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Taylor SC, Gehringer BN, Dow HC, Langer A, Rawot E, Smernoff Z, Steeman S, Almasy L, Rader DJ, Bučan M, Brodkin ES. Contrasting Views of Autism Spectrum Traits in Adults, Especially in Self-Reports vs. Informant-Reports for Women High in Autism Spectrum Traits. J Autism Dev Disord 2024; 54:1088-1100. [PMID: 36484966 PMCID: PMC9734875 DOI: 10.1007/s10803-022-05822-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 12/13/2022]
Abstract
There is uncertainty among researchers and clinicians about how to best measure autism spectrum dimensional traits in adults. In a sample of adults with high levels of autism spectrum traits and without intellectual disability (probands, n = 103) and their family members (n = 96), we sought to compare self vs. informant reports of autism spectrum-related traits and possible effects of sex on discrepancies. Using correlational analysis, we found poor agreement between self- and informant-report measures for probands, yet moderate agreement for family members. We found reporting discrepancy was greatest for female probands, often self-reporting more autism-related behaviors. Our findings suggest that autism spectrum traits are often underrecognized by informants, making self-report data important to collect in clinical and research settings.
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Affiliation(s)
- Sara C Taylor
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
- Neuroscience Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brielle N Gehringer
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Holly C Dow
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Allison Langer
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Eric Rawot
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Zoe Smernoff
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Samantha Steeman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Laura Almasy
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Daniel J Rader
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Maja Bučan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Edward S Brodkin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA.
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Dekker LP, van der Vegt EJM, Louwerse A, Visser K, van der Ende J, Maras A, Verhulst FC, Greaves-Lord K. Complementing or Congruent? Desired Characteristics in a Friend and Romantic Partner in Autistic versus Typically Developing Male Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1153-1167. [PMID: 36241943 PMCID: PMC10102130 DOI: 10.1007/s10508-022-02444-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 05/11/2023]
Abstract
Ideal friend and romantic partner characteristics related to self-perceived characteristics have been investigated in typically developing (TD) individuals, but not in individuals with autism spectrum disorder (ASD). Considering the autistic symptoms and challenges, investigating these concepts in autistic individuals is relevant. Given the lack of consensus, identity-first ("autistic person") and person-first ("person with autism") language are mixed throughout, to cover all preferences. This study explored (1) the association between self-perceived characteristics and desires in a friend/romantic partner, as well as (2) compare two groups (ASD and TD) in their desires for a friend/romantic partner. Two matched groups (ASD and TD) of 38 male adolescents (age 14-19 years) reported on the desire for nine characteristics (i.e., funny, popular, nice, cool, smart, trustworthy, good looking, similar interests, and being rich) in a friend/partner, and to what extent they felt they themselves possessed seven characteristics (i.e., funny, popular, nice, cool, smart, trustworthy, and good looking). Results showed both groups sought a friend and partner similar to themselves on intrinsic characteristics (e.g., trustworthiness), but less similar on extrinsic and social status characteristics (e.g., being less cool and popular). Particularly intrinsic characteristics, more than extrinsic and social status characteristics, were valued in both partners and friends, regardless of group. No significant differences were found between groups concerning to what extent characteristics were desired. Overall, adolescents with ASD desire similar characteristics as TD adolescents in their potential romantic partners and friends. There is some indication that the match between self-perception and desired characteristics is different.
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Affiliation(s)
- Linda P Dekker
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, Room T13-24, 3000 DR, Rotterdam, The Netherlands.
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands.
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands.
| | | | - Anneke Louwerse
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
| | - Kirsten Visser
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
- Youz Child and Adolescent Psychiatry, Team Sarr Autism Expertise Centre, Rotterdam, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Athanasios Maras
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
- Autism Team Northern-Netherlands of Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, The Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
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Tomaszewski B, Klinger LG, Pugliese CE. Self-Determination in Autistic Transition-Aged Youth without Intellectual Disability. J Autism Dev Disord 2022; 52:4067-4078. [PMID: 34536165 PMCID: PMC8930783 DOI: 10.1007/s10803-021-05280-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
Self-determination refers to an individual's capacity and opportunities to act as a causal agent in their own lives to make choices, decisions, and set goals. The current study examined self- and parent-reports of the AIR Self-Determination Scale in transition-aged autistic youth (Based on stakeholder preferences, we use identity-first(autistic) or neutral language (on the autism spectrum) (Bottema-Beutel in JAMA 3:18-29, 2020)). Autistic youth completed depression and executive function measures, and parents rated their child's social-communication and executive function difficulties. Despite differences between youth and parent reports, both youth and their parents reported lower self-determination skills (capacity) than opportunities to practice self-determined behaviors. Both depression and executive function skills were related to self-determination capacity, highlighting potential intervention targets for transition-aged youth to facilitate increased self-determination and potentially improved adult outcomes.
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Affiliation(s)
- Brianne Tomaszewski
- TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, CB#7180, Chapel Hill, NC, 27599-7180, USA.
| | - Laura G Klinger
- TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, CB#7180, Chapel Hill, NC, 27599-7180, USA
| | - Cara E Pugliese
- Center for Autism Spectrum Disorders, Division of Pediatric Neuropsychology, Children's Research Institute, Children's National Hospital, Washington, USA
- Department of Psychiatry, Behavioral Sciences & Pediatrics, The George Washington University School of Medicine, 15245 Shady Grove Rd., Suite 350, Rockville, MD, 20850, USA
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Mihailescu I, Andrei LE, Frunza AA, Manea M, Rad F. Computer-Based Assessment and Self-Report Measures of Executive Functions in High-Functioning Adults with Autism. Brain Sci 2022; 12:brainsci12081069. [PMID: 36009132 PMCID: PMC9405696 DOI: 10.3390/brainsci12081069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/22/2022] [Accepted: 08/11/2022] [Indexed: 11/24/2022] Open
Abstract
This study analyzes the profile of executive functions (EF) in high-functioning adults with autism (HFA), both in terms of performance on four computer-based tasks, as well as how these functions are perceived by the individuals through self-reporting measures. The study included 64 participants: 32 individuals with HFA, and 32 typically developing controls. Four CANTAB tasks were used (assessing spatial working memory, planning, visual memory, and inhibition), as well as a self-reported measure of executive functions (BDEFS) and a scale for the severity of autism symptoms (RAADS-R). The participants in the ASD group performed significantly lower than the control group on all four computer-based tasks, as measured by the total number of errors made (for the spatial working memory, visual memory, and inhibition tasks) and the number of problems solved at the first choice (for the planning task). No correlation was found in the ASD group between the severity of autism symptoms and the computer-based measures. These findings provide evidence that HFA adults may have various executive functioning impairments, and subsequent daily life problems, but these deficits do not necessarily correlate with the severity of core ASD symptoms.
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Affiliation(s)
- Ilinca Mihailescu
- Child and Adolescent Psychiatry Department, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
- Correspondence: (I.M.); (L.E.A.); Tel.: +40-726778518 (I.M.); +40-755423922 (L.E.A.)
| | - Lucia Emanuela Andrei
- Child and Adolescent Psychiatry Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Correspondence: (I.M.); (L.E.A.); Tel.: +40-726778518 (I.M.); +40-755423922 (L.E.A.)
| | - Alina Alexandra Frunza
- Psychiatry Department, Mina Minovici National Institute of Legal Medicine, 042122 Bucharest, Romania
| | - Mirela Manea
- Department of Psychiatry and Psychology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Psychiatry, “Prof. Dr. Alexandru Obregia” Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Florina Rad
- Child and Adolescent Psychiatry Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Differences in daily life executive functioning between people with autism and people with schizophrenia. J Autism Dev Disord 2022:10.1007/s10803-022-05547-6. [PMID: 35441913 DOI: 10.1007/s10803-022-05547-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
This is a comparative analysis of everyday executive functioning between individuals with Autism Spectrum Disorder (ASD), Schizophrenia Spectrum Disorders (SSD) and controls using Dysexecutive Questionnaire-Spanish (DEX-Sp), to identify patterns of difficulties. Also we assessed the relationship between EF and adaptive behavior as measured by the Vineland Adaptive Behavioral Scale-II. Common areas of everyday executive functions were established as problematic in individuals with ASD and SSD related to Disinhibition and Apathy, while Disorganization and Impulsivity was gravely affected in ASD group only. The degree of Dysexecutive Syndrome was predictive of adaptive behavior in ASD group only. These suggest that DEX-Sp could be a useful tool in differentiating areas of strength and weaknesses in clinical groups such as ASD and SDD.
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Martínez-González AE, Cervin M, Piqueras JA. Relationships Between Emotion Regulation, Social Communication and Repetitive Behaviors in Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:4519-4527. [PMID: 34709530 PMCID: PMC8551658 DOI: 10.1007/s10803-021-05340-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 01/26/2023]
Abstract
The relationship between emotion regulation, social interaction and different types of restricted and repetitive behaviors is poorly understood. In the present study, structural equation modeling based on information about 239 individuals with autism was used to examine whether emotion regulation and social communication were associated with self-injury and stereotyped behaviors. Results showed that poor emotion regulation had a unique association with self-injury while difficulties with social communication was uniquely associated with stereotyped behaviors. Emotion regulation and social communication were strongly associated and self-injury and stereotyped behaviors moderately associated. This implies that these types of behaviors are often expressions of broader negative emotional states in autism. Treatments that help improve coping and social communication strategies may benefit individuals with autism.
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Affiliation(s)
- Agustín E Martínez-González
- Department of Developmental Psychology and Didactics, University of Alicante. Education Faculty, Carretera San Vicente del Raspeig s/n, Campus San Vicente del Raspeig, Edificio Facultad de Educación, Apdo. Correos, PO 99, 03080, Alicante, Spain.
| | - Matti Cervin
- Lund University and Skane Child and Adolescent Psychiatry, Lund, Sweden
| | - Jose A Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche, Edificio Altamira, Avda. de La Universidad, s/n Elche, 03202, Alicante, Spain
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St John T, Woods S, Bode T, Ritter C, Estes A. A review of executive functioning challenges and strengths in autistic adults. Clin Neuropsychol 2021; 36:1116-1147. [PMID: 34499568 DOI: 10.1080/13854046.2021.1971767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: There has been a steady rise in research characterizing executive functioning (EF) impairments in autistic individuals but limited research investigating EF strengths. This review provides a summary of current EF research in autistic adults with a focus on EF challenges and strengths and potential sources of heterogeneity in research findings. New avenues for addressing gaps in our understanding of EF strengths are proposed.Method: A review of the EF literature was conducted. One hundred twenty-four studies of inhibition, working memory, cognitive flexibility, fluency, planning, decision-making, and subjective measures of EF in autistic adults were included.Results: Autistic adults with average intellectual functioning demonstrate difficulties with cognitive flexibility, phonemic fluency, and working memory. Strengths in planning, decision-making, and semantic verbal fluency were evident in some but not all studies. Findings regarding inhibition are inconclusive. Key findings across each EF domain are discussed and sources of potential heterogeneity across studies were evaluated. The type of measure used appears to contribute to heterogeneous findings. Subjective EF measures revealed more consistent findings of deficits in autistic adults than objective EF measures.Conclusions: Research reveals areas of EF weaknesses as well as strengths in autistic adults. Unlike EF challenges, EF strengths are not well understood. Future research identifying EF strengths is needed to improve services and supports for autistic adults. Further investigation of potential factors that interact with or constrain EF such as comorbid disorders, verbal ability, sensory processing, and other factors specific to autism will be critical to move the field forward and increase understanding of how EF is related to everyday functioning in autistic adults.
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Affiliation(s)
- Tanya St John
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA.,University of Washington Autism Center, University of Washington, Seattle, WA, USA.,Center on Human Development and Disability, University of Washington, Seattle, WA, USA
| | - Sara Woods
- University of Washington Autism Center, University of Washington, Seattle, WA, USA.,Center on Human Development and Disability, University of Washington, Seattle, WA, USA
| | | | - Cassidy Ritter
- College of Education, University of Washington, Seattle, WA, USA
| | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA.,University of Washington Autism Center, University of Washington, Seattle, WA, USA.,Center on Human Development and Disability, University of Washington, Seattle, WA, USA
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Joyal CC, Carpentier J, McKinnon S, Normand CL, Poulin MH. Sexual Knowledge, Desires, and Experience of Adolescents and Young Adults With an Autism Spectrum Disorder: An Exploratory Study. Front Psychiatry 2021; 12:685256. [PMID: 34177667 PMCID: PMC8219850 DOI: 10.3389/fpsyt.2021.685256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/03/2021] [Indexed: 11/15/2022] Open
Abstract
Although most persons with an Autism Spectrum Disorder (ASD) wish to have romantic and/or sexual relationships, little is known about self-report sexuality of adolescents/young adults with ASD. In this exploratory study, 172 male and female adolescents/young adults (68 with ASD and 104 without ASD) completed an online version of the Sexual Behavior Scale-Third edition. Although many more similarities than differences were observed between the groups for views and desires about romantic relationships (e.g., wishing to have a girlfriend/boyfriend), fewer participants with ASD (mostly boys) had experience with a variety of sexual/dyadic behaviors, and approximately half of girls with ASD reported negative sexual experiences. Significantly higher rates of participants with ASD felt their knowledge about sexuality was limited and found it difficult to understand sexual education compared with typically developing (TD) participants. Significantly lower rates of participants with ASD reported that they identify to their assigned gender compared with TD participants. Multiple regressions revealed that being older at first diagnosis and possessing better knowledge about sexuality were significant predictors of both positive and negative sexual experience. This study explores strengths and challenges related with the sexual health of adolescents/young adults with ASD and implications for clinical and educational practice are discussed.
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Affiliation(s)
- Christian C. Joyal
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Julie Carpentier
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Suzie McKinnon
- Integrated University Health and Social Services Centre (IUHSSC) of Saguenay-Lac-Saint-Jean, IUHSSC Bas-Saint-Laurent and IUHSSC Côte-Nord, Saguenay, QC, Canada
- Intellectual Disability and Autism Spectrum Disorder Research Institute, IUHSSC of Mauricie and Centre-du-Québec, Trois-Rivières, QC, Canada
| | - Claude L. Normand
- Intellectual Disability and Autism Spectrum Disorder Research Institute, IUHSSC of Mauricie and Centre-du-Québec, Trois-Rivières, QC, Canada
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Marie-Hélène Poulin
- Intellectual Disability and Autism Spectrum Disorder Research Institute, IUHSSC of Mauricie and Centre-du-Québec, Trois-Rivières, QC, Canada
- Department of Psychoeducation, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
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Appelqvist-Schmidlechner K, Lämsä R, Tuulio-Henriksson A. Factors associated with positive mental health in young adults with a neurodevelopmental disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 106:103780. [PMID: 32950021 DOI: 10.1016/j.ridd.2020.103780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Positive dimension of mental health has gained less attention in previous research on individuals with neurodevelopmenal disorders. However, knowledge on factors associated with mental well-being is crucial for planning effective interventions for this target group. AIMS The aim of the study was to investigate the determinants of positive mental health among young adults with neurodevelopmental disorders. METHODS AND PROCEDURES The study sample consisted of 171 young adults (18-35 years, mean age 25 years, SD 4.35) with a diagnosis of Autism Spectrum Disorder (ASD) or ADHD/ADD. The data were collected with questionnaires. RESULTS The mean score of SWEMWBS was 20.98 (n = 168, ranging 14.75-35.00, SD = 3.55). Provisions of social relationships, functional capacity and self-rated state of health associated independently with positive mental health. CONCLUSION AND IMPLICATIONS The level of positive mental health of study participants was relatively low compared with previous studies in other clinical settings or general populations. Promotion of social competence and social relationship should be included in rehabilitation programmes targeted at individuals with neurodevelopmental disorder. This may be beneficial in reaching also other goals set for the rehabilitation, such as increasing capacity to work or study.
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Affiliation(s)
| | - Riikka Lämsä
- National Institute for Health and Welfare, Equality and Inclusion Unit, P.O. Box 30, FI-00271, Helsinki, Finland; University of Helsinki, Faculty of Medicine, Department of Public Health, P.0. Box 20, 00014, Finland.
| | - Annamari Tuulio-Henriksson
- University of Helsinki, Faculty of Medicine, Department of Psychology and Logopedics, P.0. Box 21, 00014, Finland.
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Schwartzman JM, Corbett BA. Higher depressive symptoms in early adolescents with Autism Spectrum Disorder by self- and parent-report compared to typically-developing peers. RESEARCH IN AUTISM SPECTRUM DISORDERS 2020; 77:101613. [PMID: 32802155 PMCID: PMC7423017 DOI: 10.1016/j.rasd.2020.101613] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Depression is more prevalent among male early adolescents with Autism Spectrum Disorder (ASD) than their typically- developing (TD) peers, but findings are limited to two male-only studies. Therefore, a broader understanding of depressive symptoms among both male and female early adolescents with ASD in larger samples is needed. Self- and parent-ratings are frequently used, yet rater differences may emerge and provide unique insights. METHOD Ratings of adolescent depressive symptoms were examined among 230 early adolescents (10:0-13:5 years) with and without ASD using self- (Children's Depression Inventory, Second Edition; CDI-2) and parent- report (Child Behavior Checklist; CBCL) measures. The influence of diagnostic group (ASD vs. TD) and rater (early adolescent vs. parent) on ratings were examined with Full Scale IQ and sex as covariates. Additionally, the reliability and strength of agreement between raters were examined. RESULTS Higher depressive symptoms were reported by both raters in the ASD group (Borderline range) compared to the TD group (Average range). The interaction of diagnostic group and rater was nonsignificant, but significant main effects emerged. Sex was a significant covariate, but Full Scale IQ was not. The reliability and strength of agreement between raters in the ASD group only were not significant. CONCLUSIONS Findings suggest that depressive symptoms may be higher in both male and female early adolescents with ASD across self- and parent- reports. However, measurement of depression in ASD may be complicated by nonsignificant reliability and strength of agreement between raters. Results have implications for screening and intervention for early adolescents with ASD.
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Affiliation(s)
- Jessica M. Schwartzman
- Vanderbilt University Medical Center, 1601 23 Avenue South, Nashville, TN, United States 37212
| | - Blythe A. Corbett
- Vanderbilt University Medical Center, 1601 23 Avenue South, Nashville, TN, United States 37212
- Vanderbilt Kennedy Center, 110 Magnolia Circle, Nashville, TN, United States 37203
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Unruh KE, Bodfish JW, Gotham KO. Adults with Autism and Adults with Depression Show Similar Attentional Biases to Social-Affective Images. J Autism Dev Disord 2020; 50:2336-2347. [PMID: 29882107 PMCID: PMC6286233 DOI: 10.1007/s10803-018-3627-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Individuals with ASD have increased rates of depression compared to the general population. Repetitive cognition is a core feature of ASD; in typically developing adults, repetitive cognition has been associated with attentional biases to negative emotional material and increased prospective depression risk. We compared adults with ASD to typically developing adults with depression and never-depressed controls, using a paired preference paradigm sensitive to affective biases in the context of repetitive cognition. Both clinical cohorts oriented faster to negative social-emotional material and spent less time overall on positive material, compared to healthy controls. Exploratory analyses within ASD revealed specific influences of repetitive behavior on patterns of affective bias. Findings help pinpoint susceptibilities in ASD that may confer increased risk for depression.
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Affiliation(s)
- Kathryn E Unruh
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Schiefelbusch Institute for Life Span Studies and Kansas Center for Autism Research and Training (K-CART), University of Kansas, Lawrence, KS, USA
| | - James W Bodfish
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Hearing & Speech Sciences, Vanderbilt University, Nashville, TN, USA
| | - Katherine O Gotham
- Department of Hearing & Speech Sciences, Vanderbilt University, Nashville, TN, USA.
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Dekker LP, Visser K, van der Vegt EJM, Maras A, van der Ende J, Tick NT, Verhulst FC, Greaves-Lord K. Insight into Informant Discrepancies Regarding Psychosexual Functioning of Adolescents with and without Autism Spectrum Disorder. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2020; 30:487-501. [PMID: 31802571 DOI: 10.1111/jora.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The private nature of psychosexual functioning leads adolescents and their parents to have different perspectives, which highlights studying parent-child informant discrepancies in this domain. We investigated informant discrepancy in psychosexual functioning, using the self-report and parent report versions of the Teen Transition Inventory (TTI), of adolescents with autism spectrum disorder (ASD; 136 parent-child dyads) compared to adolescents from the general population (GP; 70 parent-child dyads). Significantly larger informant discrepancies exist in ASD dyads than GP dyads in most domains of psychosexual functioning, except for Body image, Sexual behavior, and Confidence in the future. It is important to use and pay attention to both informants, as discrepancies are relevant for both research and clinical practice regarding psychosexual functioning.
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Affiliation(s)
| | - Kirsten Visser
- Erasmus MC-Sophia
- Yulius, Organization for Mental Health
- Youz Child & Adolescent Psychiatry, Team Sarr Autism Expertise Centre
| | | | | | | | - Nouchka T Tick
- Yulius, Organization for Mental Health
- University Utrecht
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13
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Trimarco B, Manti F, Nardecchia F, Melogno S, Testa M, Meledandri G, Carducci C, Penge R, Leuzzi V. Executive functioning, adaptive skills, emotional and behavioral profile: A comparison between autism spectrum disorder and phenylketonuria. Mol Genet Metab Rep 2020; 23:100577. [PMID: 32181141 PMCID: PMC7066217 DOI: 10.1016/j.ymgmr.2020.100577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 02/22/2020] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Influential theories maintain that some of Autism Spectrum Disorder (ASD) core symptoms may arise from deficits in executive functions (EF). EF deficits are also considered a neuropsychological marker of early treated individuals with phenylketonuria (PKU). Aims of this study were: to verify the occurrence and patterns of specific EF impairments in both clinical groups; to explore the coexistence of EF alterations with adaptive, behavioral and emotional problems in each clinical condition. MATERIAL AND METHODS We assessed EF, adaptive, behavioral and emotional profile in 21 participants with ASD, 15 early treated PKU individuals, comparable for age and IQ, and 14 controls, comparable for age to the clinical groups (age range: 7-14 years). RESULTS ASD and PKU participants presented two different, but partially overlapping patterns of EF impairment. While ASD participants showed a specific deficit in cognitive flexibility only, PKU individuals showed a more extensive impairment in EF with a weaker performance in two core EF domains (inhibition, cognitive flexibility) as compared to healthy controls. Psychological and adaptive profile was typical in PKU participants, while ASD participants experienced behavioral (externalizing symptoms), emotional (internalizing symptoms) and adaptive disorders (general, practical, social domains). CONCLUSIONS Present results support the view of a relative disengagement of adaptive and emotional-behavioral profile with respect to EF skills and suggest that other dysfunctions contribute to the multidimensional phenotype of ASD participants.
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Affiliation(s)
- Barbara Trimarco
- Department of Human Neuroscience, “Sapienza” University of Rome, Via dei Sabelli 108, 00185 Rome, Italy
| | - Filippo Manti
- Department of Human Neuroscience, “Sapienza” University of Rome, Via dei Sabelli 108, 00185 Rome, Italy
| | - Francesca Nardecchia
- Department of Human Neuroscience, “Sapienza” University of Rome, Via dei Sabelli 108, 00185 Rome, Italy
| | - Sergio Melogno
- Department of Human Neuroscience, “Sapienza” University of Rome, Via dei Sabelli 108, 00185 Rome, Italy
| | - Mara Testa
- Department of Human Neuroscience, “Sapienza” University of Rome, Via dei Sabelli 108, 00185 Rome, Italy
| | - Giovanni Meledandri
- Department of Human Science, “Università degli Studi Guglielmo Marconi”, Via Plinio 44, 00193 Rome, Italy
| | - Claudia Carducci
- Department of Experimental Medicine, Sapienza University of Rome, Viale del policlinico 155, 00161 Rome, Italy
| | - Roberta Penge
- Department of Human Neuroscience, “Sapienza” University of Rome, Via dei Sabelli 108, 00185 Rome, Italy
| | - Vincenzo Leuzzi
- Department of Human Neuroscience, “Sapienza” University of Rome, Via dei Sabelli 108, 00185 Rome, Italy
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Almonte MT, Capellàn P, Yap TE, Cordeiro MF. Retinal correlates of psychiatric disorders. Ther Adv Chronic Dis 2020; 11:2040622320905215. [PMID: 32215197 PMCID: PMC7065291 DOI: 10.1177/2040622320905215] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/08/2020] [Indexed: 12/27/2022] Open
Abstract
Diagnosis and monitoring of psychiatric disorders rely heavily on subjective self-reports of clinical symptoms, which are complicated by the varying consistency of accounts reported by patients with an impaired mental state. Hence, more objective and quantifiable measures have been sought to provide clinicians with more robust methods to evaluate symptomology and track progression of disease in response to treatments. Owing to the shared origins of the retina and the brain, it has been suggested that changes in the retina may correlate with structural and functional changes in the brain. Vast improvements in retinal imaging, namely optical coherence tomography (OCT) and electrodiagnostic technology, have made it possible to investigate the eye at a microscopic level, allowing for the investigation of potential biomarkers in vivo. This review provides a summary of retinal biomarkers associated with schizophrenia, bipolar disorder and major depression, demonstrating how retinal biomarkers may be used to complement existing methods and provide structural markers of pathophysiological mechanisms that underpin brain dysfunction in psychiatric disorders.
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Affiliation(s)
- Melanie T. Almonte
- Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
| | | | - Timothy E. Yap
- Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
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15
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Hillier A, Ryan J, Buckingham A, Schena D, Queenan A, Dottolo A, Abreu M. Prospective College Students With Autism Spectrum Disorder: Parent Perspectives. Psychol Rep 2020; 124:88-107. [PMID: 32056494 DOI: 10.1177/0033294120905517] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Young adults with autism spectrum disorder (ASD) are attending university in increasing numbers. While those with ASD may be very knowledgeable within their chosen field, a range of academic-related and nonacademic challenges may hinder their success including executive functioning challenges and interpersonal issues. The purpose of this study was to conduct a preliminary investigation into the perspective of parents of high schoolers with ASD regarding their son/daughters' transition to college. Qualitative analysis of parent interviews examined the concerns and challenges they anticipated their son/daughter might experience in a university setting, as well as supports they are seeking as they consider postsecondary options. Prominent themes that emerged as areas of concern were social skills, executive functioning, academics, campus living, and support services. These findings highlight some key potential pitfalls for students with ASD which may be useful targets for prevention and remediation, as well as informing policy for colleges and universities as they consider cost-effective interventions to improve the academic success of students with ASD.
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Affiliation(s)
| | | | | | | | - Alexa Queenan
- Department of Psychology, University of Massachusetts Lowell, MA, USA
| | - Andrea Dottolo
- Department of Psychology, 6747Rhode Island College, Providence, RI, USA
| | - Marlene Abreu
- Department of Psychology, University of Massachusetts Lowell, MA, USA
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16
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Day TC, McNaughton KA, Naples AJ, McPartland JC. Self-reported social impairments predict depressive disorder in adults with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:297-306. [PMID: 31238701 PMCID: PMC6930361 DOI: 10.1177/1362361319857375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In adults with autism spectrum disorder, co-occurring psychiatric conditions are prevalent, and depression is one of the most common co-occurring disorders. This study examined the relationship between depression and cognitive ability, autism symptom severity, and self-reported social impairments in autism spectrum disorder. A total of 33 adults with autism spectrum disorder and 28 adults with typical development completed a standardized psychiatric interview, cognitive test, measure of clinician-rated autism symptom severity, and self-report of social impairments. Nine participants with autism spectrum disorder (27%) met the criteria for a depressive disorder (autism spectrum disorder + depressive disorder). Relatively more females with autism spectrum disorder had a co-occurring depressive disorder. The typical development group had a higher intelligence quotient than the autism spectrum disorder group, but the autism spectrum disorder + depressive disorder group did not differ from the typical development or autism spectrum disorder group. While the autism spectrum disorder + depressive disorder group had lower clinician-rated autism symptom severity than the autism spectrum disorder group, the autism spectrum disorder + depressive disorder group reported more social impairments than the autism spectrum disorder group. Self-reported social impairments predicted depression in adults with autism spectrum disorder when accounting for symptom severity and cognitive ability. These findings suggest that more self-perceived social impairments are related to depressive disorders in autism spectrum disorder, and may help clinicians identify individuals who are vulnerable in developing a co-occurring depressive disorder. Future directions include follow-up studies with larger cohorts and longitudinal designs to support inferences regarding directionality of these relationships.
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17
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Russell A, Gaunt D, Cooper K, Horwood J, Barton S, Ensum I, Ingham B, Parr J, Metcalfe C, Rai D, Kessler D, Wiles N. Guided self-help for depression in autistic adults: the ADEPT feasibility RCT. Health Technol Assess 2019; 23:1-94. [PMID: 31856942 PMCID: PMC6943380 DOI: 10.3310/hta23680] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Co-occurring depression frequently occurs in autism. Evidence-based psychological interventions have been successfully adapted to treat co-occurring anxiety, but there is little evidence about the usefulness of adapted cognitive-behavioural therapy for depression. To the authors' knowledge, to date there have been no randomised trials investigating the usefulness of low-intensity cognitive-behavioural therapy for depression in autism. OBJECTIVES The objectives of the study were to (1) develop a low-intensity psychological intervention for depression adapted for autism, (2) assess the feasibility and patient and therapist acceptability of the intervention, (3) estimate the rates of recruitment and retention for a full-scale randomised controlled trial and (4) identify an appropriate measure of depression to be used in a full-scale randomised controlled trial. DESIGN The study comprised a randomised controlled trial (n = 70) with a nested qualitative evaluation (n = 21). Seventy eligible and consenting participants were randomly allocated to guided self-help or to treatment as usual. SETTING Adult autism services in two NHS regions. PARTICIPANTS Adults with a diagnosis of autism spectrum disorder with depression, that is, a Patient Health Questionnaire-9 items score of ≥ 10. People who had attended more than six sessions of cognitive-behavioural therapy in the previous 6 months were excluded. INTERVENTIONS The low-intensity intervention (guided self-help) comprised materials for nine individual sessions, based on behavioural activation adapted for autism, facilitated by therapist guides (coaches) who were graduate-level psychologists who attended training and regular supervision. Treatment as usual was standard NHS care for depression. MAIN OUTCOME MEASURES Outcomes were measured 10, 16 and 24 weeks post randomisation using self-report and interview measures of depression, anxiety, obsessive-compulsive symptoms, social function and quality of life, and a health-care and service use questionnaire. As this was a feasibility study also designed to identify the most appropriate measure of depression, it was not possible to specify the primary outcome measure or outcome point a priori. RESULTS The aims of the study were met in full. The guided self-help intervention was feasible and well received by participants and coaches. The majority of allocated participants attended the intervention in full. The most practical outcome point was determined to be 16 weeks. There were differential rates of attrition across the treatment groups: 86% of the guided self-help group remained in the study at 24 weeks, compared with 54% of treatment as usual group. The qualitative study suggested that guided self-help had enhanced credibility with participants at the point of randomisation. Inter-rater reliability of the interview measure of depression was less than adequate, limiting the conclusions that can be drawn from the prespecified sensitivity to change analyses. CONCLUSIONS The intervention was feasible and well received. Although this feasibility study was not a fully powered trial, it provided some evidence that the guided self-help intervention was effective in reducing depressive symptoms. A full-scale clinical effectiveness and cost-effectiveness trial of the intervention is warranted. FUTURE WORK Improvements to the intervention materials as a result of qualitative interviews. Stakeholder consultation to consider future trial design, consider strategies to improve retention in a treatment as usual arm and select a self-report measure of depression to serve as the primary outcome measure. TRIAL REGISTRATION Current Controlled Trials ISRCTN54650760. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 68. See the NIHR Journals Library website for further project information. This study was also supported by the NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol.
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Affiliation(s)
- Ailsa Russell
- Centre for Applied Autism Research, Department of Psychology, Faculty of Humanities and Social Sciences, University of Bath, Bath, UK
| | - Daisy Gaunt
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Cooper
- Centre for Applied Autism Research, Department of Psychology, Faculty of Humanities and Social Sciences, University of Bath, Bath, UK
| | - Jeremy Horwood
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Stephen Barton
- Newcastle Cognitive and Behavioural Therapies Centre, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ian Ensum
- BASS Adult Autism Service, Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | - Barry Ingham
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jeremy Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Chris Metcalfe
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Dheeraj Rai
- School of Social and Community Medicine, Bristol Medical School, University of Bristol, Bristol, UK
| | - David Kessler
- School of Social and Community Medicine, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicola Wiles
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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18
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Russell A, Gaunt DM, Cooper K, Barton S, Horwood J, Kessler D, Metcalfe C, Ensum I, Ingham B, Parr JR, Rai D, Wiles N. The feasibility of low-intensity psychological therapy for depression co-occurring with autism in adults: The Autism Depression Trial (ADEPT) - a pilot randomised controlled trial. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:1360-1372. [PMID: 31782656 PMCID: PMC8645299 DOI: 10.1177/1362361319889272] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Low-intensity cognitive behaviour therapy including behavioural activation is an evidence-based treatment for depression, a condition frequently co-occurring with autism. The feasibility of adapting low-intensity cognitive behaviour therapy for depression to meet the needs of autistic adults via a randomised controlled trial was investigated. The adapted intervention (guided self-help) comprised materials for nine individual sessions with a low-intensity psychological therapist. Autistic adults (n = 70) with depression (Patient Health Questionnaire-9 score ⩾10) recruited from National Health Service adult autism services and research cohorts were randomly allocated to guided self-help or treatment as usual. Outcomes at 10-, 16- and 24-weeks post-randomisation were blind to treatment group. Rates of retention in the study differed by treatment group with more participants attending follow-up in the guided self-help group than treatment as usual. The adapted intervention was well-received, 86% (n = 30/35) of participants attended the pre-defined 'dose' of five sessions of treatment and 71% (25/35) attended all treatment sessions. The findings of this pilot randomised controlled trial indicate that low-intensity cognitive behaviour therapy informed by behavioural activation can be successfully adapted to meet the needs of autistic people. Evaluation of the effectiveness of this intervention in a full scale randomised controlled trial is now warranted.
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Affiliation(s)
| | | | | | | | | | | | | | - Ian Ensum
- Avon and Wiltshire Mental Health Partnership NHS Trust, UK
| | - Barry Ingham
- Northumberland, Tyne and Wear NHS Foundation Trust, UK
| | - Jeremy R Parr
- Northumberland, Tyne and Wear NHS Foundation Trust, UK.,Newcastle University, UK
| | - Dheeraj Rai
- University of Bristol, UK.,Avon and Wiltshire Mental Health Partnership NHS Trust, UK
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19
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Johnston K, Murray K, Spain D, Walker I, Russell A. Executive Function: Cognition and Behaviour in Adults with Autism Spectrum Disorders (ASD). J Autism Dev Disord 2019; 49:4181-4192. [PMID: 31281952 PMCID: PMC6751156 DOI: 10.1007/s10803-019-04133-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Studies of executive function (EF) in autism spectrum disorder (ASD) have reported mixed findings. Possible confounds include EF domain assessed and co-occurring neurodevelopmental diagnoses. EF task performance across multiple domains and everyday function of autistic adults (n = 110) was significantly different to age- and IQ-matched controls (n = 31). Although significantly more likely to fall into the clinically impaired range, 35.8% of the ASD group showed no impairment on EF measures. Factor analysis revealed a single unifying EF construct rather than a selective pattern of impairment. Dysexecutive behaviours were frequently reported in the ASD group, unrelated to Autism symptoms, EF task performance or co-occurring conditions. This study suggests autistic adults can experience clinically significant executive function difficulties and co-occuring dysexecutive behaviours that are disabling in everyday life.
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Affiliation(s)
- Kate Johnston
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London & Maudsley NHS Foundation Trust, National & Specialist CAMHS, Adolescent At-risk & Forensic Service, Michael Rutter Centre, Maudsley Hospital, De Crespigny Park, London, SE5 8AZ UK
| | - Kim Murray
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Debbie Spain
- Autism Assessment and Behavioural Genetics Clinic, South London and Maudsley Foundation NHS Trust, London, UK
- MRC Centre for Social Genetic and Developmental Psychiatry, King’s College London, London, SE5 8AF UK
| | - Ian Walker
- Department of Psychology, University of Bath, Bath, BA2 7AY UK
| | - Ailsa Russell
- Department of Psychology, University of Bath, Bath, BA2 7AY UK
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, BA2 7AY UK
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20
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Hollocks MJ, Lerh JW, Magiati I, Meiser-Stedman R, Brugha TS. Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis. Psychol Med 2019; 49:559-572. [PMID: 30178724 DOI: 10.1017/s0033291718002283] [Citation(s) in RCA: 367] [Impact Index Per Article: 73.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Adults with autism spectrum disorder (ASD) are thought to be at disproportionate risk of developing mental health comorbidities, with anxiety and depression being considered most prominent amongst these. Yet, no systematic review has been carried out to date to examine rates of both anxiety and depression focusing specifically on adults with ASD. This systematic review and meta-analysis examined the rates of anxiety and depression in adults with ASD and the impact of factors such as assessment methods and presence of comorbid intellectual disability (ID) diagnosis on estimated prevalence rates. Electronic database searches for studies published between January 2000 and September 2017 identified a total of 35 studies, including 30 studies measuring anxiety (n = 26 070; mean age = 30.9, s.d. = 6.2 years) and 29 studies measuring depression (n = 26 117; mean age = 31.1, s.d. = 6.8 years). The pooled estimation of current and lifetime prevalence for adults with ASD were 27% and 42% for any anxiety disorder, and 23% and 37% for depressive disorder. Further analyses revealed that the use of questionnaire measures and the presence of ID may significantly influence estimates of prevalence. The current literature suffers from a high degree of heterogeneity in study method and an overreliance on clinical samples. These results highlight the importance of community-based studies and the identification and inclusion of well-characterized samples to reduce heterogeneity and bias in estimates of prevalence for comorbidity in adults with ASD and other populations with complex psychiatric presentations.
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Affiliation(s)
| | - Jian Wei Lerh
- Department of Psychology,National University of Singapore,Singapore
| | - Iliana Magiati
- Department of Psychology,National University of Singapore,Singapore
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21
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Thompson C, Bölte S, Falkmer T, Girdler S. Viewpoints on how students with autism can best navigate university. Scand J Occup Ther 2018; 26:294-305. [DOI: 10.1080/11038128.2018.1495761] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Craig Thompson
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Sven Bölte
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
- Department of Women’s and Children’s Health, Pediatric Neuropsychiatry Unit, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Child and Adolescent Psychiatry Research Center, Karolinska Institutet, Stockholm, Sweden
- Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Torbjörn Falkmer
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department for Rehabilitation, Jönköping University, Jönköping, Sweden
| | - Sonya Girdler
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
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22
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Thompson C, Bölte S, Falkmer T, Girdler S. To be understood: Transitioning to adult life for people with Autism Spectrum Disorder. PLoS One 2018; 13:e0194758. [PMID: 29579089 PMCID: PMC5868819 DOI: 10.1371/journal.pone.0194758] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 03/07/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The purpose of this study was to explore the viewpoints of parents of young people with Autism Spectrum Disorder (ASD) in relation to their child's transition to adulthood. METHODS Data were collected during four structured focus groups with 19 parents of young people with ASD with average to high intellectual capacities. Condensed meaning units were identified and checked during focus groups, and were subsequently linked to the International Classification of Functioning, Disability and Health (ICF). RESULTS Three major themes emerged: to be understood, to understand the world and to succeed. The ICF domains of activity and participation and environmental factors emerged as having the greatest potential to influence transition outcomes. CONCLUSIONS Policies and services should focus on strengths to maximise participation in higher education, employment and independent living amongst young people with ASD. Interventions targeting environmental factors could be effective in improving participation in adult life. Person-centred and individualised approaches could further complement this approach supporting the transition to adulthood for people with ASD, ultimately improving outcomes in adulthood.
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Affiliation(s)
- Craig Thompson
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Sven Bölte
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
- Department of Women’s and Children’s Health, Pediatric Neuropsychiatry Unit, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Child and Adolescent Psychiatry Research Center, Karolinska Institutet, Stockholm, Sweden
- Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Torbjörn Falkmer
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Sonya Girdler
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
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23
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Cassidy SA, Bradley L, Bowen E, Wigham S, Rodgers J. Measurement properties of tools used to assess depression in adults with and without autism spectrum conditions: A systematic review. Autism Res 2018; 11:738-754. [PMID: 29360200 PMCID: PMC6001465 DOI: 10.1002/aur.1922] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 12/05/2017] [Accepted: 12/27/2017] [Indexed: 12/03/2022]
Abstract
Depression is the most commonly experienced mental health condition in adults with autism spectrum conditions (ASC). However, it is unclear what tools are currently being used to assess depression in ASC, or whether tools need to be adapted for this group. This systematic review therefore aimed to identify tools used to assess depression in adults with and without ASC, and then evaluate these tools for their appropriateness and measurement properties. Medline, PsychINFO and Web of Knowledge were searched for studies of depression in: (a) adults with ASC, without co‐morbid intellectual disability; and (b) adults from the general population without co‐morbid conditions. Articles examining the measurement properties of these tools were then searched for using a methodological filter in PubMed, and the quality of the evidence was evaluated using the COSMIN checklist. Twelve articles were identified which utilized three tools to assess depression in adults with ASC, but only one article which assessed the measurement properties of one of these tools was identified and thus evaluated. Sixty‐four articles were identified which utilized five tools to assess depression in general population adults, and fourteen articles had assessed the measurement properties of these tools. Overall, two tools were found to be robust in their measurement properties in the general population—the Beck Depression Inventory (BDI‐II), and the patient health questionnaire (PHQ‐9). Crucially only one study was identified from the COSMIN search, which showed weak evidence in support of the measurement properties of the BDI‐II in an ASC sample. Implications for effective measurement of depression in ASC are discussed. Autism Res2018, 11: 738–754. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Lay Summary Depression is the most common mental health problem experienced by adults with autism. However, the current study found very limited evidence regarding how useful tools developed for the general population are for adults with autism. We therefore suggest how these tools could be adapted to more effectively assess depression in adults with autism, and improve these individuals access to mental health assessment and support.
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Affiliation(s)
- S A Cassidy
- School of Psychology, University of Nottingham, UK.,Institute of Neuroscience, Newcastle University, UK.,Centre for Innovative Research Across the Life Course, Coventry University, UK
| | - L Bradley
- Centre for Innovative Research Across the Life Course, Coventry University, UK
| | - E Bowen
- Centre for Violence Prevention, University of Worcester, UK
| | - S Wigham
- Institute of Neuroscience, Newcastle University, UK
| | - J Rodgers
- Institute of Neuroscience, Newcastle University, UK
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Dekker LP, van der Vegt EJM, van der Ende J, Tick N, Louwerse A, Maras A, Verhulst FC, Greaves-Lord K. Psychosexual Functioning of Cognitively-able Adolescents with Autism Spectrum Disorder Compared to Typically Developing Peers: The Development and Testing of the Teen Transition Inventory- a Self- and Parent Report Questionnaire on Psychosexual Functioning. J Autism Dev Disord 2017; 47:1716-1738. [PMID: 28299510 PMCID: PMC5432605 DOI: 10.1007/s10803-017-3071-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To gain further insight into psychosexual functioning, including behaviors, intrapersonal and interpersonal aspects, in adolescents with Autism Spectrum Disorder (ASD), comprehensive, multi-informant measures are needed. This study describes (1) the development of a new measure of psychosexual functioning in both parent- and self-reports (Teen Transition Inventory; TTI) covering all three domains of psychosexual functioning (i.e. psychosexual socialization, psychosexual selfhood, and sexual/intimate behavior). And (2) the initial testing of this instrument, comparing adolescents with ASD (n = 79 parent-report; n = 58 self-report) to Typically Developing (TD) adolescents (n = 131 parent-report; n = 91 self-report) while taking into account gender as a covariate. Results from both informants indicate more difficulties regarding psychosexual socialization and psychosexual selfhood in the ASD group. With regard to sexual/intimate behavior, only parents reported significantly more problems in adolescents with ASD.
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Affiliation(s)
- Linda P Dekker
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands. .,Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands.
| | - Esther J M van der Vegt
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands.,Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands
| | - Nouchka Tick
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands.,Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands
| | - Anneke Louwerse
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands.,Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands
| | - Athanasios Maras
- Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands.,Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands
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Heasman B, Gillespie A. Perspective-taking is two-sided: Misunderstandings between people with Asperger's syndrome and their family members. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 22:740-750. [PMID: 28683569 PMCID: PMC6055325 DOI: 10.1177/1362361317708287] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Misunderstandings are social in nature, always having two sides. Yet the misunderstandings experienced by people with Asperger's syndrome are usually studied in terms of the individual with a diagnosis, with less emphasis on social relations. We use a two-sided methodology to map out misunderstandings within 22 dyads (n = 44) consisting of people with Asperger's syndrome and their family members. Both sides of the relationship were asked about 12 topics in terms of one's rating of Self, one's rating of Other and one's predicted rating by Other. The findings show that people with Asperger's are able to predict lower scores from family members, despite disagreeing with their view, and that family members often over-estimate the extent to which their relatives with Asperger's syndrome are egocentrically anchored in their own perspective. The research demonstrates that a two-sided methodology is viable, and it uses it to identify how representations of Asperger's syndrome can both support and hinder social understanding within relationships affected by Asperger's.
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Affiliation(s)
- Brett Heasman
- The London School of Economics and Political Science, UK
| | - Alex Gillespie
- The London School of Economics and Political Science, UK
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26
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Lerma A, Perez-Grovas H, Bermudez L, Peralta-Pedrero ML, Robles-García R, Lerma C. Brief cognitive behavioural intervention for depression and anxiety symptoms improves quality of life in chronic haemodialysis patients. Psychol Psychother 2017; 90:105-123. [PMID: 27435635 DOI: 10.1111/papt.12098] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 03/04/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Psychological treatment of depression in end-stage renal disease (ESRD) has focused on severely depressed patients. We designed and tested a brief (5 weeks) cognitive behavioural intervention (CBI) to reduce mild and moderate depression and anxiety symptoms in patients with ESRD. DESIGN For the purpose of this study, a single-blind, randomized controlled design was used to compare patients with ESRD under haemodialysis treatment with and without the CBI. METHODS Depression and anxiety symptoms were screened in 152 subjects (18-60 years old, 84 male). Sixty participants (age 41.8 ± 14.7, 29 males) with mild or moderate scores of depression (Beck Depression Inventory) and anxiety (Beck Anxiety Inventory) were randomly assigned to CBI or the control group. CBI techniques consisted of positive self-reinforcement, deep breathing, muscle relaxation, and cognitive restructuring. Depression, anxiety, quality of life (QoL), and cognitive distortion scores were evaluated at baseline, after 5 weeks (end of treatment) and after 4-week follow-up. All scores were compared by ANOVA for repeated measures with post-hoc tests adjusted by Bonferroni's method (p < .05 was considered significant). RESULTS At follow-up, depression, anxiety, and cognitive distortions had decreased, and QoL had increased in the intervention group, and there were no changes in the control group. Clinical utility was 33% for depression and 43% for anxiety. CONCLUSIONS A brief CBI of 5 weeks is effective for decreasing mild or moderate depression and anxiety symptoms and improving QoL in ESRD haemodialysis patients. PRACTITIONER POINTS A brief, systematic and structured cognitive behavioural intervention (CBI) decreases anxiety and depression symptoms and improves quality of life in patients with end-stage renal disease (ESRD) who are being treated with haemodialysis. These benefits are not achieved when anxiety and depression symptoms are identified but not treated psychologically. This CBI consisted of cognitive restructuring of the distorted thoughts (perfectionism, catastrophic thinking, negative self-labelling, and dichotomous thinking) that are correlated with depression and anxiety symptoms and that can be assessed by a validated questionnaire designed for patients with ESRD. The handbooks that were developed for this study are structured and systematic. They could be valuable in supporting the efforts and participation of non-specialized health professionals in CBI such as nurses, physicians, social workers, and psychologists, raising the possibility of further application in a variety of clinical populations. Both the therapy and the client workbooks are available in Spanish upon request.
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Affiliation(s)
- Abel Lerma
- University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, Mexico.,Direction of Epidemiological and Psychosocial Research, National Institute of Psychiatry "Ramón de la Fuente", Distrito Federal, Mexico
| | - Héctor Perez-Grovas
- Department of Nephrology, National Institute of Cardiology "Ignacio Chávez", Distrito Federal, Mexico
| | - Luis Bermudez
- London Medical, Medical and Equipment Services, Distrito Federal, Mexico
| | - María L Peralta-Pedrero
- Coordination of High Specialty Medical Units, Mexican Institute of Social Security, Distrito Federal, Mexico
| | - Rebeca Robles-García
- Direction of Epidemiological and Psychosocial Research, National Institute of Psychiatry "Ramón de la Fuente", Distrito Federal, Mexico
| | - Claudia Lerma
- Department of Electromechanical Instrumentation, National Institute of Cardiology "Ignacio Chávez", Distrito Federal, Mexico
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27
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Gernsbacher MA, Stevenson JL, Dern S. Specificity, contexts, and reference groups matter when assessing autistic traits. PLoS One 2017; 12:e0171931. [PMID: 28192464 PMCID: PMC5305234 DOI: 10.1371/journal.pone.0171931] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/29/2017] [Indexed: 12/18/2022] Open
Abstract
Many of the personality and behavioral traits (e.g., social imperviousness, directness in conversation, lack of imagination, affinity for solitude, difficulty displaying emotions) that are known to be sensitive to context (with whom?) and reference group (according to whom?) also appear in questionnaire-based assessments of autistic traits. Therefore, two experiments investigated the effects of specifying contexts and reference groups when assessing autistic traits in autistic and non-autistic participants. Experiment 1 (124 autistic and 124 non-autistic participants) demonstrated that context matters when assessing autistic traits (F(1,244) = 267.5, p < .001, η2p = .523). When the context of the Broad Autism Phenotype Questionnaire was specified as the participants’ out-group (e.g., “I like being around non-autistic people” or “I like being around autistic people”), both autistic and non-autistic participants self-reported having more autistic traits; when the context was specified as the participants’ in-group, participants reported having fewer autistic traits. Experiment 2 (82 autistic and 82 non-autistic participants) demonstrated that reference group matters when assessing autistic traits (F(2,160) = 94.38, p < .001, η2p = .541). When the reference group on the Social Responsiveness Scale was specified as the participants’ out-group (e.g., “According to non-autistic people, I have unusual eye contact”), autistic participants reported having more autistic traits; when the reference group was their in-group, autistic participants reported having fewer autistic traits. Non-autistic participants appeared insensitive to reference group on the Social Responsiveness Scale. Exploratory analyses suggested that when neither the context nor the reference group is specified (for assessing autistic traits on the Autism-Spectrum Quotient), both autistic and non-autistic participants use the majority (“non-autistic people”) as the implied context and reference group.
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Affiliation(s)
- Morton Ann Gernsbacher
- Department of Psychology, University of Wisconsin–Madison, Madison, Wisconsin, United States of America
- * E-mail:
| | - Jennifer L. Stevenson
- Department of Psychology, Ursinus College, Collegeville, Pennsylvania, United States of America
| | - Sebastian Dern
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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28
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Lever AG, Geurts HM. Psychiatric Co-occurring Symptoms and Disorders in Young, Middle-Aged, and Older Adults with Autism Spectrum Disorder. J Autism Dev Disord 2017; 46:1916-1930. [PMID: 26861713 PMCID: PMC4860203 DOI: 10.1007/s10803-016-2722-8] [Citation(s) in RCA: 273] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although psychiatric problems are less prevalent in old age within the general population, it is largely unknown whether this extends to individuals with autism spectrum disorders (ASD). We examined psychiatric symptoms and disorders in young, middle-aged, and older adults with and without ASD (Nmax = 344, age 19–79 years, IQ > 80). Albeit comparable to other psychiatric patients, levels of symptoms and psychological distress were high over the adult lifespan; 79 % met criteria for a psychiatric disorder at least once in their lives. Depression and anxiety were most common. However, older adults less often met criteria for any psychiatric diagnosis and, specifically, social phobia than younger adults. Hence, despite marked psychological distress, psychiatric problems are also less prevalent in older aged individuals with ASD.
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Affiliation(s)
- Anne G Lever
- Dutch Autism and ADHD Research Center, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WT, Amsterdam, The Netherlands.
| | - Hilde M Geurts
- Dutch Autism and ADHD Research Center, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WT, Amsterdam, The Netherlands.,Dr. Leo Kannerhuis, Research Development and Innovation, Houtsniplaan 1a, 6865 XZ, Doorwerth, The Netherlands
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29
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Taylor JL, Gotham KO. Cumulative life events, traumatic experiences, and psychiatric symptomatology in transition-aged youth with autism spectrum disorder. J Neurodev Disord 2016; 8:28. [PMID: 27468315 PMCID: PMC4962443 DOI: 10.1186/s11689-016-9160-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/17/2016] [Indexed: 11/30/2022] Open
Abstract
Background Co-occurring mood and anxiety symptomatology is commonly observed among youth with autism spectrum disorders (ASD) during adolescence and adulthood. Yet, little is known about the factors that might predispose youth with ASD to mood and anxiety problems. In this study, we focus on the role of cumulative stressful life events and trauma in co-occurring psychopathology among youth with ASD who are preparing to exit high school. Specifically, we examined the distribution of cumulative life events and traumatic experiences and their relations with mood and anxiety symptomatology. Methods Participants included 36 youth with ASD, all of whom were in their last year of high school. Cumulative life events and trauma were assessed by parent report. Mood and anxiety symptomatology was determined using a variety of methods (structured interview, questionnaire, self- and informant report). Frequencies were used to examine the distributions of cumulative life events (count of total events) and trauma (coded into any trauma vs. no trauma), as well as mood and anxiety symptomatology (categorized into clinical-level, sub-threshold, or none for each). Bivariate relations between life events/trauma and mood/anxiety symptomatology were assessed using analysis of variance and chi-square. Ordinal logistic regression models were used to test whether significant bivariate relations remained after controlling for the sex of the youth with ASD and his/her IQ. Results Over 50 % of youth had experienced at least one trauma. Nearly one half had clinical-level mood or anxiety symptomatology. There was a statistically significant relation between absence/presence of trauma and mood symptomatology; nearly 90 % of the youth with clinical-level mood symptoms had at least one trauma, compared to 40 % of those with no mood symptomatology. Conclusions Our findings suggest that contextual factors such as trauma might be important for the development of mood symptomatology in individuals with ASD. Although this idea is well-accepted in typically developing populations, contextual factors are rarely studied in investigations of psychopathology or transition outcomes in ASD. Given the high rates of psychiatric comorbidities in this population, future research should continue to identify the range of possible factors—both behavioral and contextual—that might influence the emergence of these disorders. Electronic supplementary material The online version of this article (doi:10.1186/s11689-016-9160-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julie Lounds Taylor
- Department of Pediatrics and Vanderbilt Kennedy Center, Vanderbilt University School of Medicine, PMB 40 - 230 Appleton Pl., Nashville, TN 37203 USA
| | - Katherine O Gotham
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Vanderbilt Kennedy Center, 1200 21st Ave. S, suite 2272, Nashville, TN 37203 USA
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30
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Fernandes LC, Gillberg CI, Cederlund M, Hagberg B, Gillberg C, Billstedt E. Aspects of Sexuality in Adolescents and Adults Diagnosed with Autism Spectrum Disorders in Childhood. J Autism Dev Disord 2016; 46:3155-65. [DOI: 10.1007/s10803-016-2855-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Rieske RD, Matson JL, Beighley JS, Cervantes PE, Goldin RL, Jang J. Comorbid psychopathology rates in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5. Dev Neurorehabil 2016; 18:218-23. [PMID: 23869479 DOI: 10.3109/17518423.2013.790519] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To investigate differences in comorbid psychopathology rates between individuals who meet criteria of Autism Spectrum Disorders (ASDs) according to DSM-5 or the DSM-IV-TR. METHODS Comorbid psychopathology was measured using the Autism Spectrum Disorders- Comorbid for Children. 424 individuals between the ages of 2 and 18 years of age; including children who met criteria for an ASD according to the DSM-5, the DSM-IV-TR only, and a control group that did not meet either set of criteria. RESULTS Of the ASD participants, 36% would no longer meet criteria according to proposed DSM-5. Comorbidity rates for the ASD groups were significantly different from the control group; however, ASD groups were not significantly different in terms of total comorbid psychopathology. CONCLUSION The results elucidate the need for further research regarding services and treatments for those individuals that will no longer meet criteria for an ASD but still have significant rates of comorbid psychopathology.
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Affiliation(s)
- Robert D Rieske
- Department of Psychology, Louisiana State University , Baton Rouge, LA , USA
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32
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Aggernæs B. Rethinking the Concept of Psychosis and the Link Between Autism and Schizophrenia. Scand J Child Adolesc Psychiatr Psychol 2015. [DOI: 10.21307/sjcapp-2016-002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Bodil Aggernæs
- Child and Adolescent Psychiatry , Region Zealand, Roskilde , Denmark
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33
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Borgwardt L, Thuesen AM, Olsen KJ, Fogh J, Dali CI, Lund AM. Cognitive profile and activities of daily living: 35 patients with alpha-mannosidosis. J Inherit Metab Dis 2015; 38:1119-27. [PMID: 26016802 DOI: 10.1007/s10545-015-9862-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 05/05/2015] [Accepted: 05/11/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Alpha-mannosidosis (OMIM 248500) (AM) is a rare lysosomal storage disease caused by a deficiency of the alpha-mannosidase enzyme. The typical signs consist of hearing impairment, intellectual disabilities, coarse facial features and motor function disturbances. We report on the cognitive function and activities of daily living in patients with AM. METHODS Thirty five AM patients, age 6-35 years, were included in the study. As a cognitive function test, we used the Leiter international performance scale-revised (Leiter-R), which consists of two batteries: the visual function and reasoning battery and the memory and attention battery, the latter including a memory screening. Additional two questionnaires, The Childhood Health Assessment Questionnaire (CHAQ) and EQ-5D-5 L, were filled out. RESULTS We found IQ in the range of 30-81 in our cohort. The total equivalent age (mental age) was significantly reduced, between 3-9 years old for the visual function and reasoning battery, between 2.3-10.2 years for the memory screening. Data suggested a specific developmental profile for AM with a positive intellectual development until the chronological age 10-12 years, followed by a static or slightly increasing intellectual level. All patients were to varying degrees socially and practically dependent and unable to take care of themselves in daily life. CONCLUSIONS Intellectual disability is a consistent finding in patients with alpha-mannosidosis but with extensive variation. We assess that this group of patients has, despite their intellectual disabilities, a potential for continuous cognitive development, especially during childhood and early teenage years. This should be included and supported in the individual educational planning.
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Affiliation(s)
- L Borgwardt
- Department of Clinical Genetics, Centre for Inherited Metabolic Diseases, Copenhagen University Hospital, Rigshospitalet, 9 Blegdamsvej, 2100, Copenhagen, Denmark.
| | | | | | - J Fogh
- Zymenex A/S (Chiesi Group), Hilleroed, Denmark
| | - C I Dali
- Department of Clinical Genetics, Centre for Inherited Metabolic Diseases, Copenhagen University Hospital, Rigshospitalet, 9 Blegdamsvej, 2100, Copenhagen, Denmark
| | - A M Lund
- Department of Clinical Genetics, Centre for Inherited Metabolic Diseases, Copenhagen University Hospital, Rigshospitalet, 9 Blegdamsvej, 2100, Copenhagen, Denmark
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34
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Are Sensory Processing Features Associated with Depressive Symptoms in Boys with an ASD? J Autism Dev Disord 2015; 46:242-252. [DOI: 10.1007/s10803-015-2569-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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35
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Asperger syndrome and nonverbal learning difficulties in adult males: self- and parent-reported autism, attention and executive problems. Eur Child Adolesc Psychiatry 2015; 24:969-77. [PMID: 25399237 DOI: 10.1007/s00787-014-0646-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 11/05/2014] [Indexed: 10/24/2022]
Abstract
A specific overlap between Asperger syndrome (AS) and nonverbal learning difficulties (NLD) has been proposed, based on the observation that, as a group, people with AS tend to have significantly higher verbal IQ (VIQ) than performance IQ (PIQ), one of the core features of NLD. The primary aim was to assess the longer term outcome of NLD--broken down into persistent and transient forms. The present study of 68 individuals was performed in the context of a larger prospective longitudinal study to late adolescence/early adult life of 100 boys with AS. Using self- and parent-report measures, we studied the longer term outcome of the NLD (defined as VIQ > PIQ by 15 points) as regards social communication, repetitive behaviour, attention, and executive function (EF) was studied. Three subgroups were identified: (1) Persistent NLD (P-NLD), (2) Childhood "only" NLD (CO-NLD) and (3) Never NLD (NO-NLD). The P-NLD group had the worst outcome overall. The CO-NLD group had better reported EF scores than the two other AS subgroups. There were no differences between the subgroups regarding social communication, repetitive behaviour, or attentional skills. Low PIQ increased the risk of ADHD symptoms. In the context of AS in males, P-NLD carries a relatively poor outcome, particularly with regard to self-reported EF. However, CO-NLD appears to entail a significantly better outcome. The results underscore the importance of analysing the cognitive profile both at diagnosis and after several years, so as to be able to formulate a realistic prognosis.
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36
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Andersen PN, Skogli EW, Hovik KT, Egeland J, Øie M. Associations Among Symptoms of Autism, Symptoms of Depression and Executive Functions in Children with High-Functioning Autism: A 2 Year Follow-Up Study. J Autism Dev Disord 2015; 45:2497-507. [DOI: 10.1007/s10803-015-2415-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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37
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Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD. J Autism Dev Disord 2014; 44:2041-51. [PMID: 24634065 DOI: 10.1007/s10803-014-2087-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a waitlist. Following the intervention program, participants who were initially symptomatic reported significantly lower depression and stress scores on the Depression Anxiety Stress Scales in comparison to individuals on the waitlist. There was no significant change in anxiety related symptoms. The benefits were maintained at 3 and 9 month follow-up. Our findings demonstrate the potential of CBT in a small group setting for assisting young people with ASD who have symptoms of depression and stress.
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38
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Dekker LP, Hartman CA, van der Vegt EJ, Verhulst FC, van Oort FV, Greaves-Lord K. The longitudinal relation between childhood autistic traits and psychosexual problems in early adolescence: The Tracking Adolescents' Individual Lives Survey study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2014; 19:684-93. [PMID: 25192861 DOI: 10.1177/1362361314547114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Individuals with autistic traits are considered to be prone to develop psychosexual problems due to their limited social skills and insight. This study investigated the longitudinal relation between autistic traits in childhood (T1; age 10-12 years) and parent-reported psychosexual problems in early adolescence (T2; age 12-15 years). In a general population cohort study (n = 1873; the Tracking Adolescents' Individual Lives Survey (TRAILS)), autistic traits and psychosexual problems were determined. Logistic regression analyses were used to investigate whether childhood autistic traits, in individuals displaying no psychosexual problems in childhood, predicted the presence of psychosexual problems in adolescence, while controlling for pubertal development and conduct problems. Higher levels of autistic traits at T1 significantly predicted mild psychosexual problems at T2, above and beyond pubertal development and conduct problems. Particularly two dimensions of autistic traits at T1 were significant predictors; i.e. 'reduced contact/social interest' and 'not optimally tuned to the social situation'. Children with autistic traits - especially those with limited social interest and social regulation problems - showed to have a higher risk to develop psychosexual problems, albeit mild, in early adolescence as reported by parents. Although we showed that autistic traits predict psychosexual problems, it is only one of multiple predictors.
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Affiliation(s)
- Linda P Dekker
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC - Sophia, The Netherlands Yulius, Organization for Mental Health, The Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Esther Jm van der Vegt
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC - Sophia, The Netherlands Yulius, Organization for Mental Health, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC - Sophia, The Netherlands
| | - Floor Va van Oort
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC - Sophia, The Netherlands
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC - Sophia, The Netherlands Yulius, Organization for Mental Health, The Netherlands
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Gotham K, Unruh K, Lord C. Depression and its measurement in verbal adolescents and adults with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2014; 19:491-504. [PMID: 24916450 DOI: 10.1177/1362361314536625] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In a sample of 50 verbally fluent adolescents and adults with autism spectrum disorders (age: 16-31 years; verbal IQ: 72-140), we examined the pattern of response and associations between scores on common measures of depressive symptoms, participant characteristics, and clinical diagnosis of depressive disorders. Beck Depression Inventory-Second Edition item descriptives in this autism spectrum disorder sample were compared to previously published data from a large typically developing sample, with results suggesting that cognitive-attributional symptoms of depression may be particularly prevalent in autism spectrum disorder. Scores on a variety of self- and parent-report depression measures were not associated with chronological age or verbal IQ, and were relatively highly correlated with each other and with clinical diagnosis of a mood disorder. The Beck Depression Inventory-Second Edition and the Adult Self-Report "Depressive" scale best identified both depressed and non-depressed participants in this sample, though neither was particularly strong. Validation studies of depression measures in the autism spectrum disorder population are necessary to advance research into this prevalent and impairing comorbidity.
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Gotham K, Bishop SL, Brunwasser S, Lord C. Rumination and perceived impairment associated with depressive symptoms in a verbal adolescent-adult ASD sample. Autism Res 2014; 7:381-91. [PMID: 24802136 DOI: 10.1002/aur.1377] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 03/19/2014] [Indexed: 11/06/2022]
Abstract
The aim of this study was to examine the association between depressive symptoms and several psychosocial constructs (insight into autism symptoms, rumination, desire for social interaction, and satisfaction with social support) that may play a role in the development or maintenance of depression in verbally fluent adolescents and adults with ASD. Participants included 50 individuals with ASD and verbal IQ ≥ 70, aged 16-35 (sample size varied by measure). Elevated depressive symptoms on the Beck Depression Inventory, 2nd edition (BDI-II), were associated with greater self-perceived, autism-related impairments (n = 48), greater rumination (n = 21), and lower perceived social support (n = 37). Rumination tended to moderate the association between self-perceived autism symptoms and BDI-II scores (n = 21), and was significantly associated with ASD-related insistence on sameness behaviors (n = 18). An unexpected relationship between depressive features and social participation and motivation will need to be clarified by longitudinal research. These and similar findings contribute to our understanding of the phenomenology of depression in ASD, which is critical to the development of practical prevention and treatment.
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Affiliation(s)
- Katherine Gotham
- Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tennessee
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41
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Harsányi A, Csigó K, Rajkai C, Demeter G, Németh A, Racsmány M. Two types of impairments in OCD: obsessions, as problems of thought suppression; compulsions, as behavioral-executive impairment. Psychiatry Res 2014; 215:651-8. [PMID: 24418048 DOI: 10.1016/j.psychres.2013.11.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 09/07/2012] [Indexed: 11/19/2022]
Abstract
Impairments in executive functioning have been identified as an underlying cause of Obsessive-Compulsive Disorder (OCD). Obsessive patients attempt to suppress certain unwanted thoughts through a mechanism that Wegner referred to as 'chronic thought suppression', whereas compulsive patients are unable to inhibit their rituals. We tested 51 OCD patients using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the White Bear Suppression Inventory (WBSI) and the Dysexecutive Questionnaire (DEX). Executive functions were tested using a cognitive test battery. We found that the total WBSI score was correlated with the Y-BOCS obsessive score but not with the Y-BOCS compulsive score. A stronger correlation was observed between the Y-BOCS obsessive score and the 'unwanted intrusive thoughts' factor based on Blumberg's 3-factor model of the WBSI. The total WBSI score was not correlated with the cognitive test results. The DEX score was significantly correlated with the Y-BOCS compulsive score; however, no correlation was found between the DEX score and the Y-BOCS obsessive score. A stronger correlation was observed between the Y-BOCS compulsive score and the 'inhibition' component of the DEX score, as defined by Burgess's 5-factor model. The DEX scores were correlated with cognitive test results measuring attention, cognitive flexibility and inhibitory processes. We conclude that obsessions indicate a failure of cognitive inhibition but do not involve significant impairment of executive functions, whereas compulsions indicate ineffective behavior inhibition and impaired executive functions.
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Affiliation(s)
- András Harsányi
- Nyírő Gyula Hospital, II Psychiatric Department, Lehel út 59, 1135 Budapest, Hungary.
| | - Katalin Csigó
- Nyírő Gyula Hospital, II Psychiatric Department, Lehel út 59, 1135 Budapest, Hungary
| | - Csaba Rajkai
- Nyírő Gyula Hospital, II Psychiatric Department, Lehel út 59, 1135 Budapest, Hungary
| | - Gyula Demeter
- Department of Cognitive Science, Budapest University of Technology and Economics, Stoczek utca 2, 1111 Budapest, Hungary
| | - Attila Németh
- Semmelweis University, Department of Psychiatry, Balassa utca 6, 1083 Budapest, Hungary
| | - Mihály Racsmány
- Department of Cognitive Science, Budapest University of Technology and Economics, Stoczek utca 2, 1111 Budapest, Hungary
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42
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Reinvall O, Voutilainen A, Kujala T, Korkman M. Neurocognitive functioning in adolescents with autism spectrum disorder. J Autism Dev Disord 2014; 43:1367-79. [PMID: 23104618 DOI: 10.1007/s10803-012-1692-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
There is a paucity of research studying comprehensive neurocognitive profiles of adolescents with higher functioning autism spectrum disorders (ASD). This study compared the neurocognitive profiles of higher functioning adolescents with ASD (n = 30, mean age 13.5) with that of typically developing adolescents (n = 30; mean age 13.7). Adolescents with ASD demonstrated a significantly higher mean Verbal Intelligence Quotient compared to the standardized mean. However, the ASD group had significantly lower scores than the control group on the subtests Auditory Attention and Response Set, Memory for Faces, Visuomotor Precision, and Design Copying. Thus, particular strengths were seen in verbal reasoning, while weaknesses were observed in auditory attention, facial recognition memory, and visuomotor functions in adolescents with ASD.
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Affiliation(s)
- Outi Reinvall
- Institute of Behavioural Sciences, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland.
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43
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Posserud MB, Breivik K, Gillberg C, Lundervold AJ. ASSERT--the Autism Symptom SElf-ReporT for adolescents and adults: bifactor analysis and validation in a large adolescent population. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4495-4503. [PMID: 24176259 DOI: 10.1016/j.ridd.2013.09.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 09/17/2013] [Accepted: 09/19/2013] [Indexed: 06/02/2023]
Abstract
With a view to developing a brief screening instrument for autism symptoms in a general population of adolescents, seven items from the Asperger syndrome (and high-functioning autism) diagnostic interview were adapted for use as self-report in an online questionnaire for youths aged 16-19 years (N=10,220). The selected items target lack of social understanding (4 items) and rigid and repetitive behavior and interests (RRBI; 3 items). Factor analyses were performed, and the seven items were also validated against self-reported ASD diagnosis. Best statistical model fit was found for a bifactor model with one general factor and two domain specific factors tied to social difficulties and RRBI. Both the general and the domain specific factors were associated with self-reported ASD diagnoses. The scale (referred to as the Autism Symptom SElf-ReporT for Adolescents and Adults--ASSERT) had good screening properties with a receiver operating curve-area under the curve (ROC-AUC) of 0.87 and a diagnostic odds ratio (DOR) of 15.8. Applying a modified scoring of the scale further improved the screening properties leading to a ROC-AUC of 0.89 and a DOR of 24.9. The ASSERT holds promise as a brief self-report screen for autism symptoms in adolescents, and further studies should explore its usefulness for adults.
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Affiliation(s)
- Maj-Britt Posserud
- Department of Child and Adolescent Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health, Uni Research, P.O. Box 7800, 5020 Bergen, Norway; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, P.O. Box 7800, Bergen, Norway.
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44
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Beighley JS, Matson JL, Rieske RD, Jang J, Cervantes PE, Goldin RL. Comparing challenging behavior in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5. Dev Neurorehabil 2013; 16:375-81. [PMID: 23477536 DOI: 10.3109/17518423.2012.760119] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the current study is to investigate challenging behavior in children who may no longer meet criteria for an autism spectrum disorder (ASD) diagnosis according to the proposed fifth edition of the Diagnostic and Statistical Manual (DSM-5). METHOD Children and adolescents (n = 459) were separated into three groups including those who met criteria for ASD according to the DSM-5 criteria (n = 219); those who will no longer qualify for an ASD diagnosis according to the DSM-5 but met criteria according to the DSM-IV-TR (n = 109); and a control group (n = 131). Scores on the Autism Spectrum Disorders - Problem Behaviors for Children (ASD-PB-C) were compared among groups. RESULTS The DSM-5 captured a slightly more impaired population in terms of problem behavior. CONCLUSION Implications regarding access to treatment for those no longer meeting criteria need to be taken into consideration in the coming months.
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Affiliation(s)
- Jennifer S Beighley
- Department of Psychology, Louisiana State University , Baton Rouge, LA , USA
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45
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Mazzone L, Postorino V, De Peppo L, Fatta L, Lucarelli V, Reale L, Giovagnoli G, Vicari S. Mood symptoms in children and adolescents with autism spectrum disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3699-3708. [PMID: 24029798 DOI: 10.1016/j.ridd.2013.07.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 07/30/2013] [Accepted: 07/30/2013] [Indexed: 05/28/2023]
Abstract
Asperger Syndrome (AS) and High Functioning Autism (HFA) are psychiatric conditions belonging to the Autistic Spectrum Disorders (ASDs), characterized by social dysfunction and focused interest, in the absence of mental retardation. Previous reports suggest that AS/HFA may be associated with important psychiatric comorbidities. Among the psychiatric internalizing disorders, depression and anxiety are probably the most common disorders. The aim of this study is to evaluate the prevalence of mood disorders and identifying peculiar clinical features in subjects suffering from AS and HFA. 30 male patients with AS/HFA, 30 male patients affected by Major Depression (MD) and 35 male Typically Developing (TD) comparison were assessed with the CDI and the CDRS-R. Participants' parents were invited to complete the CBCL and the P-YMRS. Moreover, the CGAS was rated by the clinicians. The evaluation of depressive symptoms showed that AS/HFA group reported higher depressive symptoms, as showed by CDI total, CBCL internalizing and CDRS-R total, compared to the TD group. No significant difference of depressive symptoms was found between the AS/HFA and the MD group, with the exception of CDRS-R total score. Moreover, linear regression analysis in the AS/HFA group between CGAS and depressive symptoms revealed that a higher level of depressive symptoms increased the risk of poorer global functioning. These results suggest that the depressive symptoms in AS/HFA patients may be associated with poorer global functioning, with a consequent impairment in their psychological profile and social adjustment, and should alert clinicians to the importance of assessing mood disorders in order to choose the appropriate treatment.
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Affiliation(s)
- Luigi Mazzone
- Child Neuropsychiatry Unit, Department of Neuroscience, I.R.C.C.S. Children's Hospital Bambino Gesù, Rome, Italy.
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46
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Mynatt BS, Gibbons MM, Hughes A. Career Development for College Students With Asperger’s Syndrome. JOURNAL OF CAREER DEVELOPMENT 2013. [DOI: 10.1177/0894845313507774] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An increasing number of students with Asperger’s syndrome are entering college today. Students with Asperger’s syndrome face complex symptomology such as difficulty with social skills, narrowed interests, sensory issues, and lack of self-awareness that may affect their ability to complete college and successfully enter the workforce. Career counselors could apply social cognitive career theory as an effective intervention when working with college students diagnosed with Asperger’s syndrome. A case illustration is presented as an example.
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Affiliation(s)
- Blair Sumner Mynatt
- Department of Educational Psychology and Counseling, The University of Tennessee, Knoxville, TN, USA
| | - Melinda M. Gibbons
- Department of Educational Psychology and Counseling, The University of Tennessee, Knoxville, TN, USA
| | - Amber Hughes
- Department of Educational Psychology and Counseling, The University of Tennessee, Knoxville, TN, USA
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47
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Sipes M, Matson JL. Factor Structure for Autism Spectrum Disorders with Toddlers Using DSM-IV and DSM-5 Criteria. J Autism Dev Disord 2013; 44:636-47. [DOI: 10.1007/s10803-013-1919-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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Berthoz S, Lalanne C, Crane L, Hill EL. Investigating emotional impairments in adults with autism spectrum disorders and the broader autism phenotype. Psychiatry Res 2013; 208:257-64. [PMID: 23747233 DOI: 10.1016/j.psychres.2013.05.014] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 02/11/2013] [Accepted: 05/09/2013] [Indexed: 01/24/2023]
Abstract
There is an increasing interest in the socio-affective atypicalities observed in adults with autism spectrum disorder (ASD). The aim of this study was to further explore emotional responsiveness in adults with ASD using well-validated self-reports of alexithymia and to determine whether anhedonic features are part of a broader autism phenotype (BAP). Participants comprised 38 adults with ASD, 87 parents of ASD individuals and 47 typical controls. All participants completed the Autism Spectrum Quotient (AQ), the 20-item Toronto Alexithymia Scale, and the Bermond-Vorst Alexithymia Questionnaire, as well as the Chapman Physical and Social Anhedonia Scales. The ASD group differed from controls and parents on most measures, with the exception of physical and social anhedonia, relative to parents. Parents differed from controls on social anhedonia, and a higher proportion of parents were classed as alexithymic, relative to controls. Cluster analysis revealed that some parents share more similarities with ASD participants than with controls. The results suggest that socio-affective impairments characteristic of ASD are part of the BAP.
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Affiliation(s)
- Sylvie Berthoz
- Institut National de la Santé et de la Recherche Médicale (INSERM U669), Maison de Solenn-Cochin, Paris, France
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49
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Turygin N, Matson JL, Beighley J, Adams H. The effect of DSM-5 criteria on the developmental quotient in toddlers diagnosed with autism spectrum disorder. Dev Neurorehabil 2013; 16:38-43. [PMID: 23031060 DOI: 10.3109/17518423.2012.712065] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the effect of the changing fifth edition of the Diagnostic and Statistical Manual (DSM-5) criteria on the developmental profiles of children diagnosed with an Autism spectrum disorder (ASD). METHODS This study examines the effect of DSM-5 changes on impairment profiles of a population of 2054 at-risk toddlers aged 17-36 months using the Battelle Developmental Inventory, Second Edition. RESULTS Toddlers diagnosed with an ASD according to the DSM-5 were found to represent a more impaired population compared to those who qualified for a diagnosis of an ASD based on the DSM-IV-TR, but not the DSM-5. The group diagnosed according to the DSM-IV-TR represented a population of toddlers who were more impaired than atypically developing peers. CONCLUSIONS The proposed changes to the DSM will likely result in those diagnosed with an ASD according to the new criteria representing a more functionally impaired group. Implications of this proposed change are discussed.
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Affiliation(s)
- Nicole Turygin
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA.
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50
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Lau WYP, Gau SSF, Chiu YN, Wu YY, Chou WJ, Liu SK, Chou MC. Psychometric properties of the Chinese version of the Autism Spectrum Quotient (AQ). RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:294-305. [PMID: 22985783 DOI: 10.1016/j.ridd.2012.08.005] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 08/08/2012] [Accepted: 08/08/2012] [Indexed: 06/01/2023]
Abstract
The Autism Spectrum Quotient (AQ) has been widely used for measuring autistic characteristics in parents of children with autism spectrum disorders (ASD). Nonetheless, its psychometric validity is yet to be justified. This study tested the factor structure of the AQ by means of principal component analysis and confirmatory factor analysis using, for the first time, data from 4192 Taiwanese parents (1208 with ASD children and 2984 with typically developing children). Results yielded a 35-item, 5-dimensional factor solution that had favorable psychometric characteristics (RMSEA = .054; NNFI = .962; CFI = .969) than any of the previously-published AQ factor solutions. Subscales of this new AQ-Chinese model were statistically and semantically coherent, namely: Socialness, Mindreading, Patterns, Attention to Details and Attention Switching. The psychometric properties of the AQ-Chinese did not change between clinic-based and community-based data suggesting good fitting for a continuum of autistic expression. Furthermore, the considerable overlap between the AQ-Chinese and the AQ factor structures derived previously using student samples indicated consistency in the manifestation of the autistic profile across different cultures and age groups. Group differences in the AQ-Chinese scores were in line with previous studies, i.e. males generally scored radically higher than females except in Attention to Details. Interestingly, mothers of ASD children reported lower total AQ scores than community mothers yet no significant group difference for the fathers. Important research and clinical implications pertinent to parents with children with ASD and the utility of the AQ were drawn.
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Affiliation(s)
- Winnie Yu-Pow Lau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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