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Loizou S, Pemovska T, Stefanidou T, Foye U, Cooper R, Kular A, Greenburgh A, Baldwin H, Griffiths J, Saunders KRK, Barnett P, Minchin M, Brady G, Ahmed N, Parker J, Chipp B, Olive RR, Jackson R, Timmerman A, Sapiets S, Driskell E, Parsons B, Spain D, Totsika V, Mandy W, Pender R, Clery P, Trevillion K, Lloyd-Evans B, Simpson A, Johnson S. Approaches to improving mental healthcare for autistic people: systematic review. BJPsych Open 2024; 10:e128. [PMID: 39087319 DOI: 10.1192/bjo.2024.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental healthcare. Therefore, there is a need to identify and examine strategies to improve mental healthcare for autistic people. AIMS To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults, and to examine evidence on their acceptability, feasibility and effectiveness. METHOD A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach. RESULTS A total of 30 articles were identified. These included 16 studies of adapted mental health interventions, eight studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences and modifying the structure and content of interventions. CONCLUSION Many identified strategies are feasible and acceptable, and can be readily implemented in services with the potential to make mental healthcare more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.
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Affiliation(s)
- Sofia Loizou
- National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit, King's College London, UK
| | - Tamara Pemovska
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK
| | - Theodora Stefanidou
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK
| | - Una Foye
- National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit, King's College London, UK
| | - Ruth Cooper
- National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit, King's College London, UK
| | - Ariana Kular
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK
| | - Anna Greenburgh
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK
| | - Helen Baldwin
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK
| | - Jessica Griffiths
- National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit, King's College London, UK
| | - Katherine R K Saunders
- National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit, King's College London, UK
| | - Phoebe Barnett
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK; Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, UK; and National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
| | | | - Gráinne Brady
- Division of Psychiatry, University College London, UK
| | - Nafiso Ahmed
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK
| | - Jennie Parker
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, UK; and School of Health and Psychological Sciences, City, University of London, UK
| | - Beverley Chipp
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, UK
| | - Rachel R Olive
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, UK
| | - Robin Jackson
- Lancaster and Morecambe Child and Adolescent Mental Health Services, Lancashire and South Cumbria NHS Foundation Trust, Morecambe, UK; and University of Wolverhampton, UK
| | - Amanda Timmerman
- Department of Clinical, Educational and Health Psychology, University College London, UK
| | | | | | | | | | - Vaso Totsika
- Division of Psychiatry, University College London, UK
| | - Will Mandy
- Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Richard Pender
- Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Philippa Clery
- Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, London, UK
| | - Kylee Trevillion
- National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit, King's College London, UK
| | - Brynmor Lloyd-Evans
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK
| | - Alan Simpson
- National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit, King's College London, UK
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, London, UK
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Alhuzimi TE. Saudi parents' perspectives of the factors influencing the quality of life of their children with autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 152:104799. [PMID: 39002204 DOI: 10.1016/j.ridd.2024.104799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/03/2024] [Accepted: 07/09/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Research indicates that the deficits in social communication and the repetitive, restrictive behaviour of persons with Autistic Spectrum Disorder (ASD) can pose challenges to their functioning in different Quality of Life (QoL) domains, leading to lower levels of life satisfaction. Evidence also indicates that various social and family factors, such as the support received in the community/environment and the composition of the family, could impact the QoL of persons with ASD. AIM To study the factors influencing the QoL of children with ASD in the Kingdom of Saudi Arabia (KSA) by investigating the perspectives of their parents. METHOD Questionnaires were completed by 110 parents who had a child with ASD. The questionnaire included the 96-item KidsLife-ASD scale to capture parents' perspectives regarding the difficulties experienced by their child, the ASD support received by their families, and the QoL of the child. The data obtained from the questionnaire were statistically analysed using IBM SPSS software. RESULTS The difficulties experienced by children with ASD and aspects of the support (services and interventions, and challenges) they receive are factors that influence the QoL of children with ASD in the KSA. Moreover, the number of children in the family, the birth order of child with ASD, and the severity of ASD symptoms are factors that influence parents' perceptions of their children's difficulties, family ASD support, and the child's QoL. CONCLUSIONS Saudi parents who have one child with ASD believed that the QoL of their child was high and confirmed that the difficulties experienced by the child and the support received by the family were factors which influenced the QoL of a child with ASD.
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Affiliation(s)
- Talal E Alhuzimi
- Department of Special Education, College of Education, King Saud University, Riyadh, Saudi Arabia.
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Liu F, Begeer S, Hoekstra RA, Wang C, Scheeren AM. Autistic adults in China and the Netherlands: Proxy-reported community integration and life satisfaction. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241258182. [PMID: 38864577 DOI: 10.1177/13623613241258182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
LAY ABSTRACT Even though there are about 10 million Chinese autistic individuals, we know little about autistic adults in China. This study examined how well young autistic adults in China integrate into their communities (such as having a job, living independently and having friends) and how satisfied they are with their lives as reported by their caregivers. We compared them to autistic adults with similar characteristics (such as high support needs) from the Netherlands. We included 99 autistic adults in China and 109 in the Netherlands (18-30 years). In both countries, autistic adults were reported to have a hard time fitting into their communities. They often had no work, did not live on their own and had few close friends. Also, in both countries, caregivers reported that autistic adults felt low satisfaction with their life. Chinese adults were less satisfied with their life than Dutch adults, as indicated by their caregivers. This could be because of a lack of support for autistic adults in China, higher parental stress in Chinese caregivers, or general cross-country differences in happiness. Only in the Dutch group, younger compared with older adults fitted better into their communities, and adults without additional psychiatric conditions were reported to have higher life satisfaction. Country was a significant predictor of independent living only, with Dutch participants more likely living in care facilities than Chinese participants. In conclusion, our study shows that autistic adults with high support needs generally face similar challenges in both China and the Netherlands.
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Affiliation(s)
- Fangyuan Liu
- Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, The Netherlands
| | - Sander Begeer
- Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, The Netherlands
| | | | | | - Anke M Scheeren
- Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, The Netherlands
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Thiel T, Riedelbauch S, Gaigg S, Roessner V, Ring M. The impact of depressive and anxious symptoms on quality of life in adults on the autism spectrum. Autism Res 2024; 17:1161-1174. [PMID: 38783834 DOI: 10.1002/aur.3144] [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] [Received: 07/24/2022] [Accepted: 04/19/2024] [Indexed: 05/25/2024]
Abstract
Quality of life (QoL) is lower in adults on the autism spectrum (AS) compared with typically developing (TD) adults. In this context, recent studies have examined the role of depression and anxiety in reducing QoL in AS adults. The aim of this study was to (1) replicate these findings of lower QoL and (2) assess the negative influence of depressive and anxious symptoms on QoL in an adult AS (N = 86) and TD (N = 87) German sample with a broad age range (18-70 years). For this, we used questionnaires that have been validated for the AS and TD population: the World Health Organization Quality of Life Brief Version, the Autism-Specific QoL items, and the Hospital Anxiety and Depression Scale. We replicated previous findings and extended them to autism-specific QoL. Our AS sample had lower QoL compared with the TD adults. However, depressive symptoms were the largest contributor to lower QoL in both samples, more so than group membership and anxious symptoms. We conclude that interventions to improve QoL in AS adults should specifically target depressive symptoms and for this, improvements to the diagnostic process and treatment of depression in AS are necessary.
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Affiliation(s)
- Tobias Thiel
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, TU Dresden, Dresden, Germany
| | - Saskia Riedelbauch
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, TU Dresden, Dresden, Germany
| | - Sebastian Gaigg
- Autism Research Group, Department of Psychology, City, University of London, London, UK
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, TU Dresden, Dresden, Germany
| | - Melanie Ring
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Medizinische Fakultät, TU Dresden, Dresden, Germany
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Øverland E, Hauge ÅL, Orm S, Øie MG, Skogli EW, Pellicano E, Andersen PN. "I have to charge my social battery": Perspectives from autistic young adults on Quality of Life. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1369-1381. [PMID: 38629698 DOI: 10.1177/13623613241245578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
LAY ABSTRACT In this study we have asked a group of autistic young adults to describe what is important for their quality of life. The 14 participants (aged 21-29 years) were recruited from a 10-year follow-up study of autistic people. During interviews, our participants described the importance of having relationships with family, friends and pets. Having meaningful activities and being able to immerse themselves in particular interests was also reported to be important for a good quality of life. Interests had also guided their choice of what to study and what to do for work. They also spoke of how communication problems with professionals, bullying and sensory and emotional overload could have a negative impact on quality of life. Future interventions should focus on how professionals can help autistic people to connect to people/animals and meaningful activities, as the participants described this as important for having a good quality of life. These findings may be helpful in enhancing how passions and interests can be seen as opportunities for both academic and work careers for autistic people. Future research and interventions should also look at the communication barriers between autistic people and professionals, and how two-way understanding can be improved.
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Affiliation(s)
- Elisabeth Øverland
- Innlandet Hospital Trust, Norway
- Inland Norway University of Applied Sciences, Norway
| | | | - Stian Orm
- Innlandet Hospital Trust, Norway
- Inland Norway University of Applied Sciences, Norway
| | | | - Erik Winther Skogli
- Innlandet Hospital Trust, Norway
- Inland Norway University of Applied Sciences, Norway
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Minhas A, Whitlock K, Rosenfelt C, Shatto J, Finlay B, Zwicker J, Lippe S, Jacquemont S, Hagerman R, Murias K, Bolduc FV. Analyzing the Quality of Life in Individuals with Fragile X Syndrome in Relation to Sleep and Mental Health. J Autism Dev Disord 2024:10.1007/s10803-024-06317-2. [PMID: 38653851 DOI: 10.1007/s10803-024-06317-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 04/25/2024]
Abstract
The purpose of this paper was to examine the physical, emotional, social and school functioning domains of quality of life of individuals with Fragile X Syndrome, in relation to mental health and sleep patterns to gain a better understanding of how these aspects are affected by the disorder. This study included 119 individuals with Fragile X Syndrome who were given different cognitive examinations by a neuropsychologist or by parent-proxy questionnaires. This study focused on the Pediatric Quality of Life Inventory (PedsQoL), the Anxiety, Depression and Mood Scale (ADAMS), the Children's Sleep Habits Questionnaire (CSHQ), but did include other cognitive tests (Vineland Adaptive Behaviour Scales, Nonverbal IQ, Autism Diagnostic Observation Schedule). We identified significant associations between decreases in emotional, social and school domains of PedsQoL and the ADAMS subtests of Generalized Anxiety, Manic/Hyperactivity and Obsessive/Compulsivity, with the subtest of Depressed Mood having associations with lower physical and emotional domains. We also identified a significant impact between CSHQ subtests of Sleep Anxiety, Night Wakings, Daytime Sleepiness, and Parasomnia with the emotional and school domains of PedsQoL. There were associations connecting school functioning with Bedtime Resistance, and additional associations connecting emotional functioning with Sleep Duration and Sleep Onset Delay. Physical functioning was also associated with Sleep Anxiety. Our study shows how mental health and sleep defects impact improper sleep patterns and mental health which leads to decreases in the quality of life for individuals with FXS, and how it is important to screen for these symptoms in order to alleviate issues.
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Affiliation(s)
- Amrita Minhas
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Kerri Whitlock
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Cory Rosenfelt
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Julie Shatto
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Brittany Finlay
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Jennifer Zwicker
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Sarah Lippe
- Hopital Sainte-Justine, Universite de Montreal, Montreal, QC, Canada
| | | | - Randi Hagerman
- MIND Institute, University of California, Sacramento, CA, USA
| | - Kara Murias
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Francois V Bolduc
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada.
- Women and Children Health Research Institute, University of Alberta, Edmonton, AB, Canada.
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Mahjoob M, Cardy R, Penner M, Anagnostou E, Andrade BF, Crosbie J, Kelley E, Ayub M, Ayub M, Brian J, Iaboni A, Schachar R, Georgiades S, Nicolson R, Jones J, Kushki A. Predictors of health-related quality of life for children with neurodevelopmental conditions. Sci Rep 2024; 14:6377. [PMID: 38493236 PMCID: PMC10944519 DOI: 10.1038/s41598-024-56821-9] [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] [Received: 02/15/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
Neurodevelopmental conditions can be associated with decreased health-related quality of life; however, the predictors of these outcomes remain largely unknown. We characterized the predictors of health-related quality of life (HRQoL) in a sample of neurodiverse children and youth. We used a cross-sectional subsample from the Province of Ontario Neurodevelopmental Disorders Network (POND) consisting of those children and young people in the POND dataset with complete study data (total n = 615; 31% female; age: 11.28 years ± 2.84 years). Using a structural equation model, we investigated the effects of demographics (age, sex, socioeconomic status), core features (Social Communication Questionnaire, Toronto Obsessive Compulsive Scale, Strengths and Weaknesses of attention deficit/hyperactivity disorder (ADHD)-symptoms and Normal Behavior), co-occurring symptoms (Child Behaviour Checklist), and adaptive functioning (Adaptive Behaviour Assessment System) on HRQoL (KINDL). A total of 615 participants had complete data for this study (autism = 135, ADHD = 273, subthreshold ADHD = 7, obsessive-compulsive disorder (OCD) = 38, sub-threshold OCD = 1, neurotypical = 161). Of these participants, 190 (31%) identified as female, and 425 (69%) identified as male. The mean age was 11.28 years ± 2.84 years. Health-related quality of life was negatively associated with co-occurring symptoms (B = - 0.6, SE = 0.20, CI (- 0.95, - 0.19), p = 0.004)) and age (B = - 0.1, SE = 0.04, CI (- 0.19, - 0.01), p = 0.037). Fewer co-occurring symptoms were associated with higher socioeconomic status (B = - 0.5, SE = - 0.05, CI (- 0.58, - 0.37), p < 0.001). This study used a cross-sectional design. Given that one's experiences, needs, supports, and environment and thus HrQoL may change significantly over the lifespan and a longitudinal analysis of predictors is needed to capture these changes. Future studies with more diverse participant groups are needed. These results demonstrate the importance of behavioural and sociodemographic characteristics on health-related quality of life across neurodevelopmental conditions.
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Affiliation(s)
- Maryam Mahjoob
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Robyn Cardy
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Melanie Penner
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Brendan F Andrade
- Department of Psychiatry, Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children (SickKids), Toronto, Canada
| | | | - Muhammad Ayub
- Department of Psychiatry, Queen's University, Kingston, Canada
| | - Muhammad Ayub
- Department of Psychology, Queen's University, Kingston, Canada
| | - Jessica Brian
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Alana Iaboni
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Russell Schachar
- Department of Psychiatry, The Hospital for Sick Children (SickKids), Toronto, Canada
| | - Stelios Georgiades
- Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Rob Nicolson
- Department of Psychiatry, Western University, London, Canada
| | - Jessica Jones
- Department of Psychiatry, Queen's University, Kingston, Canada
| | - Azadeh Kushki
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada.
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Grosvenor LP, Errichetti CL, Holingue C, Beasley JB, Kalb LG. Self-Report Measurement of Well-Being in Autistic Adults: Psychometric Properties of the PERMA Profiler. AUTISM IN ADULTHOOD 2023; 5:401-410. [PMID: 38116049 PMCID: PMC10726181 DOI: 10.1089/aut.2022.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Background Studies of positive psychology and emotional well-being have broadened our understanding of mental health. However, mental health research involving autistic adults has been largely deficit-focused. Few studies have examined well-being using established positive psychological frameworks. Methods This study examined the psychometric characteristics of the PERMA Profiler, a 23-item questionnaire that measures well-being across five subscales (Positive emotion, Engagement, Relationships, Meaning, and Accomplishment), in a sample of 517 autistic adults ages 18-84 years (M = 39.5, standard deviation [SD] = 13.3). Reliability (internal consistency), structural validity (via confirmatory factor analysis including bifactor modeling), and concurrent validity were examined. Results The PERMA Profiler mean (SD) well-being score was 5.4 (SD = 1.7), which is notably lower than the mean of 7.0 previously found in nonautistic samples. Subscale scores were highest for Engagement (M = 6.8; SD = 1.9), followed by Accomplishment (M = 5.6; SD = 2.2), Relationships (M = 5.2; SD = 2.6), Meaning (M = 5.2; SD = 2.7), and Positive emotion (M = 5.0; SD = 2.4). Factor analyses revealed strong psychometrics (Cronbach's α = 0.93; Comparative Fit Index = 0.94; Tucker-Lewis Index = 0.97; root mean square error of approximation = 0.08; standardized root mean residual = 0.05) and superior fit of the bifactor model, supporting a general factor for conceptualizing well-being as opposed to a five-factor model. PERMA well-being and subscale scores were significantly correlated (p < 0.001) with mental health conditions and life satisfaction. Conclusion These findings support use of an adapted version of the PERMA Profiler in mental health research to evaluate well-being among autistic adults. Similar to studies with nonautistic populations, the Engagement measure may not capture the experiences of the autistic population and further refinement is needed. Follow-up research should represent a more diverse autistic population, collaborate with autistic coinvestigators, and explore potential correlates of well-being (such as social stigma) while using the PERMA Profiler.
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Affiliation(s)
- Luke P. Grosvenor
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cheryl L. Errichetti
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Calliope Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Joan B. Beasley
- Institute on Disability, University of New Hampshire College of Health and Human Services, Durham, New Hampshire, USA
| | - Luther G. Kalb
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Institute on Disability, University of New Hampshire College of Health and Human Services, Durham, New Hampshire, USA
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Sanz-Gómez S, Alacreu-Crespo A, Guija JA, Giner L. Reliability and validity of proxy reports of impulsivity and aggression: An evidence-based assessment approach to psychological autopsy methods. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023:S2950-2853(23)00057-1. [PMID: 37979784 DOI: 10.1016/j.sjpmh.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 10/11/2023] [Accepted: 10/19/2023] [Indexed: 11/20/2023]
Abstract
INTRODUCTION Psychological autopsy methods often include measures of impulsivity and aggression. The aim is to assess their reliability and validity in a Spanish sample. METHODS Cross-sectional web-based survey was fulfilled by 184 proband and proxy pairs. Data was collected on sociodemographic characteristics, impulsivity through Barratt Impulsiveness Scale (BIS-11), aggression through Buss-Perry Aggression Questionnaire (BPAQ), and history of suicide ideation. Proxies filled out BIS-11, BPAQ and suicide ideation with the responses they would expect from the probands. Reliability was assessed using intraclass correlation coefficients (ICC) between proband and proxies. Logistic regression analysis was performed to assess the predictive validity of proxy reports in predicting probands' suicide ideation. RESULTS Bivariate analysis showed differences in BPAQ (Median 68 vs. 62; p=0.001), but not in BIS-11 (p>.050). BIS-11 showed good concordance (ICC=0.754; CI 95% 0.671-0.816) and BPAQ acceptable (ICC=0.592; CI 95% 0.442-0.699). In the probands regression model BPAQ predicted suicide ideation (OR 1.038; CI 95% 1.016-1.061) but not BIS-11 (OR 0.991; CI 95% 0.958-1.025). In the proxy-report model BPAQ also predicted probands' suicide ideation (OR 1.036; CI 95% 1.014-1.058) but not BIS-11 (OR 0.973; CI 95% 0.942-1.004). CONCLUSION Used as proxy-reported assessment tools, BIS-11 showed better reliability than the BPAQ. However, both showed validity in Spanish population and could be included in psychological autopsy protocols.
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Affiliation(s)
| | | | - Julio Antonio Guija
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain; Servicio de Psiquiatría Forense, Instituto de Medicina Legal y Ciencias Forenses de Sevilla, Seville, Spain
| | - Lucas Giner
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain
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Capp SJ, Agnew-Blais J, Lau-Zhu A, Colvert E, Tye C, Aydin Ü, Lautarescu A, Ellis C, Saunders T, O'Brien L, Ronald A, Happé F, McLoughlin G. Is quality of life related to high autistic traits, high ADHD traits and their Interaction? Evidence from a Young-Adult Community-Based twin sample. J Autism Dev Disord 2023; 53:3493-3508. [PMID: 35802291 PMCID: PMC10465683 DOI: 10.1007/s10803-022-05640-w] [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: 06/06/2022] [Indexed: 10/17/2022]
Abstract
This study explored whether high autistic traits, high attention deficit hyperactivity disorder (ADHD) traits and their interaction were associated with quality of life (QoL) in a sample of 556 of young-adult twins (Mean age 22 years 5 months, 52% Female). Four participant groups were created: high autistic traits, high ADHD traits, high autistic/ADHD traits, and low ADHD/autistic traits. High autistic traits were associated with lower QoL across domains (physical, psychological, social, and environmental). High ADHD traits associated with lower physical, psychological, and environmental QoL. The interaction of autistic and ADHD traits was not significant in any domain. While mental health difficulties were associated with lower QoL, after accounting for mental health, most relationships between autistic traits, ADHD traits and QoL remained.
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Affiliation(s)
- Simone J Capp
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Medical Sciences Division, Oxford Institute for Clinical Psychology Training and Research, University of Oxford, Oxford, UK.
| | - Jessica Agnew-Blais
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, School of School of Biological and Chemical Sciences, Queen Mary University London, London, UK
| | - Alex Lau-Zhu
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emma Colvert
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Charlotte Tye
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ümit Aydin
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alexandra Lautarescu
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Claire Ellis
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tyler Saunders
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- University of Edinburgh, Edinburgh, UK
| | - Lucy O'Brien
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, University of London, Birkbeck, London, UK
| | - Francesca Happé
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gráinne McLoughlin
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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11
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Caregiver-Child Agreement in Health-Related Quality of Life of Autistic Children and Adolescents. J Autism Dev Disord 2023; 53:977-986. [PMID: 35922687 PMCID: PMC9362400 DOI: 10.1007/s10803-022-05689-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/25/2022]
Abstract
This study examined the agreement of perceived health-related quality of life (HRQOL) between caregivers and autistic children and adolescents (n = 133, 5-12 years) using the Pediatric Quality of Life Inventory Generic Core Scales, Fourth Edition (PedsQL 4.0). Results reveal good to excellent agreement over this age range across the total, physical, and psychosocial health scales. However, the emotional, social, and school functioning scores demonstrated lower agreement in dyads with children aged 5-7 than in dyads with children aged 8-12 years. Despite these differences in agreement, overall, the PedsQL 4.0 caregiver-module is a reliable instrument for measuring HRQOL in autistic individuals aged 5-12 years.
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12
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Tomaszewski B, Savage MN, Hume K. Examining physical activity and quality of life in adults with autism spectrum disorder and intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:1075-1088. [PMID: 34514893 PMCID: PMC8918041 DOI: 10.1177/17446295211033467] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 06/01/2023]
Abstract
Adults with autism and co-occurring intellectual disability engage in low levels of physical activity and are at increased risk of developing secondary health conditions attributed to physical inactivity compared to adults in the general population. Few studies have examined the use of objective measures to characterize physical activity levels for adults with autism and intellectual disability. The current study aimed to examine the relationship between physical activity, using an activity tracker, and quality of life in adults with autism and intellectual disability. In the current study, 38 adults with autism and intellectual disability, ages 18-55, wore a Fitbit Flex 2® activity tracker for 1 week, and completed the Quality of Life Questionnaire. The relationship between average daily step count quality of life was examined. Most adults in the sample were overweight and taking fewer daily steps than recommended guidelines. Increased average daily step count was significantly associated with quality of life.
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Affiliation(s)
- Brianne Tomaszewski
- Brianne Tomaszewski, TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, 100 Renee Lynn Court, Carrboro, NC 27510, USA. Emails: ;
| | - Melissa N Savage
- The Department of Educational Psychology, University of North Texas, USA
| | - Kara Hume
- School of Education, University of North Carolina at Chapel Hill, USA
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13
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Øverland E, Hauge ÅL, Orm S, Pellicano E, Øie MG, Skogli EW, Andersen PN. Exploring life with autism: Quality of Life, daily functioning and compensatory strategies from childhood to emerging adulthood: A qualitative study protocol. Front Psychiatry 2022; 13:1058601. [PMID: 36506426 PMCID: PMC9732257 DOI: 10.3389/fpsyt.2022.1058601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction This study aims to investigate self-perceived quality of life, daily functioning, and the use of compensatory strategies in emerging adults with autism. Methods and analysis Participants will be recruited from the Lillehammer Neurodevelopmental 10-year follow-up study (LINEUP), with the aim of 15 individual in-depth interviews. Subsequently, two focus groups with clinicians will be invited to reflect on the themes found in the individual interviews. All interviews will be recorded and analyzed using reflexive thematic analysis. Ethics and dissemination The study is approved by the Regional Committee for Medical Research Ethics in South-East Norway. The findings will be disseminated to academic and clinical audiences through journal articles and conference presentations. To reach the broader autistic and autism communities, the findings will be shared with the Autism Society at national and local meetings, in their membership magazine, and on their social media channel.
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Affiliation(s)
- Elisabeth Øverland
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Åshild Lappegard Hauge
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stian Orm
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Elizabeth Pellicano
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Erik Winther Skogli
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
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14
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Capp SJ, Mason D, Colvert E, Agnew-Blais J, Happé F. COVID-19 and Perceived Changes to Quality of Life, Anxiety, Depression, and Loneliness in Autistic and Other Neurodivergent U.K. Adults. AUTISM IN ADULTHOOD 2022; 4:233-246. [PMID: 36606155 PMCID: PMC9645677 DOI: 10.1089/aut.2021.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background In the United Kingdom, we have experienced many changes to our daily lives as a result of COVID-19. Autistic and other neurodivergent (ND, e.g., those with attention-deficit hyperactivity disorder) adults may be more vulnerable to negative effects of the pandemic due to pre-existing mental health disparities and unmet support needs. Furthermore, there is little research, either pandemic related or otherwise, which considers how the experiences of autistic adults with additional intersecting ND identities might differ from those without. Methods We collected data from an online survey during June 2020 to September 2020 to explore the psychological impact of the coronavirus pandemic on U.K. adults (N = 286, age 18-72 years). Participants included neurotypical (NT) adults (N = 98), autistic adults (N = 73), other ND adults (N = 53), as well as autistic adults with an additional intersecting ND identity (N = 63). We measured and compared levels of quality of life (QoL), depression, anxiety, and loneliness across groups as well as perceived change in these as a result of the pandemic. Results Autistic adults, with and without additional ND identities, had consistently low QoL and high anxiety, depression, and loneliness compared with NT adults. We found no differences in these areas between autistic adults with and without additional intersecting ND identities. In some areas, non-autistic ND participants were also doing poorly compared with their NT peers. Many participants felt that their QoL, mental health, and loneliness had worsened due to the pandemic, and this was largely similar across groups. Conclusions These results highlight that COVID-19 may have led to increased need and demand for mental health services across the U.K. adult population. Both autistic and ND adults may be in particular need of increased (and improved) mental health and well-being support. This is likely because of pre-existing differences in mental health and well-being as well as individuals facing further difficulties as a result of the pandemic.
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Affiliation(s)
- Simone J. Capp
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - David Mason
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Emma Colvert
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Jessica Agnew-Blais
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychology, School of Biological and Chemical Sciences, Queen Mary University London, London, United Kingdom
| | - Francesca Happé
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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15
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Cheak-Zamora N, Odunleye O. Stress and Coping in Autistic Young Adults. AUTISM IN ADULTHOOD 2022; 4:193-202. [PMID: 36606158 PMCID: PMC9645673 DOI: 10.1089/aut.2021.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Introduction Half a million autistic youth will enter adulthood over the next decade. Support services to help youth successfully transition into adulthood are limited and not tailored to the autistic youth and young adult's needs. This study utilized qualitative methods to understand how autistic young adults experience and cope with stress during the transition to adulthood. Methods The study recruited 15 autistic young adults aged 18-25 years. Each participant completed a short demographic survey and individual interview. Interviews were conducted online via Google Docs or in-person based on the participants' preference. Three researchers organized and coded the data using a thematic approach. Results Based on our analysis, three themes emerged. Within the first theme, young adults in this study described experiencing a great deal of stress and provided examples of how it manifested in physical and emotional ways. In the second theme, youth described that the causes of this stress stemmed from general problems handling new or multiple responsibilities and specific problems in school, work, financial responsibilities, and social relationships. Finally, young adults described using various coping mechanisms including relaxation techniques, use of technology, and friends and family social support. Conclusions The study findings can help service providers and family members find new ways to help autistic young adults manage their stress. This study provides a unique understanding of stress and coping from the autistic individuals' point of view. Stress is most often derived from managing new responsibilities in general and school, work, money, and relationships in particular. Tailored support services that follow the individual from adolescence through adulthood are needed to manage these stressors. Researchers and service providers can utilize these recommendations for future program development. Furthermore, the method used in this study can be replicated to facilitate autistic individual input on future program development.
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Affiliation(s)
- Nancy Cheak-Zamora
- Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, Missouri, USA
| | - Olakunle Odunleye
- Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, Missouri, USA
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16
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Santoro SL, Donelan K, Constantine M. Proxy-report in individuals with intellectual disability: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1088-1108. [PMID: 35676858 PMCID: PMC9378492 DOI: 10.1111/jar.13013] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 04/04/2022] [Accepted: 05/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Views can be collected from individuals (self-report) or others on their behalf (proxy-report). OBJECTIVE We aimed to review the literature on methods and statistical approaches used to evaluate observer versus self-report responses from individuals with intellectual disability or Down syndrome. METHODS A series of key questions related to statistical approaches and data collection methods were formulated a priori to inform the search strategy and review process. These addressed the topics of self-report in individuals with intellectual disability, including Down syndrome. Using the National Library of Medicine database, PubMed, detailed literature searches were performed. The quality of available evidence was then evaluated, the existing literature was summarised, and knowledge gaps and research needs were identified. RESULTS Fifty relevant original articles were identified which addressed at least one key question. Study details, including: research design, internal validity, external validity, and relevant results are presented. Review of studies of individuals with intellectual disability which used a variety of statistical approaches showed mixed agreement between self-report and proxy-report. CONCLUSION Few studies identified to-date have used self-report from individuals with Down syndrome, but lessons from the existing intellectual disability literature can guide researchers to incorporate self-report from individuals with Down syndrome in the future.
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Affiliation(s)
- Stephanie L. Santoro
- Division of Medical Genetics and Metabolism, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Karen Donelan
- Institute on Healthcare Systems, Brandeis University, Waltham, Massachusetts, United States
- Survey Research and Implementation Unit, Division of Clinical Research, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Melissa Constantine
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States
- Evidera Inc, Bethesda, Maryland, USA
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17
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Mason D, Happé F. The role of alexithymia and autistic traits in predicting quality of life in an online sample. RESEARCH IN AUTISM SPECTRUM DISORDERS 2022; 90:None. [PMID: 35116075 PMCID: PMC8763252 DOI: 10.1016/j.rasd.2021.101887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Autistic people tend to report poorer Quality of Life (QOL) than comparison groups, though some studies do report more optimistic findings. Higher autistic traits are also related to poorer QOL. However, the role of alexithymia in this relationship has not been explored. METHOD A total of 163 participants (N = 53 autistic and N = 111 comparison) consented to take part; however, 30 participants were excluded due to missing data (who did not differ from those who were retained on age, gender, education, employment, or living status), leaving a final sample of 133 (N = 42 Autistic and 91 Comparison participants). Demographic information (including age, gender) was collected, alongside self-report measures of autistic traits, mental health, alexithymia, and QOL. We estimated regression models based on pre-registered analysis, and we conducted exploratory network analyses. RESULTS Alexithymic traits did not predict QOL when controlling for covariates. Depression significantly predicted Physical, Psychological, and Social QOL. When examining the impact of just alexithymic traits and autistic traits, both were significantly associated with Physical and Psychological QOL. For participants with a low depression score, the correlation between alexithymia and QOL was strong; suggesting that depression occludes the association between alexithymia and QOL. Network analyses suggested that depression and anxiety exert direct effects on Physical and Psychological QOL, whereas alexithymia scores may influence Physical QOL via autistic traits. CONCLUSION In sum, depression is a pervasive negative predictor of multiple QOL domains. The role of alexithymia in predicting QOL dimensionally and categorically was not ruled out, given our exploratory analyses, we suggest that interventions which target alexithymia may positively impact QOL for those who score low on depressive symptoms.
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Affiliation(s)
- David Mason
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, UK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, UK
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18
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Kim SY, Lecavalier L. Evaluating the Use of Self-reported Measures in Autistic Individuals in the Context of Psychiatric Assessment: A Systematic Review. J Autism Dev Disord 2021; 52:4355-4374. [PMID: 34643862 DOI: 10.1007/s10803-021-05323-y] [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: 10/02/2021] [Indexed: 11/24/2022]
Abstract
The current review examined the use of self-report measures in autistic individuals in the context of psychiatric assessments. It focused on inter-rater agreement, internal consistency, test-retest reliability, and criterion validity with clinical diagnoses. It also gathered information on constructs measured, the nature of the samples, and the quality of the studies. Thirty-six out of 10,557 studies met inclusion criteria. We found that the majority of studies (1) targeted young people with average or above average cognitive abilities, (2) measured anxiety symptoms, and (3) evaluated parent-child agreement. More studies are needed on individuals with lower cognitive abilities, adults, and other constructs. Studies assessing criterion validity and test-retest reliability are also needed.
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Affiliation(s)
- Soo Youn Kim
- Nisonger Center, The Ohio State University, 1581 Dodd Drive, Columbus, OH, 43210, USA
| | - Luc Lecavalier
- Nisonger Center, The Ohio State University, 1581 Dodd Drive, Columbus, OH, 43210, USA.
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19
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Bat-Pitault F, Da Silva C, Charvin I, Da Fonseca D. Sleep disturbances in anorexia nervosa subtypes in adolescence. Eat Weight Disord 2021; 26:1845-1852. [PMID: 33025527 DOI: 10.1007/s40519-020-01033-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This retrospective study investigated, for the first time, sleep characteristics in anorexia nervosa (AN) subtypes and the clinical profile in adolescents, as well as the quality of life (QoL) and emotionality in these patients with poor sleep. METHODS The sample included 111 adolescents with AN. First, restrictive AN (ANR) and binge eating/purging AN (ANB/P) groups were compared in terms of self-reported sleep characteristics, sleepiness and chronotype. Second, the clinical profile, QoL, and emotionality of good sleepers (GS) and poor sleepers (PS) were compared. RESULTS Compared to the ANR group, participants with ANB/P showed significantly greater sleep disturbances and sleepiness, and also a higher preference for an eveningness chronotype. Results also showed a clinical profile significantly more severe in PS than in GS. After adjustment, only the ANB/P subtype and the EDI-2 ineffectiveness subscale remained significantly linked to poor sleep. Moreover, the QoL was lower and emotionality more negative in PS with respect to GS. CONCLUSION Findings suggest that subjective sleep disturbances may be used as a clinical marker for AN severity and for ANB/P subtype. Importantly, findings suggest that improving sleep quality in adolescents with AN may help managing their ED and their comorbidities, but also improve their QoL. LEVEL OF EVIDENCE Level V, descriptive study (evaluation data retrospectively studied).
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Affiliation(s)
- Flora Bat-Pitault
- Child and Adolescent Psychiatry Unit, Salvator Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, 249 Boulevard Sainte-Marguerite, 13009, Marseille, France. .,Institute of Neuroscience Timone, CNRS, Aix-Marseille University, Marseille, France.
| | - Catarina Da Silva
- Child and Adolescent Psychiatry Unit, Salvator Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, 249 Boulevard Sainte-Marguerite, 13009, Marseille, France.,Institute of Neuroscience Timone, CNRS, Aix-Marseille University, Marseille, France
| | - Isabelle Charvin
- Child and Adolescent Psychiatry Unit, Salvator Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, 249 Boulevard Sainte-Marguerite, 13009, Marseille, France
| | - David Da Fonseca
- Child and Adolescent Psychiatry Unit, Salvator Hospital, Public Assistance-Marseille Hospitals, Aix-Marseille University, 249 Boulevard Sainte-Marguerite, 13009, Marseille, France.,Institute of Neuroscience Timone, CNRS, Aix-Marseille University, Marseille, France
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20
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Leader G, Flynn C, O'Rourke N, Coyne R, Caher A, Mannion A. Comorbid Psychopathology, Challenging Behavior, Sensory Issues, Adaptive Behavior and Quality of Life in Children and Adolescents with Autism Spectrum Disorder. Dev Neurorehabil 2021; 24:397-407. [PMID: 33706637 DOI: 10.1080/17518423.2021.1898058] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aim: Comorbid psychopathology refers to having a diagnosis of two or more co-occurring psychological disorders. The current study investigated the differences between children and adolescents with no-mild, moderate and severe comorbid psychopathology in children and adolescents with ASD.Method: Parents of 133 children completed the Autism Spectrum Disorder-Comorbid for Children, Behavior Problems Inventory-Short Form, Pediatric Quality of Life Inventory, Vineland Adaptive Behavior Scales, Social Communication Questionnaire, Short Sensory Profile, and Behavioral/Educational Interventions and Complementary/Alternative Medicine (CAM) Interventions of the Autism Treatment Network Registry Parent Baseline Assessment.Results: A significant difference was found between severity of comorbid psychopathology and all types of challenging behavior and all sensory issues except movement. A small effect size was also found between comorbid psychopathology and quality of life.Conclusion: The findings from this study show significant difficulties associated with those with comorbid psychopathology in ASD in challenging behavior, sensory issues and quality of life.
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Affiliation(s)
- Geraldine Leader
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - Christopher Flynn
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - Nathan O'Rourke
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - Rory Coyne
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - Aoife Caher
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - Arlene Mannion
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
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21
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Searching for What Really Matters: A Thematic Analysis of Quality of Life among Preschool Children on the Autism Spectrum. J Autism Dev Disord 2021; 52:2098-2111. [PMID: 34060000 DOI: 10.1007/s10803-021-05097-3] [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: 05/16/2021] [Indexed: 10/21/2022]
Abstract
Quality of life (QoL) is an essential measure when assessing health interventions. Most early interventions for preschool children on the spectrum evaluate the effects on autism symptoms. However, researchers increasingly believe that good interventions should also improve the QoL of these children. Domains of QoL among preschool children on the autism spectrum have not previously been researched. We interviewed adults on the spectrum to explore early childhood experiences that made their lives satisfying. Our data revealed four major themes: interests, environmental regularity, sensory differences and social interactions. This study provides the first insights on aspects of life important to pre-schoolers on the spectrum. Findings will contribute to developing items for a measure of QoL among this population.
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22
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Skaletski EC, Bradley L, Taylor D, Travers BG, Bishop L. Quality-of-Life Discrepancies Among Autistic Adolescents and Adults: A Rapid Review. Am J Occup Ther 2021; 75:12495. [PMID: 34781339 DOI: 10.5014/ajot.2021.046391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Quality of life (QoL) is a core outcome of occupational therapy, but it is decreased among autistic adolescents and adults. This is the first review of QoL from an occupational therapy standpoint. OBJECTIVE To identify self-reported QoL differences between autistic and nonautistic samples; investigate sex differences in QoL among autistic people; examine consistency in QoL among autistic people across age, intellectual disability (ID), and self- versus proxy-report method; and appraise occupational therapy-related interventions addressing QoL among autistic people. DATA SOURCES Articles published in peer-reviewed journals between 2010 and 2020, located through Academic Search Ultimate, PubMed, and OTseeker, along with the American Journal of Occupational Therapy, British Journal of Occupational Therapy, Canadian Journal of Occupational Therapy, and Australian Occupational Therapy Journal. Study Selection and Data Collection: Article samples consisted of at least 20% autistic females and used self-reported QoL measures. Qualitative research was excluded, as well as studies with participants younger than age 13 yr. Twenty-seven articles qualified (3 Level 1B, 13 Level 3B, and 11 Level 4). FINDINGS Autistic adolescents and adults demonstrated decreased self-reported QoL compared with nonautistic peers across age and ID presence. One article compared sex differences in QoL among autistic people. Interventions improved QoL among autistic people. CONCLUSIONS AND RELEVANCE Autistic adolescents and adults demonstrate decreased QoL in comparison with nonautistic peers. Questions remain related to sex differences in QoL among autistic people, an area for future research. Multiple evidence-based approaches to improve QoL in the autistic population are relevant to occupational therapy practice. What This Article Adds: Self-reported QoL among autistic adolescents and adults is clearly lower than among their nonautistic counterparts. This article provides information on multiple interventions related to occupational therapy to improve QoL among autistic people.
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Affiliation(s)
- Emily C Skaletski
- Emily C. Skaletski, MOT, OTR/L, is PhD Student, Occupational Therapy Program, Department of Kinesiology, University of Wisconsin-Madison;
| | - Laura Bradley
- Laura Bradley, MSEd, is Research Specialist, Waisman Center, University of Wisconsin-Madison
| | - Desiree Taylor
- Desiree Taylor, MSOT, is Research Assistant, Waisman Center, University of Wisconsin-Madison
| | - Brittany G Travers
- Brittany G. Travers, PhD, is Associate Professor, Occupational Therapy Program, Department of Kinesiology, and Investigator, Waisman Center, University of Wisconsin-Madison
| | - Lauren Bishop
- Lauren Bishop, PhD, MSW, is Assistant Professor, Sandra Rosenbaum School of Social Work, and Investigator, Waisman Center, University of Wisconsin-Madison
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Ozboke C, Yanardag M, Yilmaz I. Exploring the relationships between motor proficiency, independence and quality of life in adolescents with autism spectrum disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:850-857. [PMID: 36568624 PMCID: PMC9788684 DOI: 10.1080/20473869.2021.1900506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 05/30/2023]
Abstract
The aim of this study was to explore the relationships between autism severity, motor performance, independence in daily living skills and quality of life in adolescents with autism spectrum disorder (ASD). The study included 31 participants, aged 13-18 years. Evaluations were made with the Gilliam Autistic Disorders Rating Scale-2 (GARS-2), Bruininks-Oseretsky Test of Motor Proficiency-2 Short Form (BOT-2-SF), Functional Independence Measure (WeeFIM II), and Pediatric Quality of Life Inventory (PedsQL). Motor performance of the participants was determined as below average according to the norms of BOT-2 SF, and were negatively correlated with GARS-2 at a moderate level (r = -0.61, p < 0.001), and a moderate negative correlation was determined between GARS-2 and WeeFIM II (r = -0.65, p < 0.001) and PedsQL (r = -0.61, p < 0.001). Independence in daily living skills (DLS) and autism severity were found to be significant predictors of PedsQL (R2 = 0.463, p < 0.05). Motor impairment still appears to be a missing piece of the puzzle for this age group. Promoting motor skill acquisition and independence could be a key factor in preventing the deterioration of physical health and improving quality of life in adolescents with ASD.
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Affiliation(s)
- Caner Ozboke
- Faculty of Sport Sciences, Eskisehir Technical University, Eskisehir, Turkey
| | - Mehmet Yanardag
- Research Institute for Individuals with Disability, Anadolu University, Eskisehir, Turkey
| | - Ilker Yilmaz
- Faculty of Sport Sciences, Eskisehir Technical University, Eskisehir, Turkey
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Lam GYH, Sabnis S, Migueliz Valcarlos M, Wolgemuth JR. A Critical Review of Academic Literature Constructing Well-Being in Autistic Adults. AUTISM IN ADULTHOOD 2021; 3:61-71. [PMID: 36601269 PMCID: PMC8992886 DOI: 10.1089/aut.2020.0053] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The emergence of critical autism studies has fueled efforts to interrogate how autistic people are studied and described in academic literature. While there is a call for research that promotes better well-being for autistic people, little attention has been paid to the concept of well-being itself. Just as the medical model limits critical understandings of autism in the academic literature, so too may psychological accounts of well-being limit, rather than expand, possibilities of living a good life for autistic people. The purpose of this critical review was to identify and critique how well-being in autistic adults is constructed in research. Based on a systematic search of peer-reviewed empirical research published from 2013 to 2020, we identified 63 articles that involved direct data collection with autistic adults and focused on well-being constructs such as quality of life, life satisfaction, and happiness. We examined the articles using the techniques of critical discourse analysis to discern assumptions underlying constructions of autistic well-being, with special attention to the axiological and teleological contributions of autistic perspectives in the research and writing processes. We identified several approaches through which the literature constructed autistic well-being: (1) well-being as an objective uncontested variable, (2) well-being as personal and not fixed, (3) well-being that warrants a specific measure for the autistic population, and (4) well-being as a situated account that privileges and centers autistic people's perspectives. We subject these accounts to critical analysis, pointing to how they limit and open life possibilities for autistic people. We recommend that researchers and practitioners critically reflect on how they engage autistic adults and use their input to create works that support well-being in ways that are meaningful and ethical to autistic adults, as well as do justice to changing broader narratives of autism in research and society. Lay summary Why was this study done?: More autistic people and researchers have advocated to study autism in critical and positive ways. While it is important to promote better well-being for autistic people, little is known about what well-being actually means to them.What was the purpose of this study?: The purpose of our critical review was to identify how the concept of well-being in autistic people is understood and described in academic literature. We also critiqued how well-being research considers the input and perspectives of autistic adults.What did we do?: We systematically searched for research articles published between 2013 and 2020. We identified 63 articles that involved direct data collection with autistic adults and focused on well-being and related concepts such as quality of life, life satisfaction, and happiness. We analyzed the articles by focusing on how they used language to describe well-being in autistic adults and how they valued the data collected from these adults.What did we find?: We identified several ways that article authors described their understanding of autistic well-being: (1) well-being as an objective and uncontested object, (2) well-being is personal and can vary in nature, (3) well-being warrants a measure that considers opinions of autistic people, and (4) well-being as very specific to autistic people's subjective perspectives. We critically analyzed how these different understandings limit or open life possibilities for autistic people's well-being.How will this work help autistic people?: We recommend that researchers critically reflect on how they engage autistic adults and use their input in research. Promoting well-being needs to be meaningful and ethical to autistic adults. Research also needs to advocate for social justice to challenge how the majority in society understands or misunderstands autistic people.
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Affiliation(s)
- Gary Yu Hin Lam
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.,Address correspondence to: Gary Yu Hin Lam, PhD, Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Room 304, Ho Tim Building, Shatin, New Territories, Hong Kong
| | - Sujay Sabnis
- Department of Educational Psychology, College of Education, Health, and Society, Miami University, Oxford, Ohio, USA
| | - Maria Migueliz Valcarlos
- Department of Educational Psychology, College of Education, Health, and Society, University of South Florida, Tampa, Florida, USA
| | - Jennifer R. Wolgemuth
- Department of Educational Psychology, College of Education, Health, and Society, University of South Florida, Tampa, Florida, USA
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25
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Ueda R, Okada T, Kita Y, Ozawa Y, Inoue H, Shioda M, Kono Y, Kono C, Nakamura Y, Amemiya K, Ito A, Sugiura N, Matsuoka Y, Kaiga C, Kubota M, Ozawa H. The quality of life of children with neurodevelopmental disorders and their parents during the Coronavirus disease 19 emergency in Japan. Sci Rep 2021; 11:3042. [PMID: 33589663 PMCID: PMC7884401 DOI: 10.1038/s41598-021-82743-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/18/2021] [Indexed: 12/17/2022] Open
Abstract
This study aimed to reveal how the COVID-19 stay-at-home period has affected the quality of life (QOL) of children with neurodevelopmental disorders and their parents and to identify possible factors that enabled them to maintain their QOL. We enrolled 136 school-aged children (intellectual quotient ≥ 50) and their parents and administered QOL questionnaires to assess the maladaptive behavior of the children; depression, anxiety, and stress of the parents; and activities of their daily lives. The relationship between their QOL and clinical features was examined. The decrease in QOL of children and parents was associated with the mother’s limited job flexibility. Decreased QOL was also associated with changes in the sleep rhythms of the children. Maladaptive behaviors in children were associated with parental stress. However, maintained QOL of some families who faced these same conditions of job stress and sleep disorders was associated with less parental stress, less parental depression and anxiety, and milder maladaptive behavior in children. Both mothers with limited job flexibility and changes in the sleep rhythm of children were associated with reduced QOL of children and their parents. Low parental stress was associated with decreased maladaptive behavior in children and with maintained QOL of the family.
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Affiliation(s)
- Riyo Ueda
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-Cho, Kodaira, Tokyo, 187-8553, Japan. .,Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan.
| | - Takashi Okada
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-Cho, Kodaira, Tokyo, 187-8553, Japan
| | - Yosuke Kita
- Mori Arinori Center for Higher Education and Global Mobility, Hitotsubashi University, Tokyo, Japan.,Cognitive Brain Research Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Yuri Ozawa
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Hisami Inoue
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Mutsuki Shioda
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Yoshimi Kono
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Chika Kono
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Yukiko Nakamura
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Kaoru Amemiya
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Ai Ito
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Nobuko Sugiura
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Yuichiro Matsuoka
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Chinami Kaiga
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Masaya Kubota
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
| | - Hiroshi Ozawa
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Tokyo, Japan
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26
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Pett MA, Guo JW, Cardell B, Johnson EP, Guerra N, Clark L. Psychometric properties of a brief self-reported health-related quality of life measure (HRQoL-IDD) for persons with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:877-890. [PMID: 33522020 PMCID: PMC8247975 DOI: 10.1111/jar.12831] [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] [Received: 05/17/2020] [Revised: 09/29/2020] [Accepted: 10/29/2020] [Indexed: 12/02/2022]
Abstract
Background To encourage self‐determination and address health disparities among persons with intellectual and developmental disabilities, clinicians and researchers rely on self‐reported measures like health‐related quality of life (HRQoL). This study evaluated the psychometric properties of a theory‐driven self‐reported HRQoL measure for adults requiring mild to moderate support related to intellectual and developmental disabilities. Method 224 volunteers completed 42 quality of life items developed with extensive input from persons with intellectual and developmental disabilities, family members/caregivers, and providers. The 5‐point Likert scale format with visual images of fluid‐filled cups represented the range of responses. Results Exploratory and Unrestricted Factor Analyses yielded 16 HRQoL items with 4 subscales: Functional Well‐Being, Emotional Well‐Being, Social Well‐Being, and Healthy Decision‐making. The HRQoL‐IDD explained 62.8% of variance, had satisfactory internal consistency (0.73–0.83), stability of reponses, and reading level (2nd grade, ages 7‐8). Conclusions The HRQoL‐IDD is a promising measure of self‐reported HRQoL for use in community‐based settings for persons requiring mild to moderate support related to intellectual and developmental disabilities.
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Affiliation(s)
- Marjorie A Pett
- University of Utah College of Nursing, Salt Lake City, UT, USA
| | - Jia-Wen Guo
- University of Utah College of Nursing, Salt Lake City, UT, USA
| | - Beth Cardell
- Department of Occupational and Recreational Therapies, College of Health, University of Utah, Salt Lake City, UT, USA
| | - Erin P Johnson
- Department of Obstetrics and Gynecology, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Lauren Clark
- School of Nursing, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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27
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Brief report: Changes in quality of life and social functioning during vocational program - a pilot study of autistic adults. J Autism Dev Disord 2021; 51:3774-3781. [PMID: 33387243 DOI: 10.1007/s10803-020-04821-9] [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: 11/26/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Quality of life (QoL), social-emotional and occupational functioning are often diminished in young autistic adults. Measuring these constructs as vocational training outcomes may inform future programming and relevancy of measures. METHODS This pilot study analyzed changes in social-emotional functioning and QoL during the involvement at a vocational program for autistic adults using the WHOQOL-BREF, a modified version of the Birchwood- Social Functioning Scale (SFS-m) and a piloted measure. Participants completed these self-reported questionnaires upon admission and at 3 months. RESULTS Significant change was found on the SFS-m and two WHOQOL-BREF domains: psychological and environmental. CONCLUSIONS This pilot study suggests that autistic adults, similar in characterization, can self-report using these QoL and social measures; further, these measures are sensitive to certain changes over time in such group programs.
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28
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Ueda R, Okada T, Kita Y, Ozawa Y, Inoue H, Shioda M, Kono Y, Kono C, Nakamura Y, Amemiya K, Ito A, Sugiura N, Matsuoka Y, Kaiga C, Kubota M, Ozawa H. Psychological Status Associated With Low Quality of Life in School-Age Children With Neurodevelopmental Disorders During COVID-19 Stay-At-Home Period. Front Psychiatry 2021; 12:676493. [PMID: 34733180 PMCID: PMC8558384 DOI: 10.3389/fpsyt.2021.676493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 09/23/2021] [Indexed: 12/05/2022] Open
Abstract
Background: This study seeks to ascertain how the COVID-19 stay-at-home period has affected the quality of life (QOL) of children with neurodevelopmental disorders (NDDs) who had experienced sleep schedules alteration and clarify what psychological status predicted low QOL in children with and without altered sleep patterns. Materials and Methods: Study participants were 86 children between 8 and 17 years of age (mean age, 11.7 years; 70 boys, 16 girls; mean intellectual quotient, 83.6). QOL was evaluated using the self-assessment KINDLR. Participants answered questions regarding depression and anxiety on a visual analog scale (VAS) for temporary mood. Their parents answered questionnaires regarding their maladaptive behaviors and differences in sleep patterns before and during the COVID-19 pandemic. The student's t-test was performed to examine the presence or absence of sleep changes in the children, which affected QOL, temporary mood, and maladaptive behaviors. Multiple or simple linear regression analyses were also performed to identify the psychogenic factors that significantly affected decreased QOL for each group with and without changes in sleep schedule. Results: During the COVID-19 stay-at-home period, 46.5% of participants experienced changes in sleep patterns. These changes were associated with decreased QOL as well as internalized symptoms. The decreased QOL of children with sleep patterns changed was predicted by a high level of depression. In addition, low QOL in children with unchanged sleep patterns was predicted by a high level of depression and low current mood status. Conclusions: Almost half of the participants experienced a poor sleep schedule during the stay-at-home period. These alterations in sleep patterns were associated with a low QOL. The QOL of children with a stable life schedule was affected not only by depressive tendencies but also temporary moods. Therefore, they need to live a fulfilling life to maintain their QOL. However, the QOL of children with poor sleep patterns was affected only by depressive tendencies. Hence, clinicians need to ensure that children with NDDs are well-diagnosed with depression and treated for sleep problems.
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Affiliation(s)
- Riyo Ueda
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.,Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Takashi Okada
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yosuke Kita
- Mori Arinori Center for Higher Education and Global Mobility, Hitotsubashi University, Kunitachi, Japan.,Cognitive Brain Research Unit (CBRU), Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Yuri Ozawa
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Hisami Inoue
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Mutsuki Shioda
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Yoshimi Kono
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Chika Kono
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Yukiko Nakamura
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Kaoru Amemiya
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Ai Ito
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Nobuko Sugiura
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Yuichiro Matsuoka
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Chinami Kaiga
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Masaya Kubota
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
| | - Hiroshi Ozawa
- Department of Child Neurology, Shimada Ryoiku Center Hachioji, Hachioji, Japan
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Conrad CE, Rimestad ML, Rohde JF, Petersen BH, Korfitsen CB, Tarp S, Cantio C, Lauritsen MB, Händel MN. Parent-Mediated Interventions for Children and Adolescents With Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:773604. [PMID: 34867556 PMCID: PMC8632873 DOI: 10.3389/fpsyt.2021.773604] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/26/2021] [Indexed: 12/27/2022] Open
Abstract
There has been increasing interest in parent-mediated interventions (PMIs) for children with autism spectrum disorders (ASDs). The objective of this systematic review and meta-analysis was to examine the effect of PMIs compared to no PMI for children with ASD aged 2-17 years. The primary outcome was adaptive functioning rated by a parent or clinician. The secondary outcomes were long-term adaptive functioning rated by the parents, adverse events, core symptoms of ASD, disruptive behavior, parental well-being, quality of life of the child rated by the parents and anxiety. The MEDLINE, PsycInfo, Embase, and CINAHL databases were searched in March 2020. The Cochrane Risk of Bias Tool was used to rate the individual studies, and the certainty in the evidence was evaluated using GRADE. We identified 30 relevant randomized controlled trials (RCTs), including 1,934 participants. A clinically relevant effect of PMIs on parent-rated adaptive functioning was found with a low certainty of evidence [Standard mean difference (SMD): 0.28 (95% CI: -0.01, 0.57)] on Vineland Adaptive Behavior Scales (VABS), whereas no clinically relevant effect was seen for clinician-rated functional level, with a very low certainty of evidence [SMD on Clinical Global Impressions (CGI)-severity scale: SMD -0.45 [95% CI: -0.87, -0.03)]. PMIs may slightly improve clinician-rated autism core symptoms [SMD: -0.35 (95% CI: -0.71, 0.02)]. Additionally, no effect of PMIs on parent-rated core symptoms of ASD, parental well-being or adverse effects was identified, all with a low certainty of evidence. There was a moderate certainty of evidence for a clinically relevant effect on disruptive behavior [SMD: 0.55 (95% Cl: 0.36, 0.74)]. The certainty in the evidence was downgraded due to serious risk of bias, lack of blinding, and serious risk of imprecision due to few participants included in meta-analyses. The present findings suggest that clinicians may consider introducing PMIs to children with ASD, but more high-quality RCTs are needed because the effects are not well-established, and the results are likely to change with future studies. The protocol for the systematic review is registered at the Danish Health Authority website (www.sst.dk).
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Affiliation(s)
- Charlotte Engberg Conrad
- Psychiatry, Department of Clinical Medicine, Aalborg University Hospital, Aalborg University, Aalborg, Denmark
| | | | - Jeanett Friis Rohde
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark.,The Danish Health Authority, Copenhagen, Denmark
| | | | | | - Simon Tarp
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark.,The Danish Health Authority, Copenhagen, Denmark
| | - Cathriona Cantio
- Institute of Psychology, University of Southern Denmark, Odense, Denmark.,Child and Adolescent Mental Health Services, Region of Southern Denmark, Odense, Denmark
| | - Marlene Briciet Lauritsen
- Psychiatry, Department of Clinical Medicine, Aalborg University Hospital, Aalborg University, Aalborg, Denmark
| | - Mina Nicole Händel
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark.,The Danish Health Authority, Copenhagen, Denmark
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30
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Plichta M, Jezewska-Zychowicz M. Orthorexic Tendency and Eating Disorders Symptoms in Polish Students: Examining Differences in Eating Behaviors. Nutrients 2020; 12:E218. [PMID: 31952161 PMCID: PMC7019551 DOI: 10.3390/nu12010218] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/16/2019] [Accepted: 01/06/2020] [Indexed: 12/12/2022] Open
Abstract
Orthorexia nervosa (ON) may precede, ensue, or coexist with eating disorders (ED) and also affect eating behaviors. The aim of this study was to explore the dietary patterns (DPs) and other eating habits of people showing ON tendency, ED symptoms, and both ON tendency and ED symptoms, as well as those not showing either. The data for the study were collected from a sample of 1120 Polish college students through a cross-sectional survey in 2017. The questionnaire used in the survey included the ORTO-15, the Eating Disorder Screen for Primary Care (ESP), and the Food Frequency Questionnaire (FFQ-6), and the students were also asked questions about their eating habits and special diets. A factor analysis was conducted to identify the following five DPs: "high-sugar products and refined products," "meat and meat products," "alcohol," "high-fiber products and nuts," and "dairy products and whole-meal bread." Univariate logistic regression analyses were carried out to verify the associations between the variables. Students in the "ON and without ED" group were found to exhibit more healthy eating habits than the students in the "ED and without ON" group. The use of a special diet in the past and currently increased the risk of displaying ON tendency and ED symptoms. Students in the "ON and without ED" and "ON and ED" groups were characterized by less frequent consumption of high-sugar and refined products. Students who rarely consumed meat and related products were found to be less likely to display "ON and ED." In conclusion, different eating habits shown by people with ON tendency and ED symptoms confirmed the difference between ON and ED. However, the simultaneous displaying of ON and ED leads to the overlapping of specificity of eating habits, which can make the diagnosis based only on the eating habits difficult. Thus, there is still a need for further research involving the use of more sensitive tools that can better identify ON tendency and ED symptoms, as well as DPs.
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Affiliation(s)
- Marta Plichta
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland;
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Hartley M, Dorstyn D, Due C. Mindfulness for Children and Adults with Autism Spectrum Disorder and Their Caregivers: A Meta-analysis. J Autism Dev Disord 2019; 49:4306-4319. [DOI: 10.1007/s10803-019-04145-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Parra-Fernández ML, Onieva-Zafra MD, Fernández-Martínez E, Abreu-Sánchez A, Fernández-Muñoz JJ. Assessing the Prevalence of Orthorexia Nervosa in a Sample of University Students Using Two Different Self-Report Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142459. [PMID: 31373283 PMCID: PMC6678205 DOI: 10.3390/ijerph16142459] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/28/2019] [Accepted: 07/09/2019] [Indexed: 02/01/2023]
Abstract
In recent decades, orthorexia nervosa (ON) has increased presence in society. It is related with beliefs and attitudes towards eating and is characterized by an obsessive behavior toward heathy eating. The prevalence of ON has been reported by numerous researchers, with rates varying considerably according to the tool used to evaluate the same parameter. The aim of this study was to compare the prevalence of ON in a single population using two different questionnaires. The test for the diagnosis of orthorexia (ORTO-11-ES) assessment tool for orthorexia nervosa and the Düsseldorfer Ortorexie Skala (DOS-ES), constitute brief self-report assessment tools which measure the risk of suffering ON. A sample of 492 students from the University of Castilla la Mancha (Spain) participated in this study, of whom 43.1% were male and 56.9% were female. The findings show that, according to the DOS-ES, only 10.5% of students displayed ON whereas, with the ORTO-11-ES, the prevalence of ON increased to 25.2%. The tendency towards orthorexic behavior is more closely associated with the female gender. The Body Mass Index (BMI) had no influence on the tendency for ON. This study provides valuable information on the usefulness of both questionnaires and the possible limitations associated with the use of these tools in the general population.
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Affiliation(s)
- María Laura Parra-Fernández
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing of Ciudad Real, Universidad de Castilla-La-Mancha, 13071 Ciudad Real, Spain
| | - María Dolores Onieva-Zafra
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing of Ciudad Real, Universidad de Castilla-La-Mancha, 13071 Ciudad Real, Spain.
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Characteristics of Young Adults with Autism Spectrum Disorder Performing Different Daytime Activities. J Autism Dev Disord 2019; 49:542-555. [PMID: 30151782 PMCID: PMC6373303 DOI: 10.1007/s10803-018-3730-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Daytime activity, in terms of engagement in an occupation or education, is highly important for individuals with autism spectrum disorder (ASD), regardless of their level of functioning. In this nationwide survey, the parents of young adults diagnosed with ASD in childhood (n = 1266) provided information about the current daytime activity of their child, as well as behavioral characteristics, comorbidity, history of schooling during primary and secondary school, and availability of support. The young adults without a regular daytime activity constituted approximately one-fifth of the sample and had more behavioral difficulties and comorbidities than young adults with a daytime activity. Intellectual disability, part-time job, history of schooling, including type of school, and availability of support were found to be associated with daytime activity.
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