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Uğurlu M, Sözer Boz E, Turgut S. Psychometric Properties of the Child Behavior Checklist (CBCL) for Ages 6-18 to Identify Autism Spectrum Disorders (ASD) in a Turkish Parent Sample. J Autism Dev Disord 2024:10.1007/s10803-024-06495-z. [PMID: 39060705 DOI: 10.1007/s10803-024-06495-z] [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: 07/15/2024] [Indexed: 07/28/2024]
Abstract
The Child Behavior Checklist for ages 6-18 (CBCL/6-18) is broadly used for psycho-educational assessment in identifying children's behavior problems in special education and psychology. However, the usefulness of the CBCL/6-18 in a Turkish sample still needs to be investigated. The current study aimed to investigate the psychometric properties of the measures of the CBCL/6-18 within a sample of Turkish parents. The psychometric evaluation includes item calibration using the Partial Credit Model (PCM). We analyzed data from 548 parents who have children with autism spectrum disorder. According to the PCM calibration, the results suggested that the Internalizing, Externalizing, and Total Problem subscales were unidimensional and showed local independence successfully. All subscales demonstrated adequate reliability, indicating that the scale distinguishes between children with different behavior problems. The subscales had varying item step ordering, meaning that transitions from one category to second by parent ratings are relatively straightforward. Some items with easy-to-define behavior problems, for example, Item 42 (constipated), were more likely to be endorsed by parents. Consequently, the CBCL/6-18 has adequate psychometric properties for accurately assessing problem behaviors in children based on parent ratings.
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Affiliation(s)
- Mahir Uğurlu
- Department of Special Education, Bartin University, Bartin, Turkey.
| | - Esra Sözer Boz
- Department of Educational Measurement and Evaluation, Bartin University, Bartin, Turkey
| | - Sedat Turgut
- Department of Primary Education, Bartin University, Bartin, Turkey
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2
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Agebjörn J, Gillberg C, Eberhard J, Billstedt E, Nyrenius J. Association Between Autism and PTSD Among Adult Psychiatric Outpatients. J Autism Dev Disord 2024:10.1007/s10803-024-06439-7. [PMID: 38916696 DOI: 10.1007/s10803-024-06439-7] [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: 06/08/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE Autism Spectrum Disorder (ASD) occurs in 1-1.5% of the general population and possibly in up to 20% of psychiatric outpatients. Post Traumatic Stress Disorder (PTSD) occurs at some point in life in 4% of the general population and in 14-20% of psychiatric outpatients. Knowledge about how PTSD manifests in people with ASD is important in order for it to be correctly diagnosed and intervened for. METHODS This study investigated the relationship between PTSD and autism among adult psychiatric outpatients (N = 90) of whom 63 had ASD or subthreshold ASD based on DSM-5 criteria. The study group was subjected to in-depth psychiatric assessments using validated instruments. Diagnosis of PTSD was made based on the Mini International Neuropsychiatric Interview (MINI). RESULTS There was a trend towards PTSD being more common among participants with ASD compared to participants without ASD, although significant differences could not be shown in this small sample. 21% of the ASD group had current PTSD, compared to 4% of the study group without ASD. There were no differences between the groups regarding exposure to trauma. There was a trend towards a relationship between number of autism symptoms and hyperarousal symptoms in PTSD. Conversely, the PTSD symptom of irritability/outbursts of anger, was significantly associated with number of autism symptoms. CONCLUSIONS A subgroup of psychiatric outpatients with ASD also suffer from PTSD. Hyperarousal symptoms are possibly more prevalent in the presentation of PTSD in individuals/patients with ASD compared to those without ASD.
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Affiliation(s)
- Johan Agebjörn
- Adult Psychiatric Clinic Arlöv, Region Skåne, Arlöv, Sweden.
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jonas Eberhard
- Adult Psychiatry Helsingborg, Region Skåne, Sweden; and Department of Clinical Sciences Lund/Clinical Sciences Helsingborg,, Lund University, Lund, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Nyrenius
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Adult Psychiatry Helsingborg, Region Skåne, Sweden; and Department of Clinical Sciences Lund/Clinical Sciences Helsingborg,, Lund University, Lund, Sweden
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3
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Takata K, Yoshikawa Y, Muramatsu T, Matsumoto Y, Ishiguro H, Mimura M, Kumazaki H. Social skills training using multiple humanoid robots for individuals with autism spectrum conditions. Front Psychiatry 2023; 14:1168837. [PMID: 37539327 PMCID: PMC10394831 DOI: 10.3389/fpsyt.2023.1168837] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/23/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction Social skills training (SST) is used to help individuals with autism spectrum conditions (ASC) better understand the perspectives of others and social interactions, develop empathy skills, and learn how to engage with others socially. However, many individuals with ASC cannot easily sustain high motivation and concentration during such an intervention when it is administered by humans. We developed a social skills training program using multiple humanoid robots (STUH), including an android robot, that aimed to enable individuals with ASC to become familiar with the perspectives of others and improve their sociability and empathy skills. The objective of the present study was to investigate the effectiveness of STUH for these individuals. Methods In STUH, we prepared 50 social exercises that consisted of conversations and behavioral interactions between an android robot and a simple humanoid robot. We prepared another humanoid robot that featured a cartoon-like and mechanical design, which played the role of host. In the first half-session of STUH, participants worked on the exercise from the perspective of an outsider. In the second half-session of STUH, they simulated experience by using robots as their avatars. The intervention associated with STUH was conducted for five days in total. We conducted an analysis of variance (ANOVA) featuring the intervention time point as the independent variable to examine changes in each score on the sociability index items. Results In total, 14 individuals with ASC participated in the study. The results of multiple comparison tests using the Bonferroni method indicated that all sociability index items improved between preintervention and follow-up. Our program enabled the participants to become familiar with the perspectives of others and improve their sociability. Discussion Given the promising results of this study, future studies featuring long-term follow-up should be conducted to draw definitive conclusions about the efficacy of our training system.
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Affiliation(s)
- Keiji Takata
- Department of Psychology, Saitama Gakuen University, Saitama, Japan
| | - Yuichiro Yoshikawa
- Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Taro Muramatsu
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yoshio Matsumoto
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Chiba, Japan
- Department of Clinical Research on Social Recognition and Memory, Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
| | - Hiroshi Ishiguro
- Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hirokazu Kumazaki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Chiba, Japan
- College of Science and Engineering, Kanazawa University, Ishikawa, Japan
- Department of Neuropsychiatry, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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4
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Aydin Ü, Cañigueral R, Tye C, McLoughlin G. Face processing in young adults with autism and ADHD: An event related potentials study. Front Psychiatry 2023; 14:1080681. [PMID: 36998627 PMCID: PMC10043418 DOI: 10.3389/fpsyt.2023.1080681] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/14/2023] [Indexed: 03/18/2023] Open
Abstract
Background Atypicalities in perception and interpretation of faces and emotional facial expressions have been reported in both autism and attention-deficit/hyperactivity disorder (ADHD) during childhood and adulthood. Investigation of face processing during young adulthood (18 to 25 years), a transition period to full-fledged adulthood, could provide important information on the adult outcomes of autism and ADHD. Methods In this study, we investigated event-related potentials (ERPs) related to visual face processing in autism, ADHD, and co-occurring autism and ADHD in a large sample of young adults (N = 566). The groups were based on the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2) and the Autism Diagnostic Observation Schedule-2 (ADOS-2). We analyzed ERPs from two passive viewing tasks previously used in childhood investigations: (1) upright and inverted faces with direct or averted gaze; (2) faces expressing different emotions. Results Across both tasks, we consistently found lower amplitude and longer latency of N170 in participants with autism compared to those without. Longer P1 latencies and smaller P3 amplitudes in response to emotional expressions and longer P3 latencies for upright faces were also characteristic to the autistic group. Those with ADHD had longer N170 latencies, specific to the face-gaze task. Individuals with both autism and ADHD showed additional alterations in gaze modulation and a lack of the face inversion effect indexed by a delayed N170. Conclusion Alterations in N170 for autistic young adults is largely consistent with studies on autistic adults, and some studies in autistic children. These findings suggest that there are identifiable and measurable socio-functional atypicalities in young adults with autism.
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Affiliation(s)
- Ümit Aydin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Roser Cañigueral
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Charlotte Tye
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Gráinne McLoughlin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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Kopp S, Asztély KS, Landberg S, Waern M, Bergman S, Gillberg C. Girls With Social and/or Attention Deficit Re-Examined in Young Adulthood: Prospective Study of Diagnostic Stability, Daily Life Functioning and Social Situation. J Atten Disord 2023; 27:830-846. [PMID: 36915033 DOI: 10.1177/10870547231158751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Investigate diagnostic stability, daily life functioning and social situation in women diagnosed with ADHD and/or ASD in childhood. METHODS Prospective 17 to 20-year follow-up study of 100 girls of whom 92 diagnosed in childhood with main DSM-IV ADHD or ASD, and 60 comparison girls. Ninety and 54 of these women were examined (M = 27, 4 years old) with semi-structured interviews and questionnaires, close relatives were interviewed. RESULTS At follow-up, 89% of women with ADHD or ASD in childhood still met the criteria for either of these diagnoses. Very few women were "in remission." In 34% the main diagnosis shifted from ADHD to ASD. Women with ADHD and ASD had significantly more disability and unfavorable social situation than comparison women. CONCLUSION Women with ADHD and/or ASD in childhood had impairing problems 17 to 20 years later. Early ADHD changed to ASD in adulthood in some cases. Nearly all with ASD met criteria for ADHD as adults.
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Affiliation(s)
- Svenny Kopp
- University of Gothenburg Institute of Neuroscience and Physiology, Göteborg, Sweden
| | | | - Sara Landberg
- University of Gothenburg Institute of Neuroscience and Physiology, Göteborg, Sweden
| | - Margda Waern
- University of Gothenburg Institute of Neuroscience and Physiology, Göteborg, Sweden
| | - Stefan Bergman
- University of Gothenburg Institute of Medicine, Göteborg, VG Region, Sweden
| | - Christopher Gillberg
- University of Gothenburg Institute of Neuroscience and Physiology, Göteborg, Sweden
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Eberhard D, Billstedt E, Gillberg C. Neurodevelopmental disorders and comorbidity in young adults attending a psychiatric outpatient clinic. Psychiatry Res 2022; 313:114638. [PMID: 35597136 DOI: 10.1016/j.psychres.2022.114638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 05/10/2022] [Accepted: 05/13/2022] [Indexed: 12/27/2022]
Abstract
"Missed" cases with neurodevelopmental disorders (NDDs) within adult psychiatry services have attracted increasing attention in the last decade. Key questions have been what the prevalence of NDDs (particularly attention-deficit/hyperactivity disorder/ADHD and autism spectrum disorder/ASD) is, and what the clinical and gender characteristics of those with NDD in adult psychiatry are. All first-time attenders at an adult psychiatry clinic serving 18-25 years old were invited to take part in the study regardless of cause of concern. Participation in the study included diagnostic in-depth evaluation performed by experienced adult psychiatrists. Clinical diagnoses (DSM-IV-TR and DSM-5 criteria) were based on all available information (clinical psychiatric interview, clinical observation, and self-rating questionnaires). Almost two thirds (63%) of the study group met criteria for ADHD or ASD. Most of the patients with NDD (particularly the "NDD females") had not been diagnosed in childhood. Twelve percent of the females included had been given an ADHD diagnosis in childhood. In the current study we found that 48% of the females had ADHD. The high male:female NDD ratio reported among children, was not obvious in our NDD group. The results underscore the importance of screening for NDD in adult psychiatric services regardless of referral reason.
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Affiliation(s)
- David Eberhard
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Sweden; PRIMA Adult psychiatry, Stockholm, Sweden.
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Sweden; Child Neuropsychiatric Clinic, Queen Silvia Children´s Hospital, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Sweden; Child Neuropsychiatric Clinic, Queen Silvia Children´s Hospital, Gothenburg, Sweden
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7
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Prevalence of Autism Spectrum Disorders in Adult Outpatient Psychiatry. J Autism Dev Disord 2022; 52:3769-3779. [PMID: 34993724 DOI: 10.1007/s10803-021-05411-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/22/2022]
Abstract
Relatively little has been published about the prevalence of autism in adults with psychiatric disorders. In this study, all new patients referred to an adult psychiatric outpatient clinic in Sweden between November 2019 and October 2020 (n = 562) were screened for autism spectrum disorders using the Ritvo Autism and Asperger Diagnostic Scale Screen (RAADS-14). Out of the 304 (58%) responders, 197 who scored above the cut off (14) were invited to participate in an in-depth assessment. Twenty-six of the 48 that participated in the assessment met criteria for ASD and an additional eight had subthreshold ASD symptoms. We estimated the prevalence of ASD in this population to at least 18.9%, with another 5-10% having subthreshold symptoms.
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8
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Posserud MB, Skretting Solberg B, Engeland A, Haavik J, Klungsøyr K. Male to female ratios in autism spectrum disorders by age, intellectual disability and attention-deficit/hyperactivity disorder. Acta Psychiatr Scand 2021; 144:635-646. [PMID: 34494265 DOI: 10.1111/acps.13368] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/19/2021] [Accepted: 09/01/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine the gender distribution in ASD in adults compared with children and the impact of comorbid intellectual disability (ID) and attention-deficit/hyperactivity disorder (ADHD) on the male to female ratio (MFR). METHODS We estimated the MFR and the male prevalence ratio (PR) for ASD in adults and children using the Medical Birth Registry of Norway, including all individuals born during 1967-2011. We examined variation with age, comorbid ID and ADHD as defined by diagnoses in the Norwegian Patient Registry during 2008-2015 and/or a dispensed prescription for ADHD medication. RESULTS The sample included 1,701,206 adults and 804,146 children, including 8,995 (0.5%) adults and 8,056 (1.0%) children with ASD, 53,822 (3.2%) adults and 26,967 (3.4%) children with ADHD and 9,178 (0.5%) adults and 5,038 (0.6%) children with ID. The MFR for ASD was 3.67 in children and 2.57 in adults, corresponding to a male PR in ASD of 1.54 (95% CI 1.53-1.56) and 1.41 (1.39-1.24), respectively. Comorbid ID decreased the MFR and the male PR in both adults and children, whereas comorbid ADHD significantly increased the male PR in children. The MFR and the population prevalence of ASD, ADHD and ID decreased from children to younger adults and yet further to older adults. CONCLUSION We found a lower MFR and male PR in adults than in children. Findings suggest the strong male predominance seen in childhood/clinical studies of ASD diminishes in adult samples, possibly reflecting the influence of non-aetiological factors such as later diagnosis in females, diagnostic biases and diagnostic trends.
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Affiliation(s)
- Maj-Britt Posserud
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Berit Skretting Solberg
- Department of Biomedicine, University of Bergen, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Child and Adolescent Psychiatric Outpatient Unit, Hospital Betanien, Bergen, Norway
| | - Anders Engeland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Jan Haavik
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
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9
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A Systematic Review and Meta-analysis of Social Skills Training for Adults with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:1598-1609. [PMID: 33963965 DOI: 10.1007/s10803-021-05058-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
This systematic review and meta-analysis is the first to evaluate the effects of group-based social skills training (SST) on parent-report social responsiveness in adults with autism spectrum disorder (ASD). A total of 18 studies were included in the narrative review and among them five randomized-controlled trials (n = 145) were included in the meta-analysis. SST had large positive effects on social responsiveness. The narrative review identified that SST could improve patient's outcomes in adults with ASD. These results should be interpreted with caution due to the moderate quality of the existing evidence, which could have inflated effect sizes. The absence of active comparator control groups makes unclear whether improvements at post-treatment are treatment-specific or are attributable to common factors to all psychotherapies.
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10
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Rosello R, Martinez-Raga J, Mira A, Girela B, Cortese S. Developmental outcomes in adolescence of children with autism spectrum disorder without intellectual disability: A systematic review of prospective studies. Neurosci Biobehav Rev 2021; 126:590-603. [PMID: 33872683 DOI: 10.1016/j.neubiorev.2021.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/23/2021] [Accepted: 04/10/2021] [Indexed: 11/30/2022]
Abstract
Individuals with Autism Spectrum Disorder (ASD) without intellectual disability (ID) represent approximately two-thirds of the ASD population. Here we focused on prospective research assessing different areas of functioning of children with ASD, without ID, until adolescence. Based on a pre-registered protocol (PROSPERO CRD42020189029), a systematic review of prospective studies (published between 01.01.2010 and 01.01.2020) was conducted. Twenty-eight studies met eligibility criteria. Findings indicated that ASD diagnosis and the Intelligence Quotient were highly stable over time across studies. Executive Functioning, Theory of Mind and Central Coherence processes tended to improve, although deficits remained when compared to typically developed controls. Adaptive difficulties and psychiatric comorbidity were relatively stable over time. We discuss potential implications of the findings for clinicians and educators and suggest recommendations for future research.
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Affiliation(s)
- Rocio Rosello
- Division of Psychiatry, Imperial College London, UK.
| | - Jose Martinez-Raga
- Psychiatry Department, University Hospital Doctor Peset of Valencia & University of Valencia, Spain
| | - Alvaro Mira
- Division of Developmental and Educational Psychology, University of Valencia, Spain
| | | | - Samuele Cortese
- Centre for Innovation in Mental Health (CIMH), School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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11
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Chopik WJ, Oh J, Nuttall AK, Thakkar KN, Ingersoll B. Age differences in broader autism phenotype traits from young adulthood to older adulthood. Autism Res 2021; 14:1456-1471. [PMID: 33764656 DOI: 10.1002/aur.2504] [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: 10/29/2020] [Accepted: 03/09/2021] [Indexed: 11/12/2022]
Abstract
Much of past research has been dedicated to refining the operationalization and correlates of the broader autism phenotype (BAP) and less on how the BAP differs by socio-demographic characteristics, like age-particularly after midlife. This gap is important because other nonclinical trait-like characteristics (e.g., personality) have shown considerable age differences, leading to work assessing the malleability of psychological characteristics and improving outcomes for individuals and their significant others. In the current study, we examined cross-sectional age differences in the BAP in a large sample of adults ranging in age from 18 to 85. We recruited a sample of 2966 adults ranging in age from 18 to 85 (Mage = 36.53, SD = 12.61; 58.9% Female; 1.1% with an ASD diagnosis) recruited from an online survey service. We found that total BAP scores were higher in younger adults and lower among older adults. These differences were particularly true for pragmatic language difficulties, with this component of the BAP showing the most dramatic age differences. Aloofness showed similar negative associations with age, albeit much smaller. Rigidity was not significantly associated with age. The results are consistent with other research showing an abatement of symptoms among individuals with autism spectrum disorders (ASDs) across early life and theories predicting changes in other psychological characteristics (e.g., personality). The results are discussed in the context of the malleability of ASD and BAP traits across life, the clinical implications of these changes, and the origins and consequences for lifespan differences in BAP. LAY SUMMARY: Little is known about how subclinical autistic-like traits among middle-aged and older adults compare to younger adults. We found that these subclinical traits were highest in young adults and lowest in older adults. Knowing how these traits differ by age can provide researchers and clinicians with a sense of how much these traits might change across life, if the traits might be sensitive to interventions, and when in development it might be best to intervene.
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Affiliation(s)
- William J Chopik
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Jeewon Oh
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Amy K Nuttall
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Katharine N Thakkar
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Brooke Ingersoll
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
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12
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Higher levels of autistic traits associated with lower levels of self-efficacy and wellbeing for performing arts professionals. PLoS One 2021; 16:e0246423. [PMID: 33596243 PMCID: PMC7888677 DOI: 10.1371/journal.pone.0246423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 01/19/2021] [Indexed: 11/19/2022] Open
Abstract
This study sought for the first time to identify the extent to which autistic people are pursuing careers in the performing arts, and to determine the nature of the relationship between individuals' autistic traits and their reported wellbeing. To address these aims, we recruited a self-selecting, community-based sample of individuals working in the performing arts and invited them to complete an online survey. A total of 1,427 respondents took part. We collected responses on participants' backgrounds, including diagnostic history as well as measures assessing their level of autistic traits, perceived occupational self-efficacy, quality of life, and mental health. They were also asked open-ended questions about support needed, received, or desired in their workplace. Eleven of the 1,427 professionals (1%) reported a clinical diagnosis of autism. Correlational analyses demonstrated that higher levels of autistic traits were significantly associated with lower levels of quality of life, lower levels of occupational self-efficacy and greater severity of mental health conditions. Almost half the sample of professionals (N = 621; 44%) reported a desire for more employment-based support, and autistic traits were significantly higher in those participants who wanted greater support. Within the community of those working in the performing arts, there are a minority of individuals who are autistic or who have high levels of autistic traits. We have demonstrated for the first time that these individuals may be especially vulnerable to lower wellbeing.
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13
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Sarovic D. A Unifying Theory for Autism: The Pathogenetic Triad as a Theoretical Framework. Front Psychiatry 2021; 12:767075. [PMID: 34867553 PMCID: PMC8637925 DOI: 10.3389/fpsyt.2021.767075] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/27/2021] [Indexed: 12/27/2022] Open
Abstract
This paper presents a unifying theory for autism by applying the framework of a pathogenetic triad to the scientific literature. It proposes a deconstruction of autism into three contributing features (an autistic personality dimension, cognitive compensation, and neuropathological risk factors), and delineates how they interact to cause a maladaptive behavioral phenotype that may require a clinical diagnosis. The autistic personality represents a common core condition, which induces a set of behavioral issues when pronounced. These issues are compensated for by cognitive mechanisms, allowing the individual to remain adaptive and functional. Risk factors, both exogenous and endogenous ones, show pathophysiological convergence through their negative effects on neurodevelopment. This secondarily affects cognitive compensation, which disinhibits a maladaptive behavioral phenotype. The triad is operationalized and methods for quantification are presented. With respect to the breadth of findings in the literature that it can incorporate, it is the most comprehensive model yet for autism. Its main implications are that (1) it presents the broader autism phenotype as a non-pathological core personality domain, which is shared across the population and uncoupled from associated features such as low cognitive ability and immune dysfunction, (2) it proposes that common genetic variants underly the personality domain, and that rare variants act as risk factors through negative effects on neurodevelopment, (3) it outlines a common pathophysiological mechanism, through inhibition of neurodevelopment and cognitive dysfunction, by which a wide range of endogenous and exogenous risk factors lead to autism, and (4) it suggests that contributing risk factors, and findings of immune and autonomic dysfunction are clinically ascertained rather than part of the core autism construct.
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Affiliation(s)
- Darko Sarovic
- Gillberg Neuropsychiatry Centre, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.,MedTech West, Gothenburg, Sweden
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14
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Laporte N, Ozolins A, Westling S, Westrin Å, Wallinius M. Clinical Characteristics and Self-Harm in Forensic Psychiatric Patients. Front Psychiatry 2021; 12:698372. [PMID: 34408680 PMCID: PMC8365140 DOI: 10.3389/fpsyt.2021.698372] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/02/2021] [Indexed: 01/01/2023] Open
Abstract
Self-harm, comprising non-suicidal self-injury, and suicide attempts, is a serious and potentially life-threatening behavior that has been associated with poor life quality and an increased risk of suicide. In forensic populations, increased rates of self-harm have been reported, and suicide is one of the leading causes of death. Aside from associations between self-harm and mental disorders, knowledge on self-harm in forensic psychiatric populations is limited. The purpose of this study was to characterize the clinical needs of a cohort of forensic psychiatric patients, including self-harm and possible risk factors thereof. Participants (N = 98) were consecutively recruited from a cohort of forensic psychiatric patients in Sweden from 2016 to 2020. Data were collected through file information, self-reports, and complemented with semi-structured interviews. Results showed that self-harm was common among the participants, more than half (68.4%) of whom had at some point engaged in self-harm. The most common methods of non-suicidal self-injury were banging one's head or fist against a wall or other solid surface and cutting, and the most common method of suicide attempt was hanging. The most prominent functions of non-suicidal self-injury among the participants were intrapersonal functions such as affect regulation, self-punishment, and marking distress. Self-harm in general was associated to neurodevelopmental disorders (p = 0.014, CI = 1.23-8.02, OR = 3.14) and disruptive impulse-control and conduct disorders (p = 0.012, CI = 1.19-74.6, OR = 9.41), with reservation to very wide confidence intervals. Conclusions drawn from this study are that self-harm was highly prevalent in this sample and seems to have similar function in this group of individuals as in other studied clinical and non-clinical groups.
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Affiliation(s)
- Natalie Laporte
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Centre for Ethics, Law, and Mental Health, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
| | - Andrejs Ozolins
- Department of Psychology, Linneaus University, Växjö, Sweden
| | - Sofie Westling
- Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.,Office of Psychiatry and Habilitation, Psychiatric Clinic Lund, Lund, Sweden.,Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Lund, Sweden
| | - Åsa Westrin
- Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.,Office of Psychiatry and Habilitation, Psychiatric Clinic Lund, Lund, Sweden.,Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Lund, Sweden
| | - Märta Wallinius
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Centre for Ethics, Law, and Mental Health, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
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15
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Sarovic D, Hadjikhani N, Schneiderman J, Lundström S, Gillberg C. Autism classified by magnetic resonance imaging: A pilot study of a potential diagnostic tool. Int J Methods Psychiatr Res 2020; 29:1-18. [PMID: 32945591 PMCID: PMC7723195 DOI: 10.1002/mpr.1846] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Individual anatomical biomarkers have limited power for the classification of autism. The present study introduces a multivariate classification approach using structural magnetic resonance imaging data from individuals with and without autism. METHODS The classifier utilizes z-normalization, parameter weighting, and interindividual comparison on brain segmentation data, for estimation of an individual summed total index (TI). The TI indicates whether the gross morphological pattern of each individual's brain is in the direction of cases or controls. RESULTS Morphometric analysis found significant differences within subcortical gray matter structures and limbic areas. There was no significant difference in total brain volume. A case-control pilot-study of TIs in normally intelligent individuals with autism (24) and without (21) yielded a maximal accuracy of 78.9% following cross-validation. It showed a high accuracy compared with machine learning methods when tested on the same dataset. The TI correlated well with the autism quotient (R = 0.51) across groups. CONCLUSION These results are on par with studies on autism using machine learning. The main contributions are its transparency and simplicity. The possibility of including additional neuroimaging data further increases the potential of the classifier as a diagnostic aid for neuropsychiatric disorders, as well as a research tool for neuroscientific investigations.
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Affiliation(s)
- Darko Sarovic
- Gillberg Neuropsychiatry Centre, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,MedTech West, Gothenburg, Sweden
| | - Nouchine Hadjikhani
- Gillberg Neuropsychiatry Centre, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Harvard University, Charlestown, Massachusetts, USA
| | - Justin Schneiderman
- MedTech West, Gothenburg, Sweden.,Department of Clinical Neurophysiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland, UK
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16
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Kulage KM, Goldberg J, Usseglio J, Romero D, Bain JM, Smaldone AM. How has DSM-5 Affected Autism Diagnosis? A 5-Year Follow-Up Systematic Literature Review and Meta-analysis. J Autism Dev Disord 2020; 50:2102-2127. [PMID: 30852784 DOI: 10.1007/s10803-019-03967-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We conducted a 5-year follow-up systematic review and meta-analysis to determine change in frequency of autism spectrum disorder (ASD) diagnosis since diagnostic and statistical manual 5 (DSM-5) publication and explore the impact of Social Communication Disorder (SCD). For 33 included studies, use of DSM-5 criteria suggests decreases in diagnosis for ASD [20.8% (16.0-26.7), p < 0.001], DSM-IV-TR Autistic Disorder [10.1% (6.2-16.0), p < 0.001], and Asperger's [23.3% (12.9-38.5), p = 0.001]; pervasive developmental disorder-not otherwise specified decrease was not significant [46.1% (34.6-58.0), p = 0.52]. Less than one-third [28.8% (13.9-50.5), p = 0.06] of individuals diagnosed with DSM-IV-TR but not DSM-5 ASD would qualify for SCD. Findings suggest smaller decreases in ASD diagnoses compared to earlier reviews. Future research is needed as concerns remain for impaired individuals without a diagnosis.
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Affiliation(s)
- Kristine M Kulage
- Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY, 10032, USA.
| | - Johanna Goldberg
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia University Irving Medical Center, 701 West 168th Street, New York, NY, 10032, USA
| | - Danielle Romero
- Lucile Packard Children's Hospital at Stanford, 770 Welch Road, Palo Alto, CA, 94304, USA
| | - Jennifer M Bain
- Department of Neurology, Division of Child Neurology, Columbia University Vagelos College of Physicians and Surgeons, 180 Fort Washington Avenue, 5th Floor, New York, NY, 10032, USA
| | - Arlene M Smaldone
- Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY, 10032, USA
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17
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Sandercock RK, Lamarche EM, Klinger MR, Klinger LG. Assessing the convergence of self-report and informant measures for adults with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:2256-2268. [PMID: 32744068 PMCID: PMC7541713 DOI: 10.1177/1362361320942981] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Self-report measures are widely used for research and clinical assessment of adults with autism spectrum disorder. However, there has been little research examining the convergence of self- and informant-report in this population. This study examined agreement between 40 pairs of adults with autism spectrum disorder and their caregivers on measures of symptom severity, daily living skills, quality of life, and unmet service needs. In addition, this study examined the predictive value of each reporter for objective independent living and employment outcomes. Caregiver and self-report scores were significantly positively correlated on all measures (all r’s >0.50). Results indicated that there were significant differences between reporter ratings of daily living skills, quality of life, and unmet service needs, but no significant differences between ratings of symptom severity. Combining caregiver-report and self-report measures provided significantly higher predictive value of objective outcomes than measures from a single reporter. These findings indicate that both informants provide valuable information and adults with autism spectrum disorder should be included in reporting on their own symptoms and experiences. Given that two reporters together were more predictive of objective outcomes; however, a multi-informant assessment may be the most comprehensive approach for evaluating current functioning and identifying service needs in this population.
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18
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Abstract
Purpose and aim: The overall aim of this study was to examine the relationship between adaptive function and cognitive factors in young adults diagnosed with autism spectrum disorder (ASD) in adult age.Methods: The study included 30 adults (age 18-30) diagnosed with ASD in adulthood. All participants were clinically referred to an adult psychiatric clinic for assessment. Adaptive functioning was measured with Adaptive Behavior Assessment System - 2nd edition (parent version). Wechsler scales of intelligence and Delis-Kaplan Executive Function System were used to measure intelligence and executive function.Results: We found considerable adaptive functioning deficits regardless of Full Scale Intelligence Quotient (FSIQ) level. FSIQ, working memory and processing speed were positively associated with adaptive functioning. No associations were found between adaptive functioning and cognitive flexibility, inhibition, word generation or shifting. Regression analysis showed that working memory and processing speed predicted 23% of the variance in adaptive functioning in this group.Conclusions: The results suggest that cognitive dysfunction could be an important area for intervention to improve adaptive functioning in ASD.
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Affiliation(s)
- Johan Nyrenius
- Division of Psychiatry, Specialized Outpatient Unit, Helsingborg, Sweden.,Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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19
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Nylander L, Axmon A, Björne P, Ahlström G, Gillberg C. Older Adults with Autism Spectrum Disorders in Sweden: A Register Study of Diagnoses, Psychiatric Care Utilization and Psychotropic Medication of 601 Individuals. J Autism Dev Disord 2019; 48:3076-3085. [PMID: 29663191 PMCID: PMC6096790 DOI: 10.1007/s10803-018-3567-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In a Swedish sample of persons eligible for disability services and aged 55 years or older in 2012, persons (n = 601) with autism spectrum disorder diagnoses registered in specialist care were identified. Register data concerning diagnoses of other psychiatric disorders, psychiatric care, and psychiatric medication were reviewed. More than 60% had been in contact with psychiatric care. The majority had no intellectual disability (ID) diagnosis recorded during the study period. Apart from ID, affective disorders, anxiety and psychotic disorders were most commonly registered; alcohol/substance abuse disorders were uncommon. Psychotropic drug prescriptions were very common, especially in the ID group. Professionals need awareness of this vulnerable group; studies concerning their life circumstances and service requirements should be conducted.
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Affiliation(s)
- Lena Nylander
- Department of Clinical Sciences/Psychiatry, Lund University, 221 00, Lund, Sweden. .,Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, 411 19, Sweden. .,VUB-teamet Psykiatriska Kliniken, Baravägen 1, 221 85, Lund, Sweden.
| | - Anna Axmon
- Division of Occupational and Environmental Medicine, Lund University, 221 00, Lund, Sweden.,Department of Health Sciences, Lund University, 221 00, Lund, Sweden
| | - Petra Björne
- Research and Development Unit, City Office, City of Malmö, 205 80, Malmö, Sweden
| | - Gerd Ahlström
- Department of Health Sciences, Lund University, 221 00, Lund, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, 411 19, Sweden
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20
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d'Albis MA, Guevara P, Guevara M, Laidi C, Boisgontier J, Sarrazin S, Duclap D, Delorme R, Bolognani F, Czech C, Bouquet C, Ly-Le Moal M, Holiga S, Amestoy A, Scheid I, Gaman A, Leboyer M, Poupon C, Mangin JF, Houenou J. Local structural connectivity is associated with social cognition in autism spectrum disorder. Brain 2019; 141:3472-3481. [PMID: 30423029 DOI: 10.1093/brain/awy275] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/12/2018] [Indexed: 12/13/2022] Open
Abstract
The current theory implying local, short-range overconnectivity in autism spectrum disorder, contrasting with long-range underconnectivity, is based on heterogeneous results, on limited data involving functional connectivity studies, on heterogeneous paediatric populations and non-specific methodologies. In this work, we studied short-distance structural connectivity in a homogeneous population of males with high-functioning autism spectrum disorder and used a novel methodology specifically suited for assessing U-shaped short-distance tracts, including a recently developed tractography-based atlas of the superficial white matter fibres. We acquired diffusion-weighted MRI for 58 males (27 subjects with high-functioning autism spectrum disorder and 31 control subjects) and extracted the mean generalized fractional anisotropy of 63 short-distance tracts. Neuropsychological evaluation included Wechsler Adult Intelligence Scale IV (WAIS-IV), Communication Checklist-Adult, Empathy Quotient, Social Responsiveness Scale and Behaviour Rating Inventory of Executive Function-Adult (BRIEF-A). In contradiction with the models of short-range over-connectivity in autism spectrum disorder, we found that patients with autism spectrum disorder had a significantly decreased anatomical connectivity in a component comprising 13 short tracts compared to controls. Specific short-tract atypicalities in temporal lobe and insula were significantly associated with clinical manifestations of autism spectrum disorder such as social awareness, language structure, pragmatic skills and empathy, emphasizing their importance in social dysfunction. Short-range decreased anatomical connectivity may thus be an important substrate of social deficits in autism spectrum disorder, in contrast with current models.
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Affiliation(s)
- Marc-Antoine d'Albis
- UNIACT, Psychiatry Team, Neurospin, Atomic Energy Commission, Gif-Sur-Yvette, France.,INSERM, U955, Translational Psychiatry Team, Créteil, France.,Fondation Fondamental, Créteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Psychiatry, Mondor University Hospital, DHU PePsy, Créteil, France
| | - Pamela Guevara
- Faculty of Engineering, Universidad de Concepción, Concepción, Chile
| | - Miguel Guevara
- Faculty of Engineering, Universidad de Concepción, Concepción, Chile.,Neurospin, CEA, Paris Saclay University, Gif-sur-Yvette, France
| | - Charles Laidi
- UNIACT, Psychiatry Team, Neurospin, Atomic Energy Commission, Gif-Sur-Yvette, France.,INSERM, U955, Translational Psychiatry Team, Créteil, France.,Fondation Fondamental, Créteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Psychiatry, Mondor University Hospital, DHU PePsy, Créteil, France
| | - Jennifer Boisgontier
- UNIACT, Psychiatry Team, Neurospin, Atomic Energy Commission, Gif-Sur-Yvette, France.,INSERM, U955, Translational Psychiatry Team, Créteil, France.,Fondation Fondamental, Créteil, France
| | - Samuel Sarrazin
- UNIACT, Psychiatry Team, Neurospin, Atomic Energy Commission, Gif-Sur-Yvette, France.,INSERM, U955, Translational Psychiatry Team, Créteil, France.,Fondation Fondamental, Créteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Psychiatry, Mondor University Hospital, DHU PePsy, Créteil, France
| | - Delphine Duclap
- Neurospin, CEA, Paris Saclay University, Gif-sur-Yvette, France
| | - Richard Delorme
- Fondation Fondamental, Créteil, France.,Service de psychiatrie de l'enfant et de l'adolescent, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Robert Debré, Paris, France.,Institut Pasteur, Human Genetics and Cognitive Functions Unit, Paris, France
| | - Federico Bolognani
- Neuroscience, Ophtalmology, and Rare Disease (NORD), Roche Pharma Research and Early Development, Roche Innovation Center Basel, F.Hoffman-La Roche Ltd. Basel, Switzerland
| | - Christian Czech
- Neuroscience, Ophtalmology, and Rare Disease (NORD), Roche Pharma Research and Early Development, Roche Innovation Center Basel, F.Hoffman-La Roche Ltd. Basel, Switzerland
| | - Céline Bouquet
- Neuroscience, Ophtalmology, and Rare Disease (NORD), Roche Pharma Research and Early Development, Roche Innovation Center Basel, F.Hoffman-La Roche Ltd. Basel, Switzerland
| | | | - Stefan Holiga
- Neuroscience, Ophtalmology, and Rare Disease (NORD), Roche Pharma Research and Early Development, Roche Innovation Center Basel, F.Hoffman-La Roche Ltd. Basel, Switzerland
| | - Anouck Amestoy
- Charles Perrens Hospital, Autism Expert Center, Bordeaux, France
| | - Isabelle Scheid
- INSERM, U955, Translational Psychiatry Team, Créteil, France.,Fondation Fondamental, Créteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Psychiatry, Mondor University Hospital, DHU PePsy, Créteil, France
| | - Alexandru Gaman
- INSERM, U955, Translational Psychiatry Team, Créteil, France.,Fondation Fondamental, Créteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Psychiatry, Mondor University Hospital, DHU PePsy, Créteil, France
| | - Marion Leboyer
- INSERM, U955, Translational Psychiatry Team, Créteil, France.,Fondation Fondamental, Créteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Psychiatry, Mondor University Hospital, DHU PePsy, Créteil, France.,Faculté de Médecine, Université Paris Est Créteil, Créteil, France
| | - Cyril Poupon
- Neurospin, CEA, Paris Saclay University, Gif-sur-Yvette, France
| | | | - Josselin Houenou
- UNIACT, Psychiatry Team, Neurospin, Atomic Energy Commission, Gif-Sur-Yvette, France.,INSERM, U955, Translational Psychiatry Team, Créteil, France.,Fondation Fondamental, Créteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Psychiatry, Mondor University Hospital, DHU PePsy, Créteil, France.,Faculté de Médecine, Université Paris Est Créteil, Créteil, France
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21
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Dinkler L, Rydberg Dobrescu S, Råstam M, Gillberg IC, Gillberg C, Wentz E, Hadjikhani N. Visual scanning during emotion recognition in long-term recovered anorexia nervosa: An eye-tracking study. Int J Eat Disord 2019; 52:691-700. [PMID: 30828832 DOI: 10.1002/eat.23066] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 02/15/2019] [Accepted: 02/17/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine Facial Emotion Recognition (FER) and visual scanning behavior (eye-tracking) during FER in women long-term recovered from teenage-onset anorexia nervosa (recAN) with and without autism spectrum disorder (±ASD) and age-matched comparison women (COMP), using a sensitive design with facial emotion expressions at varying intensities in order to approximate real social contexts. METHOD Fifty-seven 38-47-year-old women (26 recAN of whom six with ASD, 31 COMP) participated in the study. They completed a non-verbal FER task, consisting of matching basic emotions at different levels of expression intensity with full emotional expressions. Accuracy, response time and visual scanning behavior were measured. RESULTS There were no differences between recAN-ASD and COMP in FER accuracy and visual scanning behavior during FER, including eye viewing and hyperscanning. In an exploratory analysis, recAN+ASD were more accurate than recAN-ASD in identifying expressions at low intensity, but not at medium or high expression intensity. Accuracy was not associated with the extent of attention to the eye region. DISCUSSION Our data indicate that women long-term recovered from adolescent-onset AN do not have deficits in basic FER ability and visual scanning behavior during FER. However, the presence of comorbid ASD might affect face processing in recovered AN. Future studies investigating basic FER in acute and recovered AN and other conditions need to ensure that the stimuli used are sensitive enough to detect potential deficits.
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Affiliation(s)
- Lisa Dinkler
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Sandra Rydberg Dobrescu
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Maria Råstam
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - I Carina Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Elisabet Wentz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Nouchine Hadjikhani
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
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22
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Orekhova EV, Stroganova TA, Schneiderman JF, Lundström S, Riaz B, Sarovic D, Sysoeva OV, Brant G, Gillberg C, Hadjikhani N. Neural gain control measured through cortical gamma oscillations is associated with sensory sensitivity. Hum Brain Mapp 2019; 40:1583-1593. [PMID: 30549144 DOI: 10.1002/hbm.24469] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/21/2018] [Accepted: 10/29/2018] [Indexed: 12/17/2022] Open
Abstract
Gamma oscillations facilitate information processing by shaping the excitatory input/output of neuronal populations. Recent studies in humans and nonhuman primates have shown that strong excitatory drive to the visual cortex leads to suppression of induced gamma oscillations, which may reflect inhibitory-based gain control of network excitation. The efficiency of the gain control measured through gamma oscillations may in turn affect sensory sensitivity in everyday life. To test this prediction, we assessed the link between self-reported sensitivity and changes in magneto-encephalographic gamma oscillations as a function of motion velocity of high-contrast visual gratings. The induced gamma oscillations increased in frequency and decreased in power with increasing stimulation intensity. As expected, weaker suppression of the gamma response correlated with sensory hypersensitivity. Robustness of this result was confirmed by its replication in the two samples: neurotypical subjects and people with autism, who had generally elevated sensory sensitivity. We conclude that intensity-related suppression of gamma response is a promising biomarker of homeostatic control of the excitation-inhibition balance in the visual cortex.
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Affiliation(s)
- Elena V Orekhova
- Gillberg Neuropsychiatry Centre (GNC), University of Gothenburg, Gothenburg, Sweden.,Moscow State University of Psychology and Education, Center for Neurocognitive Research (MEG Center), Moscow, Russia.,Autism Research Laboratory, Moscow State University of Psychology and Education, Moscow, Russia
| | - Tatiana A Stroganova
- Moscow State University of Psychology and Education, Center for Neurocognitive Research (MEG Center), Moscow, Russia.,Autism Research Laboratory, Moscow State University of Psychology and Education, Moscow, Russia
| | - Justin F Schneiderman
- Department of Clinical Neurophysiology, University of Gothenburg, Institute of Neuroscience & Physiology, Gothenburg, Sweden.,Chalmers University of Technology and MedTech West, Gothenburg, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre (GNC), University of Gothenburg, Gothenburg, Sweden
| | - Bushra Riaz
- Department of Clinical Neurophysiology, University of Gothenburg, Institute of Neuroscience & Physiology, Gothenburg, Sweden
| | - Darko Sarovic
- Gillberg Neuropsychiatry Centre (GNC), University of Gothenburg, Gothenburg, Sweden
| | - Olga V Sysoeva
- Moscow State University of Psychology and Education, Center for Neurocognitive Research (MEG Center), Moscow, Russia.,Autism Research Laboratory, Moscow State University of Psychology and Education, Moscow, Russia
| | - Georg Brant
- Chalmers University of Technology and MedTech West, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre (GNC), University of Gothenburg, Gothenburg, Sweden
| | - Nouchine Hadjikhani
- Gillberg Neuropsychiatry Centre (GNC), University of Gothenburg, Gothenburg, Sweden.,MGH/MIT/HST Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, Massachusetts
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23
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de Giambattista C, Ventura P, Trerotoli P, Margari M, Palumbi R, Margari L. Subtyping the Autism Spectrum Disorder: Comparison of Children with High Functioning Autism and Asperger Syndrome. J Autism Dev Disord 2019; 49:138-150. [PMID: 30043350 PMCID: PMC6331497 DOI: 10.1007/s10803-018-3689-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Since Hans Asperger's first description (Arch Psych Nervenkrankh 117:76-136, 1944), through Lorna Wing's translation and definition (Psychol Med 11:115-129, 1981), to its introduction in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM, 1994), Asperger Syndrome has always aroused huge interest and debate, until vanishing in the DSM fifth edition (2013). The debate regarded its diagnostic validity and its differentiation from high functioning autism (HFA). The present study aimed to examine whether AS differed from HFA in clinical profiles and to analyze the impact of DSM-5's innovation. Differences in cognitive, language, school functioning and comorbidities, were revealed when 80 AS and 70 HFA patients (3-18 years) were compared. Results suggested that an AS empirical distinction within autism spectrum disorder should be clinically useful.
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Affiliation(s)
- Concetta de Giambattista
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy
| | - Patrizia Ventura
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy
| | - Paolo Trerotoli
- Medical Statistic, Department of Biomedical Science and Human Oncology, University of “Aldo Moro” Bari, Bari, Italy
| | - Mariella Margari
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy
| | - Roberto Palumbi
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy
| | - Lucia Margari
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy
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Decreased Cortical Thickness in the Anterior Cingulate Cortex in Adults with Autism. J Autism Dev Disord 2018; 49:1402-1409. [DOI: 10.1007/s10803-018-3807-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Bitsika V, Arnold WM, Sharpley CF. Cluster analysis of autism spectrum disorder symptomatology: Qualitatively distinct subtypes or quantitative degrees of severity of a single disorder? RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 76:65-75. [PMID: 29579688 DOI: 10.1016/j.ridd.2018.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 03/08/2018] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
The decision to collapse several related disorders into a single diagnosis of Autism Spectrum Disorder (ASD) generated significant controversy and debate. There has been mixed evidence as to whether various ASD subtypes are qualitatively distinct or if they exist on a spectrum of symptom severity. The present study conducted a two-step cluster analysis of major ASD symptoms in a sample of 147 young males with ASD aged between 6yr and 18yr with IQ > 70. Results indicated that a two-cluster solution (high and low severity of ASD symptomatology) was reliable and valid. Further, the construct of challenging behaviour was not a necessary component of the two-cluster solution, verifying the new conceptualisation of ASD. Further replication of these findings with other subsets of individuals with ASD is needed.
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Affiliation(s)
- Vicki Bitsika
- Centre for Autism Spectrum Disorder, Bond University, Robina, Queensland, 4229, Australia
| | - Wayne M Arnold
- Centre for Autism Spectrum Disorder, Bond University, Robina, Queensland, 4229, Australia
| | - Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, 2351, New South Wales, Australia.
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Bieleninik Ł, Posserud MB, Geretsegger M, Thompson G, Elefant C, Gold C. Tracing the temporal stability of autism spectrum diagnosis and severity as measured by the Autism Diagnostic Observation Schedule: A systematic review and meta-analysis. PLoS One 2017; 12:e0183160. [PMID: 28934215 PMCID: PMC5608197 DOI: 10.1371/journal.pone.0183160] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 07/31/2017] [Indexed: 12/27/2022] Open
Abstract
Background Exploring ways to improve the trajectory and symptoms of autism spectrum disorder is prevalent in research, but less is known about the natural prognosis of autism spectrum disorder and course of symptoms. The objective of this study was to examine the temporal stability of autism spectrum disorder and autism diagnosis, and the longitudinal trajectories of autism core symptom severity. We furthermore sought to identify possible predictors for change. Methods We searched PubMed, PsycInfo, EMBASE, Web of Science, Cochrane Library up to October 2015 for prospective cohort studies addressing the autism spectrum disorder/autism diagnostic stability, and prospective studies of intervention effects. We included people of all ages with autism spectrum disorder/autism or at risk of having autism spectrum disorder, who were diagnosed and followed up for at least 12 months using the Autism Diagnostic Observation Schedule (ADOS). Both continuous ADOS scores and dichotomous diagnostic categories were pooled in random-effects meta-analysis and meta-regression. Results Of 1443 abstracts screened, 44 were eligible of which 40 studies contained appropriate data for meta-analysis. A total of 5771 participants from 7 months of age to 16.5 years were included. Our analyses showed no change in ADOS scores across time as measured by Calibrated Severity Scores (mean difference [MD] = 0.05, 95% CI -0.26 to 0.36). We observed a minor but statistically significant change in ADOS total raw scores (MD = -1.51, 95% CI -2.70 to -0.32). There was no improvement in restricted and repetitive behaviours (standardised MD [SMD] = -0.04, 95% CI -0.19 to 0.11), but a minor improvement in social affect over time (SMD = -0.31, 95% CI -0.50 to -0.12). No changes were observed for meeting the autism spectrum disorder criteria over time (risk difference [RD] = -0.01, 95% CI -0.03 to 0.01), but a significant change for meeting autism criteria over time (RD = -0.18, 95% CI -0.29 to -0.07). On average, there was a high heterogeneity between studies (I2 range: 65.3% to 93.1%). Discussion While 18% of participants shifted from autism to autism spectrum disorder diagnosis, the overall autism spectrum disorder prevalence was unchanged. Overall autism core symptoms were remarkably stable over time across childhood indicating that intervention studies should focus on other areas, such as quality of life and adaptive functioning. However, due to high heterogeneity between studies and a number of limitations in the studies, the results need to be interpreted with caution.
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Affiliation(s)
- Łucja Bieleninik
- GAMUT–The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
| | - Maj-Britt Posserud
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Monika Geretsegger
- GAMUT–The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
| | - Grace Thompson
- Melbourne Conservatorium of Music, the University of Melbourne, Melbourne, Australia
| | - Cochavit Elefant
- School for Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Christian Gold
- GAMUT–The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
- * E-mail:
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Cerebellar anatomical alterations and attention to eyes in autism. Sci Rep 2017; 7:12008. [PMID: 28931838 PMCID: PMC5607223 DOI: 10.1038/s41598-017-11883-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 08/29/2017] [Indexed: 01/01/2023] Open
Abstract
The cerebellum is implicated in social cognition and is likely to be involved in the pathophysiology of autism spectrum disorder (ASD). The goal of our study was to explore cerebellar morphology in adults with ASD and its relationship to eye contact, as measured by fixation time allocated on the eye region using an eye-tracking device. Two-hundred ninety-four subjects with ASD and controls were included in our study and underwent a structural magnetic resonance imaging scan. Global segmentation and cortical parcellation of the cerebellum were performed. A sub-sample of 59 subjects underwent an eye tracking protocol in order to measure the fixation time allocated to the eye region. We did not observe any difference in global cerebellar volumes between ASD patients and controls; however, regional analyses found a decrease of the volume of the right anterior cerebellum in subjects with ASD compared to controls. There were significant correlations between fixation time on eyes and the volumes of the vermis and Crus I. Our results suggest that cerebellar morphology may be related to eye avoidance and reduced social attention. Eye tracking may be a promising neuro-anatomically based stratifying biomarker of ASD.
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Livingston LA, Happé F. Conceptualising compensation in neurodevelopmental disorders: Reflections from autism spectrum disorder. Neurosci Biobehav Rev 2017; 80:729-742. [PMID: 28642070 PMCID: PMC7374933 DOI: 10.1016/j.neubiorev.2017.06.005] [Citation(s) in RCA: 202] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/25/2017] [Accepted: 06/13/2017] [Indexed: 11/24/2022]
Abstract
Within research into neurodevelopmental disorders, little is known about the mechanisms underpinning changes in symptom severity across development. When the behavioural presentation of a condition improves/symptoms lessen, this may be because core underlying atypicalities in cognition/neural function have ameliorated. An alternative possibility is 'compensation'; that the behavioural presentation appears improved, despite persisting deficits at cognitive and/or neurobiological levels. There is, however, currently no agreed technical definition of compensation or its behavioural, cognitive and neural characteristics. Furthermore, its workings in neurodevelopmental disorders have not been studied directly. Here, we review current evidence for compensation in neurodevelopmental disorders, using Autism Spectrum Disorder as an example, in order to move towards a better conceptualisation of the construct. We propose a transdiagnostic framework, where compensation represents the processes responsible for an observed mismatch between behaviour and underlying cognition in a neurodevelopmental disorder, at any point in development. Further, we explore potential cognitive and neural mechanisms driving compensation and discuss the broader relevance of the concept within research and clinical settings.
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Affiliation(s)
- Lucy Anne Livingston
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Francesca Happé
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
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Abstract
Asperger syndrome (AS) is a subtype of Autism Spectrum Disorder (ASD) characterized by major problems in social and nonverbal communication, together with limited and repetitive forms of behavior and interests. The linguistic and cognitive development in AS is preserved which help us to differentiate it from other subtypes of ASD. However, significant effects of AS on cognitive abilities and brain functions still need to be researched. Although a clear cut pathology for Asperger has not been identified yet, recent studies have largely focused on brain imaging techniques to investigate AS. In this regard, we carried out a systematic review on behavioral, cognitive, and neural markers (specifically using MRI and fMRI) studies on AS. In this paper, behavior, motor skills and language capabilities of individuals with Asperger are compared to those in healthy controls. In addition, common findings across MRI and fMRI based studies associated with behavior and cognitive disabilities are highlighted.
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Affiliation(s)
- Farnaz Faridi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
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Bush KL, Tassé MJ. Employment and choice-making for adults with intellectual disability, autism, and down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 65:23-34. [PMID: 28433791 DOI: 10.1016/j.ridd.2017.04.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 03/28/2017] [Accepted: 04/05/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Adults with disabilities are employed at a significantly lower rate than adults without disabilities. Of adults with disabilities in the workforce, more individuals work in a facility setting rather than a community setting, despite efforts to improve community inclusion. Choice-making has been proposed as a predictive factor for employment for individuals with disabilities. AIMS The purpose of this research was to examine the current state of employment for three groups of adults with intellectual disability (ID): individuals with autism spectrum disorder (ASD), individuals with Down syndrome (DS), and individuals with idiopathic ID. Choice-making and its relation to improved employment outcomes was explored. METHODS This study used National Core Indicator's Adult Consumer Survey datasets from years 2011-2012 and 2012-2013. Factor analyses revealed latent variables from six choice-making questions in the Adult Consumer Survey. Ordinal logistic regression was used to identify factors related to employment status. RESULTS Adults with DS had the highest rates of paid community jobs, but adults with ID had the highest rates of choice-making. ID severity level and short-term choice-making had the greatest effects on employment status in all three groups. CONCLUSIONS Employment rates remain low despite national efforts to find jobs for people with disabilities. Choice-making is a unique factor that was found to be associated with employment status and provides a target for interventions to increase employability.
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Affiliation(s)
- Kelsey L Bush
- The Ohio State University Nisonger Center, 1581 Dodd Dr., Columbus, OH 43210, United States.
| | - Marc J Tassé
- The Ohio State University Nisonger Center, 1581 Dodd Dr., Columbus, OH 43210, United States
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Taylor MJ, Gillberg C, Lichtenstein P, Lundström S. Etiological influences on the stability of autistic traits from childhood to early adulthood: evidence from a twin study. Mol Autism 2017; 8:5. [PMID: 28316769 PMCID: PMC5351180 DOI: 10.1186/s13229-017-0120-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/10/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Autism spectrum disorders (ASD) are persistent and lifelong conditions. Despite this, almost all twin studies focus on childhood. This twin study investigated the stability of autistic traits from childhood to early adulthood and explored the degree to which any stability could be explained by genetic or environmental factors. METHODS Parents of over 2500 twin pairs completed questionnaires assessing autistic traits when twins were aged either 9 or 12 years and again when twins were aged 18. Bivariate twin analysis assessed the degree of phenotypic and etiological stability in autistic traits across this period. Genetic overlap in autistic traits across development was also tested in individuals displaying a broad ASD phenotype, defined as scoring within the highest 5% of the sample. RESULTS Autistic traits displayed moderate phenotypic stability (r = .39). The heritability of autistic traits was 76-77% in childhood and 60-62% in adulthood. A moderate degree of genetic influences on childhood autistic traits were carried across into adulthood (genetic correlation = .49). The majority (85%) of the stability in autistic traits was attributable to genetic factors. Genetic influences on autistic traits were moderately stable from childhood to early adulthood at the extremes (genetic correlation = .64). CONCLUSIONS Broad autistic traits display moderate phenotypic and etiological stability from childhood to early adulthood. Genetic factors accounted for almost all phenotypic stability, although there was some phenotypic and etiological instability in autistic traits. Thus, autistic traits in adulthood are influenced by a combination of enduring and unique genetic factors.
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Affiliation(s)
- Mark J. Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 17177 Stockholm, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Kungsgatan 12, 41119 Gothenburg, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 17177 Stockholm, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Kungsgatan 12, 41119 Gothenburg, Sweden
- Centre for Ethics, Law, and Mental Health, Institute of Neuroscience and Physiology, University of Gothenburg, Rågården, Hus 1, SU-Östra sjukhuset, 41685 Gothenburg, Sweden
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Dell’Osso L, Luche RD, Gesi C, Moroni I, Carmassi C, Maj M. From Asperger's Autistischen Psychopathen to DSM-5 Autism Spectrum Disorder and Beyond: A Subthreshold Autism Spectrum Model. Clin Pract Epidemiol Ment Health 2016; 12:120-131. [PMID: 27867417 PMCID: PMC5095893 DOI: 10.2174/1745017901612010120] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 08/27/2016] [Accepted: 08/27/2016] [Indexed: 01/11/2023]
Abstract
Growing interest has recently been devoted to partial forms of autism, lying at the diagnostic boundaries of those conditions previously diagnosed as Asperger's Disorder. This latter includes an important retrieval of the European classical psychopathological concepts of adult autism to which Hans Asperger referred in his work. Based on the review of Asperger's Autistische Psychopathie, from first descriptions through the DSM-IV Asperger's Disorder and up to the recent DSM-5 Autism Spectrum Disorder, the paper aims to propose a Subthreshold Autism Spectrum Model that encompasses not only threshold-level manifestations but also mild/atypical symptoms, gender-specific features, behavioral manifestations and personality traits associated with Autism Spectrum Disorder. This model includes, but is not limited to, the so-called broad autism phenotype spanning across the general population that does not fully meet Autism Spectrum Disorder criteria. From this perspective, we propose a subthreshold autism as a unique psychological/behavioral model for research that could help to understand the neurodevelopmental trajectories leading from autistic traits to a broad range of mental disorders.
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Affiliation(s)
- Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56100 Pisa, Italy
| | - Riccardo Dalle Luche
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56100 Pisa, Italy
| | - Camilla Gesi
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56100 Pisa, Italy
| | - Ilenia Moroni
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56100 Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56100 Pisa, Italy
| | - Mario Maj
- Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie 1, 80138 Naples, Italy
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Abstract
Abstract
ASD research is at an important crossroads. The ASD diagnosis is important for assigning a child to early behavioral intervention and explaining a child’s condition. But ASD research has not provided a diagnosis-specific medical treatment, or a consistent early predictor, or a unified life course. If the ASD diagnosis also lacks biological and construct validity, a shift away from studying ASD-defined samples would be warranted. Consequently, this paper reviews recent findings for the neurobiological validity of ASD, the construct validity of ASD diagnostic criteria, and the construct validity of ASD spectrum features. The findings reviewed indicate that the ASD diagnosis lacks biological and construct validity. The paper concludes with proposals for research going forward.
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Helles A, Gillberg IC, Gillberg C, Billstedt E. Asperger syndrome in males over two decades: Quality of life in relation to diagnostic stability and psychiatric comorbidity. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:458-469. [DOI: 10.1177/1362361316650090] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined objective quality of life (work, academic success, living situation, relationships, support system) and subjective quality of life (Sense of Coherence and Short-Form Health Survey-36) in an adult sample of males ( n = 50, mean age: 30 years) with Asperger syndrome diagnosed in childhood and followed prospectively over two decades. The association between long-term diagnostic stability of an autism spectrum disorder and/or comorbid psychiatric disorders with quality of life was also examined. The results showed great variability as regards quality of life. The subsample that no longer fulfilled an autism spectrum disorder had full-time jobs or studies (10/11), independent living (100%), and reported having two or more friends (100%). In the stable autism spectrum disorder group, 41% had full-time job or studies, 51% lived independently, and 33% reported two or more friends, and a significant minority had specialized employments, lived with support from the government, or had no friends. Academic success was positively correlated with IQ. A majority of the total group scored average Sense of Coherence scores, and the mean for Short-Form Health Survey-36 was above average regarding psychical health and below average regarding mental health. Stability of autism spectrum disorder diagnosis was associated with objective but not subjective quality of life, while psychiatric comorbidity was associated with subjective but not objective quality of life.
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Affiliation(s)
- Adam Helles
- University of Gothenburg, Sweden
- Uppsala University, Sweden
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Helles A, Wallinius M, Gillberg IC, Gillberg C, Billstedt E. Asperger syndrome in childhood - personality dimensions in adult life: temperament, character and outcome trajectories. BJPsych Open 2016; 2:210-216. [PMID: 27703778 PMCID: PMC4995175 DOI: 10.1192/bjpo.bp.116.002741] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 04/18/2016] [Accepted: 05/11/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Temperament and character have been shown to be important factors in understanding psychiatric and neurodevelopmental disorder. Adults with autism spectrum disorder (ASD) have repeatedly been shown to have a distinct temperament and character, but this has not been evaluated in relation to psychiatric comorbidity and ASD diagnostic stability. AIMS To examine temperament and character in males that were diagnosed with ASD in childhood and followed prospectively over almost two decades. METHOD Temperament and character were assessed in 40 adult males with a childhood diagnosis of ASD. Results were analysed by the stability of ASD diagnosis over time and current psychiatric comorbidity. RESULTS Three distinct temperament and character profiles emerged from the data. Those no longer meeting criteria for ASD had high reward dependence while those with a stable ASD diagnosis and psychiatric comorbidity showed elevated harm avoidance and low self-directedness and cooperativeness. Finally, those with a stable ASD and no comorbidity showed low novelty seeking and somewhat elevated harm avoidance. CONCLUSIONS Temperament and character are important factors correlated with long-term diagnostic stability and psychiatric comorbidity in males diagnosed with ASD in childhood. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
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Affiliation(s)
- Adam Helles
- , MSc, Gillberg Neuropsychiatry Centre, Institute of Neuroscience & Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Centre for Research & Development, Uppsala University, Uppsala, Sweden; County Council of Gävleborg, Gävle, Sweden
| | - Märta Wallinius
- , PhD, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - I Carina Gillberg
- , MD, Gillberg Neuropsychiatry Centre, Institute of Neuroscience & Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Christopher Gillberg
- , MD, Gillberg Neuropsychiatry Centre, Institute of Neuroscience & Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Eva Billstedt
- , PhD, Gillberg Neuropsychiatry Centre, Institute of Neuroscience & Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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Lahiri DK, Maloney B, Bayon BL, Chopra N, White FA, Greig NH, Nurnberger JI. Transgenerational latent early-life associated regulation unites environment and genetics across generations. Epigenomics 2016; 8:373-87. [PMID: 26950428 DOI: 10.2217/epi.15.117] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The origin of idiopathic diseases is still poorly understood. The latent early-life associated regulation (LEARn) model unites environmental exposures and gene expression while providing a mechanistic underpinning for later-occurring disorders. We propose that this process can occur across generations via transgenerational LEARn (tLEARn). In tLEARn, each person is a 'unit' accumulating preclinical or subclinical 'hits' as in the original LEARn model. These changes can then be epigenomically passed along to offspring. Transgenerational accumulation of 'hits' determines a sporadic disease state. Few significant transgenerational hits would accompany conception or gestation of most people, but these may suffice to 'prime' someone to respond to later-life hits. Hits need not produce symptoms or microphenotypes to have a transgenerational effect. Testing tLEARn requires longitudinal approaches. A recently proposed longitudinal epigenome/envirome-wide association study would unite genetic sequence, epigenomic markers, environmental exposures, patient personal history taken at multiple time points and family history.
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Affiliation(s)
- Debomoy K Lahiri
- Department of Psychiatry, Stark Neurosciences Research Institute, Indiana University School of Medicine, 320 West 15th Street, Indianapolis, IN 46202, USA.,Department of Medical & Molecular Genetics, Indiana University School of Medicine, 320 West 15th Street, Indianapolis, IN 46202, USA
| | - Bryan Maloney
- Department of Psychiatry, Stark Neurosciences Research Institute, Indiana University School of Medicine, 320 West 15th Street, Indianapolis, IN 46202, USA
| | - Baindu L Bayon
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, 320 West 15th Street, Indianapolis, IN 46202, USA
| | - Nipun Chopra
- Department of Psychiatry, Stark Neurosciences Research Institute, Indiana University School of Medicine, 320 West 15th Street, Indianapolis, IN 46202, USA
| | - Fletcher A White
- Department of Anesthesia, Stark Neurosciences Research Institute, Indiana University School of Medicine, 320 West 15th Street, Indianapolis, IN 46202, USA
| | - Nigel H Greig
- Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - John I Nurnberger
- Department of Psychiatry, Stark Neurosciences Research Institute, Indiana University School of Medicine, 320 West 15th Street, Indianapolis, IN 46202, USA.,Department of Medical & Molecular Genetics, Indiana University School of Medicine, 320 West 15th Street, Indianapolis, IN 46202, USA
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Norén Selinus E, Molero Y, Lichtenstein P, Larson T, Lundström S, Anckarsäter H, Gumpert CH. Childhood Symptoms of ADHD Overrule Comorbidity in Relation to Psychosocial Outcome at Age 15: A Longitudinal Study. PLoS One 2015; 10:e0137475. [PMID: 26360378 PMCID: PMC4567137 DOI: 10.1371/journal.pone.0137475] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Accepted: 08/17/2015] [Indexed: 12/18/2022] Open
Abstract
Objective Neurodevelopmental problems (NDPs) may influence the transition from childhood to adolescence. Our aim was to study long-term psychosocial outcomes of NDPs, focusing on ADHD. Method Data was collected through a telephone interview with parents of twins at ages 9 or 12 years. NDP screen-positive children were clinically assessed at age 15; N = 450. Psychosocial outcome concerning peers, school, internalizing problems, antisocial behavior, alcohol misuse, drug misuse, and impaired daily functioning was examined. Results Even after controlling for other NDP comorbidity, screen-positivity for ADHD doubled or tripled the odds of later psychosocial problems. When controlling for parental education level, the significant effect of ADHD remained only for antisocial behavior and impaired daily functioning. Conclusions Signs of NDPs as well as other psychiatric diagnoses at ages 9 or 12 years are associated with a more problematic adolescence. However, despite the presence of comorbidity, early ADHD symptoms stand out as the most important risk factor for later antisocial development and impaired daily functioning.
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Affiliation(s)
- Eva Norén Selinus
- Department of Clinical Neuroscience, Centre for Psychiatry Research & Education, Karolinska Institutet & Stockholm County Council, Stockholm, Sweden
- * E-mail:
| | - Yasmina Molero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Larson
- Center for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Göteborg, Sweden
| | - Sebastian Lundström
- Center for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Göteborg, Sweden
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Göteborg, Sweden
| | - Henrik Anckarsäter
- Center for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Göteborg, Sweden
| | - Clara Hellner Gumpert
- Department of Clinical Neuroscience, Centre for Psychiatry Research & Education, Karolinska Institutet & Stockholm County Council, Stockholm, Sweden
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Gillberg IC, Helles A, Billstedt E, Gillberg C. Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis. J Autism Dev Disord 2015. [DOI: 10.1007/s10803-015-2544-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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