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Davis TE, Brennan J. Specific Phobia, Fear, and the Autism Spectrum in Children and Adolescents: Adapting OST for ASD. Clin Child Fam Psychol Rev 2024; 27:509-522. [PMID: 38632150 DOI: 10.1007/s10567-024-00475-6] [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] [Accepted: 03/08/2024] [Indexed: 04/19/2024]
Abstract
Fears and phobias are a common mental health concern for youth, and particularly for autistic youth. The following review briefly summarizes the extant literature on specific phobias and specific phobias in autistic youth. The evidence base is briefly highlighted pointing to the strong base behind behavioral and cognitive-behavioral treatments and techniques. A broad discussion of key evidence-based treatment findings is presented, leading up to the impactful work of Thomas H. Ollendick in researching Öst's One-Session Treatment (OST) with children and adolescents. OST for child specific phobias is discussed, and particular emphasis is given to this treatment's ongoing adaptation for use with youth on the autism spectrum.
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Affiliation(s)
- Thompson E Davis
- Department of Psychology, The University of Alabama, 348 Gordon Palmer Hall, Box 870348, Tuscaloosa, AL, 35487, USA.
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA.
| | - Justine Brennan
- Department of Psychology, The University of Alabama, 348 Gordon Palmer Hall, Box 870348, Tuscaloosa, AL, 35487, USA
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2
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A Hosny S, M Abdelmenem A, Azouz T, S Kamar S, M ShamsEldeen A, A El-Shafei A. Beneficial Effect of Erythropoietin on Ameliorating Propionic Acid-Induced Autistic-Like Features in Young Rats. Acta Histochem Cytochem 2023; 56:77-86. [PMID: 37970239 PMCID: PMC10644041 DOI: 10.1267/ahc.23-00027] [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: 05/01/2023] [Accepted: 08/22/2023] [Indexed: 11/17/2023] Open
Abstract
Autism is a neurodevelopmental disorder that impairs communication and social interaction. This study investigated the possible beneficial effects of erythropoietin (EPO) on experimental autistic-like behaviors induced by propionic acid (PPA). Twenty-four rats were distributed into three groups: (i) control; (ii) PPA_Gp: daily injected subcutaneously with PPA for five consecutive days; PPA+EPO-Gp: injected with PPA, then received intraperitoneal injection of EPO once daily for two weeks. Behavioral changes in the rats were assessed. Specimens from the cerebellar hemispheres were subjected to histological and ultrastructure examination, immunohistochemistry for glial fibrillary acidic protein (GFAP) and calbindin-D28K, and biochemical analysis for glutathione peroxidase (GSH-Px), malondialdehyde (MDA), gamma amino-butyric acid (GABA), and serotonin. PPA-Gp showed significant behavioral impairment, with a significant depletion in GSH-px, GABA, and serotonin and a significant increase in MDA. Histological examination revealed reduced Purkinje cell count with ultrastructural degeneration, irregularly arranged nerve fibers in the molecular layer, astrogliosis, and significantly decreased calbindin-immunostaining compared to the control. EPO protected cerebellar structure, increased Purkinje cell count, improved neuronal morphology, reduced PPA-induced autistic-like features, alleviated neuronal oxidative stress, increased intercellular antioxidant levels, and suppressed inflammation. EPO provided significant protection against PPA-induced autistic features in rats, with structural preservation of Purkinje cells.
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Affiliation(s)
- Sara A Hosny
- Histology Department, Faculty of Medicine, Cairo University, Manial, Cairo, Egypt
| | | | - Taha Azouz
- Medical Biochemistry Department, Faculty of Medicine, Cairo University, Manial, Cairo, Egypt
| | - Samaa S Kamar
- Histology Department, Faculty of Medicine, Cairo University, Manial, Cairo, Egypt
| | - Asmaa M ShamsEldeen
- Physiology Department, Faculty of Medicine, Cairo University, Manial, Cairo, Egypt
| | - Asmaa A El-Shafei
- Histology Department, Faculty of Medicine, Cairo University, Manial, Cairo, Egypt
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3
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Ludlow AK, Osborne C, Keville S. Selective Mutism in Children With and Without an Autism Spectrum Disorder: The Role of Sensory Avoidance in Mediating Symptoms of Social Anxiety. J Autism Dev Disord 2023; 53:3891-3900. [PMID: 35904647 DOI: 10.1007/s10803-022-05674-0] [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] [Accepted: 07/03/2022] [Indexed: 10/16/2022]
Abstract
The present study addressed the different contributors to social anxiety in children with Selective Mutism (SM), with and without co-occurring Autism Spectrum Disorder (ASD) (SM + ASD). Seventy-five parents completed an online composite questionnaire consisting of the symptoms of SM and ASD, anxiety and sensory measures. The results found the SM + ASD group showed significantly higher levels of social anxiety and sensory avoidance compared to the SM only group. However, a simple mediation model revealed sensory avoidance to be a mediator of this relationship between the diagnosis and social anxiety.. Therefore, higher levels of sensory avoidance may help to differentiate social anxiety between the groups and may also be a sign of ASD in children with SM who have and/or are yet to receive an ASD diagnosis.
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Affiliation(s)
- Amanda K Ludlow
- School of Psychology, Geography and Sports Sciences, University of Hertfordshire, College Lane, AL10 9AB, Hatfield, UK.
| | - Clarissa Osborne
- School of Psychology, Geography and Sports Sciences, University of Hertfordshire, College Lane, AL10 9AB, Hatfield, UK
| | - Saskia Keville
- School of Psychology, Geography and Sports Sciences, University of Hertfordshire, College Lane, AL10 9AB, Hatfield, UK
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Mylett ML, Boucher TQ, Scheerer NE, Iarocci G. Examining the Relations Between Social Competence, Autistic Traits, Anxiety and Depression in Autistic and Non-Autistic Children. J Autism Dev Disord 2023:10.1007/s10803-023-06012-8. [PMID: 37341858 DOI: 10.1007/s10803-023-06012-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/22/2023]
Abstract
The current study examined whether social competence and autistic traits are related to anxiety and depression in autistic and non-autistic children. Parents of 340 children aged 6 to 12 years old, including 186 autistic and 154 non-autistic children completed the Autism Spectrum Quotient (AQ) to assess their child's autistic traits, the Multidimensional Social Competence Scale (MSCS) to assess their child's social competence, and the Behaviour Assessment Scale for Children 2 (BASC-2) to assess their child's internalizing symptoms of depression and anxiety, and children were administered the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II) to assess their intellectual abilities. Hierarchical multiple regression analyses were conducted to investigate the relations between social competence, autistic traits, anxiety, and depression. Social competence was related to anxiety and depression symptoms in autistic children, but only depression symptoms in non-autistic children, above and beyond the effects of autistic traits, IQ and age. Autistic children were also reported to experience more severe anxiety and depression symptoms, and more autistic traits were related to higher levels of anxiety and depression in both groups. These findings suggest that social competence and internalizing symptoms are intricately connected in autistic children and need to be jointly considered in both assessment and intervention. The social implications are discussed with an emphasis on acceptance of diverse social styles as a viable avenue to reduce children's internalizing symptoms.
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Affiliation(s)
- Marisa L Mylett
- Department of Psychology, Simon Fraser University, RCB 5213, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Troy Q Boucher
- Department of Psychology, Simon Fraser University, RCB 5213, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Nichole E Scheerer
- Psychology Department, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON, N2L3C5, Canada
| | - Grace Iarocci
- Department of Psychology, Simon Fraser University, RCB 5213, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
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Hussein AM, Mahmoud SA, Elazab KM, Abouelnaga AF, Abass M, Mosa AAH, Hussein MAM, Elsayed MEG. Possible Mechanisms of the Neuroprotective Actions of Date Palm Fruits Aqueous Extracts against Valproic Acid-Induced Autism in Rats. Curr Issues Mol Biol 2023; 45:1627-1643. [PMID: 36826050 PMCID: PMC9954972 DOI: 10.3390/cimb45020105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/16/2023] Open
Abstract
The current study aimed to determine how palm date aqueous fruit extracts (AFE) affected the autistic-like behaviors brought on by valproic acid (VPA) injection, as well as any potential contributions from Sirt-1, oxidative stress, apoptosis, and autophagy. The pregnant Sprague Dawley females were treated with VPA at 12.5th gestation day and pregnant females and their offspring were treated with AFE orally at doses of 4 mg/Kg by gastric gavage for 45 days after birth. The elevated plus-T maze, water maze, and rotarod tests were used to examine autism-like behaviors. At the end of the study, the expression of Nrf2, heme oxygenase (HO-1), Sirt-1, caspase-3 (a marker of apoptosis), LC3 (a marker of autophagy), and NFκB (inflammatory cytokines) were evaluated along with the oxidative stress in brain tissues and the histological changes in the cerebellum and hippocampus. The neurobehavioral assessments significantly declined due to VPA, which also significantly increased oxidative stress in the brain tissues and significantly decreased Nrf2 and HO-1 expression. Additionally, VPA administration caused significant increase in the expression of caspase-3 in the cerebellar cortex, not in the hippocampus; LC3 and NFκB in the hippocampus, not in the cerebellar cortex; and significant reduction in the expression of Sirt-1 in the hippocampus, not in the cerebellum. On the other hand, AFE treatment significantly improved the neurobehavioral changes as well as it improved significantly the oxidative stress and the expression of LC3, NFκB, NrF2, HO-1, and Sirt-1 in the cerebellum and hippocampus. Conclusions: AFE administration might improve the autistic-like symptoms induced by VPA in rats via attenuation of the oxidative stress, upregulation of Nrf2 and HO-1, Sirt-1 and LC3 expression with downregulation of caspase-3, and NFκB expression in the cerebellum and hippocampus.
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Affiliation(s)
- Abdelaziz M. Hussein
- Department of Medical Physiology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
- Correspondence: ; Tel.: +20-10-02421140; Fax: +20-5-02263717
| | | | | | - Ahmed F. Abouelnaga
- Department of Animal Husbandry and Development of Animal Wealth, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Marwa Abass
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Ahmed A. H. Mosa
- Department of Neurology, Faculty of Medicine, Delta University for Science and Technology, Gamasa 11152, Egypt
| | | | - Mohamed E. G. Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, 89075 Ulm, Germany
- Department of Psychiatry, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany
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Dysregulation in Children and Adolescents Presenting to a Multidisciplinary Autism Clinic. J Autism Dev Disord 2021; 52:1762-1770. [PMID: 34009549 DOI: 10.1007/s10803-021-05056-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
Research indicates that children with autism spectrum disorder (ASD) frequently exhibit dysregulation, which refers to poorly coordinated affective, behavioral, and cognitive responses to a given situation. We examined the characteristics of dysregulation in children presenting to a multidisciplinary ASD clinic for an ASD diagnostic evaluation. Sixty percent of children presenting for an ASD evaluation exhibited dysregulation. Dysregulation prevalence was higher in children without ASD versus with ASD (69% versus 56%). Severe dysregulation was higher in children without ASD (29% versus 16%). Both groups with severe dysregulation were equally likely to be taking psychiatric medications, however, children with ASD were less likely to be receiving therapy. These findings highlight the importance of implementing dysregulation screening and treatment protocols in ASD centers.
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Diefenbach GJ, Stevens KT, Dunlap A, Nicholson AM, Grella ON, Pearlson G, Assaf M. Autistic Traits Moderate Reappraisal Success for Depression and Anxiety Symptoms. J Autism Dev Disord 2021; 52:1435-1443. [PMID: 33929680 DOI: 10.1007/s10803-021-05003-x] [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] [Accepted: 04/01/2021] [Indexed: 04/12/2023]
Abstract
Cognitive reappraisal is associated with reduced emotional distress; however, little is known about the nature of this relationship in autism. This study tested whether autistic traits moderate reappraisal success (i.e., the negative correlation between reappraisal use and emotional symptom severity). Emotional symptoms were assessed using measures of depression, anxiety, and stress. It was hypothesized that more severe autistic traits would be associated with weaker reappraisal success across all scales. Data were collected from 377 adults using an on-line survey. Structural equation models found moderation effects for depression and anxiety, but not stress. Contrary to hypotheses, more severe autistic traits were associated with stronger reappraisal success. These preliminary results support including reappraisal in emotion regulation treatments for individuals with autistic traits.
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Affiliation(s)
- Gretchen J Diefenbach
- Anxiety Disorders Center, The Institute of Living, 200 Retreat Avenue, Hartford, CT, 06106, USA. .,Yale University School of Medicine, New Haven, CT, USA.
| | - Kimberly T Stevens
- Anxiety Disorders Center, The Institute of Living, 200 Retreat Avenue, Hartford, CT, 06106, USA
| | - Amanda Dunlap
- Olin Neuropsychiatry Research Center, The Institute of Living, 200 Retreat Avenue, Hartford, CT, 06106, USA
| | - Alycia M Nicholson
- Olin Neuropsychiatry Research Center, The Institute of Living, 200 Retreat Avenue, Hartford, CT, 06106, USA
| | - Olivia N Grella
- Olin Neuropsychiatry Research Center, The Institute of Living, 200 Retreat Avenue, Hartford, CT, 06106, USA
| | - Godfrey Pearlson
- Yale University School of Medicine, New Haven, CT, USA.,Olin Neuropsychiatry Research Center, The Institute of Living, 200 Retreat Avenue, Hartford, CT, 06106, USA
| | - Michal Assaf
- Yale University School of Medicine, New Haven, CT, USA.,Olin Neuropsychiatry Research Center, The Institute of Living, 200 Retreat Avenue, Hartford, CT, 06106, USA
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Abstract
This study examined age trends in anxious and depressive symptoms, from older adolescence to old age, and explored the association between anxious and depressive symptoms with gender, ASD severity, and socio-economic factors. Two hundred and fifty-five individuals with ASD (151 males, Mage = 33.52 years, SDage = 14.98) took part. More than one-third of participants reported clinically significant anxiety (38.4%) or depression (38%). A slight trend for an increase in the severity of both anxiety and depression from adolescence to middle adulthood, and then a slight decline in older adulthood was found. Female gender and higher ASD severity predicted more anxiety and depression symptoms. Our findings emphasise the need to provide timely assessment and treatment of anxiety and depression in ASD.
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Toscano R, Baillie AJ, Lyneham HJ, Kelly A, Kidd T, Hudson JL. Assessment of anxiety in children and adolescents: A comparative study on the validity and reliability of the Spence Children's Anxiety Scale in children and adolescents with anxiety and Autism Spectrum Disorder. J Affect Disord 2020; 260:569-576. [PMID: 31539694 DOI: 10.1016/j.jad.2019.09.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/18/2019] [Accepted: 09/08/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The present study assessed the utility of the Spence Children's Anxiety Scale - Parent Form (SCAS-P) across parents of children with (i) anxiety and (ii) Autism Spectrum Disorder (ASD). METHOD Parents of children aged 7-18 years with anxiety or ASD completed the SCAS-P. Multiple indicator multiple cause (MIMIC) structural equation modelling was utilized to analyse the data. RESULTS Analysis revealed different factor structures between the Anxious and ASD groups and evidence for measurement variance across groups in some parts of the SCAS-P. CONCLUSION Results on the SCAS-P in children with ASD need to be interpreted with caution. Some SCAS-P items cannot be interpreted in the same way in an ASD population compared to neurotypical children with anxiety.
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Affiliation(s)
- Ramona Toscano
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109 Australia
| | - Andrew J Baillie
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109 Australia
| | - Heidi J Lyneham
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109 Australia
| | - Anna Kelly
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109 Australia
| | - Theresa Kidd
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109 Australia
| | - Jennifer L Hudson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, 2109 Australia.
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Wilson AC, King J, Bishop DVM. Autism and social anxiety in children with sex chromosome trisomies: an observational study. Wellcome Open Res 2019; 4:32. [PMID: 31231689 PMCID: PMC6567293 DOI: 10.12688/wellcomeopenres.15095.2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Recent studies suggest that an extra sex chromosome increases the risk of both autism and social anxiety, but it unclear whether these risks are specific to particular karyotypes. Methods: We considered diagnostic data from an online psychiatric assessment (DAWBA – The Development and Well-Being Assessment) and questionnaire responses completed by parents of children with 47,XXX (N = 29), 47,XXY (N = 28) and 47,XYY (N = 32) karyotypes. Analysis focused mainly on 54 children who were diagnosed prenatally or on the basis of other medical concerns in childhood (Low Bias subgroup), to minimise ascertainment bias. Results: Children with symptoms of autism who fell short of meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria were coded as cases of Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS). The odds ratio of autism or PDDNOS in the Low Bias group was computed relative to gender-specific population norms. This gave log odds ratio (95% confidence interval) of 5.56 (4.25 - 6.88) for XXX girls; 4.00 (2.66 - 5.33) for XXY boys; and 4.60 (3.46 - 5.74) for XYY boys. Despite this elevated risk, most children had no autistic features. A diagnosis of DSM-IV Social Phobia was rare, though, in line with prediction, all three Low Bias cases with this diagnosis had 47,XXY karyotype. All three trisomy groups showed increased risk of milder symptoms of social anxiety. Conclusions: An increased risk of autism was found in girls with 47,XXX karyotype, as well as in boys with 47,XXY or 47,XYY. Symptoms of social anxiety were increased in all three karyotypes. There was wide variation in psychiatric status of children with the same karyotype, suggesting that an extra sex chromosome affects developmental stability in a non-specific way, with a diverse range of possible phenotypes.
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Affiliation(s)
- Alexander C Wilson
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK
| | - Judith King
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Dorothy V M Bishop
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK
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Sleep problems and anxiety from 2 to 8 years and the influence of autistic traits: a longitudinal study. Eur Child Adolesc Psychiatry 2019; 28:1117-1127. [PMID: 30659385 DOI: 10.1007/s00787-019-01275-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 01/03/2019] [Indexed: 12/28/2022]
Abstract
Whether or not childhood sleep problems and anxiety occur simultaneously, or one precedes the other, and any effect of autistic traits on this relationship remains unclear. We investigated longitudinal associations between sleep and anxiety at 2 years and sleep and anxiety at 8 years controlling for demographic variables. We also examined the additional influence of autistic traits at 2 years on sleep problems and anxiety at 8 years. Participants were from the Western Australian Pregnancy Cohort (Raine) Study, where 2900 pregnant women were recruited between 1989 and 1991 and their children assessed every 2-3 years thereafter. Demographic information was provided at 16-18 weeks gestation. Children's sleep and anxiety at 2 and 8 years and autistic traits at 2 years were measured using the Child Behavior Checklist. Hierarchical multiple regression models tested the prediction of both anxiety and sleep problems at 8 years. Sleep problems at 2 years and 8 years, anxiety at 2 years, and autistic traits at 2 years were significantly associated with anxiety at 8 years. Sleep problems at 2 years and anxiety at 8 years were significantly related to sleep problems at 8 years. Each of these models explained about 20% of variance. Childhood sleep problems, anxiety and autistic traits are interrelated and can occur concurrently in young children, but the best predictor of poor sleep in middle childhood is concurrent anxiety and vice versa. Anxiety and sleep problems may be an early indicator of autism in young children and early autistic traits may also contribute to anxiety problems later in childhood.
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12
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Yang C, Han P, Ruan F, Zhou T, Luo B, Qiu Y, Lin Y, Lin Z, He C. Lactational exposure to environmentally relevant benzo(a)pyrene causes astrocytic activation and anxiety-like behavior in male mice. CHEMOSPHERE 2019; 221:67-74. [PMID: 30634150 DOI: 10.1016/j.chemosphere.2019.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 01/01/2019] [Accepted: 01/02/2019] [Indexed: 06/09/2023]
Abstract
Previous studies have shown the adversely neurodevelopmental effects of exposure to benzo(a)pyrene (BaP) at early life stage. However, it is unclear the effects of lactational exposure to environmentally relevant BaP on anxiety-like behavior and the molecular mechanisms related. In this study, lactational exposure to 1 and 10 μg/kg bw BaP from postnatal day 3-21 caused anxiety-like behavior and alterations of the expressions of the neurodevelopment and anxiety-related genes in adolescence male mice using O cycle maze. Moreover, BaP exposure increased the expression level of glial fibrillary acidic protein, a typical marker of astrocytes, in hippocampus of male offspring. The release of pro-inflammatory cytokines interleukin 6 and tumor necrosis factor α was also elevated in BaP-treated offspring. Further, lactational exposure to BaP decreased the level of glutathione and the expressions of antioxidant genes (Thioredoxin 1 and Glutaredoxin 2) in male offspring. Our study demonstrated that environmentally relevant BaP lactational exposure caused anxiety-like behavior in male offspring involved in astrocytic activation, neuroinflammation, and antioxidant capability dysfunction.
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Affiliation(s)
- Chuanli Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, State Key Laboratory of Cellular Stress Biology, Xiamen University, Xiamen, Fujian, 361102, China
| | - Peiyu Han
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, State Key Laboratory of Cellular Stress Biology, Xiamen University, Xiamen, Fujian, 361102, China
| | - Fengkai Ruan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, State Key Laboratory of Cellular Stress Biology, Xiamen University, Xiamen, Fujian, 361102, China
| | - Tengjian Zhou
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, State Key Laboratory of Cellular Stress Biology, Xiamen University, Xiamen, Fujian, 361102, China
| | - Bing Luo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, State Key Laboratory of Cellular Stress Biology, Xiamen University, Xiamen, Fujian, 361102, China
| | - Yang Qiu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, State Key Laboratory of Cellular Stress Biology, Xiamen University, Xiamen, Fujian, 361102, China
| | - Yuchun Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, State Key Laboratory of Cellular Stress Biology, Xiamen University, Xiamen, Fujian, 361102, China
| | - Zhongning Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, State Key Laboratory of Cellular Stress Biology, Xiamen University, Xiamen, Fujian, 361102, China.
| | - Chengyong He
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, State Key Laboratory of Cellular Stress Biology, Xiamen University, Xiamen, Fujian, 361102, China.
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13
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Wilson AC, King J, Bishop DV. Autism and social anxiety in children with sex chromosome trisomies: an observational study. Wellcome Open Res 2019; 4:32. [DOI: 10.12688/wellcomeopenres.15095.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Recent studies suggest that an extra sex chromosome increases the risk of both autism and social anxiety, but it unclear whether these risks are specific to particular karyotypes. Methods: We considered diagnostic data from an online psychiatric assessment (DAWBA – The Development and Well-Being Assessment) and questionnaire responses completed by parents of children with 47,XXX (N = 29), 47,XXY (N = 28) and 47,XYY (N = 32) karyotypes. Analysis focused mainly on 54 children who were diagnosed prenatally or on the basis of other medical concerns in childhood (Low Bias subgroup), to minimise ascertainment bias. Results: Children with symptoms of autism who fell short of meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria were coded as cases of Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS). The odds ratio of autism or PDDNOS in the Low Bias group was computed relative to gender-specific population norms. This gave log odds ratio (95% confidence interval) of 5.56 (4.25 - 6.88) for XXX girls; 4.00 (2.66 - 5.33) for XXY boys; and 4.60 (3.46 - 5.74) for XYY boys. Despite this elevated risk, most children had no autistic features. A diagnosis of DSM-IV Social Phobia was rare, though, in line with prediction, all three Low Bias cases with this diagnosis had 47,XXY karyotype. All three trisomy groups showed increased risk of milder symptoms of social anxiety. Conclusions: An increased risk of autism was found in girls with 47,XXX karyotype, as well as in boys with 47,XXY or 47,XYY. Symptoms of social anxiety were increased in all three karyotypes. There was wide variation in psychiatric status of children with the same karyotype, suggesting that an extra sex chromosome affects developmental stability in a non-specific way, with a diverse range of possible phenotypes.
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14
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McVey AJ, Schiltz HK, Haendel AD, Dolan BK, Willar KS, Pleiss SS, Karst JS, Carlson M, Krueger W, Murphy CC, Casnar CL, Yund B, Van Hecke AV. Social difficulties in youth with autism with and without anxiety and ADHD symptoms. Autism Res 2018; 11:1679-1689. [PMID: 30475451 PMCID: PMC6311999 DOI: 10.1002/aur.2039] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 08/31/2018] [Accepted: 10/02/2018] [Indexed: 12/28/2022]
Abstract
Social difficulties inherent to autism spectrum disorder are often linked with co-occurring symptoms of anxiety and attention deficit hyperactivity disorder (ADHD). The present study sought to examine the relation between such co-occurring symptoms and social challenges. Parents of adolescents with autism (N = 113) reported upon social challenges via the social responsiveness scale (SRS) and anxiety and ADHD symptomatology via the Child Behavior Checklist. Results revealed differences in SRS scores across co-occurring symptom subgroups (Anxiety, ADHD, Both, Neither)-namely, adolescents with autism and anxiety as well as those with autism, anxiety, and ADHD showed greater scores on the SRS than the other groups. Implications for research and clinical practice are discussed and recommendations are offered. Autism Research 2018, 11: 1679-1689. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Anxiety and attention deficit hyperactivity disorder (ADHD) symptoms are related to greater social challenges for adolescents with autism spectrum disorder. The present study found that autism with anxiety and autism with anxiety and ADHD, was related to greater social difficulties than autism alone. Findings provide further support for the intertwined nature of anxiety and ADHD symptoms in autism. What this may mean for research and clinical practice is considered and recommendations are suggested.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Christina L Casnar
- Alpert Medical School of Brown University, Clinical Psychology Training Consortium, Providence, Rhode Island
| | - Brianna Yund
- University of Wisconsin - Milwaukee, Milwaukee, Wisconsin
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15
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James AC, Reardon T, Soler A, James G, Creswell C. Cognitive behavioural therapy for anxiety disorders in children and adolescents. Hippokratia 2018. [DOI: 10.1002/14651858.cd013162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Anthony C James
- University of Oxford; Department of Psychiatry; Oxford UK OX3 7JX
- Warneford Hospital; Highfield Unit; Oxford UK
| | - Tessa Reardon
- University of Reading; School of Psychology & Clinical Language Sciences; Reading UK
| | | | | | - Cathy Creswell
- University of Reading; School of Psychology & Clinical Language Sciences; Reading UK
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16
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Capriola-Hall NN, Wieckowski AT, Ollendick TH, White SW. The Influence of Social Communication Impairments on Gaze in Adolescents with Social Anxiety Disorder. Child Psychiatry Hum Dev 2018; 49:672-679. [PMID: 29383468 PMCID: PMC6021221 DOI: 10.1007/s10578-018-0782-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Adolescents with social anxiety disorder (SAD) often present distorted beliefs related to expected social rejection, coupled with avoidance of social stimuli including interpersonal interactions and others' gaze. Social communication (SC) deficits, often seen in SAD, may play a role in avoidance of social stimuli. The present study evaluated whether SC impairment uniquely contributes to diminished or heightened attention to social stimuli. Gaze patterns to social stimuli were examined in a sample of 41 adolescents with SAD (12-16 years of age; 68% female). Unexpectedly, no significant relationship was observed between SC impairment and fixation duration to angry or neutral faces. However, SC impairment did predict greater fixation duration to happy faces, after controlling for social anxiety severity [adjusted R 2 = 0.201, F(2, 38) = 4.536, p = 0.018]. Clinical implications are discussed, focusing on the potential utility of targeting SC impairments directly in light of the role of SC difficulties in youth with SAD.
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Affiliation(s)
- Nicole N. Capriola-Hall
- Virginia Tech, Department of Psychology (0436), Blacksburg, VA 24061, Phone: (540) 231-8276; Fax: (540) 231-3652
| | - Andrea Trubanova Wieckowski
- Virginia Tech, Department of Psychology (0436), Blacksburg, VA 24061, Phone: (540) 231-8276; Fax: (540) 231-3652
| | - Thomas H. Ollendick
- Virginia Tech, Department of Psychology (0436), Blacksburg, VA 24061, Phone: (540) 231-8276; Fax: (540) 231-3652
| | - Susan W. White
- Virginia Tech, Department of Psychology (0436), Blacksburg, VA 24061, Phone: (540) 231-8276; Fax: (540) 231-3652
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17
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George R, Stokes MA. A Quantitative Analysis of Mental Health Among Sexual and Gender Minority Groups in ASD. J Autism Dev Disord 2018; 48:2052-2063. [DOI: 10.1007/s10803-018-3469-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Glod M, Creswell C, Waite P, Jamieson R, McConachie H, Don South M, Rodgers J. Comparisons of the Factor Structure and Measurement Invariance of the Spence Children's Anxiety Scale-Parent Version in Children with Autism Spectrum Disorder and Typically Developing Anxious Children. J Autism Dev Disord 2017; 47:3834-3846. [PMID: 28393292 PMCID: PMC5676838 DOI: 10.1007/s10803-017-3118-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The Spence Children's Anxiety Scale-Parent version (SCAS-P) is often used to assess anxiety in children with autism spectrum disorder (ASD), however, little is known about the validity of the tool in this population. The aim of this study was to determine whether the SCAS-P has the same factorial validity in a sample of young people with ASD (n = 285), compared to a sample of typically developing young people with anxiety disorders (n = 224). Poor model fit with all of the six hypothesised models precluded invariance testing. Exploratory factor analysis indicated that different anxiety phenomenology characterises the two samples. The findings suggest that cross-group comparisons between ASD and anxious samples based on the SCAS-P scores may not always be appropriate.
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Affiliation(s)
- Magdalena Glod
- Institute of Neuroscience, Newcastle University, Level 3, Sir James Spence Institute, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Cathy Creswell
- Anxiety and Depression in Young People (AnDY) Research Clinic, School of Psychology and Clinical Language Sciences, University of Reading, Earley Gate, Reading, RG6 6AL, UK
| | - Polly Waite
- Anxiety and Depression in Young People (AnDY) Research Clinic, School of Psychology and Clinical Language Sciences, University of Reading, Earley Gate, Reading, RG6 6AL, UK
| | - Ruth Jamieson
- School of Psychology, Newcastle University, 4th Floor, Ridley Building 1, Queen Victoria Road, Newcastle upon Tyne, NE1 7RU, UK
- Greater Glasgow and Clyde NHS, Glasgow, Scotland, UK
| | - Helen McConachie
- Institute of Health and Society, Newcastle University, Level 3, Sir James Spence Institute, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Mikle Don South
- Department of Psychology, Brigham Young University, 245 TLRB, Provo, UT, 84602, USA
| | - Jacqui Rodgers
- Institute of Neuroscience, Newcastle University, Level 3, Sir James Spence Institute, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK.
- School of Psychology, Newcastle University, 4th Floor, Ridley Building 1, Queen Victoria Road, Newcastle upon Tyne, NE1 7RU, UK.
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19
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South M, Carr AW, Stephenson KG, Maisel ME, Cox JC. Symptom overlap on the srs-2 adult self-report between adults with asd and adults with high anxiety. Autism Res 2017; 10:1215-1220. [PMID: 28266790 DOI: 10.1002/aur.1764] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 12/04/2016] [Accepted: 01/10/2017] [Indexed: 11/10/2022]
Abstract
Many people diagnosed with autism spectrum disorder (ASD) also experience significant symptoms of anxiety, while many people with anxiety disorders likewise experience social difficulties. These concerns can be difficult to tease apart in general clinical settings. The Social Responsiveness Scale (SRS) is one of the most frequently used measures of dimensional ASD symptoms. In order to investigate the overlap of autism and anxiety on the SRS, we compared three groups of adults (an ASD group, n = 40; a high anxious group, n = 56; and a typical comparison group, n = 29) using the new Adult Self Report version of the SRS-2nd Edition (SRS-2-ASR) alongside a battery of anxiety questionnaires. Based on previous research with children from the parent-report SRS (first edition), we hypothesized that the SRS-2-ASR would have difficulty discriminating between the ASD and high anxious groups. Results showed that both these clinical groups scored significantly higher on the SRS than a typical control group. Discriminant validity was poor, including sensitivity of 0.65 when including all participants and 0.48 when only the two clinical groups were included. In particular, the Social Motivation subscale of the SRS-ASR failed to distinguish between ASD and anxiety groups. As recommended in the SRS-2 manual, we highlight the need for caution when using the SRS-2-ASR to support diagnostic decision making, especially in clinical settings involving anxiety, ADHD, or other concerns that can affect reciprocal social communication and/or behavioral flexibility. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1215-1220. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Mikle South
- Department of Psychology, Brigham Young University, Provo, Utah.,Neuroscience Center, Brigham Young University, Provo, Utah
| | - AnnaLisa W Carr
- Department of Psychology, Brigham Young University, Provo, Utah
| | | | - Max E Maisel
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Jonathan C Cox
- Counseling and Psychological Services Center, Brigham Young University, Provo, Utah
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20
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Targeting Heterogeneity and Comorbidity in Children with Autism Spectrum Disorder Through the Resilience Builder Group Therapy Program. CHILD & YOUTH CARE FORUM 2017. [DOI: 10.1007/s10566-017-9394-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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21
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Abstract
Most neurodevelopmental disorders are defined by their clinical symptoms and many disorders share common features. Recently there has been an increase in the number of children diagnosed with autism spectrum disorder, although concerns have been raised about the accuracy of the reported prevalence rates. This article reviews the essential features of autism spectrum disorder and describes other conditions that may include similar symptoms that may be misdiagnosed as autism spectrum disorder (primary communication disorders, anxiety disorders, attachment disorders, intellectual disability, vision and hearing impairment, and normal variations). An approach to differential diagnosis is discussed with particular attention to evaluation of young children.
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Affiliation(s)
- Mark D Simms
- Section of Developmental Pediatrics, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA; Child Development Center, Children's Hospital of Wisconsin, PO Box 1997, Mail Station 744, Milwaukee, WI 53226, USA.
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22
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Kerns CM, Newschaffer CJ, Berkowitz SJ. Traumatic Childhood Events and Autism Spectrum Disorder. J Autism Dev Disord 2016; 45:3475-86. [PMID: 25711547 DOI: 10.1007/s10803-015-2392-y] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Traumatic childhood events are associated with a wide range of negative physical, psychological and adaptive outcomes over the life course and are one of the few identifiable causes of psychiatric illness. Children with autism spectrum disorder (ASD) may be at increased risk for both encountering traumatic events and developing traumatic sequelae; however, this topic has been understudied. This review considers the rationale for examining traumatic events and related symptomology in individuals with ASD and summarizes the limited research on this topic. A conceptual framework for understanding the interplay of ASD, trauma and traumatic sequelae is proposed and recommendations for future research presented.
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Affiliation(s)
- Connor Morrow Kerns
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA.
| | - Craig J Newschaffer
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Steven J Berkowitz
- Department of Psychiatry, University of Pennsylvania, Pennsylvania, PA, USA
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Pellecchia M, Connell JE, Kerns CM, Xie M, Marcus SC, Mandell DS. Child characteristics associated with outcome for children with autism in a school-based behavioral intervention. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 20:321-9. [PMID: 25911092 DOI: 10.1177/1362361315577518] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study examined the extent to which clinical and demographic characteristics predicted outcome for children with autism spectrum disorder. Participants included 152 students with autism spectrum disorder in 53 kindergarten-through-second-grade autism support classrooms in a large urban public school district. Associations between child characteristics (including age, language ability, autism severity, social skills, adaptive behavior, co-occurring psychological symptoms, and restrictive and repetitive behavior) and outcome, as measured by changes in cognitive ability following one academic year of an intervention standardized across the sample were evaluated using linear regression with random effects for classroom. While several scales and subscales had statistically significant bivariate associations with outcome, in adjusted analysis, only age and the presence of symptoms associated with social anxiety, such as social avoidance and social fearfulness, as measured through the Child Symptom Inventory-4, were associated with differences in outcome. The findings regarding the role of social anxiety are new and have important implications for treatment. Disentangling the construct of social anxiety to differentiate between social fearfulness and social motivation has important implications for shifting the focus of early treatment for children with autism spectrum disorder.
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James AC, James G, Cowdrey FA, Soler A, Choke A. Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev 2015; 2015:CD004690. [PMID: 25692403 PMCID: PMC6491167 DOI: 10.1002/14651858.cd004690.pub4] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND A previous Cochrane review (James 2005) showed that cognitive behavioural therapy (CBT) was effective in treating childhood anxiety disorders; however, questions remain regarding (1) the relative efficacy of CBT versus non-CBT active treatments; (2) the relative efficacy of CBT versus medication and the combination of CBT and medication versus placebo; and (3) the long-term effects of CBT. OBJECTIVES To examine (1) whether CBT is an effective treatment for childhood and adolescent anxiety disorders in comparison with (a) wait-list controls; (b) active non-CBT treatments (i.e. psychological placebo, bibliotherapy and treatment as usual (TAU)); and (c) medication and the combination of medication and CBT versus placebo; and (2) the long-term effects of CBT. SEARCH METHODS Searches for this review included the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Depression, Anxiety and Neurosis Group Register, which consists of relevant randomised controlled trials from the bibliographic databases-The Cochrane Library (1970 to July 2012), EMBASE, (1970 to July 2012) MEDLINE (1970 to July 2012) and PsycINFO (1970 to July 2012). SELECTION CRITERIA All randomised controlled trials (RCTs) of CBT versus waiting list, active control conditions, TAU or medication were reviewed. All participants must have met the criteria of the Diagnostic and Statistical Manual (DSM) or the International Classification of Diseases (ICD) for an anxiety diagnosis, excluding simple phobia, obsessive-compulsive disorder, post-traumatic stress disorder and elective mutism. DATA COLLECTION AND ANALYSIS The methodological quality of included trials was assessed by three reviewers independently. For the dichotomous outcome of remission of anxiety diagnosis, the odds ratio (OR) with 95% confidence interval (CI) based on the random-effects model, with pooling of data via the inverse variance method of weighting, was used. Significance was set at P < 0.05. Continuous data on each child's anxiety symptoms were pooled using the standardised mean difference (SMD). MAIN RESULTS Forty-one studies consisting of 1806 participants were included in the analyses. The studies involved children and adolescents with anxiety of mild to moderate severity in university and community clinics and school settings. For the primary outcome of remission of any anxiety diagnosis for CBT versus waiting list controls, intention-to-treat (ITT) analyses with 26 studies and 1350 participants showed an OR of 7.85 (95% CI 5.31 to 11.60, Z = 10.26, P < 0.0001), but with evidence of moderate heterogeneity (P = 0.04, I² = 33%). The number needed to treat (NNT) was 6.0 (95% CI 7.5 to 4.6). No difference in outcome was noted between individual, group and family/parental formats. ITT analyses revealed that CBT was no more effective than non-CBT active control treatments (six studies, 426 participants) or TAU in reducing anxiety diagnoses (two studies, 88 participants). The few controlled follow-up studies (n = 4) indicate that treatment gains in the remission of anxiety diagnosis are not statistically significant. AUTHORS' CONCLUSIONS Cognitive behavioural therapy is an effective treatment for childhood and adolescent anxiety disorders; however, the evidence suggesting that CBT is more effective than active controls or TAU or medication at follow-up, is limited and inconclusive.
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Affiliation(s)
- Anthony C James
- University of Oxford Department of Psychiatry, University of Oxford, Oxford, UK, OX3 7JX.
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25
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Cholemkery H, Mojica L, Rohrmann S, Gensthaler A, Freitag CM. Can autism spectrum disorders and social anxiety disorders be differentiated by the social responsiveness scale in children and adolescents? J Autism Dev Disord 2014; 44:1168-82. [PMID: 24682652 DOI: 10.1007/s10803-013-1979-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorder (ASD) as well as social phobia (SP), and selective mutism (SM) are characterised by impaired social interaction. We assessed the validity of the Social Responsiveness Scale (SRS) to differentiate between ASD, and SP/SM. Raw scores were compared in 6-18 year old individuals with ASD (N = 60), SP (N = 38), SM (N = 43), and typically developed (N = 42). Sensitivity and specificity were examined. The three disorders showed overlapping SRS scores. Especially in boys with SM (ROC-AUC = .81), presence of ASD was overestimated by the SRS. A combination of three disorder specific questionnaires resulted in marginally improved diagnostic accuracy. For the clinically very relevant differential diagnosis of SP/SM, SRS results must be interpreted with caution.
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Affiliation(s)
- Hannah Cholemkery
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, JW Goethe University Hospital, Deutschordenstraße 50, 60528, Frankfurt am Main, Germany,
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26
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The Relationship Between Autistic Traits and Social Anxiety, Worry, Obsessive–Compulsive, and Depressive Symptoms: Specific and Non-specific Mediators in a Student Sample. J Autism Dev Disord 2014; 45:858-72. [DOI: 10.1007/s10803-014-2238-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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27
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Luo G, Wang S, Li Z, Wei R, Zhang L, Liu H, Wang C, Niu R, Wang J. Maternal bisphenol a diet induces anxiety-like behavior in female juvenile with neuroimmune activation. Toxicol Sci 2014; 140:364-73. [PMID: 24824810 DOI: 10.1093/toxsci/kfu085] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Maternal Bisphenol A (BPA) diet triggers anxiety in rodents, but the underlying mechanism is still unclear. Accumulating epidemiological and experimental data have demonstrated that the anxiety is associated with aberrant neuroimmune response. In this study, we found that maternal BPA diet (MBD) exacerbated anxiety-like behavior in female juvenile mice, and the molecular evidence further showed that this behavioral phenotype was connected to the neuroimmune activation, such as elevated tumor necrosis factor alpha (TNF-α) and interleukin (IL)-6 levels in prefrontal cortex (PFC) rather than in peripheral blood, which indicated that neuroimmune response might be ascribed to neuroglial activation because activated neuroglia cells could secrete proinflammatory cytokines. Subsequently, we found that ionized calcium-binding adapter molecule (Iba)-1 as a selective marker for microglia and glial fibrillary acidic protein as a specific marker for astrocyte were significantly increased at transcriptional and translational levels, which confirmed the neuroglial activation in this model. Therefore, we conclude that MBD induces excessive anxiety-like behavior in female juvenile with elevated TNF-α and IL-6 levels, as well as activated microglia and astrocyte in PFC. Herein caution must be taken to prevent potential risks from MBD becuase exacerbated anxiety-like behavior in female juvenile by MBD may be a critical contribution for subsequent growth or mental disorders.
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Affiliation(s)
- Guangying Luo
- Shanxi Key Laboratory of Environmental Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi 030801, PR China
| | - Shaolin Wang
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia 22911
| | - Zhigang Li
- Shanxi Key Laboratory of Environmental Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi 030801, PR China Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing 100101, China
| | - Ruifen Wei
- Shanxi Key Laboratory of Environmental Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi 030801, PR China
| | - Lianjie Zhang
- Shanxi Key Laboratory of Environmental Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi 030801, PR China
| | - Huanhuan Liu
- Shanxi Key Laboratory of Environmental Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi 030801, PR China
| | - Chong Wang
- Shanxi Key Laboratory of Environmental Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi 030801, PR China
| | - Ruiyan Niu
- Shanxi Key Laboratory of Environmental Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi 030801, PR China
| | - Jundong Wang
- Shanxi Key Laboratory of Environmental Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi 030801, PR China
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28
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White SW, Schry AR, Kreiser NL. Social Worries and Difficulties: Autism and/or Social Anxiety Disorder? HANDBOOK OF AUTISM AND ANXIETY 2014. [DOI: 10.1007/978-3-319-06796-4_9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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29
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Conner CM, Maddox BB, White SW. Parents' state and trait anxiety: relationships with anxiety severity and treatment response in adolescents with autism spectrum disorders. J Autism Dev Disord 2013; 43:1811-8. [PMID: 23224592 PMCID: PMC11097144 DOI: 10.1007/s10803-012-1728-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Comorbid anxiety is common among children with Autism Spectrum Disorder (ASD), and parents of children with ASD are more likely to have anxiety disorders. This study investigated the relationship between parents' state and trait anxiety and parent-reported internalizing and externalizing symptoms among adolescents (n = 30) with ASD, as well as the relationship of parents' anxiety symptoms and adolescent treatment response in the context of a randomized controlled trial. Parental state anxiety correlated with severity of adolescent anxiety, and trait anxiety in parents correlated with parent-reported adolescent internalizing and externalizing symptoms. Also, parents of adolescent treatment responders experienced a decrease in their own trait anxiety. Findings highlight the importance of considering parental anxiety when targeting anxiety among youth with ASD.
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Affiliation(s)
- Caitlin M Conner
- Department of Psychology, Virginia Polytechnic Institute and State University, 109 Williams Hall (0436), Blacksburg, VA 24061, USA.
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30
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Rudy BM, Lewin AB, Storch EA. Managing anxiety comorbidity in youth with autism spectrum disorders. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/npy.13.53] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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31
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Favre MR, Barkat TR, LaMendola D, Khazen G, Markram H, Markram K. General developmental health in the VPA-rat model of autism. Front Behav Neurosci 2013; 7:88. [PMID: 23898245 PMCID: PMC3721005 DOI: 10.3389/fnbeh.2013.00088] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 07/01/2013] [Indexed: 12/28/2022] Open
Abstract
Autism is a neurodevelopmental condition diagnosed by impaired social interaction, abnormal communication and, stereotyped behaviors. While post-mortem and imaging studies have provided good insights into the neurobiological symptomology of autism, animal models can be used to study the neuroanatomical, neurophysiological and molecular mediators in more detail and in a more controlled environment. The valproic acid (VPA) rat model is an environmentally triggered model with strong construct and clinical validity. It is based on VPA teratogenicity in humans, where mothers who are medicated with VPA during early pregnancy show an increased risk for giving birth to an autistic child. In rats, early embryonic exposure, around the time of neural tube closure, leads to autism-like anatomical and behavioral abnormalities in the offspring. Considering the increasing use of the VPA rat model, we present our observations of the general health of Wistar dams treated with a single intraperitoneal injection of 500 or, 600 mg/kg VPA on embryonic day E12.5, as well as their male and female offspring, in comparison to saline-exposed controls. We report increased rates of complete fetal reabsorption after both VPA doses. VPA 500 mg/kg showed no effect on dam body weight during pregnancy or, on litter size. Offspring exposed to VPA 500 mg/kg showed smaller brain mass on postnatal days 1 (P1) and 14 (P14), in addition to abnormal nest seeking behavior at P10 in the olfactory discrimination test, relative to controls. We also report increased rates of physical malformations in the offspring, rare occurrences of chromodacryorrhea and, developmentally similar body mass gain. Further documentation of developmental health may guide sub-grouping of individuals in a way to better predict core symptom severity.
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Affiliation(s)
- Mônica R. Favre
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de LausanneLausanne, Switzerland
| | - Tania R. Barkat
- Department of Neuroscience and Pharmacology, Copenhagen UniversityCopenhagen, Denmark
| | - Deborah LaMendola
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de LausanneLausanne, Switzerland
| | - Georges Khazen
- Computer Science and Mathematics Department, School of Arts and Sciences, Lebanese American UniversityByblos, Lebanon
| | - Henry Markram
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de LausanneLausanne, Switzerland
| | - Kamila Markram
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de LausanneLausanne, Switzerland
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32
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James AC, James G, Cowdrey FA, Soler A, Choke A. Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev 2013:CD004690. [PMID: 23733328 DOI: 10.1002/14651858.cd004690.pub3] [Citation(s) in RCA: 221] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND A previous Cochrane review (James 2005) showed that cognitive behavioural therapy (CBT) was effective in treating childhood anxiety disorders; however, questions remain regarding (1) the relative efficacy of CBT versus non-CBT active treatments; (2) the relative efficacy of CBT versus medication and the combination of CBT and medication versus placebo; and (3) the long-term effects of CBT. OBJECTIVES To examine (1) whether CBT is an effective treatment for childhood and adolescent anxiety disorders in comparison with (a) wait-list controls; (b) active non-CBT treatments (i.e. psychological placebo, bibliotherapy and treatment as usual (TAU)); and (c) medication and the combination of medication and CBT versus placebo; and (2) the long-term effects of CBT. SEARCH METHODS Searches for this review included the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Depression, Anxiety and Neurosis Group Register, which consists of relevant randomised controlled trials from the bibliographic databases-The Cochrane Library (1970 to July 2012), EMBASE, (1970 to July 2012) MEDLINE (1970 to July 2012) and PsycINFO (1970 to July 2012). SELECTION CRITERIA All randomised controlled trials (RCTs) of CBT versus waiting list, active control conditions, TAU or medication were reviewed. All participants must have met the criteria of the Diagnostic and Statistical Manual (DSM) or the International Classification of Diseases (ICD) for an anxiety diagnosis, excluding simple phobia, obsessive-compulsive disorder, post-traumatic stress disorder and elective mutism. DATA COLLECTION AND ANALYSIS The methodological quality of included trials was assessed by three reviewers independently. For the dichotomous outcome of remission of anxiety diagnosis, the odds ratio (OR) with 95% confidence interval (CI) based on the random-effects model, with pooling of data via the inverse variance method of weighting, was used. Significance was set at P < 0.05. Continuous data on each child's anxiety symptoms were pooled using the standardised mean difference (SMD). MAIN RESULTS Forty-one studies consisting of 1806 participants were included in the analyses. The studies involved children and adolescents with anxiety of mild to moderate severity in university and community clinics and school settings. For the primary outcome of remission of any anxiety diagnosis for CBT versus waiting list controls, intention-to-treat (ITT) analyses with 26 studies and 1350 participants showed an OR of 0.13 (95% CI 0.09 to 0.19, Z = 10.26, P < 0.0001), but with evidence of moderate heterogeneity (P = 0.04, I² = 33%). The number needed to treat (NNT) was 6.0 (95% CI 7.5 to 4.6). No difference in outcome was noted between individual, group and family/parental formats. ITT analyses revealed that CBT was no more effective than non-CBT active control treatments (six studies, 426 participants) or TAU in reducing anxiety diagnoses (two studies, 88 participants). The few controlled follow-up studies (n = 4) indicate that treatment gains in the remission of anxiety diagnosis are not statistically significant. AUTHORS' CONCLUSIONS Cognitive behavioural therapy is an effective treatment for childhood and adolescent anxiety disorders; however, the evidence suggesting that CBT is more effective than active controls or TAU or medication at follow-up, is limited and inconclusive.
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Matson JL, Williams LW. Differential diagnosis and comorbidity: distinguishing autism from other mental health issues. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/npy.13.1] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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