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Le Cunff AL, Glover C, Martis BL, Giampietro V, Dommett E. Methodological adjustments for experimental studies including neurodiverse participants: A checklist for before, during, and after laboratory visits. MethodsX 2024; 12:102658. [PMID: 38510933 PMCID: PMC10950872 DOI: 10.1016/j.mex.2024.102658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/08/2024] [Indexed: 03/22/2024] Open
Abstract
In this paper, we developed an experimental checklist for laboratory experiments including neurodiverse participants, particularly those with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and dyslexia. The checklist suggests additions to the basic requirements for ethical laboratory-based studies with human participants. The suggestions emphasize physical comfort, the agency of participants concerning environmental adjustments, clarity of communication, and a focus on participants' overall well-being. Those methodological guidelines aim to help researchers in facilitating inclusive and accessible laboratory environments for neurodiverse participants in order to: •Enhance research validity by minimizing the influence of factors that affect responses in neuroscience experiments.•Facilitate research recruitment by encouraging continued participation in future studies and increasing word-of-mouth.•Improve research dissemination by fostering a more positive perception of the research process amongst neurodiverse individuals and encouraging community involvement.
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Affiliation(s)
- Anne-Laure Le Cunff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AB, United Kingdom
| | - Caitlin Glover
- School of Engineering and Informatics, University of Sussex, Brighton, BN1 9RH, United Kingdom
| | - Brandon-Lee Martis
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AB, United Kingdom
| | - Vincent Giampietro
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AB, United Kingdom
| | - Eleanor Dommett
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AB, United Kingdom
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Edwards H, Wright S, Sargeant C, Cortese S, Wood-Downie H. Research Review: A systematic review and meta-analysis of sex differences in narrow constructs of restricted and repetitive behaviours and interests in autistic children, adolescents, and adults. J Child Psychol Psychiatry 2024; 65:4-17. [PMID: 37485556 DOI: 10.1111/jcpp.13855] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Evidence that autism often manifests differently between males and females is growing, particularly in terms of social interaction and communication, but it is unclear if there are sex differences in restricted and repetitive behaviours and interests (RRBIs) when rigorously focusing on the narrow construct level (i.e., stereotyped behaviour, restricted interests, insistence on sameness, and/or sensory experiences). METHODS We conducted a systematic review and four random effects meta-analyses investigating sex differences in narrow construct measures of RRBIs in autistic children, adolescents, and adults (Prospero registration ID: CRD42021254221). Study quality was appraised using the Newcastle-Ottawa Quality Assessment Scale. RESULTS Forty-six studies were narratively synthesised and 25 of these were included in four random effects meta-analyses. Results found that autistic males had significantly higher levels of stereotyped behaviours (SMD = 0.21, 95% confidence interval (CI) [0.09, 0.33], p < .001) and restricted interests (SMD = 0.18, 95% CI [0.07, 0.29], p < .001) compared to autistic females. In contrast, there were no significant sex differences for sensory experiences (SMD = -0.09, 95% CI [-0.27, 0.09], p = .32) and insistence on sameness (SMD = 0.01, 95% CI [-0.03, 0.05], p = .68). The findings from the narrative synthesis were generally consistent with those from the meta-analyses and also found qualitative sex differences in the way RRBIs manifest. CONCLUSIONS Our findings show significant differences in narrowly defined RRBIs in males and females. Practitioners need to be aware of such differences, which could be contributing to the under-recognition of autism in females and may not be captured by current diagnostic instruments.
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Affiliation(s)
- Hannah Edwards
- Doctorate in Educational Psychology, University of Southampton, Southampton, UK
- Hampshire and Isle of Wight Educational Psychology Service (HIEP), Havant, UK
| | - Sarah Wright
- Doctorate in Educational Psychology, University of Southampton, Southampton, UK
| | - Cora Sargeant
- Doctorate in Educational Psychology, University of Southampton, Southampton, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health - Developmental Lab, School of Psychology, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- New York University Child Study Center, New York, NY, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Henry Wood-Downie
- Doctorate in Educational Psychology, University of Southampton, Southampton, UK
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3
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Li C, Tian Y, Zeng D, Shepherd BE. Asymptotic Properties for Cumulative Probability Models for Continuous Outcomes. MATHEMATICS (BASEL, SWITZERLAND) 2023; 11:4896. [PMID: 38374966 PMCID: PMC10875740 DOI: 10.3390/math11244896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Regression models for continuous outcomes frequently require a transformation of the outcome, which is often specified a priori or estimated from a parametric family. Cumulative probability models (CPMs) nonparametrically estimate the transformation by treating the continuous outcome as if it is ordered categorically. They thus represent a flexible analysis approach for continuous outcomes. However, it is difficult to establish asymptotic properties for CPMs due to the potentially unbounded range of the transformation. Here we show asymptotic properties for CPMs when applied to slightly modified data where bounds, one lower and one upper, are chosen and the outcomes outside the bounds are set as two ordinal categories. We prove the uniform consistency of the estimated regression coefficients and of the estimated transformation function between the bounds. We also describe their joint asymptotic distribution, and show that the estimated regression coefficients attain the semiparametric efficiency bound. We show with simulations that results from this approach and those from using the CPM on the original data are very similar when a small fraction of the data are modified. We reanalyze a dataset of HIV-positive patients with CPMs to illustrate and compare the approaches.
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Affiliation(s)
- Chun Li
- Division of Biostatistics, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, USA
| | - Yuqi Tian
- Department of Biostatistics, Vanderbilt University, Nashville, TN 37203, USA
| | - Donglin Zeng
- Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Bryan E. Shepherd
- Department of Biostatistics, Vanderbilt University, Nashville, TN 37203, USA
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Riquelme I, Hatem SM, Sabater-Gárriz Á, Montoya P. A multidimensional investigation of the relationship between skin-mediated somatosensory signals, emotion regulation and behavior problems in autistic children. Front Neurosci 2023; 17:1227173. [PMID: 37662109 PMCID: PMC10470890 DOI: 10.3389/fnins.2023.1227173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/25/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Autistic children may have abnormal sensory perception, emotion dysregulation and behavior problems. The aim of this cross-sectional study was to explore the relationship between skin-mediated somatosensory signals and emotion/behavior difficulties in autistic children and adolescents, in comparison typically developing peers (TDP). Methods Thirty-eight autistic children and adolescents and 34 TDP completed a multidimensional assessment consisting of the measurement of somatosensory thresholds of touch, pain and temperature, a task on emotion knowledge and parent-reported questionnaires on sensory reactivity, emotion regulation and behavior. Results Autistic children had higher pain sensitivity, less sensory reactive behaviors and more behavior problems than their TDP. In contrast to TDP, several somatosensory thresholds of autistic children correlated with emotion regulation and behavior problems. Discussion Sensory dysfunction may affect the development of emotional processing and behavior in autistic children and adolescents. This knowledge can lay the foundation for future studies on co-occurring alterations in corresponding neural networks and for the implementation of early interventions, including sensory rehabilitation therapy, for promoting regulated behaviors in autistic children and adolescents.
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Affiliation(s)
- Inmaculada Riquelme
- Research Institute on Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Samar M. Hatem
- Faculty of Medicine, STIMULUS Research Group (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Brussels, Belgium
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Álvaro Sabater-Gárriz
- Research Institute on Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
- Balearic ASPACE Foundation, Marratxí, Spain
| | - Pedro Montoya
- Research Institute on Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma de Mallorca, Spain
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
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He JL, Williams ZJ, Harris A, Powell H, Schaaf R, Tavassoli T, Puts NAJ. A working taxonomy for describing the sensory differences of autism. Mol Autism 2023; 14:15. [PMID: 37041612 PMCID: PMC10091684 DOI: 10.1186/s13229-022-00534-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 12/14/2022] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Individuals on the autism spectrum have been long described to process sensory information differently than neurotypical individuals. While much effort has been leveraged towards characterizing and investigating the neurobiology underlying the sensory differences of autism, there has been a notable lack of consistency in the terms being used to describe the nature of those differences. MAIN BODY We argue that inconsistent and interchangeable terminology-use when describing the sensory differences of autism has become problematic beyond mere pedantry and inconvenience. We begin by highlighting popular terms that are currently being used to describe the sensory differences of autism (e.g. "sensitivity", "reactivity" and "responsivity") and discuss why poor nomenclature may hamper efforts towards understanding the aetiology of sensory differences in autism. We then provide a solution to poor terminology-use by proposing a hierarchical taxonomy for describing and referring to various sensory features. CONCLUSION Inconsistent terminology-use when describing the sensory features of autism has stifled discussion and scientific understanding of the sensory differences of autism. The hierarchical taxonomy proposed was developed to help resolve lack of clarity when discussing the sensory differences of autism and to place future research targets at appropriate levels of analysis.
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Affiliation(s)
- Jason L He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ashley Harris
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Helen Powell
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Roseann Schaaf
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, USA
| | - Teresa Tavassoli
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK
| | - Nicolaas A J Puts
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
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6
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Hoffman T, Bar-Shalita T, Granovsky Y, Gal E, Kalingel-Levi M, Dori Y, Buxbaum C, Yarovinsky N, Weissman-Fogel I. Indifference or hypersensitivity? Solving the riddle of the pain profile in individuals with autism. Pain 2023; 164:791-803. [PMID: 36730631 DOI: 10.1097/j.pain.0000000000002767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/16/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Excitatory-inhibitory (E/I) imbalance is a mechanism that underlies autism spectrum disorder, but it is not systematically tested for pain processing. We hypothesized that the pain modulation profile (PMP) in autistic individuals is characterized by less efficient inhibitory processes together with a facilitative state, indicative of a pronociceptive PMP. Fifty-two adults diagnosed with autism and 52 healthy subjects, age matched and sex matched, underwent quantitative sensory testing to assess the function of the (1) pain facilitatory responses to phasic, repetitive, and tonic heat pain stimuli and (2) pain inhibitory processes of habituation and conditioned pain modulation. Anxiety, pain catastrophizing, sensory, and pain sensitivity were self-reported. The autistic group reported significantly higher pain ratings of suprathreshold single ( P = 0.001), repetitive (46°C- P = 0.018; 49°C- P = 0.003; 52°C- P < 0.001), and tonic ( P = 0.013) heat stimuli that were cross correlated ( r = 0.48-0.83; P < 0.001) and associated with sensitivity to daily life pain situations ( r = 0.39-0.45; P < 0.005) but not with psychological distress levels. Hypersensitivity to experimental pain was attributed to greater autism severity and sensory hypersensitivity to daily stimuli. Subjects with autism efficiently inhibited phasic but not tonic heat stimuli during conditioned pain modulation. In conclusion, in line with the E/I imbalance mechanism, autism is associated with a pronociceptive PMP expressed by hypersensitivity to daily stimuli and experimental pain and less-efficient inhibition of tonic pain. The latter is an experimental pain model resembling clinical pain. These results challenge the widely held belief that individuals with autism are indifferent to pain and should raise caregivers' awareness of pain sensitivity in autism.
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Affiliation(s)
- Tseela Hoffman
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Yelena Granovsky
- Department of Neurology, Rambam Health Care Center, Haifa, Israel
- Laboratory of Clinical Neurophysiology, Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Eynat Gal
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Merry Kalingel-Levi
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Yael Dori
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Chen Buxbaum
- Department of Neurology, Rambam Health Care Center, Haifa, Israel
| | - Natalya Yarovinsky
- Department of Cognitive Neurology, Rambam Health Care Center, Haifa, Israel
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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The relevance of the interpersonal theory of suicide for predicting past-year and lifetime suicidality in autistic adults. Mol Autism 2022; 13:14. [PMID: 35313974 PMCID: PMC8935684 DOI: 10.1186/s13229-022-00495-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/10/2022] [Indexed: 12/19/2022] Open
Abstract
Background While there are known risk factors for suicidality in autistic adults, these are often unconnected from theoretical frameworks that might explain why risk is elevated and guide clinical interventions. The present study investigated the relevance of constructs from the Interpersonal Theory of Suicide (ITS), including perceived burdensomeness, thwarted belongingness and acquired capability for suicide, and explored mechanisms through which certain risk factors (relationship status, age at diagnosis) might elevate suicide risk. Methods Autistic adults (n = 314) completed an online study including measures of depression, anxiety and constructs from the ITS. Linear and multinomial regression analysis disentangled contributions of ITS variables from effects of depression and anxiety for past-year suicide ideation, past-year and lifetime suicide attempts. Mediation analyses examined associations between risk factors and these suicide outcomes via mechanisms proposed by the ITS. Results Past-year suicide ideation was associated with burdensomeness, mental rehearsal of suicide plans (a facet of acquired capability), and depression. Greater feelings of burdensomeness, and reduced fear of death, marked out participants who had attempted suicide in comparison to those who had experienced suicide ideation in the past year. Relationship status was indirectly associated with past-year suicide ideation via the mediators of depression and burdensomeness, and was associated with past-year attempts via its effect on ideation. Age at diagnosis was unrelated to any variables. Limitations Cross-sectional research is insensitive to causality and temporal dynamics, which is likely why interaction hypotheses from the ITS were unsupported. Normative measures may be invalid in autistic samples. There was no control group. The autistic sample was unrepresentative of the whole population, particularly autistic people with intellectual disabilities, ethnic/racial minorities, and gender minorities. Conclusions Perceived burdensomeness and acquired capability appear potentially important to suicide in autistic people, and may mediate the effects of some risk factors. Future research should explore the temporal dynamics of suicide trajectories in longitudinal, prospective designs. Supplementary Information The online version contains supplementary material available at 10.1186/s13229-022-00495-5.
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Voluntary exercise attenuates nociceptive abnormalities with no significant alterations of social interaction deficits in the BTBR mouse model of autism. Behav Brain Res 2021; 420:113727. [PMID: 34954299 DOI: 10.1016/j.bbr.2021.113727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/24/2022]
Abstract
Due to the financial burden and undesired side effects of treatment options, researchers have begun exploring alternative methods of treating autism spectrum disorder (ASD). Based on research suggesting impressive health benefits of engaging in physical activity, exercise treatment to alleviate symptoms could be a more cost effective alternative to pharmaceutical interventions. This study examined the effects of physical exercise on nociceptive responses and social interactions in an autism mouse model (BTBR T+ Itpr3tf/J). Subjects (n = 32) were separated into groups (BTBR vs B6 controls) based on the genetic strain and activity condition they were assigned. When compared to B6 controls, the BTBR mice demonstrated thermal hypoalgesia that normalized following 5 weeks of voluntary wheel running. However, exercise did not significantly attenuate social interaction deficits in BTBR mice, despite scores trending toward a positive direction. These results suggest that exercise could serve as a potential additive to other therapies for abnormal nociception in individuals with Autism Spectrum Disorder.
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9
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Oztenekecioglu B, Mavis M, Osum M, Kalkan R. Genetic and Epigenetic Alterations in Autism Spectrum Disorder. Glob Med Genet 2021; 8:144-148. [PMID: 34877571 PMCID: PMC8635813 DOI: 10.1055/s-0041-1735540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/02/2021] [Indexed: 12/13/2022] Open
Abstract
It is extremely important to understand the causes of autism spectrum disorder (ASD) which is a neurodevelopmental disease. Treatment and lifelong support of autism are also important to improve the patient's life quality. In this article, several findings were explained to understand the possible causes of ASD. We draw, outline, and describe ASD and its relation with the epigenetic mechanisms. Here, we discuss, several different factors leading to ASD such as environmental, epigenetic, and genetic factors.
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Affiliation(s)
- Bugsem Oztenekecioglu
- Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Near East University, Nicosia, Cyprus
| | - Merdiye Mavis
- Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Near East University, Nicosia, Cyprus
| | - Meryem Osum
- Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Near East University, Nicosia, Cyprus
| | - Rasime Kalkan
- Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Near East University, Nicosia, Cyprus.,Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
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10
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Bundo M, de Schrijver E, Federspiel A, Toreti A, Xoplaki E, Luterbacher J, Franco OH, Müller T, Vicedo-Cabrera AM. Ambient temperature and mental health hospitalizations in Bern, Switzerland: A 45-year time-series study. PLoS One 2021; 16:e0258302. [PMID: 34637463 PMCID: PMC8509878 DOI: 10.1371/journal.pone.0258302] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 09/23/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Psychiatric disorders constitute a major public health concern that are associated with substantial health and socioeconomic burden. Psychiatric patients may be more vulnerable to high temperatures, which under current climate change projections will most likely increase the burden of this public health concern. OBJECTIVE This study investigated the short-term association between ambient temperature and mental health hospitalizations in Bern, Switzerland. METHODS Daily hospitalizations for mental disorders between 1973 and 2017 were collected from the University Hospital of Psychiatry and Psychotherapy in Bern. Population-weighted daily mean ambient temperatures were derived for the catchment area of the hospital from 2.3-km gridded weather maps. Conditional quasi-Poisson regression with distributed lag linear models were applied to assess the association up to three days after the exposure. Stratified analyses were conducted by age, sex, and subdiagnosis, and by subperiods (1973-1989 and 1990-2017). Additional subanalyses were performed to assess whether larger risks were found during the warm season or were due to heatwaves. RESULTS The study included a total number of 88,996 hospitalizations. Overall, the hospitalization risk increased linearly by 4.0% (95% CI 2.0%, 7.0%) for every 10°C increase in mean daily temperature. No evidence of a nonlinear association or larger risks during the warm season or heatwaves was found. Similar estimates were found across for all sex and age categories, and larger risks were found for hospitalizations related to developmental disorders (29.0%; 95% CI 9.0%, 54.0%), schizophrenia (10.0%; 95% CI 4.0%, 15.0%), and for the later rather than the earlier period (5.0%; 95% CI 2.0%, 8.0% vs. 2.0%; 95% CI -3.0%, 8.0%). CONCLUSIONS Our findings suggest that increasing temperatures could negatively affect mental status in psychiatric patients. Specific public health policies are urgently needed to protect this vulnerable population from the effects of climate change.
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Affiliation(s)
- Marvin Bundo
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Evan de Schrijver
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center (TRC), University Hospital of Psychiatry and Psychotherapy University of Bern, Bern, Switzerland
| | - Andrea Toreti
- European Commission, Joint Research Centre, Ispra, Italy
| | - Elena Xoplaki
- Department of Geography, Climatology, Climate Dynamics and Climate Change, Justus Liebig University Giessen, Giessen, Germany
- Center for International Development and Environmental Research (ZEU), Justus Liebig University Giessen, Giessen, Germany
| | - Jürg Luterbacher
- World Meteorological Organization (WMO), Science and Innovation Department, Geneva, Switzerland
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Thomas Müller
- Translational Research Center (TRC), University Hospital of Psychiatry and Psychotherapy University of Bern, Bern, Switzerland
- Privatclinic Meiringen, Meiringen, Switzerland
| | - Ana M. Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
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11
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Buyuktaskin D, Iseri E, Guney E, Gunendi Z, Cengiz B. Somatosensory Temporal Discrimination in Autism Spectrum Disorder. Autism Res 2021; 14:656-667. [PMID: 33522138 DOI: 10.1002/aur.2479] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/15/2020] [Accepted: 12/20/2020] [Indexed: 12/14/2022]
Abstract
Sensory differences are common in Autism Spectrum Disorder (ASD). While there is no well-accepted method to measure sensory differences objectively, there is accumulating evidence from recent years concerning sensory perception, including data concerning temporal discrimination thresholds of individuals with ASD as measured by different measures. The somatosensory temporal discrimination (STD) test measures the threshold at which an individual can temporally discriminate multiple tactile stimuli delivered in succession. We aimed to investigate tactile perception in ASD and hypothesized that children with ASD have impaired STD related to their subjective sensory symptoms and daily difficulties. Thirty adolescents with ASD and 30 typically developed subjects were recruited. The Childhood Autism Rating Scale, Strengths and Difficulties Questionnaire, and Adolescent/Adult Sensory Profile were implemented before STD evaluation. Average somatosensory detection (1.48 ± 0.42) and discrimination thresholds (112.70 ± 43.45) of the children with ASD were significantly higher (P = 0.010, P = 0.001, respectively) than those of the controls (1.18 ± 0.42, 79.95 ± 31.60, respectively). Sensory seeking scores of the ASD group (40.8 ± 7.60) were significantly lower (P = 0.024) than those of the control group (45.83 ± 9.17). However, the psychophsycal thresholds did not have any statistically significant relationships with subjective sensory symptoms or daily difficulties. This study demonstrates impaired sensory processing in ASD evaluated by STD and its lack of relationship with subjective sensory symptoms and daily difficulties. This psychophysical evidence of increased STD thresholds and decreased sensory seeking profile supports the disturbances in the regulation of sensory processing in ASD. LAY SUMMARY: Sensory differences are common in autism; however, there is no well-accepted method to measure them objectively. This study aims to investigate somatosensory differences and their relation with sensory and emotional/behavioral difficulties of children with autism. We show that autistic children have higher tactile discrimination thresholds and fewer sensory seeking behaviors. This supports the presence of impairments in sensory processing in autism. Measuring the sensory differences may help understanding clinical symptoms and neurobiological underpinings of autism. Autism Res 2021, 14: 656-667. © 2021 International Society for Autism Research and Wiley Periodicals LLC.
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Affiliation(s)
- Dicle Buyuktaskin
- Department of Child and Adolescent Psychiatry, Cizre Dr. Selahattin Cizrelioglu State Hospital, Sirnak, Turkey.,Department of Child and Adolescent Psychiatry, Gazi University, Ankara, Turkey
| | - Elvan Iseri
- Department of Child and Adolescent Psychiatry, Gazi University, Ankara, Turkey
| | - Esra Guney
- Department of Child and Adolescent Psychiatry, Gazi University, Ankara, Turkey
| | - Zafer Gunendi
- Department of Physical Therapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Bulent Cengiz
- Department of Neurology, Gazi University, Ankara, Turkey
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12
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Failla MD, Gerdes MB, Williams ZJ, Moore DJ, Cascio CJ. Increased pain sensitivity and pain-related anxiety in individuals with autism. Pain Rep 2020; 5:e861. [PMID: 33235944 PMCID: PMC7676593 DOI: 10.1097/pr9.0000000000000861] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/14/2020] [Accepted: 09/02/2020] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Individuals with autism spectrum disorder (ASD) often exhibit differences in pain responsivity. This altered responsivity could be related to ASD-related social communication difficulties, sensory differences, or altered processing of pain stimuli. Previous neuroimaging work suggests altered pain evaluation could contribute to pain-related anxiety in ASD. OBJECTIVES We hypothesized that individuals with ASD would report increased pain sensitivity and endorse more pain-related anxiety, compared to typically developing controls. METHODS We recruited 43 adults (ASD, n = 24; typically developing, n = 19) for 3 heat pain tasks (applied to the calf). We measured heat pain thresholds using a method of limits approach, a pain-rating curve (7 temperatures between 40 and 48°C, 5 seconds, 5 trials each), and a sustained heat pain task with alternating low (42°C) and high (46°C) temperatures (21 seconds, 6 trials each). Individual differences in pain-related anxiety, fear of pain, situational pain catastrophizing, depressive symptoms, and autism-related social communication were assessed by self-report. RESULTS There were no group differences in pain thresholds. For suprathreshold tasks, mean pain ratings were higher in ASD across both the pain-rating curve and the sustained heat pain tasks, but responses in the ASD group were more varied. Pain anxiety (PASS-Total) and pain-related fear (FOP-III-Total) were higher in the ASD group and were positively associated with pain ratings. CONCLUSIONS Our results suggest that both sensory and cognitive experiences of pain are heightened and interact reciprocally in adults with ASD. Future studies are needed to evaluate the impact of pain-related anxiety on treatment-seeking and pain behaviors, given higher levels of pain-related anxiety in ASD.
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Affiliation(s)
- Michelle D. Failla
- Department of Psychiatry and Behavioral Science, Vanderbilt University, Nashville, TN, USA
| | - Madison B. Gerdes
- Department of Psychiatry and Behavioral Science, Vanderbilt University, Nashville, TN, USA
| | - Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
| | - David J. Moore
- Department of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Carissa J. Cascio
- Department of Psychiatry and Behavioral Science, Vanderbilt University, Nashville, TN, USA
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13
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Haigh SM, Endevelt-Shapira Y, Behrmann M. Trial-to-Trial Variability in Electrodermal Activity to Odor in Autism. Autism Res 2020; 13:2083-2093. [PMID: 32860323 DOI: 10.1002/aur.2377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 01/09/2023]
Abstract
Abnormal trial-to-trial variability (TTV) has been identified as a key feature of neural processing that is related to increased symptom severity in autism. The majority of studies evaluating TTV have focused on cortical processing. However, identifying whether similar atypicalities are evident in the peripheral nervous system will help isolate perturbed mechanisms in autism. The current study focuses on TTV in responses from the peripheral nervous system, specifically from electrodermal activity (EDA). We analyzed previously collected EDA data from 17 adults with autism and 19 neurotypical controls who viewed faces while being simultaneously exposed to fear (fear-induced sweat) and neutral odors. Average EDA peaks were significantly smaller and TTV was reduced in the autism group compared to controls, particularly during the fear odor condition. Amplitude and TTV were positively correlated in both groups, but the relationship was stronger in the control group. In addition, TTV was reduced in those with higher Autism Quotient scores but only for the individuals with autism. These findings confirm the existing results that atypical TTV is a key feature of autism and that it reflects symptom severity, although the smaller TTV in EDA contrasts with the previous findings of greater TTV in cortical responses. Identifying the relationship between cortical and peripheral TTV in autism is key for furthering our understanding of autism physiology. LAY SUMMARY: We compared the changes in electrodermal activity (EDA) to emotional faces over the course of repeated faces in adults with autism and their matched controls. The faces were accompanied by smelling fear-inducing odors. We found smaller and less variable responses to the faces in autism when smelling fear odors, suggesting that the peripheral nervous system may be more rigid. These findings were exaggerated in those who had more severe autism-related symptoms.
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Affiliation(s)
- Sarah M Haigh
- Department of Psychology and Center for Integrative Neuroscience, University of Nevada, Reno, Nevada, USA
| | | | - Marlene Behrmann
- Department of Psychology and Neuroscience Institute, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
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14
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Weiland RF, Polderman TJ, Hoekstra RA, Smit DJ, Begeer S. The Dutch Sensory Perception Quotient-Short in adults with and without autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:2071-2080. [PMID: 32720830 PMCID: PMC7543020 DOI: 10.1177/1362361320942085] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Sensory symptoms were recently added to the diagnostic criteria of autism spectrum disorder and may be a mechanism underlying the broad phenotype of autism spectrum disorder. To measure sensory symptoms based on perceptual rather than affective, regulative, or attention components, the Sensory Perception Quotient (SPQ) measuring five modalities of sensory sensitivity has been developed. In this study, the Dutch translation of the abridged SPQ-Short was investigated in a large sample of adults with (n = 657) and without autism spectrum disorder (n = 585). Its hypothesized factor structure, combining modality specific and one modality-independent factor, was assessed in a hierarchical model. Results show that modality-specific subscales are indeed present in the short version. Furthermore, its reliability is high and comparable to the original English version. The autism spectrum disorder group reported higher sensory sensitivities than the comparison group, and women with autism spectrum disorder reported higher sensitivities compared with men with autism spectrum disorder. The SPQ-Short correlates with all Autism Quotient (AQ)-Short subscales, except for the “imagination” subscale. The SPQ-Short seems suitable to further explore the relationship between basic sensory sensitivities in autism spectrum disorder and their related symptoms such as over- and under-responsivity to sensory stimulation.
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Affiliation(s)
| | | | | | - Dirk Ja Smit
- Academic Medical Center, Amsterdam, The Netherlands
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15
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Quinde-Zlibut JM, Okitondo CD, Williams ZJ, Weitlauf A, Mash LE, Heflin BH, Woodward ND, Cascio CJ. Elevated Thresholds for Light Touch in Children With Autism Reflect More Conservative Perceptual Decision-Making Rather Than a Sensory Deficit. Front Hum Neurosci 2020; 14:122. [PMID: 32317953 PMCID: PMC7154145 DOI: 10.3389/fnhum.2020.00122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 03/17/2020] [Indexed: 11/13/2022] Open
Abstract
Individuals with autism spectrum disorder (ASD) are often behaviorally hyper-reactive to light touch, but it is unclear to what degree this arises from a fundamental sensory difference vs. higher order systems for attention or emotion processing. Thus far, experimental findings for light touch detection are mixed, and few previous studies have independently considered sensitivity (the ability to discriminate signal from noise) and decision criterion (the overall response bias or tendency to answer “yes” or “no” in a detection task). We tested a large sample of children, adolescents, and adults with ASD (n = 88) and with neurotypical (NT) development (n = 59) using von Frey filaments to derive light touch thresholds at the palm. We calculated signal detection metrics for sensitivity (Az) and response criterion (c) from hit and false alarm rates. Both metrics exhibited significant group differences, such that the ASD group was less sensitive, but had a much more conservative response criterion. We used a best subset model selection procedure in three separate ordinal regressions for the whole group, adults, and children/adolescents. In all selected models, c was by far the most significant predictor of threshold, supplanting effects of diagnostic group that were significant in the baseline models. In contrast, Az was not a significant predictor of threshold in any of the models. Mean values of c were similar for adults with and without autism and for children/adolescents with ASD, but lower (more liberal) in neurotypical children/adolescents. This suggests that children with ASD exhibit a conservatism in their perceptual decision-making that differs from their NT peers but resembles that of adults. Across the sample, the value of c was significantly and positively correlated with age and with autism symptoms (SRS-2 total score), in addition to thresholds. The results of this study suggest that, rather than a sensory difference in detection of light touch, there is a difference in response bias such that children with ASD are more conservative/likely to report “no” if unsure, than their young NT peers. Future work should consider the implications of conservative response criterion in ASD for commonly used forced-choice psychophysical paradigms.
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Affiliation(s)
| | - Christian D Okitondo
- Graduate Program in Biostatistics, Georgia State University, Atlanta, GA, United States
| | - Zachary J Williams
- Graduate Program in Neuroscience, Vanderbilt University, Nashville, TN, United States.,Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, United States.,Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
| | - Amy Weitlauf
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Lisa E Mash
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, United States
| | - Brynna H Heflin
- Graduate Program in Clinical Psychology, Florida International University, Miami, FL, United States
| | - Neil D Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Carissa J Cascio
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.,Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN, United States
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