The Broad Autism Phenotype Questionnaire (BAPQ): Strengths, weaknesses and future improvements in Chinese version

Psychometric Properties of the MOVES Scale for Tourette Syndrome and Comorbidities in a Chinese Cultural Context

The Motor tic, Obsessions and Compulsions, Vocal tic Evaluation Survey (MOVES) is a widely used screening tool for Tourette syndrome (TS) and associated comorbidities. This study evaluated its applicability for children in China using 7,125 participants from the National Center for Children's Health (Beijing). Psychometric evaluations included exploratory and confirmatory factor analysis, yielding a 16-item, four-factor model that explained 55.11% of the variance and demonstrated good internal consistency (Cronbach's alpha = 0.88) and test-retest reliability (ICC = 0.86). The scale showed strong convergent, discriminant, and criterion-related validity and was significantly correlated with other established TS scales. The results affirm the reliability and validity of the MOVES for screening TS in Asian contexts, addressing a crucial gap in the region's TS assessment tools.

Inhibiting proBDNF to mature BDNF conversion leads to ASD-like phenotypes in vivo

Autism Spectrum Disorders (ASD) comprise a range of early age-onset neurodevelopment disorders with genetic heterogeneity. Most ASD related genes are involved in synaptic function, which is regulated by mature brain-derived neurotrophic factor (mBDNF) and its precursor proBDNF in a diametrically opposite manner: proBDNF inhibits while mBDNF potentiates synapses. Here we generated a knock-in mouse line (BDNFmet/leu) in which the conversion of proBDNF to mBDNF is attenuated. Biochemical experiments revealed residual mBDNF but excessive proBDNF in the brain. Similar to other ASD mouse models, the BDNFmet/leu mice showed reduced dendritic arborization, altered spines, and impaired synaptic transmission and plasticity in the hippocampus. They also exhibited ASD-like phenotypes, including stereotypical behaviors and deficits in social interaction. Moreover, the plasma proBDNF/mBDNF ratio was significantly increased in ASD patients compared to normal children in a case-control study. Thus, deficits in proBDNF to mBDNF conversion in the brain may contribute to ASD-like behaviors, and plasma proBDNF/mBDNF ratio may be a potential biomarker for ASD.

The Broad Autism Phenotype-International Test (BAP-IT): A two-domain-based test for the assessment of the broad autism phenotype

LAY ABSTRACT

The broad autism phenotype refers to a group of behaviors related to autism spectrum disorder, but that appear to a lesser extent. Its assessment has been performed through outdated broad autism phenotype/autism spectrum disorder definitions and tests. To address this problem, this study presents the development of a new test, the Broad Autism Phenotype-International Test, a 20-item measure consisting of two dimensions, SOCIAL-BAP and RIRE-BAP, targeting the two-domain operationalization of autism spectrum disorder in Spain and the United Kingdom. Unlike the Broad Autism Phenotype Questionnaire, this test received empirical support as a quick and effective broad autism phenotype measure that can facilitate both broad autism phenotype/autism spectrum disorder research and interventions. This is the first step to studying the BAP in several Spanish and English-speaking countries.

The economic burden of autism spectrum disorder with and without intellectual disability in China: A nationwide cost-of-illness study

OBJECTIVE

The economic burden of autism spectrum disorder (ASD) on individuals, their families and society as a whole is poorly understood. Accurate figures are crucial for economic estimates and service planning.

METHODS

The total lifetime individual costs and annual societal costs of ASD in China were estimated with a prevalence-based, gross cost of illness approach and data from multiple sources. The direct medical costs in outpatient and inpatient settings from the electronic health records (EHRs) of hospitals, and direct nonmedical costs from a national survey were included. The indirect costs were from both the national survey and the estimation using human capital methods. Age-specific lifetime incremental societal costs were measured. Comorbidity-related and unrelated costs were analyzed separately.

RESULTS

The discounted lifetime cost for an individual with ASD in China was $2.65 million (at 2020 prices, $) for those without intellectual disability (ID) and $4.61 million (at 2020 prices, $) for those with ID. The total cost of ASD amounted to $41.8 billion in 2020. Productivity loss were major cost drivers for ASD individuals without ID. Direct nonmedical costs (rehabilitation or adult care costs etc.) were major drivers for ASD individuals with ID. In a lifetime course, the total annual costs for middle aged and elderly (>42 years) were highest, followed by transitional adults (18-29 years) and preschoolers, both for individuals with or without ID. The distribution of costs over the lifespan varied by the cost category.

CONCLUSIONS

ASD imposes a substantial economic burden on families and health care systems. Sectors and services coordination should be given policy considerations.

The Chinese "Reading the Mind in the Eyes" Test: A study with normal adults, and adults with Asperger syndrome/high-functioning autism

We developed a 28-item Chinese Eyes Test and tested its psychometric properties with a mixed sample of high-functioning adults with autism or Asperger syndrome and neurotypical adults. The Chinese Eyes Test showed good convergent and divergent validity, satisfactory known-group discrimination, and acceptable internal consistency. The identified cutoff score of 18 or below (Sensitivity: 66.7%; Specificity: 84.0%) should be useful for identifying clinically significant levels of social cognitive deficits, in terms of difficulty with the perceptual understanding of others' mental states, in high-functioning adults with autism or Asperger syndrome.

Validation of the developmental, dimensional and diagnostic interview -short version (3Di-sv) for diagnosis of autism spectrum disorder in Chinese children

The purpose of this study was to evaluate the psychometric features of the Chinese version of the developmental dimensional diagnostic interview-short version (3Di-sv). A total sample of 138 children including 79 children with autism spectrum disorder (ASD) and 59 typically developing children completed the 3Di-sv interview. The Chinese version of the 3Di-sv has a good internal consistency (0.94). Test-retest analysis confirmed the instrument's time stability (0.89). The instrument's concurrent validity with the Autism Behavior Checklist (ABC), the Childhood Autism Rating Scale (CARS) and clinical diagnosis was verified; the correlation between total scores was 0.72, 0.82 and 0.90, respectively. The 3Di-sv significantly distinguished between autistic children and non-autistic children in every area of autism symptoms. Optimal cutoffs were derived using receiver operating characteristics curves. Using clinical diagnosis as criterion, overall sensitivity was 98 % and specificity was 90 %. The study determined that the Chinese version of 3Di-sv can well distinguish autistic children from typically developing children.

Diagnostic efficiency and psychometric properties of CBCL DSM-oriented scales in a large sample of Chinese school-attending students aged 5-16

BACKGROUND

Children and adolescents are vulnerable to various psychiatric disorders during the critical phase of individual development. In China, the child behavior checklist (CBCL) is a widely employed psychometric questionnaire for assessing children and adolescents. However, further validation of the psychometric properties and diagnostic effectiveness of the CBCL DSM-oriented scales is necessary. These scales were developed based on DSM diagnosis and require evaluation using a substantial sample of Chinese individuals.

METHODS

This study involved the analysis of a substantial dataset consisting of 72,109 samples collected from five provinces in China. Data was gathered using the CBCL (Parent Rating Scale), and rigorous assessments of reliability and validity were conducted. The mini-international neuropsychiatric interview for children and adolescents (MINI-KID) and the diagnostic and statistical manual of mental disorders-IV (DSM-IV) interview were employed to diagnose the participants. To ensure the accuracy of the diagnoses, receiver operating characteristic curve (ROC curves) were utilized, and the Youden Index was calculated to determine the appropriate diagnostic cut-off point for each specific target diagnosis.

RESULTS

The study included a total sample of 72,109 cases, out of which 19,782 cases underwent MINI-KID assessment and structured or semi-structured interviews based on DSM-IV to clarify the diagnosis. Reliability and validity analyses showed that the reliability of the subscales and total scales was good, except for Anxiety Problems. The Cronbach's alpha for the CBCL DSM-oriented scales was 0.92. In addition, the validity of all scales was good (CFI = 0.80). For the sample with a clear diagnosis, all five subscales of the CBCL DSM-oriented scales showed fair diagnostic efficiency for the target diagnosis. Among them, the area under curves (AUC) of Mood disorder, Anxiety, Attention deficit and hyperactivity disorder (ADHD), Oppositional defiant disorder (ODD) and Conduct disorder (CD) are 0.80, 0.74, 0.75, 0.74, 0.74. Among the three sample groups, the highest diagnostic efficiency was found in Affective Problems to Mania. The diagnostic cut-off point for each subscale on target diagnoses was clearly defined.

CONCLUSION

Overall, the reliability, validity and diagnostic efficiency of CBCL DSM-oriented scales in Chinese children and adolescents were within acceptable limits. In addition, we used ROC curves and cut-off points to predict the cut-off values of common child and adolescent psychiatric disorders mentioned in the CBCL DSM-oriented scales. This provides an important reference for the clinical application of the CBCL DSM-oriented scales in Chinese samples.

Reliability and validity of the Chinese version of the Comprehensive Autistic Trait Inventory-short form (CATI-SF-C) in the general population

The current study aims to provide psychometric analyses of a shortened version of the Comprehensive Autistic Trait Inventory (CATI) from three different samples administered to 4910 Chinese populations (56.864 % females, mean age 19.857 ± 4.083) aged 14-56. The factor structure of CATI in Chinese was examined by confirmatory factor analysis and exploratory structural equation modeling, and a 24-item Chinese version short form of CATI (CATI-SF-C) was developed. The validity (structure validity, convergent validity, and discriminant validity) and reliability (internal consistency and test-retest reliability) were evaluated, and the predictive ability for classifying autism was examined (Youden's Index = 0.690). According to these findings, the CATI-SF-C is a reliable and valid autistic traits assessment tool for the general population.

Applying a Rasch model to the Broad Autism Phenotype Questionnaire: item severity analysis and differential test functioning of the English and Spanish versions

The broad autism phenotype (BAP) represents the elevated but nonclinical levels of autism-related expressions expanding them beyond the disorder threshold towards the general population and it is assessed worldwide using the Broad Autism Phenotype Questionnaire. In this study, we applied a Rasch item response approach to the Spanish and the English BAPQ versions. This approach allows us to test the proper functioning of each version, estimate which BAP behaviours are more likeable at different levels of severity, and study whether BAPQ item’s severities and orders could be considered equivalent between both versions. A Spanish community sample of 970 participants and an English of 533 ones completed either the Spanish or the English version of the BAPQ. The results revealed a lack of unidimensionality of the Pragmatic Language subscale in both tests and the Rigid subscale in the English version. Both Aloof subscale versions and the Spanish Rigid demonstrated adequate properties but with several items showing differential functioning in the case of Aloof. We conclude by highlighting the necessity of BAP measurements paralleling the current autism spectrum disorder structure, following the severity-dimensional conceptualization (behaviours are continuously distributed according to their severity), and suitable for being adapted to different languages.