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Garcia JM, Hahs-Vaughn D, Murray M, Perry C, Brazendale K, Rice DJ, Fukuda DH. The physical and psychosocial benefits of a family judo program for parents of children with Autism Spectrum Disorder: A pilot study. Disabil Health J 2024; 17:101631. [PMID: 38702229 DOI: 10.1016/j.dhjo.2024.101631] [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: 12/04/2023] [Revised: 04/05/2024] [Accepted: 04/13/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Parents of children with Autism Spectrum Disorder (ASD) tend to have high levels of stress and poor health habits. There is a lack of interventions that focus on improving health outcomes in parents of children with ASD. OBJECTIVE To examine the physical and psychosocial effects of a family-based judo program on parents of children diagnosed with ASD. METHODS This study utilized a pre-post single group design. Eighteen parent-child dyads participated in a 14-week judo program for families of children with ASD. Judo sessions were held once a week for 45 min. Parents wore wrist accelerometers to assess physical activity/sleep quality, and completed surveys regarding self-reported stress levels pre- and post-judo. Parents also completed open-ended questions regarding their experience in the program. Paired sample t-tests were conducted to examine changes in stress, physical activity, and sleep quality from pre-to post-program. RESULTS Both a decrease in parental stress (47.77 vs. 41.61, p < 0.01) and an increase in minutes per day of physical activity (35.49 vs 45.94, p = 0.002) were observed from baseline to post-program. Fourteen of the 18 parents (78 %) reported at least one psychosocial benefit (e.g. increased self-confidence) or physical health benefit (e.g. increased physical activity) from participation in the program. CONCLUSIONS A family judo program may provide health benefits, such as reducing stress levels and increasing physical activity in parents of children with ASD. Further research involving larger sample sizes is necessary to better determine the effects of judo on both parents and their children with ASD.
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Affiliation(s)
- Jeanette M Garcia
- School of Sport Sciences, College of Applied Human Sciences, West Virginia University, Morgantown, WV, USA.
| | - Debbie Hahs-Vaughn
- College of Community Innovation and Education, University of Central Florida, Orlando, FL, USA
| | - Michelle Murray
- Department of Heath Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Caitlyn Perry
- Department of Heath Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Keith Brazendale
- Department of Heath Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - David J Rice
- School of Sport Sciences, College of Applied Human Sciences, West Virginia University, Morgantown, WV, USA
| | - David H Fukuda
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
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Neece CL, Fenning RM, Morrell HER, Benjamin LR. Comparative effects of mindfulness-based stress reduction and psychoeducational support on parenting stress in families of autistic preschoolers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:985-998. [PMID: 37555286 PMCID: PMC10853488 DOI: 10.1177/13623613231191558] [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: 08/10/2023]
Abstract
LAY ABSTRACT Parents of autistic children often experience high levels of parenting stress, which can have negative mental and physical effects on both the parent and child. This study tested the efficacy of mindfulness-based stress reduction in reducing parenting stress in parents of preschool-aged autistic children compared to a psychoeducation and support intervention. We assessed parenting stress before and after the interventions and at 6- and 12-month follow-up. Both interventions significantly decreased parenting stress, but mindfulness-based stress reduction reduced stress more than did psychoeducation and support, with the strongest effect observed 1 year later. This suggests that the stress-reducing benefits of mindfulness-based stress reduction persist and may increase over time.
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Affiliation(s)
- Cameron L. Neece
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
| | - Rachel M. Fenning
- Department of Psychological Science and The Claremont Autism Center, Claremont McKenna College; 850 Columbia Avenue, Claremont, CA 91711, United States
| | - Holly E. R. Morrell
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
| | - Laurel R. Benjamin
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
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Suvarna V, Farrell L, Adams D, Emerson LM, Paynter J. Parenting Practices and Externalizing Behaviors in Autistic Children: A Systematic Literature Review. Clin Child Fam Psychol Rev 2024; 27:235-256. [PMID: 38407761 PMCID: PMC10920481 DOI: 10.1007/s10567-024-00467-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 02/27/2024]
Abstract
There is limited recent research on the association between parenting practices and externalizing behaviors in autistic children. To address this gap, the current systematic review examined the associations between parenting practices and externalizing behaviors in autistic children, along with the mediating and moderating effects of parent and child variables (PROSPERO registration number CRD42022268667). Study inclusion criteria were (1) Peer-reviewed journals, (2) Participants included parents of autistic children and their children, (3) Quantitative measures of both parenting practices or behaviors/style and child externalizing behaviors, (4) Cross-sectional or longitudinal studies only, and (5) Studies published in English. Study exclusion criteria were: (1) Qualitative studies, (2) Published in a language other than English, (3) Participants included non-human participants, (4) Participants that did not include parents and their autistic children as participants or did not report this group separately, (5) Systematic review and meta-analyses, and (6) No quantitative measures of parenting practices and/or child externalizing behaviors. Quality appraisal and risk of bias were conducted using the McMaster Tool and results were synthesized in Covidence and Excel. Thirty studies were included in the review. Results demonstrated that mindful parenting was associated with fewer or lower levels of externalizing behaviors; positive parenting practices had non-significant associations with externalizing behaviors; specific parenting practices had differing associations with externalizing behaviors; and negative parenting practices were associated with higher levels of externalizing behaviors. We are unable to draw causal relationships due to focus on cross-sectional and longitudinal articles only. The potential for future research to target specific parent practices to support children's externalizing behaviors is discussed.
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Affiliation(s)
- Vedanta Suvarna
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia.
| | - Lara Farrell
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
| | - Dawn Adams
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Mt Gravatt, QLD, Australia
| | - Lisa-Marie Emerson
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Jessica Paynter
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
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4
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Gandía-Abellán H, Nieto C, García-Rubio C. Mindfulness for adults with autism spectrum disorder and intellectual disability: A pilot study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:927-943. [PMID: 35673766 DOI: 10.1177/17446295221107283] [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: 06/15/2023]
Abstract
The present study aims to examine the effects of the MindfulTEA program, an Mindfulness-based Interventions (MBIs) specifically designed for adults with Autism Spectrum Disorder (ASD) and Intellectual Disability, to reduce behavioural problems. MBIs are effective in improving well-being in people with high-functioning ASD, but little is known about the impact of the MBIs on people with ASD and intellectual disability associated. Fourteen adults (age 18 to 44) with ASD and intellectual disability participated in the program. Results showed a significant decrease in self-injurious and aggressive/destructive behaviours after the MBI. Stereotyped behaviour did not show significant change. Results suggest that the MindfulTEA program could effectively reduce some types of behaviour problems in people with ASD and intellectual disability. MBIs could be a useful alternative to traditional behaviour management interventions for reducing behaviour problems in this population.
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Affiliation(s)
- Helena Gandía-Abellán
- Faculty of Psychology, Universidad Autónoma de Madrid, Madrid, Spain; Spanish Federation of Autism (FESPAU), Madrid, Spain
| | - Carmen Nieto
- Faculty of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
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5
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Drüsedau LL, Götz A, Kleine Büning L, Conzelmann A, Renner TJ, Barth GM. Tübinger Training for Autism Spectrum Disorders (TüTASS): a structured group intervention on self-perception and social skills of children with autism spectrum disorder (ASD). Eur Arch Psychiatry Clin Neurosci 2023; 273:1599-1613. [PMID: 36629941 PMCID: PMC10465396 DOI: 10.1007/s00406-022-01537-y] [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: 09/07/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023]
Abstract
In autism spectrum disorders (ASD), social communication and stereotypical behaviour patterns affect all areas of life, and can result in a decrease of its quality. Previous research has shown promising results for the social skills of groups of children with ASD. Furthermore, a pilot study of the Tübingen Group Training for Autism Spectrum Disorders (TüTASS) has demonstrated that mindfulness-based elements achieve additional positive effects. To build on these findings, the TüTASS training was adapted and expanded. Indeed, the TüTASS currently includes 20 90-min appointments starting with the basic skills of emotions, body, and communication, which are then transferred to personal, family, peer, and school spheres. The appointments have a fixed, consistent structure and each includes a body awareness exercise. In this study, we evaluated the TÜTASS with 27 children with ASD. The results showed improvements in pre-post comparison in behaviours associated with autism, as well as in externalising and internalising behaviours as assessed by parent reports, participant self-reports, and independent raters in participating children. Furthermore, the perceived parent burden in relation to their children decreased, whereas the participants' self-rated quality of life increased. Overall, both the participants and their parents rated the TüTASS very positively in rating sheets and in free feedback. If replicated in larger controlled trials, TÜTASS training might be a useful treatment tool for groups of children with ASD.
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Affiliation(s)
- Laura Luisa Drüsedau
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany.
| | - Antonia Götz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany
| | - Lena Kleine Büning
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany
| | - Annette Conzelmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany
- Department of Psychology (Clinical 15 Psychology II), PFH-Private University of Applied Sciences, Göttingen, Germany
| | - Tobias J Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany
| | - Gottfried M Barth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany
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Hatfield MK, Ashcroft E, Maguire S, Kershaw L, Ciccarelli M. "Stop and just breathe for a minute": perspectives of children on the Autism Spectrum and their caregivers on a Mindfulness Group. J Autism Dev Disord 2023; 53:3394-3405. [PMID: 35771338 PMCID: PMC10465386 DOI: 10.1007/s10803-022-05542-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 10/17/2022]
Abstract
Children on the autism spectrum often experience anxiety. Mindfulness is growing in popularity as a method to support children with anxiety; however, there is limited evidence on mindfulness for children on the autism spectrum. This study investigated the feasibility of a 10-week group-based mindfulness intervention for 14 children on the autism spectrum. A one-group pre-post design determined outcomes of anxiety (caregiver and child report), mindful attention, and wellbeing (child report). Interviews explored children's and caregivers' perceptions. There were no significant differences in outcomes post-intervention. Five themes were identified from interviews: (1) Children felt calmer; (2) Parents observed differences in anxiety; (3) Breathing and yoga helped; (4) Parents wanted more; and (5) Challenges and benefits of group intervention.
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Affiliation(s)
- Megan K Hatfield
- Curtin School of Allied Health, Curtin University, GPO Box U1987, 6845, Perth, Western Australia, Australia.
| | - Emma Ashcroft
- Curtin School of Allied Health, Curtin University, GPO Box U1987, 6845, Perth, Western Australia, Australia
| | - Siobhan Maguire
- Curtin School of Allied Health, Curtin University, GPO Box U1987, 6845, Perth, Western Australia, Australia
| | - Lauren Kershaw
- Curtin School of Allied Health, Curtin University, GPO Box U1987, 6845, Perth, Western Australia, Australia
| | - Marina Ciccarelli
- Curtin School of Allied Health, Curtin University, GPO Box U1987, 6845, Perth, Western Australia, Australia
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7
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Glass A, Attrill C, Magee C, Blunden S. Factors associated with melatonin use in child sleep disturbance: A survey of Australian parents. Sleep Med 2023; 107:330-337. [PMID: 37295036 DOI: 10.1016/j.sleep.2023.04.026] [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: 12/23/2022] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Sleep disturbances are prevalent in Australian children and cause a significant amount of stress to both children and their parents. If sleep disturbances are left untreated, they can result in detrimental consequences to both child and parental wellbeing. While behavioural interventions are recognised as the gold standard treatment for paediatric insomnia, there is a growing use of melatonin from both prescription and non-prescription sources in paediatrics. However, empirical research on the efficacy and safety of melatonin for children is sparse, conflicting, and inconsistent. This first Australian study aimed to investigate correlates of melatonin use in a sample of children with sleep disturbance in Australia and assess whether melatonin is being administered to children contrary to Therapeutic Goods Administration Guidelines. METHODS An exploratory online study was undertaken with 318 parents of Australian children with sleep disturbance (95.30% females). Logistic regression, mediation and descriptive analysis were conducted. RESULTS As hypothesised, higher parental stress, older child age, and a diagnosis of ADHD were significantly associated with melatonin use in this sleep disturbed sample. Other potential correlates such as financial stress, number of household dependents, child sleep disturbance, and autism were not significantly associated with melatonin use in adjusted analyses. CONCLUSION Findings show off-label melatonin use in children with sleep disturbance is prevalent. For the first time, this study showed an indirect path linking child sleep disturbances with melatonin use via parental stress. Overall, while the safety of melatonin use remains unknown, there is a clear need to mitigate parental stress to minimise potentially unmonitored and improper use of melatonin in children.
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Affiliation(s)
- Alison Glass
- School of Health, Medical, and Applied Sciences, Central Queensland University, Queensland, Australia
| | - Ceinwyn Attrill
- Centre for Emotional Health, School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Chris Magee
- NSW government, Cambelltown local government council, Australia
| | - Sarah Blunden
- School of Health, Medical, and Applied Sciences, Central Queensland University, Queensland, Australia.
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Loftus T, Mathersul DC, Ooi M, Yau SH. The efficacy of mindfulness-based therapy for anxiety, social skills, and aggressive behaviors in children and young people with Autism Spectrum Disorder: A systematic review. Front Psychiatry 2023; 14:1079471. [PMID: 36993931 PMCID: PMC10040538 DOI: 10.3389/fpsyt.2023.1079471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/10/2023] [Indexed: 03/16/2023] Open
Abstract
IntroductionThe purpose of this systematic review was to examine the efficacy of mindfulness-based interventions for improving anxiety, social skills, and aggressive behaviors in children and young people (CYP) with Autism Spectrum Disorder (ASD); summarize the results across clinic, home, and school contexts; and evaluate the quality of these interventions for clinical practice.MethodsA search of the PsycINFO, Medline (Ovid), Web of Science, and Scopus databases was conducted in June 2021, and no date restrictions were applied. Inclusion criteria were quantitative or qualitative research implementing a mindfulness-based intervention for CYP aged 6–25 years with a diagnosis of ASD, Pervasive Development Disorder, or Asperger’s Syndrome.ResultsWe identified 23 articles for inclusion including within subject pre- and post-testing, multiple baselines, and randomized control trials, among other research designs. Of these, a quality analysis conducted using an ASD research-specific risk of bias tool found over half (14) were of weak methodological quality, whereas only four and five were found to be of strong and adequate quality, respectively.DiscussionWhile the results of this systematic review suggest promising evidence for the use of mindfulness-based interventions to improve anxiety, social skills, and aggressive behaviors in CYP with ASD, results should be interpreted with caution due to the limitations resulting from the overall weak quality of the studies.The review protocol was pre-registered on PROSPERO (CRD42021259125) and can be viewed at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259125
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Affiliation(s)
- Tundi Loftus
- School of Psychology, Murdoch University, Murdoch, WA, Australia
- *Correspondence: Tundi Loftus,
| | - Danielle C. Mathersul
- School of Psychology, Murdoch University, Murdoch, WA, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, WA, Australia
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Michelle Ooi
- School of Psychology, Murdoch University, Murdoch, WA, Australia
| | - Shu H. Yau
- School of Psychology, Murdoch University, Murdoch, WA, Australia
- School of Education, University of Bristol, Bristol, United Kingdom
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Bellone KM, Elliott SC, Hynan LS, Warren B, Jarrett RB. Mindful Self-Care for Caregivers: A Proof of Concept Study Investigating a Model for Embedded Caregiver Support in a Pediatric Setting. J Autism Dev Disord 2023; 53:539-552. [PMID: 34109461 PMCID: PMC8189552 DOI: 10.1007/s10803-021-05113-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 11/30/2022]
Abstract
We conducted an open-trial proof of concept study to determine the safety, acceptability, and feasibility of Mindful Self-Care for Caregivers (MSCC) for parents of children with Autism Spectrum Disorders (ASD) (N = 13). The intervention was offered as a co-located care model in a pediatric specialty center where the participants' children received care. Results demonstrated that the intervention was: highly acceptable to all stakeholders (i.e., participants, the group facilitator, and center administration) and could be conducted safely by a masters-level practitioner with minimal resources. Further, secondary measures support a hypothesized interventional model of MSCC, demonstrating gains in mindfulness skills and sense of competency in the parenting role reduced perceived stress and depression in parents of children with ASD.
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Affiliation(s)
- Katherine M Bellone
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9086, Dallas, TX, 75390, USA.
- Children's Health System of Texas, Dallas, TX, USA.
| | - Stephen C Elliott
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9086, Dallas, TX, 75390, USA
- Children's Health System of Texas, Dallas, TX, USA
| | - Linda S Hynan
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9086, Dallas, TX, 75390, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Beth Warren
- Children's Health System of Texas, Dallas, TX, USA
| | - Robin B Jarrett
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9086, Dallas, TX, 75390, USA
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Ahmed AN, Raj SP. Self-compassion Intervention for Parents of Children with Developmental Disabilities: A Feasibility Study. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 7:277-289. [PMID: 36440059 PMCID: PMC9676721 DOI: 10.1007/s41252-022-00305-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 05/05/2023]
Abstract
Objectives Parents of children with developmental disabilities (DDs) experience greater psychological distress (e.g., stress and depression) compared to parents of children without DDs. Self-compassion (i.e., responding with compassion to oneself during times of stress and difficulty) is associated with greater self-care as well as lower levels of stress, depression, and internalized stigma among parents of children with DDs. In this study, we tested the feasibility of a 4-week brief, asynchronous, online intervention targeting self-compassion among parents of children with DDs. Methods Participants were fifty parents (48 mothers; 2 fathers) of children with DDs. Participants' ages ranged from 25 to 62 years (M = 42.1 years, SD = 7.9 years), and 88% of participants had one child with a DD, and the remaining parents had two or more children with DDs. Child diagnoses included Down syndrome, autism spectrum disorder, and intellectual disability. Feasibility was assessed in five domains (i.e., acceptability, demand, implementation, practicability, and limited efficacy) using a combination of self-report measures, qualitative feedback, and data on attrition. Results Most parents (84%) completed ≥ 3 modules, and 74% completed all four modules. Almost all parents (> 90%) reported that they would recommend the intervention to others. Paired-samples t-tests demonstrated significant pre-intervention to post-intervention increases in self-compassion and well-being, and significant reductions in parent depression and stress. Conclusions Overall, data support feasibility of the 4-week intervention targeting parent self-compassion and provide preliminary efficacy data that need to be followed up in a larger randomized control trial.
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Clifford P, Gevers C, Jonkman KM, Boer F, Begeer S. The effectiveness of an attention-based intervention for school-aged autistic children with anger regulating problems: A randomized controlled trial. Autism Res 2022; 15:1971-1984. [PMID: 36053934 PMCID: PMC9804490 DOI: 10.1002/aur.2800] [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: 02/17/2022] [Accepted: 08/11/2022] [Indexed: 01/05/2023]
Abstract
Anger regulation is a challenge for children with autism spectrum disorders (ASD). We investigated if attention-based cognitive behavioral treatment, based on mindfulness cognitive therapy (MBCT) and dialectical behavior therapy (DBT), reduces aggressive behavior and improves anger coping in school-aged autistic children (n = 51). Children were randomized to an active-control or a treatment condition. The treatment included nine weekly sessions attention-based individual therapy. Parents in both conditions received three weekly psychoeducation group sessions to heighten awareness of expressed emotion (EE). For aggressive behavior, treatment reduced temper tantrums and arguing. No effect was found on destroying things and physical violence. For anger coping, treatment increased adaptive coping strategies of diffusion and social support seeking, but had no effect on assertion, rumination, and maladaptive coping direct anger out and avoidance. Treatment did not impact secondary outcome measures concerning children's quality of life (QoL) and parental stress-levels and psychological well-being. In conclusion, school-aged autistic children are able to acquire self-regulation skills reducing temper tantrums and arguing and increasing the use of adaptive anger coping strategies. The intervention shows potential to improve behavior and regulation, but little transfer to other domains. Limitations and future directions involving the child's social environment, including parents, siblings, and teachers are discussed. LAY SUMMARY: Children on the autism spectrum often show aggressive behavior. Treatment can train children to be more aware of their emotions. This study found that this can help reducing temper tantrums and arguing and increasing some coping skills, though no impact was found on several other domains of aggression and coping.
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Affiliation(s)
| | | | - Kim M. Jonkman
- Department of Clinical‐Neuro and Developmental PsychologyVrije Universiteit AmsterdamAmsterdamBTThe Netherlands
- Amsterdam Public HealthVrije Universiteit AmsterdamAmsterdamBTThe Netherlands
| | - Frits Boer
- Child and Adolescent PsychiatryAmsterdam Medical CenterAmsterdamAZThe Netherlands
| | - Sander Begeer
- Department of Clinical‐Neuro and Developmental PsychologyVrije Universiteit AmsterdamAmsterdamBTThe Netherlands
- Amsterdam Public HealthVrije Universiteit AmsterdamAmsterdamBTThe Netherlands
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12
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Agarwal R, Wuyke G, Sharma U, Burke SL, Howard M, Li T, Sanchez M, Bastida E. Stress and Anxiety Among Parents of Transition-Aged Children with Autism Spectrum Disorder: a Systematic Review of Interventions and Scales. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022; 11:1-23. [PMID: 36065251 PMCID: PMC9434067 DOI: 10.1007/s40489-022-00340-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 08/12/2022] [Indexed: 11/06/2022]
Abstract
The period between adolescence to young adulthood can be stressful for parents of transition-aged children (14 to 22 years old) with autism spectrum disorder. A systematic review was undertaken to examine if existing interventions address the unique parental stressors of this phase and if the scales used to measure parental stress and anxiety are suitable for this group. Of the 9813 studies screened, only 13 studies met the inclusion criteria. Findings indicated that interventions focused on mindfulness, social functioning, or multiple components, of which only two addressed the transition period and only three specifically targeted parents of this age group. Moreover, of the six scales which assessed stress or anxiety, none were designed for these parents. Findings highlight the urgent need for more suitable scales and targeted interventions.
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Affiliation(s)
- Rumi Agarwal
- FIU Embrace, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Gabriella Wuyke
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Utsav Sharma
- College of Liberal Arts and Sciences, University of Florida, Gainesville, FL 32611 USA
| | - Shanna L. Burke
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Melissa Howard
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Mariana Sanchez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Elena Bastida
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
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13
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Cheak-Zamora N, Odunleye O. Stress and Coping in Autistic Young Adults. AUTISM IN ADULTHOOD 2022; 4:193-202. [PMID: 36606158 PMCID: PMC9645673 DOI: 10.1089/aut.2021.0043] [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: 01/07/2023]
Abstract
Introduction Half a million autistic youth will enter adulthood over the next decade. Support services to help youth successfully transition into adulthood are limited and not tailored to the autistic youth and young adult's needs. This study utilized qualitative methods to understand how autistic young adults experience and cope with stress during the transition to adulthood. Methods The study recruited 15 autistic young adults aged 18-25 years. Each participant completed a short demographic survey and individual interview. Interviews were conducted online via Google Docs or in-person based on the participants' preference. Three researchers organized and coded the data using a thematic approach. Results Based on our analysis, three themes emerged. Within the first theme, young adults in this study described experiencing a great deal of stress and provided examples of how it manifested in physical and emotional ways. In the second theme, youth described that the causes of this stress stemmed from general problems handling new or multiple responsibilities and specific problems in school, work, financial responsibilities, and social relationships. Finally, young adults described using various coping mechanisms including relaxation techniques, use of technology, and friends and family social support. Conclusions The study findings can help service providers and family members find new ways to help autistic young adults manage their stress. This study provides a unique understanding of stress and coping from the autistic individuals' point of view. Stress is most often derived from managing new responsibilities in general and school, work, money, and relationships in particular. Tailored support services that follow the individual from adolescence through adulthood are needed to manage these stressors. Researchers and service providers can utilize these recommendations for future program development. Furthermore, the method used in this study can be replicated to facilitate autistic individual input on future program development.
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Affiliation(s)
- Nancy Cheak-Zamora
- Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, Missouri, USA
| | - Olakunle Odunleye
- Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, Missouri, USA
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Lunsky Y, Redquest B, Albaum C, Hutton S, Share M, Share-Strom D, Weiss J. Virtual Group-Based Mindfulness Intervention for Autistic Adults: a Feasibility Study. Mindfulness (N Y) 2022; 13:1706-1718. [PMID: 35729967 PMCID: PMC9189269 DOI: 10.1007/s12671-022-01909-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/07/2022]
Abstract
Objectives Although mindfulness-based interventions have been shown to be helpful in reducing psychological distress in autistic adults, limited research has explored virtual delivery in the autism community. We designed an adapted virtual group-based mindfulness intervention, based on input from autistic adults, and evaluated its feasibility in terms of demand, acceptability, implementation, practicality, adaptation, and limited efficacy testing. Methods Informed by an online needs assessment survey of 77 autistic adults, 37 individuals completed a six-week autism informed manualized course delivered virtually. Participants completed pre, post, and 12-week follow up, and also provided qualitative feedback. Results There was a demand for the course, adaptations were successful, and participants indicated good acceptability of the intervention. Open-ended feedback highlighted advantages and challenges with the technology, the benefits of connecting with other autistic adults, and unique aspects of the mindfulness instruction. Participants reported reduced levels of distress which were maintained at three-month follow-up, and increased mindfulness, and self-compassion. Conclusions Autism-informed adaptations to standard mindfulness-based interventions can lead to self-reported improvements in mindfulness, self-compassion, and distress by autistic adults. Continued research with outcome measures tailored toward autistic adults will be important, during and post-pandemic.
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Affiliation(s)
- 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, Canada
| | - Brianne Redquest
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Carly Albaum
- Department of Psychology, York University, Toronto, Canada
| | - Sue Hutton
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Maxine Share
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Daniel Share-Strom
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Jonathan Weiss
- Department of Psychology, York University, Toronto, Canada
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O'Halloran L, Coey P, Wilson C. Suicidality in autistic youth: A systematic review and meta-analysis. Clin Psychol Rev 2022; 93:102144. [DOI: 10.1016/j.cpr.2022.102144] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 01/26/2022] [Accepted: 03/03/2022] [Indexed: 12/28/2022]
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16
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Drüsedau L, Schoba A, Conzelmann A, Sokolov A, Hautzinger M, Renner TJ, Barth GM. A structured group intervention (TüTASS) with focus on self-perception and mindfulness for children with autism spectrum disorder, ASD. A pilot study. Eur Arch Psychiatry Clin Neurosci 2022; 272:177-185. [PMID: 34240267 PMCID: PMC8866376 DOI: 10.1007/s00406-021-01281-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 06/08/2021] [Indexed: 01/21/2023]
Abstract
Autism spectrum disorders (ASD) represent a set of long-lasting severe neurodevelopmental conditions and effective therapeutic interventions are needed. Recent research points to the importance of including mindfulness-based elements to improve emotion and body perception in the psychotherapy of patients with ASD. Therefore, we developed a structured group psychotherapy program The Tübinger Training for Autism Spectrum Disorders (Tübinger Training für Autismus-Spektrum-Störungen; TüTASS) which focuses on mindfulness-based training elements. This pilot study accompanying the TüTASS reports the first results on the feasibility of the program with a pre-post comparison of 25 treated children with ASD. The psychometric assessment comprised five standardized questionnaires/ scales evaluating on the basis of parents and patients self-reports the child's social responsiveness, behavior, strengths and difficulties, quality of life, and depressive symptoms before and after training completion. The results indicated that upon training completion, symptoms with respect to emotional and social problems, externalizing behavior, and attentional and schizoid-compulsive behavior substantially declined. In a questionnaire assessing feasibility and quality of the group training, patients and parents found the therapy highly beneficial, especially as to the focus on emotions and body, and strengths and failures. This training program was developed to bridge the gap of lacking mindfulness-based interventions with the aim to optimize the course of ASD, especially with respect to behavioral disturbances and social-emotional problems.
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Affiliation(s)
- Laura Drüsedau
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Anja Schoba
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Annette Conzelmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Alexander Sokolov
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Tübingen, Germany
| | - Martin Hautzinger
- Department of Psychology, Clinical Psychology and Psychotherapy, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Tobias J. Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Gottfried M. Barth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
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Kemeny B, Burk S, Hutchins D, Gramlich C. Therapeutic Riding or Mindfulness: Comparative Effectiveness of Two Recreational Therapy Interventions for Adolescents with Autism. J Autism Dev Disord 2022; 52:2438-2462. [PMID: 34131850 PMCID: PMC8204925 DOI: 10.1007/s10803-021-05136-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2021] [Indexed: 02/05/2023]
Abstract
Therapeutic riding (THR) and HeartMath (HM) mindfulness-based interventions have promise for reducing stress in adolescents with autism spectrum disorder. In three 10-week periods, this study compared THR, HM, and control on salivary cortisol, self-reported stress, parent-reported social responsiveness, and heart-rate variability. This crossover design included 27 participants (12-21 years) randomly assigned to order of intervention. Findings suggest that HM and THR manualized protocols are equally beneficial in decreasing cortisol levels immediately following a session, but HM sessions had more impact on heart-rate variability. There was no significant effect on follow-up cortisol levels within a week after either intervention, but THR had more impact on decreasing some self-reported stressors.
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Affiliation(s)
- Betsy Kemeny
- Department of Recreational Therapy, Slippery Rock University, 106 Patterson Hall, Slippery Rock, PA 16057 USA
| | - Steffanie Burk
- Department of Equine Science, Otterbein University, Westerville, USA
| | - Deborah Hutchins
- Department of Recreational Therapy, Slippery Rock University, 106 Patterson Hall, Slippery Rock, PA 16057 USA
| | - Courtney Gramlich
- Storm Harbor Equestrian Center, Slippery Rock University, Slippery Rock, USA
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Emotional Rational Education Training Associated with Mindfulness for Managing Anxiety within Adolescents Affected by High-Functioning Autism: A Descriptive Study. Behav Sci (Basel) 2021; 11:bs11110156. [PMID: 34821617 PMCID: PMC8614903 DOI: 10.3390/bs11110156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/21/2021] [Accepted: 11/04/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Autism spectrum disorder (ASD) is a chronic and persistent pervasive developmental disorder (PDD) whose characteristic deficit is represented by social difficulties, semantic–pragmatic alterations and a limited, unusual and repetitive pattern of interests and behaviors. Specifically, individuals with high-functioning autism (HFA) frequently exhibit associated internalizing symptoms that are not part of the diagnostic criteria but which, nonetheless, tend to impair daily functioning. In this study, we investigated how some forms of treatment could be useful in subjects with HFA who display internalizing symptoms. Theoretical background relates to standard cognitive therapy (SCT) and rational education training with mindfulness (M-ERE). Methods: In this study, we investigated how some forms of treatment could be useful in subjects with HFA and internalizing symptoms, focusing on standard cognitive therapy (SCT) and mindfulness associated with emotional rational education training (M-ERE). We selected two groups of HFA patients with significant internalizing symptoms and performed two different forms of treatment for six months: SCT and M-ERE. The aim of the study was to verify the effectiveness of an M-ERE protocol with respect to anxious and depressive symptoms in subjects with HFA. Furthermore, we wanted to compare the results obtained with this combined treatment with those obtained in HFA subjects treated with SCT. Results: Our analyses showed an improvement in the internalizing symptoms (especially those related to the anxiety dimension) of the group that followed a treatment based on mindfulness and rational emotional education for 6 months compared to the group that had instead performed a 6-month treatment based on the SCT. Conclusions: Our hypotheses were supported by the results, which highlighted the efficacy of mindfulness-based interventions in the treatment of internalizing symptoms in adolescents with HFA, and specifically showed that an M-ERE intervention appears more effective in managing anxiety compared to treatment with SCT and appears to be equally effective in the management of depressive symptoms. Not only was the M-ERE treatment effective for the management of anxious and depressive symptoms in subjects with HFA, but the efficacy for the management of anxious symptoms was greater than the SCT treatment.
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Siffredi V, Liverani MC, Smith MM, Meskaldji DE, Stuckelberger-Grobéty F, Freitas LGA, De Albuquerque J, Savigny E, Gimbert F, Hüppi PS, Merglen A, Borradori Tolsa C, Leuchter RHV. Improving executive, behavioural and socio-emotional competences in very preterm young adolescents through a mindfulness-based intervention: Study protocol and feasibility. Early Hum Dev 2021; 161:105435. [PMID: 34507019 DOI: 10.1016/j.earlhumdev.2021.105435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/17/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Very preterm (VPT) children and adolescents show executive, behavioural and socio-emotional difficulties that persist into adulthood. Despite the promising role of mindfulness-based intervention (MBI) in improving theses competences in children and adolescents, the effectiveness of an MBI has not been assessed in a VPT population so far. AIMS To describe the protocol and to evaluate the feasibility and acceptability of a clinical trial on an 8-week MBI program to enhance executive and socio-emotional competences in a cohort of VPT young adolescents. STUDY DESIGN A randomised controlled trial (RCT) and a pre-post intervention designs. PARTICIPANTS 164 VPT young adolescents from 10 to 14 years old, born before 32 gestational weeks, without major intellectual, sensory or physical impairments, and attending mainstream school, were invited to participate in an 8-week MBI program. OUTCOME MEASURES Completion rate of the study was recorded. Acceptability, satisfaction and attendance measures of the MBI were collected using self-reported questionnaires and registration of attendance. RESULTS Of the 63 participants who were enrolled in the study (38.2% of families invited to participate), 52 (82.5%) completed all assessments. Acceptability was high as shown by the high attendance rate in the sessions and the feedback evaluation questionnaire. CONCLUSIONS Our findings suggest that an MBI is feasible to implement and show a high acceptability among participants. The use of an RCT design in our study constitutes the gold standard for testing the efficacy of such intervention in VPT young adolescents. If effective, the MBI program could potentially be a valuable tool for improving executive and socio-emotional competences in the vulnerable VPT population. TRIAL REGISTRATION ClinicalTrials, NCT04638101. Registered 19 November 2020 - retrospectively registered, https://clinicaltrials.gov/show/NCT04638101.
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Affiliation(s)
- Vanessa Siffredi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Switzerland; Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Switzerland
| | - Maria Chiara Liverani
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; SensoriMotor, Affective and Social Development Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Mariana Magnus Smith
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; Division of General Paediatrics, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Djalel Eddine Meskaldji
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; Institute of Mathematics, Ecole Polytechnique Fédérale de Lausanne, Switzerland
| | - Françoise Stuckelberger-Grobéty
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Lorena G A Freitas
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Switzerland; Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Switzerland
| | - Jiske De Albuquerque
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Emilie Savigny
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Fanny Gimbert
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; SensoriMotor, Affective and Social Development Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland; University of Grenoble Alpes, CNRS, LPNC, 38000 Grenoble, France
| | - Petra Susan Hüppi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Arnaud Merglen
- Division of General Paediatrics, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Cristina Borradori Tolsa
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Russia Hà-Vinh Leuchter
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland.
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Nuske HJ, Shih WI, Sparapani N, Baczewski L, Dimachkie Nunnally A, Hochheimer S, Garcia C, Castellon F, Levato L, Fischer E, Atkinson-Diaz ZL, Li J, Mandell DS, Kasari C. Self-regulation predicts companionship in children with autism. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:889-899. [PMID: 36568619 PMCID: PMC9788710 DOI: 10.1080/20473869.2021.1917109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 06/17/2023]
Abstract
Self-regulation is associated with many positive outcomes in children with and without autism, including increased mental health and academic achievement, and decreased problem behavior. Less is known regarding whether and how self-regulation and symptoms of mental health challenges (internalizing and externalizing problems) relate to social outcomes, such as friendship quality and loneliness. Parents and teachers of 106 children with autism aged 5-12 reported on children's self-regulation difficulties and externalizing and internalizing symptoms. Four-to-five months later, children reported on the quality of their friendship with their best friend (companionship, conflict, helpfulness, sense of relationship security, closeness), and their feelings of loneliness. Linear regression was used to examine the effects of self-regulation and symptoms of mental health challenges on friendship quality and loneliness. Less self-regulation difficulties predicted stronger companionship and girls had better quality friendships with their best friend than did boys, in terms of companionship, helpfulness, security and closeness, confirming that they have a protective advantage in friendship development. Autism symptoms, IQ, and age were not associated with friendship quality or loneliness. Results highlight the importance of self-regulation and mental health interventions for school-aged children with autism.
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Affiliation(s)
- Heather J. Nuske
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Wendy I. Shih
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Nicole Sparapani
- University of California Davis MIND Institute, University of California, Davis, CA, USA
| | - Lauren Baczewski
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | | | - Samantha Hochheimer
- Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Consuelo Garcia
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Fernanda Castellon
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Lynne Levato
- Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Erin Fischer
- Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Jennica Li
- University of California Davis MIND Institute, University of California, Davis, CA, USA
| | - David S. Mandell
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Connie Kasari
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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A Systematic Review of Self-Reported Stress Questionnaires in People on the Autism Spectrum. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021; 10:295-318. [PMID: 34603935 PMCID: PMC8475841 DOI: 10.1007/s40489-021-00293-4] [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: 03/03/2021] [Accepted: 09/08/2021] [Indexed: 10/26/2022]
Abstract
Background The goal of this systematic review was to provide an overview of self-report measures of stress in populations on the autism spectrum. In addition, information regarding psychometric properties was discussed as well. Methods Four databases were systematically searched following the PRISMA guidelines and using strict eligibility criteria. Risk of bias assessment was performed using the COSMIN checklist. Results Eight questionnaires were previously used in populations on the autism spectrum, reported over 31 studies. Discussion Future research should focus more on examining psychometric properties of these self-report measures in this population as current evidence is scarce. In addition, it is important to consider which concept of stress one aims to measure as not all questionnaires cover the same aspects of stress. Supplementary Information The online version contains supplementary material available at 10.1007/s40489-021-00293-4.
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22
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Dickson KS, Lind T, Jobin A, Kinnear M, Lok H, Brookman-Frazee L. A Systematic Review of Mental Health Interventions for ASD: Characterizing Interventions, Intervention Adaptations, and Implementation Outcomes. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 48:857-883. [PMID: 33884535 PMCID: PMC8411365 DOI: 10.1007/s10488-021-01133-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 11/29/2022]
Abstract
Youth with autism spectrum disorder (ASD) have high rates of co-occurring mental health needs that necessitate mental health interventions. Given the unique clinical characteristics of youth with ASD, there have been significant efforts to adapt and test mental health interventions for this population. Yet, characterization of the nature and types of interventions adaptations is limited, especially across the wide range of interventions tested for youth with ASD with a focus on implementation factors. Additionally, understanding how these interventions may be implemented in community services is limited. The aims of this systematic review are to characterize the (1) types of interventions tested for co-occurring mental health conditions for youth with ASD; (2) adaptations to mental health interventions for use with youth with ASD; and (3) implementation strategies, outcomes, and determinants of mental health interventions to inform their translation to community service settings. Eighty-three articles testing interventions targeting mental health symptoms in youth with ASD that included implementation factors in analyses were reviewed. The Stirman et al. (2013; 2019) FRAME adaptation, Powell et al. (2012;2015) implementation strategies, and Proctor et al. (2011) implementation outcomes taxonomies were applied to characterize the nature and types of adaptations for use with youth with ASD and types of implementation strategies, outcomes, and determinants used, when available, respectively. Of the interventions examined, the majority (64.1%) were originally designed to target youth mental health concerns and were then adapted to be used with ASD. The most common adaptations included those to the intervention content, particularly adding elements with tailoring or refining aspects of the intervention while maintaining core functions. Half of the articles described at least one implementation strategy used during intervention testing. Fidelity and acceptability were the most frequently examined implementation outcomes, with some examination of appropriateness and feasibility. Nineteen percent of articles described implementation determinants (i.e. barriers/facilitators) of these implementation outcomes. The common adaptations for ASD provide direction for future intervention development and for training community therapists. Further examination, specification, and reporting of implementation strategies and outcomes within ongoing efforts to adapt and interventions to meet the co-occurring mental health needs of youth ASD are needed to facilitate their translation to community settings. Areas for future research as well as clinical implications are discussed.
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Affiliation(s)
- Kelsey S Dickson
- San Diego State University, San Diego, USA.
- Child and Adolescent Services Research Center, San Diego, CA, USA.
| | - Teresa Lind
- Child and Adolescent Services Research Center, San Diego, CA, USA
- University of California, San Diego, USA
| | - Allison Jobin
- University of California, San Diego, USA
- California State University, San Marcos, USA
| | | | - Ho Lok
- San Diego State University, San Diego, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Lauren Brookman-Frazee
- Child and Adolescent Services Research Center, San Diego, CA, USA
- University of California, San Diego, USA
- Rady Children's Hospital-San Diego, San Diego, USA
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Popow C, Ohmann S, Plener P. Practitioner's review: medication for children and adolescents with autism spectrum disorder (ASD) and comorbid conditions. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2021; 35:113-134. [PMID: 34160787 PMCID: PMC8429404 DOI: 10.1007/s40211-021-00395-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/15/2021] [Indexed: 11/14/2022]
Abstract
Alleviating the multiple problems of children with autism spectrum disorder (ASD) and its comorbid conditions presents major challenges for the affected children, parents, and therapists. Because of a complex psychopathology, structured therapy and parent training are not always sufficient, especially for those patients with intellectual disability (ID) and multiple comorbidities. Moreover, structured therapy is not available for a large number of patients, and pharmacological support is often needed, especially in those children with additional attention deficit/hyperactivity and oppositional defiant, conduct, and sleep disorders.
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Affiliation(s)
- Christian Popow
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Susanne Ohmann
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Paul Plener
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
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Narzisi A, Muccio R. A Neuro-Phenomenological Perspective on the Autism Phenotype. Brain Sci 2021; 11:914. [PMID: 34356148 PMCID: PMC8307909 DOI: 10.3390/brainsci11070914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/18/2022] Open
Abstract
In the current paper, we present a view of autism spectrum disorder (ASD) which avoids the typical relational issues, instead drawing on philosophy, in particular Husserlian phenomenology. We begin by following the recent etiological perspectives that suggest a natural predisposition of a part of individuals with ASD towards hypersensitivity and the reduced influence of cognitive priors (i.e., event schemas). Following this perspective, these two characteristics should be considered as a sort of phenomenological a priori that, importantly, could predispose people with ASD towards a spiritual experience, not intended in its religious meaning, but as an attribute of consciousness that consists of being aware of and attentive to what is occurring in the present moment. Potential clinical implications are discussed.
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Dickson KS, Lind T, Jobin A, Kinnear M, Lok H, Brookman-Frazee L. Correction to: A Systematic Review of Mental Health Interventions for ASD: Characterizing Interventions, Intervention Adaptations, and Implementation Outcomes. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 48:884-908. [PMID: 34196884 DOI: 10.1007/s10488-021-01144-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Due to the errors occurred in the originally published version, this article is being reprinted in its entirety as Correction. All errors have been corrected. It is the correct version.
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Affiliation(s)
- Kelsey S Dickson
- San Diego State University, San Diego, USA.
- Child and Adolescent Services Research Center, San Diego, CA, USA.
| | - Teresa Lind
- San Diego State University, San Diego, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
- University of California, San Diego, USA
| | - Allison Jobin
- Child and Adolescent Services Research Center, San Diego, CA, USA
- University of California, San Diego, USA
- California State University, San Marcos, USA
| | | | - Ho Lok
- San Diego State University, San Diego, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Lauren Brookman-Frazee
- Child and Adolescent Services Research Center, San Diego, CA, USA
- University of California, San Diego, USA
- Rady Children's Hospital-San Diego, San Diego, USA
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26
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Zhang S, Hong JS, Garthe RC, Espelage DL, Schacter HL. Parental stress and adolescent bullying perpetration and victimization: The mediating role of adolescent anxiety and family resilience. J Affect Disord 2021; 290:284-291. [PMID: 34015623 DOI: 10.1016/j.jad.2021.04.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/09/2021] [Accepted: 04/15/2021] [Indexed: 12/28/2022]
Abstract
Although past research suggests that parental stress can heighten adolescents' risk for bullying perpetration and victimization, the mechanisms underlying such a potential link and that may involve child psychological wellbeing remain unclear. Parental stress may heighten adolescents' risk for bullying involvement by elevating adolescents' anxiety and interfering with family functioning. Therefore, the current study investigated the role of adolescent anxiety and family resilience as mediators linking parental stress with adolescent bullying involvement. Sex differences in these associations were also explored. Analyses relied on data collected from 11,244 parents who participated in the 2019 National Survey of Children's Health. Parents completed surveys assessing parental stress, adolescent anxiety, family resilience, and adolescents' involvement in bullying perpetration as well as victimization. Results from structural equation models indicated that a higher level of parental stress was related to greater bullying perpetration and victimization among both male and female adolescents. Moreover, parental stress was indirectly related to bullying victimization via elevated adolescent anxiety for both girls and boys, whereas parental stress was indirectly related to bullying perpetration via reduced family resilience for boys but not girls. The findings highlight connections between adolescents' family and peer contexts and implicate adolescent anxiety and family resilience as putative mechanisms linking parental stress and bullying involvement.
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Affiliation(s)
- Saijun Zhang
- University of Mississippi, Department of Social Work, University, MS.
| | - Jun Sung Hong
- Wayne State University, School of Social Work, Detroit, MI
| | - Rachel C Garthe
- University of Illinois at Urbana-Champaign, School of Social Work, Urbana, IL
| | - Dorothy L Espelage
- University of North Carolina at Chapel Hill, School of Education, Chapel Hill, NC
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Hartley M, Due C, Dorstyn D. Barriers and facilitators to engaging individuals and families with autism spectrum disorder in mindfulness and acceptance-based therapies: a meta-synthesis. Disabil Rehabil 2021; 44:4590-4601. [PMID: 34033733 DOI: 10.1080/09638288.2021.1921859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE Third-wave psychological therapies can benefit individuals and families living with autism spectrum disorder (ASD). To date, little is known about individuals' perceptions and experiences of therapy. This meta-synthesis aimed to capture participants' own reflections of mindfulness and acceptance-based therapies, including potential barriers and facilitators to therapy engagement. MATERIALS AND METHODS Database searches identified 10 independent studies targeting caregivers (Nstudies = 3), dyadic parent-child interventions (Nstudies = 6), or adults with ASD (Nstudies = 1). Studies were subject to quality assessment and thematically analysed. RESULTS Caregivers highlighted a need to adapt the length and frequency of daily mindfulness practice around busy lifestyles. Adults with ASD also identified therapy barriers, although these data were less robust. Children with ASD focused on therapy benefits. CONCLUSIONS All three participant groups commented on the importance of mindfulness as a method to enhance self-awareness, self-regulation and self-care. Peer support provided in group-based therapy was also seen as beneficial. Future research should examine the application of mindfulness therapies to adults with ASD, with little currently known about this cohort's therapy experiences. Whether traditional mindfulness approaches can be effectively modified to accommodate ongoing, cumulative daily demands these families experience also requires investigation.Implications for rehabilitationIndividuals with autism spectrum disorders (ASD) and their caregivers often experience high levels of anxiety and stress.Mindfulness and acceptance-based therapies can enhance an individual's self-awareness and self-regulation, thereby reducing distress - with benefits extending to familiesGroup-based therapy is an important adjunct to the support of caregivers developing mindfulness-awareness.
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Affiliation(s)
- Matthew Hartley
- The School of Psychology, Faculty of Medical and Health Sciences, The University of Adelaide, Adelaide, South Australia
| | - Clemence Due
- The School of Psychology, Faculty of Medical and Health Sciences, The University of Adelaide, Adelaide, South Australia
| | - Diana Dorstyn
- The School of Psychology, Faculty of Medical and Health Sciences, The University of Adelaide, Adelaide, South Australia
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Brief Report: Mindfulness Training for Chinese Adolescents with Autism Spectrum Disorder and Their Parents in Hong Kong. J Autism Dev Disord 2021; 51:4147-4159. [PMID: 33484370 PMCID: PMC8510984 DOI: 10.1007/s10803-020-04729-4] [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] [Indexed: 12/11/2022]
Abstract
This study investigated the feasibility and preliminary effectiveness of a concurrent mindfulness program (MYmind) on Chinese adolescents with autism spectrum disorder and their parents in Hong Kong, China using a randomized controlled trial with a waitlist control group. Results showed the study had 80% compliance rate, 0% dropout rate, and 89% response rate. Between-group comparisons showed mindfulness had trend effects on parent’s rumination (g = 1.16), mindful parenting (d = 0.6), parenting style (d = 0.59), and parenting stress (d = 0.5). The study demonstrated the feasibility of the MYmind program in the Chinese context. A larger trial with longer follow-up period is suggested to better examine the effect of mindfulness on adolescents with ASD and their parents.
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Singh NN. Implementation Science of Mindfulness in Intellectual and Developmental Disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:345-348. [PMID: 32936888 DOI: 10.1352/1944-7558-125.5.345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Implementation science deals with the translation of evidence-based knowledge into practice in the real world. Mindfulness-based programs for people with intellectual and developmental disabilities (IDD) emerged about 20 years ago. Efficacy and effectiveness studies provide the evidence-base for these programs and the field of IDD is moving towards large scale implementation of these programs. This article presents a model for implementing mindfulness-based programs in community settings, including family and group homes, schools, vocational settings, and congregate care facilities. The model is based on the 3-tier positive behavior support (PBS) system commonly used in school, family, and agency settings. Specific mindfulness-based programs can be linked to each of the three tiers to improve the quality of life of people with IDD.
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Affiliation(s)
- Nirbhay N Singh
- Nirbhay N. Singh, Medical College of George, Augusta University
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Lim T, Tan MY, Aishworiya R, Kang YQ. Autism Spectrum Disorder and COVID-19: Helping Caregivers Navigate the Pandemic. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020112] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Tammy Lim
- National University Hospital, Singapore
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31
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Daily parenting of children with cerebral palsy: The role of daily child behavior, parents' daily psychological needs, and mindful parenting. Dev Psychopathol 2020; 33:184-200. [PMID: 32381132 DOI: 10.1017/s0954579419001688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of this study was to advance the current understanding of the daily dynamics that are involved in raising a child with Cerebral Palsy (CP). Specifically, we examined the role of mindful parenting and of day-to-day variation in parents' psychological needs and child behavior in explaining day-to-day variation in parents' autonomy-supportive, psychologically controlling, and responsive parenting behavior. Parents (N = 58) of children with CP (Mage = 12.68 years) participated in a 7-day diary study. Multilevel analyses indicated that parents' autonomy-supportive, psychologically controlling, and responsive behaviors fluctuate considerably between days. Further, daily fluctuations in both child behavior and parents' own psychological needs were found to be associated with this daily variability in parenting. In addition, interindividual differences in mindful parenting were associated positively with parents' responsiveness and negatively with psychologically controlling parenting across the week. These findings point towards the changeability of parenting behavior among parents of a child with CP and suggest that interventions targeting parenting behavior in the context of CP will be most effective when taking into account both the parents' and the child's functioning.
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Weitlauf AS, Broderick N, Stainbrook JA, Taylor JL, Herrington CG, Nicholson AG, Santulli M, Dykens EM, Juárez AP, Warren ZE. Mindfulness-Based Stress Reduction for Parents Implementing Early Intervention for Autism: An RCT. Pediatrics 2020; 145:S81-S92. [PMID: 32238534 PMCID: PMC8025402 DOI: 10.1542/peds.2019-1895k] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Systems of care emphasize parent-delivered intervention for children with autism spectrum disorder (ASD). Meanwhile, multiple studies document psychological distress within these parents. This pilot longitudinal randomized controlled trial compared the parent-implemented Early Start Denver Model (P-ESDM) to P-ESDM plus mindfulness-based stress reduction (MBSR) for parents. We evaluated changes in parent functioning during active treatment and at follow-up. METHODS Participants included children (<36 months old) with autism spectrum disorder and caregivers. Participants were randomly assigned to P-ESDM only (n = 31) or P-ESDM plus MBSR (n = 30). Data were collected at baseline, midtreatment, the end of treatment, and 1, 3, and 6 months posttreatment. Multilevel models with discontinuous slopes were used to test for group differences in outcome changes over time. RESULTS Both groups improved during active treatment in all subdomains of parent stress (β = -1.42, -1.25, -0.92; P < 0.001), depressive symptoms, and anxiety symptoms (β = -0.62 and -0.78, respectively; P < 0.05). Parents who received MBSR had greater improvements than those receiving P-ESDM only in parental distress and parent-child dysfunctional interactions (β = -1.91 and -1.38, respectively; P < 0.01). Groups differed in change in mindfulness during treatment (β = 3.15; P < .05), with P-ESDM plus MBSR increasing and P-ESDM declining. Treatment group did not significantly predict change in depressive symptoms, anxiety symptoms, or life satisfaction. Differences emerged on the basis of parent sex, child age, and child behavior problems. CONCLUSIONS Results suggest that manualized, low-intensity stress-reduction strategies may have long-term impacts on parent stress. Limitations and future directions are described.
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Affiliation(s)
| | | | | | | | | | - Amy G Nicholson
- Departments of Pediatrics and
- Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; and
| | | | - Elisabeth M Dykens
- Departments of Pediatrics and
- Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; and
- Psychology and Human Development, Vanderbilt University, Nashville, Tennessee
| | - A Pablo Juárez
- Departments of Pediatrics and
- Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; and
- Departments of Special Education and
| | - Zachary E Warren
- Departments of Pediatrics and
- Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; and
- Departments of Special Education and
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Abstract
PURPOSE OF REVIEW People with intellectual and developmental disability (IDD) commonly exhibit behaviors that present challenges to their parents, caregivers, and teachers. Mindfulness-based practices and programs have emerged as a viable alternative to current interventions for such behaviors and the stress faced by their caregivers. This review addresses publications between 2018 and 2019 that examined the effectiveness of mindfulness-based practices and programs for people living with IDD. RECENT FINDINGS Individuals with IDD can learn mindfulness practices to self-manage their aggressive and destructive behaviors. Individual practices and group-based programs continue to show that mindfulness approaches are effective for this population. Randomized controlled trials indicate that comprehensive mindfulness-based programs (e.g., mindfulness-based stress reduction, MYmind, and mindfulness-based positive behavior support) are effective for enhancing the quality of life of people living with IDD. SUMMARY Research supports the use of informal mindfulness practices for challenging behaviors of people with IDD. Formal mindfulness-based programs continue to be evaluated for their effectiveness across different populations, cultures, levels of IDD, components of the program, and length of training. The research literature on mindfulness is still in the early stages of development and much work remains.
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Ridderinkhof A, de Bruin EI, van den Driesschen S, Bögels SM. Attention in Children With Autism Spectrum Disorder and the Effects of a Mindfulness-Based Program. J Atten Disord 2020; 24:681-692. [PMID: 30222027 PMCID: PMC7003152 DOI: 10.1177/1087054718797428] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: Children with autism spectrum disorder (ASD) show atypical attention. Mindfulness-based programs (MBPs), with self-regulation of attention as a basic component, could benefit these children. Method: We investigated how 49 children with ASD differed from 51 typically developing (TD) children in their attention systems; and whether their attention systems were improved by an MBP for children and their parents (MYmind), using a cognitive measure of attention, the Attention Network Test. Results: Children with ASD did not differ from TD children in the speed of the attention systems, but were somewhat less accurate in their orienting and executive attention. Also, MYmind did not significantly improve attention, although trend effects indicated improved orienting and executive attention. Robustness checks supported these improvements. Conclusion: Trend effects of the MBP on the attention systems of children with ASD were revealed, as well as minor differences between children with ASD and TD children in their attention systems.
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Affiliation(s)
- Anna Ridderinkhof
- Research Institute of Child Development and Education, University of Amsterdam, The Netherlands,Anna Ridderinkhof, Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands.
| | - Esther I. de Bruin
- Research Institute of Child Development and Education, University of Amsterdam, The Netherlands
| | | | - Susan M. Bögels
- Research Institute of Child Development and Education, University of Amsterdam, The Netherlands,Department of Developmental Psychology, University of Amsterdam, The Netherlands,UvA minds, The Netherlands
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Editorial: Advances in understanding self-determination, mindfulness approaches, and behavioral interventions, outcomes in autistic siblings and substance abuse in neurodevelopmental disorders. Curr Opin Psychiatry 2020; 33:77-80. [PMID: 31833948 DOI: 10.1097/yco.0000000000000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Individuals with autism spectrum disorder (ASD) tend to experience difficulties with emotion regulation (ER). Treatments designed to address ER difficulties in individuals with ASD are emerging. The authors review cognitive-behavioral therapy (CBT) and mindfulness-based treatments that have focused on ER difficulties in youth and young adults with ASD. In general, these treatments addressing ER skills have included awareness of emotions/psychoeducation about emotions, frustration tolerance, and ER skills, as well as practice and use of these skills during group therapy that sometimes includes caregivers. The results from these interventions are encouraging for individuals with high-functioning ASD because ER skills tend to improve following treatment. The inclusion of ER in other ASD treatments is discussed.
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Affiliation(s)
| | | | - Judy Reaven
- Departments of Pediatrics and Psychiatry at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado
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Cousineau TM, Hobbs LM, Arthur KC. The Role of Compassion and Mindfulness in Building Parental Resilience When Caring for Children With Chronic Conditions: A Conceptual Model. Front Psychol 2019; 10:1602. [PMID: 31428005 PMCID: PMC6690403 DOI: 10.3389/fpsyg.2019.01602] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 06/25/2019] [Indexed: 01/20/2023] Open
Abstract
Compassion- and mindfulness-based interventions (CMBIs) and therapies hold promise to support parent resilience by enabling adaptive stress appraisal and coping, mindful parenting, and perhaps crucially, self-compassion. These contemplative modalities have recently been expanded to parents of children with chronic illness, building on successful applications for adults facing stress, chronic pain, or mental illness, and for healthcare professionals in response to caregiver burnout resulting from their work. The design and adaptation of interventions and therapies require a conceptual model of parent resilience in the context of childhood chronic illness that integrates mindfulness and compassion. The objective of this paper is to propose and describe such a model. First, we review the need for parent support interventions for this population. Second, we introduce a Model of Compassion, Mindfulness, and Resilience in Parental Caregiving. We highlight the mindful parenting approaches, guiding theories for adaptive coping, and family resilience frameworks that informed our model. Third, we describe a case of a parent to illustrate a practical application model. Finally, we outline future directions for intervention development and research to examine the impact of CMBIs on parent resilience.
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Affiliation(s)
- Tara M. Cousineau
- Counseling and Mental Health Services, Harvard University, Cambridge, MA, United States
- Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, MA, United States
| | - Lorraine M. Hobbs
- Youth, Family and Educational Programs, UCSD Center for Mindfulness, San Diego, CA, United States
| | - Kimberly C. Arthur
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, United States
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38
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Bögels SM, Emerson LM. The mindful family: a systemic approach to mindfulness, relational functioning, and somatic and mental health. Curr Opin Psychol 2019; 28:138-142. [DOI: 10.1016/j.copsyc.2018.12.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 11/29/2022]
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Hartley M, Dorstyn D, Due C. Mindfulness for Children and Adults with Autism Spectrum Disorder and Their Caregivers: A Meta-analysis. J Autism Dev Disord 2019; 49:4306-4319. [DOI: 10.1007/s10803-019-04145-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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40
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Burgdorf V, Szabó M, Abbott MJ. The Effect of Mindfulness Interventions for Parents on Parenting Stress and Youth Psychological Outcomes: A Systematic Review and Meta-Analysis. Front Psychol 2019; 10:1336. [PMID: 31244732 PMCID: PMC6562566 DOI: 10.3389/fpsyg.2019.01336] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 05/22/2019] [Indexed: 12/29/2022] Open
Abstract
Background: The psychological well-being of parents and children is compromised in families characterized by greater parenting stress. As parental mindfulness is associated with lower parenting stress, a growing number of studies have investigated whether mindfulness interventions can improve outcomes for families. This systematic review and meta-analysis evaluates the effectiveness of mindfulness interventions for parents, in reducing parenting stress and improving youth psychological outcomes. Methods: A literature search for peer-reviewed articles and dissertations was conducted in accordance with PRISMA guidelines in the PsycInfo, Medline, PubMed, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses databases. Studies were included if they reported on a mindfulness-based intervention delivered in person to parents with the primary aim of reducing parenting stress or improving youth psychological outcomes. Results: Twenty-five independent studies were included in the review. Eighteen studies used a single group design and six were randomized controlled trials. Within-groups, meta-analysis indicated a small, post-intervention reduction in parenting stress (g = 0.34), growing to a moderate reduction at 2 month follow-up (g = 0.53). Overall, there was a small improvement in youth outcomes (g = 0.27). Neither youth age or clinical status, nor time in mindfulness training, moderated parenting stress or overall youth outcome effects. Youth outcomes were not moderated by intervention group attendees. Change in parenting stress predicted change in youth externalizing and cognitive effects, but not internalizing effects. In controlled studies, parenting stress reduced more in mindfulness groups than control groups (g = 0.44). Overall, risk of bias was assessed as serious. Conclusions: Mindfulness interventions for parents may reduce parenting stress and improve youth psychological functioning. While improvements in youth externalizing and cognitive outcomes may be explained by reductions in parenting stress, it appears that other parenting factors may contribute to improvements in youth internalizing outcomes. Methodological weaknesses in the reviewed literature prevent firm conclusions from being drawn regarding effectiveness. Future research should address these methodological issues before mindfulness interventions for parents are recommended as an effective treatment option for parents or their children.
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Affiliation(s)
- Virginia Burgdorf
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
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41
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Salem-Guirgis S, Albaum C, Tablon P, Riosa PB, Nicholas DB, Drmic IE, Weiss JA. MYmind: a Concurrent Group-Based Mindfulness Intervention for Youth with Autism and Their Parents. Mindfulness (N Y) 2019; 10:1730-1743. [PMID: 31976019 PMCID: PMC6945985 DOI: 10.1007/s12671-019-01107-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objectives The current study evaluated the use of MYmind, a concurrent mindfulness program in which youth with autism and their parents simultaneously receive group specific mindfulness training. Youth with autism can experience emotional and behavioral challenges, which are associated with parental stress. Mindfulness-based programs are emerging as a promising support for these challenges, for both children and parents. While two studies have documented the use of concurrent parent-child programs, neither involve control conditions. Methods Using a within-subject repeated measures design with a baseline component, 23 parent-child dyads were assessed on mindfulness, mental health, and youth emotion regulation and autism symptoms. Participants also rated their perceived improvement on a social validity questionnaire. Results There was improvement in youth autism symptoms, emotion regulation, and adaptive skills, and in parent reports of their own mindfulness following the program. There was also some indication of a waitlist effect for parent mental health, but not for other outcome variables. Participant feedback was mainly positive. Conclusions MYmind has the potential to contribute to emotion regulation and adaptability in youth with autism, and mindfulness in parents, though more rigorous controlled trials are needed.
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Affiliation(s)
| | - Carly Albaum
- 2Department of Psychology, York University, Toronto, Canada
| | - Paula Tablon
- 2Department of Psychology, York University, Toronto, Canada
| | | | - David B Nicholas
- 4Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, Canada
| | - Irene E Drmic
- 5Ron Joyce Children's Health Centre, Hamilton Health Sciences, Hamilton, Ontario Canada
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Siebelink NM, Bögels SM, Boerboom LM, de Waal N, Buitelaar JK, Speckens AE, Greven CU. Mindfulness for children with ADHD and Mindful Parenting (MindChamp): Protocol of a randomised controlled trial comparing a family Mindfulness-Based Intervention as an add-on to care-as-usual with care-as-usual only. BMC Psychiatry 2018; 18:237. [PMID: 30045714 PMCID: PMC6060473 DOI: 10.1186/s12888-018-1811-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 07/09/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Self-control in childhood has been linked to long-term and cascading effects on health, academic, criminality, wealth and parenting outcomes. Hence it is important to target self-control deficits early in life. Self-control deficits are a hallmark of Attention Deficit/Hyperactivity Disorder (ADHD). Even after receiving care-as-usual (CAU) for ADHD, impaired self-control often remains. Pharmacotherapy can be hampered by side-effects, low adherence and short-term effectiveness. Other limitations of CAU are decreased effectiveness when parents have ADHD and little effect on parental well-being. Mindfulness-Based Interventions (MBIs) are an emerging non-pharmacological approach with potential to improve self-control and well-being in both children and parents. However, there is a lack of sufficiently powered randomised controlled trials (RCTs) to establish their effects in families with ADHD. This study protocol describes an RCT to investigate the effectiveness of a family MBI as an add-on to CAU in treatment of youth with ADHD, and is described in accordance with Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT). METHODS/DESIGN An RCT will be conducted in N = 100 children (aged 8-16 years) with ADHD and their parents. The experimental condition will consist of a family MBI (MYmind): 8-week group-based MBI for youth combined with parallel group-based Mindful Parenting for their parents, as an add-on to CAU. The control condition will consist of CAU-only. Assessments will take place at baseline, end of treatment (3 months later), 2 and 6 months' follow-up. Primary outcome measure will be an ecologically valid assessment of child self-control with the parent-rated Behaviour Rating Inventory of Executive Function (BRIEF). Secondary child outcome measures will be teacher-rated BRIEF, computerised self-control tasks and questionnaires on psychological symptoms (e.g. ADHD, symptoms of autism), well-being and mindfulness. For parental outcomes, secondary measures will be self-rated BRIEF, computerised self-control tasks and questionnaires on psychological symptoms, well-being and mindful parenting. DISCUSSION The proposed RCT will take account of methodological limitations of previous studies on MBIs in child ADHD populations. The current study will provide valuable information on family MBI as a potential effective intervention in targeting self-control deficits for youth with ADHD and their parents. TRIAL REGISTRATION ClinicalTrials.gov NCT03220308 . Retrospectively registered 18 July 2017.
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Affiliation(s)
- Nienke M. Siebelink
- 0000 0004 0444 9382grid.10417.33Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands ,Karakter Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, Nijmegen, 6525 GC The Netherlands
| | - Susan M. Bögels
- 0000000084992262grid.7177.6Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Lisanne M. Boerboom
- Karakter Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, Nijmegen, 6525 GC The Netherlands
| | - Noor de Waal
- Karakter Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, Nijmegen, 6525 GC The Netherlands
| | - Jan K. Buitelaar
- 0000 0004 0444 9382grid.10417.33Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands ,Karakter Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, Nijmegen, 6525 GC The Netherlands
| | - Anne E. Speckens
- 0000 0004 0444 9382grid.10417.33Department of Psychiatry, Radboudumc Centre for Mindfulness, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Corina U. Greven
- 0000 0004 0444 9382grid.10417.33Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands ,Karakter Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, Nijmegen, 6525 GC The Netherlands ,0000 0001 2322 6764grid.13097.3cKing’s College London, Social, Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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