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Costache ME, Gioia F, Vanello N, Greco A, Lefebvre F, Capobianco A, Weibel S, Weiner L. Exploring Emotion Control and Alexithymia in Autistic Adults: An Ecological Momentary Assessment Study. J Autism Dev Disord 2024:10.1007/s10803-024-06551-8. [PMID: 39333448 DOI: 10.1007/s10803-024-06551-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2024] [Indexed: 09/29/2024]
Abstract
Difficulties in controlling emotions - a proxy for emotion dysregulation (ED)-and difficulties in expressing feelings in words-'absence of emotion labelling' or alexithymia-co-exist in autism and contribute to elevated levels of impulsive and suicidal behaviour. To date, studies linking the two phenomena have relied on retrospective self-reported measures, lacking support for generalizability to real-life situations. The present study investigated in vivo emotion labelling and its impact on emotion control in 29 autistic adults without intellectual disability (ASC) and 28 neurotypical (NT) individuals of similar age, sex, and educational level. Participants were trained in an Ecological Momentary Assessment (EMA) to label their emotions, the arousal dimension, and their emotion control via smartphone over a one-week period. Findings showed that the ASC group experienced more instances of 'having an emotion that I cannot name' and, when they were able to label their emotions, they reported higher rates of negative and conflicting (simultaneously positive and negative) emotions. In both groups, the absence of emotion labelling, and intense negative emotions were associated with impaired emotion control. However, the association between lack of emotional awareness-'I have no emotion'-and impaired emotion control was only evident in ASC individuals. Our study highlights a nuanced facet of emotional processing in the ASC population. Further research is needed to gain a deeper understanding of the complex relationship between ED and alexithymia in autism.
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Affiliation(s)
- Mădălina Elena Costache
- Laboratoire de Psychologie des Cognitions, Faculté de Psychologie, University of Strasbourg, 12 Rue Goethe, 67000, Strasbourg, France.
| | - Federica Gioia
- Dipartimento di Ingegneria dell'Informazione, University of Pisa, Pisa, Italy
| | - Nicola Vanello
- Dipartimento di Ingegneria dell'Informazione, University of Pisa, Pisa, Italy
| | - Alberto Greco
- Dipartimento di Ingegneria dell'Informazione, University of Pisa, Pisa, Italy
| | - François Lefebvre
- Department of Biostatistics, Strasbourg University Hospital, Strasbourg, France
| | - Antonio Capobianco
- Ingineering Science, Computer Science and Imagery Laboratory, CNRS, University of Strasbourg, Strasbourg, France
| | - Sébastien Weibel
- Cognitive Neuropsychology and Pathophysiology of Schizophrenia, University of Strasbourg, INSERM 1114, Strasbourg, France
- UMR-S 1329, Strasbourg Translational Neuroscience & Psychiatry, INSERM, University of Strasbourg, Strasbourg, France
- Department of Psychiatry, Strasbourg University Hospital, Strasbourg, France
| | - Luisa Weiner
- Laboratoire de Psychologie des Cognitions, Faculté de Psychologie, University of Strasbourg, 12 Rue Goethe, 67000, Strasbourg, France
- Department of Psychiatry, Strasbourg University Hospital, Strasbourg, France
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Shyu HJ, Ryan Chen YW, Yih Ng D, Bundy A, Tseng MH, Cordier R. Does the PedsQL reflect the real-time quality of life in autistic adolescents? A comparison with the experience sampling methodology. Disabil Health J 2024:101690. [PMID: 39174385 DOI: 10.1016/j.dhjo.2024.101690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 07/20/2024] [Accepted: 08/19/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND The PedsQL is widely used to retrospectively evaluate quality of life (QoL) in autistic adolescents. However, concerns have arisen regarding its ability to reflect real-time QoL, considering their challenges in recollecting past experiences. OBJECTIVE We examined the overall and social QoLs of autistic adolescents compared to neurotypical peers using the PedsQL and the experience sampling method (ESM), an ecological momentary assessment of QoL in real-time. Additionally, we explored the relationship between these measures in each group. METHODS A total of 175 participants, including 117 autistic and 58 neurotypical adolescents aged 10-16, completed the PedsQL and an ESM protocol with a mobile device to record their real-time experiences seven times a day for seven days. We performed multiple linear regression and multilevel analyses to compare QoLs between groups and the association between the two measures. RESULTS Autistic adolescents scored significantly lower than neurotypical peers on PedsQL overall and social QoL but not on the real-time experiences collected with ESM. Among neurotypical adolescents, we found significant associations between the Social Functioning score of the PedsQL and various aspects of real-time social experiences recorded with ESM. For autistic adolescents, only the real-time experience of 'loneliness' during social engagement was associated with Social Functioning on the PedsQL. CONCLUSIONS The retrospective PedsQL does not entirely capture the real-time QoL via ESM. However, relying solely on ESM may overlook situations where participants opt out or could not complete surveys. Thus, using both retrospective and real-time assessments to examine QoL among autistic adolescents is recommended.
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Affiliation(s)
- Hui-Jen Shyu
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taiwan
| | - Yu-Wei Ryan Chen
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Daphne Yih Ng
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taiwan
| | - Anita Bundy
- College of Health and Human Sciences, Colorado State University, Fort Collins, USA
| | - Mei-Hui Tseng
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taiwan; Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taiwan.
| | - Reinie Cordier
- Department of Social Work, Education and Community Wellbeing, Faculty of Health & Life Sciences, Northumbria University, Newcastle, UK; Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, WA, Australia; Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Ilen L, Feller C, Schneider M. Cognitive emotion regulation difficulties increase affective reactivity to daily-life stress in autistic adolescents and young adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1703-1718. [PMID: 37882494 PMCID: PMC11191376 DOI: 10.1177/13623613231204829] [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: 10/27/2023]
Abstract
LAY ABSTRACT Previous research has shown that autistic individuals report high levels of perceived stress and have an increased likelihood of developing mental health difficulties. Increase in individuals' negative emotions in relation to perceived stress (i.e. affective reactivity to stress) is a known risk factor for mental health difficulties. In this study, we investigated perceived daily stress and affective reactivity to stress in autistic (n = 39, age = 18.4) and non-autistic (n = 55, age = 18.1) adolescents and young adults. We used the ecological momentary assessment, a technique that allows to assess individuals repeatedly in their daily life using their smartphone. Moreover, participants filled a questionnaire to evaluate the strategies they use to regulate emotions when faced with difficulties. Finally, a clinical interview and a parent-report questionnaire were used to assess mental health symptoms. Autistic youth reported higher levels of perceived daily stress compared with non-autistic peers. Moreover, they showed increased affective reactivity to stress related to their daily activities. Autistic participants reported more emotion regulation difficulties (e.g. more repetitive thinking of difficulties) compared with non-autistic participants. Difficulties in emotion regulation increased negative emotions in relation to stress and might contribute to the severity of mental health symptoms. We conclude that adolescents and young adults with autism report high perceived stress in their daily lives. To minimize the negative impact of stress and the development of mental health symptoms, people supporting autistic young people could focus on stress management skills and the strategies that the youth use to manage emotions.
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Ridgway K, Macmillan C, Demmer DH, Hooley M, Hedley D, Westrupp E, Stokes MA. Subjective wellbeing of autistic adolescents and young adults: A cross sectional study. Autism Res 2024; 17:1175-1186. [PMID: 38682234 DOI: 10.1002/aur.3139] [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: 12/20/2023] [Accepted: 03/28/2024] [Indexed: 05/01/2024]
Abstract
Subjective wellbeing (SWB) represents an individual's perception of wellness that is supported by homeostatic mechanisms. These mechanisms are proposed to be maintained by low negative affect and high positive affect, although less is known about these mechanisms and SWB in autism. The current cross-sectional study aimed to compare patterns of positive affect, negative affect (Positive Affect and Negative Affect Scale), and SWB (Personal Wellbeing Index-School Children) between autistic (n = 53) and non-autistic (n = 49) individuals aged 10-22 years (Mage = 13.97, SD = 3.13). Between-group t-tests revealed that compared with same-age peers, autistic participants scored lower SWB overall (p < 0.001). In both groups average SWB scores fell into the higher range, however, autistic participants were three-times more likely to fall below this range when compared to non-autistic participants. Negative affect had a higher intercept in the autistic sample, but no difference in slopes were observed. A hierarchical multiple regression revealed that diagnosis, positive affect, and negative affect significantly predicted SWB in our sample. Between-group t-tests found no significant difference in positive affect or negative affect across age between the autistic and non-autistic samples. In autistic participants, positive affect increased across age as SWB decreased, whilst negative affect remained stable, a pattern inconsistent with homeostatic SWB. The current study is overall consistent with the homeostatic explanation for SWB within autism; however, we identified potential differences between autistic and non-autistic participants in the contribution of positive affect and negative affect to homeostatic protect mood across development.
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Affiliation(s)
- Kathryn Ridgway
- School of Psychology, Healthy Autistic Life Lab, Deakin University, Geelong, Victoria, Australia
| | - Caitlin Macmillan
- School of Psychology, Healthy Autistic Life Lab, Deakin University, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - David H Demmer
- School of Psychology, Healthy Autistic Life Lab, Deakin University, Geelong, Victoria, Australia
| | - Merrilyn Hooley
- School of Psychology, Healthy Autistic Life Lab, Deakin University, Geelong, Victoria, Australia
| | - Darren Hedley
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Elizabeth Westrupp
- School of Psychology, Healthy Autistic Life Lab, Deakin University, Geelong, Victoria, Australia
| | - Mark A Stokes
- School of Psychology, Healthy Autistic Life Lab, Deakin University, Geelong, Victoria, Australia
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Song W, Zheng L, Tichá R, Abery B, Nguyen-Feng VN. Leisure Participation of Autistic Adults: An Ecological Momentary Assessment Feasibility Study. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:319-333. [PMID: 37470259 DOI: 10.1352/1944-7558-128.4.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 10/04/2022] [Indexed: 07/21/2023]
Abstract
Autistic adults participate less and express lower satisfaction in leisure activities than nonautistic adults, although literature is limited. The multifaceted nature of leisure participation makes it challenging to measure, with most measures being retrospective. Ecological momentary assessments (EMA) can reduce recall bias. This pilot study assessed the feasibility and acceptability of EMA among autistic adults. Participants (N = 40) were recruited via email and online. After completing a baseline interview, participants were asked to complete a once-daily survey for 30 days, in which they received survey links through a text messaging smartphone app. Surveys asked participants to report whether they participated in any leisure activities during the day, their level of enjoyment, with whom they interacted, and where they participated. The EMA appeared feasible in this sample, as participants completed the daily survey on average 27.05 (SD = 3.92) days. Regarding acceptability, most agreed that survey timing was convenient, that it was easy to enter responses and answer questions daily, and that they had enough response time. Overall, this study supports the use of EMA methodology among autistic adults. Future research should follow and improve upon these EMA data collection practices to examine daily behavior and well-being among autistic adults.
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Affiliation(s)
- Wei Song
- Wei Song, Temple University and Drexel University
| | | | - Renáta Tichá
- Renáta Tichá and Brian Abery, University of Minnesota Twin Cities
| | - Brian Abery
- Renáta Tichá and Brian Abery, University of Minnesota Twin Cities
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Feller C, Ilen L, Eliez S, Schneider M. Characterizing Daily-Life Social Interactions in Adolescents and Young Adults with Neurodevelopmental Disorders: A Comparison Between Individuals with Autism Spectrum Disorders and 22q11.2 Deletion Syndrome. J Autism Dev Disord 2023; 53:245-262. [PMID: 35018586 PMCID: PMC9889413 DOI: 10.1007/s10803-021-05423-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 02/04/2023]
Abstract
Social impairments are common features of 22q11.2 deletion syndrome (22q11DS) and autism spectrum disorders (ASD). The Ecological Momentary Assessment (EMA) allowed access to daily-life information in order to explore the phenomenology of social interactions. 32 individuals with 22q11DS, 26 individuals with ASD and 44 typically developing peers (TD) aged 12-30 were assessed during 6 days 8 times a day using a mobile app. Participants with 22q11DS and ASD did not spend more time alone but showed distinct implication in the social sphere than TD. Distinct profiles emerged between the two conditions regarding the subjective experience of aloneness and the subjective experience of social interactions. This study highlights distinct social functioning profiles in daily-life in 22q11DS and ASD that points towards different therapeutic targets.
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Affiliation(s)
- Clémence Feller
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d’Arve, 1205 Geneva, Switzerland
| | - Laura Ilen
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d’Arve, 1205 Geneva, Switzerland
| | - Stephan Eliez
- grid.8591.50000 0001 2322 4988Developmental Imaging and Psychopathology Lab Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland ,grid.8591.50000 0001 2322 4988Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maude Schneider
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d’Arve, 1205 Geneva, Switzerland ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
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Youth Psychopathology in Daily Life: Systematically Reviewed Characteristics and Potentials of Ecological Momentary Assessment Applications. Child Psychiatry Hum Dev 2022; 53:1129-1147. [PMID: 34075490 PMCID: PMC9560926 DOI: 10.1007/s10578-021-01177-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 11/25/2022]
Abstract
Traditionally, symptoms of youth psychopathology are assessed with questionnaires, clinical interviews, or laboratory observations. Ecological Momentary Assessment (EMA) could be a particularly valuable additional methodology, since EMA enables examining the daily lives of youths near real-time, considering fluctuations and specific contexts of symptoms. This systematic review aimed to review the characteristics of current EMA applications and to provide a synthesis of their potential in studying youth psychopathology. Following a systematic search in PsycInfo and Medline, we identified 50 studies in clinical samples. Most studies used EMA to examine fluctuations in symptoms, affect, and behavior, and the relation with contextual factors. EMA was also used to investigate interactions between parents and their children over time, and to monitor and predict treatment response. EMA appeared feasible in youth and could provide valuable insights that contribute to understanding youth psychopathology. Benefits, gaps, and suggestions for future research and clinical practice are discussed.
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Cooper K, Russell A, Calley S, Chen H, Kramer J, Verplanken B. Cognitive processes in autism: Repetitive thinking in autistic versus non-autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:849-858. [PMID: 34291680 PMCID: PMC9014768 DOI: 10.1177/13623613211034380] [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] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT A core feature of autism is the tendency to do the same activity or behaviour repetitively. We wanted to find out if autistic people also experience repetitive thinking, for example, having the same thoughts repeatedly. We thought that there would be a link between repetitive behaviour and repetitive thinking. We asked 54 autistic people and 66 non-autistic people to complete questionnaires measuring repetitive behaviours and obsessive thinking. Next, participants were trained by a researcher to record their thoughts using a structured paper form. They then completed 5 days of thought recording, which they did each time a random alarm sounded on their mobile phone. We found that autistic people had more repetitive thoughts than non-autistic people, but they did not report having more negative or visual thoughts compared with non-autistic people. Autistic people who had more repetitive thoughts during the 5 days of thought recording did not report more repetitive behaviour. However, autistic people who reported more obsessive thinking, for example, more negative and unwanted thoughts, also reported higher levels of repetitive behaviour. We conclude that some repetitive behaviours may be linked to anxiety and that more research is needed to better understand repetitive behaviours in autism.
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van der Linden K, Simons C, Viechtbauer W, Ottenheijm E, van Amelsvoort T, Marcelis M. A momentary assessment study on emotional and biological stress in adult males and females with autism spectrum disorder. Sci Rep 2021; 11:14160. [PMID: 34238944 PMCID: PMC8266874 DOI: 10.1038/s41598-021-93159-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/09/2021] [Indexed: 02/06/2023] Open
Abstract
Prospective momentary psychological and biological measures of real-time daily life stress experiences have been examined in several psychiatric disorders, but not in adults with an autism spectrum disorder (ASD). The current electronic self-monitoring study examined associations between momentary daily life stressors and (i) negative affect (NA; emotional stress reactivity) and (ii) cortisol levels (biological stress reactivity) in males and females with ASD (N = 50) and without ASD (N = 51). The Experience Sampling Method, including saliva sampling, was used to measure three types of daily life stress (activity-related, event-related, and social stress), NA, and cortisol. Multilevel regression analyses demonstrated significant interactions between group and stress (i.e., activity-related and event-related stress) in the model of NA, indicating stronger emotional stress reactivity in the ASD than in the control group. In the model of cortisol, none of the group × stress interactions were significant. Male/female sex had no moderating effect on either emotional or biological stress reactivity. In conclusion, adults with ASD showed a stronger emotional stress (but not cortisol) reactivity in response to unpleasant daily life events and activities. The findings highlight the feasibility of electronic self-monitoring in individuals with ASD, which may contribute to the development of more personalized stress-management approaches.
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Affiliation(s)
- Kim van der Linden
- grid.491104.9GGzE, Mental Health Institute Eindhoven, P.O. Box 909, 5600AX Eindhoven, The Netherlands ,grid.5012.60000 0001 0481 6099Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Claudia Simons
- grid.491104.9GGzE, Mental Health Institute Eindhoven, P.O. Box 909, 5600AX Eindhoven, The Netherlands ,grid.5012.60000 0001 0481 6099Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Wolfgang Viechtbauer
- grid.5012.60000 0001 0481 6099Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Emmy Ottenheijm
- grid.491104.9GGzE, Mental Health Institute Eindhoven, P.O. Box 909, 5600AX Eindhoven, The Netherlands
| | - Thérèse van Amelsvoort
- grid.5012.60000 0001 0481 6099Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Machteld Marcelis
- grid.491104.9GGzE, Mental Health Institute Eindhoven, P.O. Box 909, 5600AX Eindhoven, The Netherlands ,grid.5012.60000 0001 0481 6099Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
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Dallman AR, Bailliard A, Harrop C. Identifying Predictors of Momentary Negative Affect and Depression Severity in Adolescents with Autism: An Exploratory Ecological Momentary Assessment Study. J Autism Dev Disord 2021; 52:291-303. [PMID: 33677729 PMCID: PMC7970812 DOI: 10.1007/s10803-021-04935-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/28/2022]
Abstract
Depression is a common comorbidity in autism spectrum disorder (ASD). Little is known about risk factors for depression and depressive symptoms in this population. Ecological momentary assessment (EMA) has been used in the typically developing population to identify risk factors for depression, but has been rarely applied in ASD populations. In this exploratory study, 17 autistic adolescents participated in an EMA protocol in which they reported on their current activities and emotions six times per day for seven consecutive days. Results suggested that negative affect is predicted by momentary quality of social interaction and enjoyment of the current activity (p < 0.05). Additionally, affective instability predicted depressive symptoms. These results provide insights into risk factors for depression in this vulnerable population.
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Affiliation(s)
- Aaron R Dallman
- Department of Occupational Therapy and Occupational Science, College of Health Professions, Towson University, 8000 York Rd, Towson, MD, USA.
| | - Antoine Bailliard
- Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Clare Harrop
- Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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11
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van der Linden K, Simons C, van Amelsvoort T, Marcelis M. Lifetime and Momentary Psychotic Experiences in Adult Males and Females With an Autism Spectrum Disorder. Front Psychiatry 2020; 11:766. [PMID: 32848936 PMCID: PMC7416642 DOI: 10.3389/fpsyt.2020.00766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 07/20/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Existing research shows that adults with an autism spectrum disorder (ASD) are more vulnerable to develop overt psychosis. However, studies investigating (subclinical) psychotic experiences (PE) in ASD are scarce, and it is unknown if PE are accompanied with more distress in adults with ASD compared to the general population. This study examined lifetime PE and accompanying distress, momentary PE levels, and the impact of daily life stress and negative affect (NA) on momentary PE in males and females with ASD compared to controls. METHODS In 50 adults with ASD (males N= 26, females N= 24) and 51 adults without ASD (males N= 26, females N= 25), the Community Assessment of Psychic Experiences (CAPE) was used to analyze group differences in frequency and distress of lifetime subclinical positive, negative, and depressive symptoms. The Experience Sampling Method (ESM) was used to measure momentary PE, NA, and stress (activity-related, event-related, and social stress) for 10 days. Multilevel analyses were conducted to test whether stress and NA were associated with momentary PE and whether these associations were modified by group or sex. RESULTS Adults with ASD reported more lifetime CAPE negative and depressive symptoms, but similar levels of PE, than controls. Higher levels of accompanying distress were found in participants with ASD for each subscale. With respect to ESM momentary PE, higher levels were reported by adults with ASD and a stronger association between event-related stress and momentary PE was found compared to controls. This was not the case for NA, activity-related, and social stress. Overall, no significant differences between male and female outcomes were found. CONCLUSION Adults with ASD are more prone to encounter lifetime subclinical negative and depressive symptoms and accompanying distress compared to adults without ASD. Similar levels of lifetime PE in both groups were still accompanied with more distress in the ASD group. Furthermore, higher levels of ESM momentary PE were found in participants with ASD. Additionally, event-related stress may act as a risk factor for PE in both females and males with ASD, with a stronger risk-increasing effect than in their control counterparts.
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Affiliation(s)
- Kim van der Linden
- GGzE, Mental Healthcare Institution Eindhoven, Eindhoven, Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, Netherlands
| | - Claudia Simons
- GGzE, Mental Healthcare Institution Eindhoven, Eindhoven, Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, Netherlands
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, Netherlands
| | - Machteld Marcelis
- GGzE, Mental Healthcare Institution Eindhoven, Eindhoven, Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, Netherlands
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12
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Gerber AH, Girard JM, Scott SB, Lerner MD. Alexithymia - Not autism - is associated with frequency of social interactions in adults. Behav Res Ther 2019; 123:103477. [PMID: 31648083 DOI: 10.1016/j.brat.2019.103477] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 06/26/2019] [Accepted: 09/09/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE While much is known about the quality of social behavior among neurotypical individuals and those with autism spectrum disorder (ASD), little work has evaluated quantity of social interactions. This study used ecological momentary assessment (EMA) to quantify in vivo daily patterns of social interaction in adults as a function of demographic and clinical factors. METHOD Adults with and without ASD (NASD = 23, NNeurotypical = 52) were trained in an EMA protocol to report their social interactions via smartphone over one week. Participants completed measures of IQ, ASD symptom severity and alexithymia symptom severity. RESULTS Cyclical multilevel models were used to account for nesting of observations. Results suggest a daily cyclical pattern of social interaction that was robust to ASD and alexithymia symptoms. Adults with ASD did not have fewer social interactions than neurotypical peers; however, severity of alexithymia symptoms predicted fewer social interactions regardless of ASD status. CONCLUSIONS These findings suggest that alexithymia, not ASD severity, may drive social isolation and highlight the need to reevaluate previously accepted notions regarding differences in social behavior utilizing modern methods.
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Affiliation(s)
- Alan H Gerber
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Jeffrey M Girard
- Language Technologies Institute, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Stacey B Scott
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA.
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Bangerter A, Manyakov NV, Lewin D, Boice M, Skalkin A, Jagannatha S, Chatterjee M, Dawson G, Goodwin MS, Hendren R, Leventhal B, Shic F, Ness S, Pandina G. Caregiver Daily Reporting of Symptoms in Autism Spectrum Disorder: Observational Study Using Web and Mobile Apps. JMIR Ment Health 2019; 6:e11365. [PMID: 30912762 PMCID: PMC6454343 DOI: 10.2196/11365] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 12/05/2018] [Accepted: 12/31/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Currently, no medications are approved to treat core symptoms of autism spectrum disorder (ASD). One barrier to ASD medication development is the lack of validated outcome measures able to detect symptom change. Current ASD interventions are often evaluated using retrospective caregiver reports that describe general clinical presentation but often require recall of specific behaviors weeks after they occur, potentially reducing accuracy of the ratings. My JAKE, a mobile and Web-based mobile health (mHealth) app that is part of the Janssen Autism Knowledge Engine-a dynamically updated clinical research system-was designed to help caregivers of individuals with ASD to continuously log symptoms, record treatments, and track progress, to mitigate difficulties associated with retrospective reporting. OBJECTIVE My JAKE was deployed in an exploratory, noninterventional clinical trial to evaluate its utility and acceptability to monitor clinical outcomes in ASD. Hypotheses regarding relationships among daily tracking of symptoms, behavior, and retrospective caregiver reports were tested. METHODS Caregivers of individuals with ASD aged 6 years to adults (N=144) used the My JAKE app to make daily reports on their child's sleep quality, affect, and other self-selected specific behaviors across the 8- to 10-week observational study. The results were compared with commonly used paper-and-pencil scales acquired over a concurrent period at regular 4-week intervals. RESULTS Caregiver reporting of behaviors in real time was successfully captured by My JAKE. On average, caregivers made reports 2-3 days per week across the study period. Caregivers were positive about their use of the system, with over 50% indicating that they would like to use My JAKE to track behavior outside of a clinical trial. More positive average daily reporting of overall type of day was correlated with 4 weekly reports of lower caregiver burden made at 4-week intervals (r=-0.27, P=.006, n=88) and with ASD symptoms (r=-0.42, P<.001, n=112). CONCLUSIONS My JAKE reporting aligned with retrospective Web-based or paper-and-pencil scales. Use of mHealth apps, such as My JAKE, has the potential to increase the validity and accuracy of caregiver-reported outcomes and could be a useful way of identifying early changes in response to intervention. Such systems may also assist caregivers in tracking symptoms and behavior outside of a clinical trial, help with personalized goal setting, and monitoring of progress, which could collectively improve understanding of and quality of life for individuals with ASD and their families. TRIAL REGISTRATION ClinicalTrials.gov NCT02668991; https://clinicaltrials.gov/ct2/show/NCT02668991.
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Affiliation(s)
- Abigail Bangerter
- Neuroscience Therapeutic Area, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - Nikolay V Manyakov
- Computational Biology, Discovery Sciences, Janssen Research & Development, Beerse, Belgium
| | - David Lewin
- Clinical Biostatistics, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - Matthew Boice
- Neuroscience Therapeutic Area, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - Andrew Skalkin
- Informatics, Janssen Research & Development, LLC, Spring House, PA, United States
| | - Shyla Jagannatha
- Statistical Decision Sciences, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - Meenakshi Chatterjee
- Computational Biology, Discovery Sciences, Janssen Research & Development, LLC, Spring House, PA, United States
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Matthew S Goodwin
- Department of Health Sciences, Northeastern University, Boston, MA, United States
| | - Robert Hendren
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Bennett Leventhal
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Seth Ness
- Neuroscience Therapeutic Area, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - Gahan Pandina
- Neuroscience Therapeutic Area, Janssen Research & Development, LLC, Titusville, NJ, United States
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Cai RY, Richdale AL, Dissanayake C, Uljarević M. How Does Emotion Regulation Strategy Use and Psychological Wellbeing Predict Mood in Adults With and Without Autism Spectrum Disorder? A Naturalistic Assessment. J Autism Dev Disord 2019; 50:1786-1799. [PMID: 30790195 DOI: 10.1007/s10803-019-03934-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this study was to identify emotion regulation (ER) strategies that most strongly impact momentary mood in a sample of 23 adults with and 19 without autism spectrum disorder (ASD). Participants completed cognitive and behavioural assessments, online questionnaires, and experience sampling methodology questions. In the ASD group, the use of dampening and other-blame reduced mood while savouring and emotional acceptance improved mood. The use of self-blame and avoidance negatively impacted mood only in the non-ASD group, suggesting the use of these two strategies do not reduce mood in individuals with ASD. ER and mental health interventions should capture ER strategy use and aim to decrease maladaptive strategy use and increase adaptive strategy use.
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Affiliation(s)
- Ru Ying Cai
- School of Psychological Science, Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, 3086, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Level 3 Foxtail Building, Long Pocket, Brisbane, QLD, 4072, Australia
| | - Amanda L Richdale
- School of Psychological Science, Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, 3086, Australia.
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Level 3 Foxtail Building, Long Pocket, Brisbane, QLD, 4072, Australia.
| | - Cheryl Dissanayake
- School of Psychological Science, Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, 3086, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Level 3 Foxtail Building, Long Pocket, Brisbane, QLD, 4072, Australia
| | - Mirko Uljarević
- School of Psychological Science, Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, 3086, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Level 3 Foxtail Building, Long Pocket, Brisbane, QLD, 4072, Australia
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, School of Medicine, Stanford Autism Centre, Stanford University, Stanford, USA
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