format.
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Affiliation(s)
- Hanna Agius
- Karolinska Institutet, Stockholm Health Care Services, Sweden
- Stockholm Health Care Services, Sweden
| | | | - Anna Backman
- Karolinska Institutet, Stockholm Health Care Services, Sweden
- Stockholm Health Care Services, Sweden
| | | | | | - Sven Bölte
- Karolinska Institutet, Stockholm Health Care Services, Sweden
- Stockholm Health Care Services, Sweden
- Curtin University, Australia
| | - Tatja Hirvikoski
- Karolinska Institutet, Stockholm Health Care Services, Sweden
- Stockholm Health Care Services, Sweden
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5
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González-Martín AM, Aibar-Almazán A, Rivas-Campo Y, Castellote-Caballero Y, Carcelén-Fraile MDC. Mindfulness to improve the mental health of university students. A systematic review and meta-analysis. Front Public Health 2023; 11:1284632. [PMID: 38111480 PMCID: PMC10726040 DOI: 10.3389/fpubh.2023.1284632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/13/2023] [Indexed: 12/20/2023] Open
Abstract
Objectives This systematic review and meta-analysis was to analyze the effects of a mindfulness program on mental health in university students. Methods A systematic review was conducted using the databases Pubmed, Scopus, Web of Science and CINAHL. The selected studies had to incorporate a mindfulness intervention in university students. The methodological quality of the collected articles was evaluated using the PEDro scale. Results We initially identified 321 studies, of which 21 were included in this review. The interventions focused on mindfulness with durations ranging from 8 weeks to 3 months. The results demonstrated significant effects of a mindfulness intervention on mental health in university students. Conclusion This systematic review and meta-analysis found that mindfulness is effective for improving the mental health of college students. Systematic Review Registration identifier: CRD42023441453.
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Affiliation(s)
- Ana María González-Martín
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, Spain
- Department of Psychology, Higher Education Center for Teaching and Educational Research, Madrid, Spain
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Yulieth Rivas-Campo
- Faculty of Human and Social Sciences, University of San Buenaventura-Cali, Santiago de Cali, Colombia
| | | | - María del Carmen Carcelén-Fraile
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, Spain
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Grosvenor LP, Errichetti CL, Holingue C, Beasley JB, Kalb LG. Self-Report Measurement of Well-Being in Autistic Adults: Psychometric Properties of the PERMA Profiler. AUTISM IN ADULTHOOD 2023; 5:401-410. [PMID: 38116049 PMCID: PMC10726181 DOI: 10.1089/aut.2022.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Background Studies of positive psychology and emotional well-being have broadened our understanding of mental health. However, mental health research involving autistic adults has been largely deficit-focused. Few studies have examined well-being using established positive psychological frameworks. Methods This study examined the psychometric characteristics of the PERMA Profiler, a 23-item questionnaire that measures well-being across five subscales (Positive emotion, Engagement, Relationships, Meaning, and Accomplishment), in a sample of 517 autistic adults ages 18-84 years (M = 39.5, standard deviation [SD] = 13.3). Reliability (internal consistency), structural validity (via confirmatory factor analysis including bifactor modeling), and concurrent validity were examined. Results The PERMA Profiler mean (SD) well-being score was 5.4 (SD = 1.7), which is notably lower than the mean of 7.0 previously found in nonautistic samples. Subscale scores were highest for Engagement (M = 6.8; SD = 1.9), followed by Accomplishment (M = 5.6; SD = 2.2), Relationships (M = 5.2; SD = 2.6), Meaning (M = 5.2; SD = 2.7), and Positive emotion (M = 5.0; SD = 2.4). Factor analyses revealed strong psychometrics (Cronbach's α = 0.93; Comparative Fit Index = 0.94; Tucker-Lewis Index = 0.97; root mean square error of approximation = 0.08; standardized root mean residual = 0.05) and superior fit of the bifactor model, supporting a general factor for conceptualizing well-being as opposed to a five-factor model. PERMA well-being and subscale scores were significantly correlated (p < 0.001) with mental health conditions and life satisfaction. Conclusion These findings support use of an adapted version of the PERMA Profiler in mental health research to evaluate well-being among autistic adults. Similar to studies with nonautistic populations, the Engagement measure may not capture the experiences of the autistic population and further refinement is needed. Follow-up research should represent a more diverse autistic population, collaborate with autistic coinvestigators, and explore potential correlates of well-being (such as social stigma) while using the PERMA Profiler.
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Affiliation(s)
- Luke P. Grosvenor
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cheryl L. Errichetti
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Calliope Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Joan B. Beasley
- Institute on Disability, University of New Hampshire College of Health and Human Services, Durham, New Hampshire, USA
| | - Luther G. Kalb
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Institute on Disability, University of New Hampshire College of Health and Human Services, Durham, New Hampshire, USA
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Prince N, Chu SH, Chen Y, Mendez KM, Hanson E, Green-Snyder L, Brooks E, Korrick S, Lasky-Su JA, Kelly RS. Phenotypically driven subgroups of ASD display distinct metabolomic profiles. Brain Behav Immun 2023; 111:21-29. [PMID: 37004757 PMCID: PMC11099628 DOI: 10.1016/j.bbi.2023.03.026] [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: 12/07/2022] [Revised: 03/08/2023] [Accepted: 03/28/2023] [Indexed: 04/04/2023] Open
Abstract
Autism Spectrum Disorder (ASD) is a heterogeneous condition that includes a broad range of characteristics and associated comorbidities; however, the biology underlying the variability in phenotypes is not well understood. As ASD impacts approximately 1 in 100 children globally, there is an urgent need to better understand the biological mechanisms that contribute to features of ASD. In this study, we leveraged rich phenotypic and diagnostic information related to ASD in 2001 individuals aged 4 to 17 years from the Simons Simplex Collection to derive phenotypically driven subgroups and investigate their respective metabolomes. We performed hierarchical clustering on 40 phenotypes spanning four ASD clinical domains, resulting in three subgroups with distinct phenotype patterns. Using global plasma metabolomic profiling generated by ultrahigh-performance liquid chromatography mass spectrometry, we characterized the metabolome of individuals in each subgroup to interrogate underlying biology related to the subgroups. Subgroup 1 included children with the least maladaptive behavioral traits (N = 862); global decreases in lipid metabolites and concomitant increases in amino acid and nucleotide pathways were observed for children in this subgroup. Subgroup 2 included children with the highest degree of challenges across all phenotype domains (N = 631), and their metabolome profiles demonstrated aberrant metabolism of membrane lipids and increases in lipid oxidation products. Subgroup 3 included children with maladaptive behaviors and co-occurring conditions that showed the highest IQ scores (N = 508); these individuals had increases in sphingolipid metabolites and fatty acid byproducts. Overall, these findings indicated distinct metabolic patterns within ASD subgroups, which may reflect the biological mechanisms giving rise to specific patterns of ASD characteristics. Our results may have important clinical applications relevant to personalized medicine approaches towards managing ASD symptoms.
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Affiliation(s)
- Nicole Prince
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Su H Chu
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Yulu Chen
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Kevin M Mendez
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ellen Hanson
- Divisions of Neurology and Developmental Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | | | | | - Susan Korrick
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jessica A Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Schwartz CE, Jackson S, Valentine J, Miller N, Lowes L, Edwards D, McSherry C, Savva D, Lowe A, McSherry J, Engel P. Toward patient-centered treatment goals for duchenne muscular dystrophy: insights from the "Your Voice" study. Orphanet J Rare Dis 2023; 18:90. [PMID: 37081508 PMCID: PMC10116803 DOI: 10.1186/s13023-023-02674-w] [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: 12/02/2022] [Accepted: 03/11/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Patient-centered research has emerged as critically important for understanding the impact of treatments on key stakeholders. The subjective experience of quality of life (QOL) is increasingly recognized as fundamental to delineating treatment goals. The present study utilized content analysis of qualitative data and quantitative analysis to highlight important domains of disease burden and underlying reasons for their importance, and to characterize goals for new treatments for Duchenne Muscular Dystrophy (DMD). RESULTS The study sample reflected the perspectives of DMD patients and caregivers representing ambulatory, transitional, and non-ambulatory stages of disability progression (n = 20 per category). Open-ended interviews were content-analyzed and non-parametric statistical tests were used to compare ambulation groups. As patients progressed in disability, the noted DMD burdens reflected some differences in functional areas. While daily functioning and sports/recreation remained the most important priority areas across ambulation groups, "health" became less prominent as the disability progressed from ambulatory to transitional to non-ambulatory phases of disability; whereas relationships became more prominent as one progressed to the non-ambulatory phase from the ambulatory or transitional phases (Kruskall Wallis H = 12.24 and 5.28, p = 0.002 and 0.02, respectively). When asked why their burdens were important to them and how it impacted their or their child's life, self-esteem/confidence was most important for ambulatory patients, and became less prominent for patients in the transitional and non-ambulatory phases of disability (Kruskall Wallis H = 9.46, p = 0.009). In contrast, independence was less important for ambulatory patients, and became increasing prominent for patients in the transitional and non-ambulatory phases of disability (Kruskall Wallis H = 7.35, p = 0.025). Emotional functioning was most prominent for all ambulation groups on their best and worst days. Goals for new DMD treatments focused on functional goals, general QOL goals, and concerns about safety, ease of use, and effectiveness. CONCLUSION This study provides useful information about treatment goals for DMD from the perspective of patients and their caregivers. It highlights some consistent values across the disability trajectory, as well as introducing an evolution of priorities as the person with DMD becomes more disabled. Results provide a roadmap for patient-centered DMD drug development.
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Affiliation(s)
- Carolyn E Schwartz
- DeltaQuest Foundation, Inc, 31 Mitchell Road, Concord, MA, 01742, USA.
- Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA.
| | | | | | | | - Linda Lowes
- Nationwide Children's Hospital, Columbus, OH, USA
| | | | | | - Dimitrios Savva
- NewYork-Presbyterian Hospital / Morgan Stanley Children's Hospital, New York, NY, USA
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9
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Andersen PN, Orm S, Fossum IN, Øie MG, Skogli EW. Adolescence internalizing problems as a mediator between autism diagnosis in childhood and quality of life in emerging adults with and without autism: a 10-year longitudinal study. BMC Psychiatry 2023; 23:149. [PMID: 36894901 PMCID: PMC9996871 DOI: 10.1186/s12888-023-04635-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Individuals with autism tend to have a reduced quality of life across their lifespan. This reduced quality of life may be a result of autism traits, mental distress, and poor person/environment fit. In this longitudinal study, we looked at the role of adolescence internalizing and externalizing problems in mediating the relationship between having an autism diagnosis from childhood and perceived quality of life as emerging adults. METHODS A total of 66 participants in a group of emerging adults with autism (mean age 22.2 years), and without autism (mean age 20.9 years) were assessed in three assessment waves (T1 at 12 years, T2 at 14 years, and T3 at 22 years of age). Parents filled out the Child Behavior Checklist at T2 and participants filled out the Perceived Quality of Life Questionnaire at T3. Total and indirect effects were tested in serial mediation analysis. RESULTS The results showed that internalizing problems fully mediated the association between childhood autism diagnosis and the quality of life in emerging adulthood, while externalizing problems did not. CONCLUSION Our findings suggest that attention to adolescent internalizing problems is important to improve the later quality of life for emerging adults with autism.
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Affiliation(s)
- Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Holsetgata, Norway.
| | - Stian Orm
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingrid Nesdal Fossum
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway.,Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Erik Winther Skogli
- Department of Psychology, Inland Norway University of Applied Sciences, Holsetgata, Norway.,Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
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10
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Pagni BA, Hill E, Walsh MJM, Delaney S, Ogbeama D, Monahan L, Cook JR, Guerithault N, Dixon MV, Ballard L, Braden BB. Distinct and shared therapeutic neural mechanisms of mindfulness-based and social support stress reduction groups in adults with autism spectrum disorder. J Psychiatry Neurosci 2023; 48:E102-E114. [PMID: 36990468 PMCID: PMC10065804 DOI: 10.1503/jpn.220159] [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: 08/31/2022] [Revised: 11/16/2022] [Accepted: 12/09/2022] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Mindfulness-based stress reduction (MBSR) alleviates depression and anxiety in adults with autism spectrum disorder (ASD); however, underlying therapeutic neural mechanisms and mindfulness-specific effects have yet to be elucidated. METHODS We randomly assigned adults with ASD to MBSR or social support/education (SE). They completed questionnaires that assessed depression, anxiety, mindfulness traits, autistic traits and executive functioning abilities as well as a self-reflection functional MRI task. We used repeated-measures analysis of covariance (ANCOVA) to evaluate behavioural changes. To identify task-specific connectivity changes, we performed a generalized psychophysiological interactions (gPPI) functional connectivity (FC) analysis on regions of interest (ROIs; insula, amygdala, cingulum and prefrontal cortex [PFC]). We used Pearson correlations to explore brain-behaviour relationships. RESULTS Our final sample included 78 adults with ASD - 39 who received MBSR and 39 who received SE. Mindfulness-based stress reduction uniquely improved executive functioning abilities and increased mindfulness traits, whereas both MBSR and SE groups showed reductions in depression, anxiety and autistic traits. Decreases specific to MBSR in insula-thalamus FC were associated with anxiety reduction and increased mindfulness traits, including the trait "nonjudgment;" MBSR-specific decreases in PFC-posterior cingulate connectivity correlated with improved working memory. Both groups showed decreased amygdala-sensorimotor and medial-lateral PFC connectivity, which corresponded with reduced depression. LIMITATIONS Larger sample sizes and neuropsychological evaluations are needed to replicate and extend these findings. CONCLUSION Together, our findings suggest that MBSR and SE are similarly efficacious for depression, anxiety and autistic traits, whereas MBSR produced additional salutary effects related to executive functioning and mindfulness traits. Findings from gPPI identified shared and distinct therapeutic neural mechanisms, implicating the default mode and salience networks. Our results mark an early step toward the development of personalized medicine for psychiatric symptoms in ASD and offer novel neural targets for future neurostimulation research. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier NCT04017793.
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Affiliation(s)
- Broc A Pagni
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Ethan Hill
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Melissa J M Walsh
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Shanna Delaney
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Destiny Ogbeama
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Leanna Monahan
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - James R Cook
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | | | - Maria V Dixon
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Lisa Ballard
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - B Blair Braden
- From Arizona State University, College of Health Solutions, Phoenix, AZ
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11
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Davies C, Moosa M, McKenna K, Mittal J, Memis I, Mittal R, Eshraghi AA. Quality of Life, Neurosensory Disorders and Co-Occurring Medical Conditions in Individuals on the Spectrum, with a Special Focus on Females Diagnosed with Autism: A Systematic Review. J Clin Med 2023; 12:jcm12030927. [PMID: 36769575 PMCID: PMC9917678 DOI: 10.3390/jcm12030927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023] Open
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that has a high prevalence and a significant economic impact. Our knowledge regarding neurosensory disorders and co-occurring medical conditions in the ASD population is limited, particularly for autistic women. Most of the studies include male participants or do not make comparisons with their female counterparts. The objective of this systematic review article is to explore the quality of life as well as the prevalence of neurosensory disorders and co-occurring medical conditions in individuals on the spectrum, with a special focus on autistic females. The literature search was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. A protocol of this systematic review was designed a priori and was registered in the PROSPERO database (registration number: CRD42022330368). We concluded that numerous medical areas were of concern. Autistic females are more likely than their male counterparts with ASD to suffer from psychiatric conditions such as post-traumatic stress syndrome, depression, and eating disorders. They are also more likely to report GI-related disturbances and chronic pain. Further investigations are warranted to determine quality of life, as well as the prevalence and severity of neurosensory disorders in individuals with ASD, specifically studies comparing autistic females with their male counterparts. The information derived from these studies will help develop better support systems for individuals with autism, particularly females on the spectrum, in pursuit of improving their quality of life.
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Affiliation(s)
- Camron Davies
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Moeed Moosa
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Keelin McKenna
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Jeenu Mittal
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Idil Memis
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Rahul Mittal
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Adrien A. Eshraghi
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Correspondence:
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Brain, cognitive, and physical disability correlates of decreased quality of life in patients with Huntington's disease. Qual Life Res 2023; 32:171-182. [PMID: 35978062 PMCID: PMC9829572 DOI: 10.1007/s11136-022-03220-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE Following a case-control design, as a primary objective, this study aimed to explore the relationship between quality of life (QoL) scores and gray matter (GM) volumes in patients with Huntington's disease (HD). As a secondary objective, we assessed the relationship between QoL scores and other important behavioral, clinical and demographical variables in patients with HD and HD patients' caregivers. METHODS We recruited 75 participants (25 HD patients, 25 caregivers, and 25 controls) and assessed their QoL using the World Health Organization Quality of Life scale-Brief Version (WHOQOL-BREF). Participants were also assessed with general cognitive functioning tests and clinical scales. In addition, we acquired MRI scans from all participants. RESULTS Our results showed that patients exhibited significantly lower scores in all four QoL domains (physical health, psychological wellbeing, social relationships, and relationship with the environment) compared to caregivers and controls. Caregivers showed lower scores than controls in the physical health and the environmental domains. In HD patients, lower scores in QoL domains were associated with lower GM volumes, mainly in the precuneus and the cerebellum. Moreover, in HD patients, physical disability and GM volume reduction were significant predictors of QoL decrease in all domains. For caregivers, years of formal education was the most important predictor of QoL. CONCLUSIONS HD patients exhibit greater GM volume loss as well as lower QoL scores compared to caregivers and controls. However, caregivers displayed lower scores in QoL scores than controls, with years of education being a significant predictor. Our results reflect a first attempt to investigate the relationships among QoL, GM volumes, and other important factors in an HD and HD caregiver sample.
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Redquest B, Tint A, St. John L, Hutton S, Palmer P, Lunsky Y. Virtual group-based mindfulness program for autistic women: A feasibility study. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221142369. [PMID: 36560924 PMCID: PMC9793023 DOI: 10.1177/17455057221142369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Autistic women experience life differently than autistic men. For example, autistic women tend to be diagnosed significantly later than autistic men, they experience a higher number of traumas, and are at increased risk for mental health conditions. Given gender-specific life experiences, autistic women may benefit from gender-specific group-based supports. Virtual mindfulness has been shown to be helpful in improving well-being among autistic adults; however, limited research has explored the impact of virtual mindfulness when it is delivered to a group of autistic women only. OBJECTIVES The aim of this article is to describe a preliminary evaluation of a virtual mindfulness group piloted for autistic women. Five key areas of feasibility were assessed in the current study: demand, implementation, acceptability, practicality, and limited efficacy testing. METHODS Twenty-eight women participated in a 6-week virtual autism-informed mindfulness program and were asked to complete measures assessing psychological distress, self-compassion, and mindfulness at pre and post. Participants were also asked to complete a satisfaction survey after the program. RESULTS Results showed that the program was feasible in terms of demand, implementation, practicality, and acceptability. While quantitative results showed there were no changes in psychological distress, self-compassion, and mindfulness from pre- to post-program, qualitative results showed some benefits. CONCLUSION Given the unique challenges that some autistic women experience, offering groups to autistic women may have some value and it would be important to continue exploring this topic area.
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Affiliation(s)
- Brianne Redquest
- School and Applied Child Psychology,
Werklund School of Education, University of Calgary, Calgary, AB, Canada,Alberta Children’s Hospital Research
Institute, University of Calgary, Calgary, AB, Canada,Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada
| | - Ami Tint
- Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada
| | - Laura St. John
- Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada
| | - Sue Hutton
- Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada
| | - Pamela Palmer
- Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental
Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and
Mental Health, Toronto, ON, Canada,Department of Psychiatry, Temerty
Faculty of Medicine, University of Toronto, Toronto, ON, Canada,Yona Lunsky, Azrieli Adult
Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen
Street West, Toronto M6J 1H4, Ontario, Canada.
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Pagni BA, Walsh MJ, Ofori E, Chen K, Sullivan G, Alvar J, Monahan L, Guerithault N, Delaney S, Braden BB. Effects of age on the hippocampus and verbal memory in adults with autism spectrum disorder: Longitudinal versus cross-sectional findings. Autism Res 2022; 15:1810-1823. [PMID: 36053945 PMCID: PMC9561078 DOI: 10.1002/aur.2797] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 08/08/2022] [Indexed: 11/07/2022]
Abstract
Research studying aging in adults with autism spectrum disorder (ASD) is growing, but longitudinal work is needed. Autistic adults have increased risk of dementia, altered hippocampal volumes and fornix integrity, and verbal memory difficulties compared with neurotypical (NT) adults. This study examined longitudinal aging in middle-age adults with ASD versus a matched NT group, and compared findings with cross-sectional age effects across a broad adult age range. Participants were 194 adults with (n = 106; 74 male) and without (n = 88; 52 male) ASD, ages 18-71. Participants (n = 45; 40-70 age range) with two visits (2-3 years apart) were included in a longitudinal analysis. Hippocampal volume, fornix fractional anisotropy (FA), and verbal memory were measured via T1-weighted MRI, diffusion tensor imaging, and the Rey Auditory Verbal Learning Test, respectively. Longitudinal mixed models were used for hippocampal system variables and reliable change index categories were used for Auditory Verbal Learning Test analyses. Multivariate regression was used for cross-sectional analyses. Middle-age adults with ASD had greater longitudinal hippocampal volume loss and were more likely to show clinically meaningful decline in short-term memory, compared with NT. In contrast, cross-sectional associations between increasing age and worsening short-term memory were identified in NT, but not autistic adults. Reduced fornix FA and long-term memory in ASD were found across the broad cross-sectional age range. These preliminary longitudinal findings suggest accelerated hippocampal volume loss in ASD and slightly higher rates of clinically-meaningful decline in verbal short-term memory. Contradictory cross-sectional and longitudinal results underscore the importance of longitudinal aging research in autistic adults. LAY SUMMARY: Autistic adults have increased risk of dementia, differences in brain memory structures, and difficulty with memory compared with neurotypical (NT) adults. However, there are no publications that follow the same middle-age autistic adults over time to see how their brain and memory change. Our preliminary findings in a small middle-age autism sample suggest a key memory brain structure, the hippocampus, may shrink faster over 2-3 years compared with NT, and short-term memory may become more challenging for some. Across a broad adult range, autistic adults also had reduced integrity of connections to the hippocampus and greater challenges with long-term memory. In our larger sample across a broad age range, the results did not hint at this aforementioned pattern of accelerated aging. This underscores the importance of more aging research in autism, and especially research where people are followed over time.
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Affiliation(s)
- Broc A. Pagni
- Arizona State University, College of Health Solutions, Lattie F. Coor Hall, Room 3407, 976 S Forest Mall, Tempe, AZ, 85281
| | - Melissa J.M. Walsh
- Arizona State University, College of Health Solutions, Lattie F. Coor Hall, Room 3407, 976 S Forest Mall, Tempe, AZ, 85281
| | - Edward Ofori
- Arizona State University, College of Health Solutions, Lattie F. Coor Hall, Room 3407, 976 S Forest Mall, Tempe, AZ, 85281
| | - Kewei Chen
- Banner Alzheimer’s Institute, 901 E. Willetta St, Phoenix, AZ
| | - Georgia Sullivan
- Arizona State University, College of Health Solutions, Lattie F. Coor Hall, Room 3407, 976 S Forest Mall, Tempe, AZ, 85281
| | - Jocelyn Alvar
- Arizona State University, College of Health Solutions, Lattie F. Coor Hall, Room 3407, 976 S Forest Mall, Tempe, AZ, 85281
| | - Leanna Monahan
- Arizona State University, College of Health Solutions, Lattie F. Coor Hall, Room 3407, 976 S Forest Mall, Tempe, AZ, 85281
| | - Nicolas Guerithault
- Arizona State University, College of Health Solutions, Lattie F. Coor Hall, Room 3407, 976 S Forest Mall, Tempe, AZ, 85281
| | - Shanna Delaney
- Arizona State University, College of Health Solutions, Lattie F. Coor Hall, Room 3407, 976 S Forest Mall, Tempe, AZ, 85281
| | - B. Blair Braden
- Arizona State University, College of Health Solutions, Lattie F. Coor Hall, Room 3407, 976 S Forest Mall, Tempe, AZ, 85281
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