Exploring the autism spectrum: Moderating effects of neuroticism on stress reactivity and on the association between social context and negative affect

A systematic review of ecological momentary assessment in autism research

LAY ABSTRACT

Ecological momentary assessments assess people's in-the-moment thoughts and behaviours in their daily lives in natural environments. The number of ecological momentary assessment studies with autistic people has increased over the last decade. For the first time, this review (1) summarises how well ecological momentary assessment works for allowing autistic people to describe and express their thoughts, emotions and experiences, and (2) provides suggestions for the design of ecological momentary assessment to make this research method more accessible to future autistic participants. In total, we synthesised participation experiences from 930 autistic people. Overall, ecological momentary assessment is generally acceptable for autistic adults aged from 18 to 60 and with average or above-average intelligence and language. We also identified several issues in the ecological momentary assessment procedure and suggested researchers consider these when designing future ecological momentary assessment studies with autistic people. The findings of this review provide evidence that ecological momentary assessment can be used to investigate many different questions with autistic people and suggest a wider application of ecological momentary assessment in future studies with autistic people.

Neuroticism and posttraumatic stress disorder: A Mendelian randomization analysis

OBJECTIVE

Epidemiological studies revealed an unestablished association between neuroticism and posttraumatic stress disorder (PTSD) and we conducted mendelian randomization (MR) analyses to examine whether neuroticism clusters of worry, depressed affect, and sensitivity to environmental stress and adversity (SESA) were involved in the development of PTSD.

METHOD

We obtained data on three neuroticism clusters, PTSD, and nine other psychiatric disorders from genome-wide association studies summary statistics and employed univariable, multivariable, and mediation MR analyses to explore causal associations among them.

RESULTS

Neuroticism clusters were linked with PTSD (depressed affect (odds ratio [OR]: 2.94 [95% confidence interval: 2.21-3.92]); SESA (2.69 [1.95-3.71]; worry (1.81 [1.37-2.99])). Neuroticism clusters were also associated with psychiatric disorders, with the depressed effect on panic disorder (PD) (2.60 [1.14-5.91]), SESA on anorexia nervosa (AN) (2.77 [1.95-3.94]) and schizophrenia (2.55 [1.99-3.25]), worry on major depressive disorder (MDD) (2.58 [2.19-3.05]). In multivariable MR, only the SESA-PTSD association remained (2.60 [2.096, 3.107]) while worry-PTSD and depressed affect-PTSD associations attenuated to nonsignificance. Mediation MR analyses suggested that PD mediated 3.76% of the effect of depressed effect on PTSD and AN mediated 10.33% of the effect of SESA on PTSD.

CONCLUSION

Delving deeper into neuroticism clusters, we comprehensively understand the role of neuroticism in PTSD.

Neural correlates of neuroticism: A coordinate-based meta-analysis of resting-state functional brain imaging studies

Neuroticism is one of the most robust higher-order personality traits associated with negative emotionality and risk of mental disorders. Many studies have investigated relationships between neuroticism and the brain, but the results have been inconsistent. We conducted a meta-analysis of whole-brain resting-state functional neuroimaging studies to identify the most stable neurofunctional substrates of neuroticism. We found stable significant positive correlations between neuroticism and resting-state brain activity in the left middle temporal gyrus (MTG), left striatum, and right hippocampus. In contrast, resting-state brain activity in the left superior temporal gyrus (STG) and right supramarginal gyrus (SMG) was negatively associated with neuroticism. Additionally, meta-regression analysis revealed brain regions in which sex and age moderated the link of spontaneous activity with neuroticism. This is the first study to provide a comprehensive understanding of resting-state brain activity correlates of neuroticism, and the findings may be useful for the targeting of specific brain regions for interventions to decrease the risks of mental health problems.

Neuroticism Drives Associations Between Repetitive Behaviors and Depression in Autistic Adults

Depression is more prevalent among autistic adults than neurotypical adults, yet risk factors are incompletely understood in this population. Some research groups have focused on relationships between negative repetitive thinking and depression in the autistic population, which may explain elevated prevalence rates in line with general population findings on rumination and internalizing disorders. Little is known about associations between depression and more prototypical repetitive cognitions and/or behaviors characteristic of autism (i.e., insistence on sameness [IS] and repetitive sensorimotor [RSM] behaviors). Therefore, the present study aimed to examine associations between IS, RSM behaviors, and depressive symptoms in 762 autistic adults, and whether observed effects are confounded by additional factors (e.g., demographic factors, trait neuroticism). To test if greater IS scores were associated with greater depressive symptoms on the BDI-II, a Bayesian linear regression was conducted with BDI-II scores (dependent variable) regressed on age, gender, educational level, RSM scores, and IS scores (independent variables). To test the effects of neuroticism on observed relationships, a second regression was conducted that included all predictors from the baseline model and neuroticism. Standardized regression coefficients were tested against an interval null hypothesis of [-0.1, 0.1] to assess for practical significance. Results indicated that IS exhibited a moderate positive relationship with depressive symptoms, while RSM behaviors provided only a slight increase in predictive ability. However in the second model, neuroticism exhibited a strong positive relationship with depressive symptoms, completely attenuating the effect of IS. Associations between RSM behaviors and depressive symptoms did not meet our criteria for practical significance, particularly when neuroticism was added to the model. Neither RSM nor IS moderated the effect of neuroticism on depression. The findings from this study add to the literature on risk factors in the pathway to depression in autism, and suggest opportunities for clinical translation to screening and intervention efforts. Screening for IS in autistic individuals is a common diagnostic practice in clinical and research settings that may be leveraged to also identify those at higher risk for depression, and increasing flexibility in daily life may promote emotional regulation and distress tolerance.

A Systematic Review of Self-Reported Stress Questionnaires in People on the Autism Spectrum

Background

The goal of this systematic review was to provide an overview of self-report measures of stress in populations on the autism spectrum. In addition, information regarding psychometric properties was discussed as well.

Methods

Four databases were systematically searched following the PRISMA guidelines and using strict eligibility criteria. Risk of bias assessment was performed using the COSMIN checklist.

Results

Eight questionnaires were previously used in populations on the autism spectrum, reported over 31 studies.

Discussion

Future research should focus more on examining psychometric properties of these self-report measures in this population as current evidence is scarce. In addition, it is important to consider which concept of stress one aims to measure as not all questionnaires cover the same aspects of stress.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40489-021-00293-4.