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Martini MI, Butwicka A, Du Rietz E, Kanina A, Rosenqvist MA, Larsson H, Lichtenstein P, Taylor MJ. Age effects on autism heritability and etiological stability of autistic traits. J Child Psychol Psychiatry 2024; 65:1135-1144. [PMID: 38239074 DOI: 10.1111/jcpp.13949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND Autism and autistic traits onset in childhood but persist into adulthood. Little is known about how genetic and environmental factors influence autism and autistic traits into adulthood. We aimed to determine age effects on the heritability of clinically diagnosed autism and the etiological stability of autistic traits from childhood to adulthood using twin methods. METHODS From 23,849 twin pairs in the Swedish Twin Register born between 1959 and 2010, we identified 485 individuals (1.01%, 31.5% female) with a clinical autism diagnosis. We estimated and compared the relative contribution of genetic, shared, and nonshared environmental influences to autism in childhood and adulthood. We further used multivariate twin analysis with four measurement points among 1,348 twin pairs in the longitudinal Twin Study of Child and Adolescent Development to assess the phenotypic and etiological stability of autistic traits - measured with three scales from the Child Behavior Checklist - from childhood to adulthood. RESULTS Autism heritability was comparable from childhood, (96% [95% CI, 76-99%]) to adulthood (87% [67-96%]). Autistic traits were moderately stable (phenotypic correlation = 0.35-0.61) from childhood to adulthood, and their heritability varied between 52 and 71%. We observed stable as well as newly emerging genetic influences on autistic traits from ages 8-9 to 19-20, and unique nonshared environmental influences at each age. CONCLUSIONS Genetic factors are important for autism and autistic traits in adulthood and separate genetic studies in adults are warranted.
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Affiliation(s)
- Miriam I Martini
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Agnieszka Butwicka
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Division of Mental Health Services, R&D Department, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Aleksandra Kanina
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mina A Rosenqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mark J Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Radhoe TA, Agelink van Rentergem JA, Torenvliet C, Groenman AP, van der Putten WJ, Geurts HM. Finding Similarities in Differences Between Autistic Adults: Two Replicated Subgroups. J Autism Dev Disord 2024; 54:3449-3466. [PMID: 37438586 PMCID: PMC11362251 DOI: 10.1007/s10803-023-06042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/14/2023]
Abstract
Autism is heterogeneous, which complicates providing tailored support and future prospects. We aim to identify subgroups in autistic adults with average to high intelligence, to clarify if certain subgroups might need support. We included 14 questionnaire variables related to aging and/or autism (e.g., demographic, psychological, and lifestyle). Community detection analysis was used for subgroup identification in an original sample of 114 autistic adults with an adulthood diagnosis (autism) and 58 non-autistic adults as comparison group (COMP), and a replication sample (NAutism = 261; NCOMP = 287), both aged 30-89 years. Next, we identified subgroups and assessed external validity (for cognitive and psychological difficulties, and quality of life [QoL]) in the autism samples. To test specificity, we repeated the analysis after adding 123 adults with ADHD, aged 30-80 years. As expected, the autism and COMP groups formed distinct subgroups. Among autistic adults, we identified three subgroups of which two were replicated. One of these subgroups seemed most vulnerable on the cluster variables; this subgroup also reported the most cognitive and psychological difficulties, and lowest QoL. Adding the ADHD group did not alter results. Within autistic adults, one subgroup could especially benefit from support and specialized care, although this must be tested in future studies.
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Affiliation(s)
- Tulsi A Radhoe
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands.
| | - Joost A Agelink van Rentergem
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
| | - Carolien Torenvliet
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
| | - Annabeth P Groenman
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
- Research Institute for Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
| | - Wikke J van der Putten
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
- Leo Kannerhuis (Youz/Parnassiagroep), Overschiestraat 57, 1062 HN, Amsterdam, The Netherlands
| | - Hilde M Geurts
- Brain & Cognition, Department of Psychology, Dutch Autism & ADHD Research Center (d'Arc), University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, The Netherlands
- Leo Kannerhuis (Youz/Parnassiagroep), Overschiestraat 57, 1062 HN, Amsterdam, The Netherlands
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Lau-Zhu A, Chan C, Gibson D, Stark E, Wang J, Happé F, Stacey J, Cooper M. Specificity of Episodic Future Thinking in Adolescents: Comparing Childhood Maltreatment, Autism Spectrum, and Typical Development. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01232-7. [PMID: 39167319 DOI: 10.1007/s10802-024-01232-7] [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: 07/12/2024] [Indexed: 08/23/2024]
Abstract
Maltreatment and autism can be associated with overlapping difficulties across functional domains (e.g., social, emotional, and sensory) and high rates of mental health problems. A cognitive approach focussing on affect-laden cognition, here on episodic future thinking (FT), could help inform cognitive assessments and adapt psychological interventions. Three groups of adolescents (N = 85), (i) maltreatment (n = 28), (ii) autism (n = 29), and (iii) typical development without maltreatment/autism (TD; n = 28), matched in age (10-16 years old), sex (assigned at birth), and socioeconomic status, completed a newly adapted online Autobiographical Future Thinking Test. As predicted, the maltreatment group generated significantly fewer specific future events relative to the TD group, however, the number of specific future events did not significantly differ between the autism and the other groups. Exploratory analyses showed that lower FT specificity was significantly associated with more depressive (but not anxiety) symptoms across the three groups. These findings shed light on the cognitive profiles of both maltreatment and autism during adolescence and signal FT as a potential therapeutic target for adolescents with these developmental differences. Our study lays the foundation for additional comparisons of maltreatment-related presentations versus autism with improved designs and a broader set of cognitive and clinical domains.
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Affiliation(s)
- A Lau-Zhu
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, Oxford, UK.
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK.
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Oxford, UK.
| | - C Chan
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Oxford, UK
| | - D Gibson
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Oxford, UK
| | - E Stark
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, Oxford, UK
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
| | - J Wang
- Child and Adolescent Mental Health Services, Berkshire Healthcare NHS Foundation Trust, Reading, UK
| | - F Happé
- Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Stacey
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Oxford, UK
| | - M Cooper
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, Oxford, UK
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Bang P, Andemichael DK, Pieslinger JF, Igelström K. Sensory symptoms associated with autistic traits and anxiety levels in children aged 6-11 years. J Neurodev Disord 2024; 16:45. [PMID: 39135156 PMCID: PMC11318295 DOI: 10.1186/s11689-024-09562-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 07/17/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Autism spectrum conditions (ASC) and quantitative autistic traits (QATs) are associated with sensory symptoms, which may contribute to anxiety and adversely affect social and cognitive development. Although sensory symptoms can occur across all senses, the relative roles of specific sensory modalities as contributors to the autistic phenotype and to anxiety are not well understood. The objective of this study was to examine which sensory symptoms were most predictive of high anxiety. METHODS We recruited 257 female primary caregivers of children aged 6 to 11 years (49% girls) to a questionnaire study comprising parent-report measures for classical QATs (social, communicative, and rigid), autism-related sensorimotor symptoms (visual, auditory, tactile, olfactory, gustatory, vestibular, proprioceptive, and motor), and anxiety symptoms. First, Bayesian stochastic search variable selection (SSVS) was used to identify the most probable sensorimotor predictors of specific QATs as well as diagnosed ASC. Then, the selected predictors were used in another SSVS, using anxiety symptoms as a dependent variable, to identify which of the autism-relevant sensorimotor symptoms were most robustly predictive of anxiety. Finally, the effect sizes of anxiety-related sensory symptoms were estimated with linear regressions. RESULTS We found that auditory symptoms and motor difficulties were most predictive of ASC diagnosis. Developmental motor difficulties were also strongly related to all individual QATs, whereas auditory symptoms were more selectively predictive of rigid traits. Tactile symptoms robustly predicted social interaction QATs, and proprioceptive symptoms predicted communicative QATs. Anxiety outcomes were most strongly predicted by difficulties with auditory and olfactory processing. CONCLUSIONS The results support the clinical importance of being alert to complaints about sounds and hearing in neurodevelopmental populations, and that auditory processing difficulties may be evaluated as an early marker of poor mental health in children with and without diagnosed autism. Olfactory processing differences appeared to be an anxiety marker less strongly associated with ASC or QATs, while motor difficulties were highly autism-relevant but not equally strongly associated with anxiety outcomes. We suggest that future studies may focus on the mechanisms and consequences of neurodevelopmental central auditory processing dysfunction and its potential relationship to anxiety disorders.
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Affiliation(s)
- Peter Bang
- Division of Cell and Neurobiology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, 58185, Sweden
| | - Danait Kidane Andemichael
- Division of Cell and Neurobiology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, 58185, Sweden
| | - Johan F Pieslinger
- Division of Cell and Neurobiology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, 58185, Sweden
| | - Kajsa Igelström
- Division of Cell and Neurobiology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, 58185, Sweden.
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Lenders M, Ouwens MA, Wilting RMHJ, Videler AC. First things first: An exploration of the effects of psychoeducation for older autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2028-2039. [PMID: 38197411 PMCID: PMC11301958 DOI: 10.1177/13623613231219745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
LAY ABSTRACT After receiving an autism diagnosis, psychoeducation (i.e. information regarding autism) is a first intervention. We adjusted a psychoeducation program that was originally developed by the Dutch Association for Autism for older adults to enhance its feasibility and efficacy in later life. We expected that participants would report an increase in knowledge and acceptance of the diagnosis and that people close to them would also observe this. Indeed, we found this and participants and those close to them agreed on this. Furthermore, we found some evidence that older autistic adults were better at coping with their autism. We found no positive intervention effects on psychological distress. The feedback of participants and informants about the psychoeducation program was largely positive. In future research, we advise using larger group samples and larger time scales and we also advise to further adjust the program to the needs and requirements of older adults, and to help older autistic adults to construct a new narrative of themselves, and the life they have lived, in the light of the recent autism diagnosis.
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Affiliation(s)
| | | | | | - Arjan C Videler
- GGz Breburg, The Netherlands
- Tilburg University, The Netherlands
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Brede J, Babb C, Jones CRG, Serpell L, Hull L, Adamson J, Baker H, Fox JRE, Mandy W. The clinical characteristics of autistic women with restrictive eating disorders. BJPsych Open 2024; 10:e131. [PMID: 39056242 DOI: 10.1192/bjo.2024.65] [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: 07/28/2024] Open
Abstract
BACKGROUND Autistic women are at high risk of developing restrictive eating disorders (REDs), such as anorexia nervosa. AIMS This study provides an overview of the clinical characteristics of autistic women with REDs to (i) enhance understanding of increased risk, and (ii) support the identification of autistic women in eating disorder services. METHOD We compared self-reported autistic and disordered eating characteristics of: autistic participants with REDs (Autism + REDs; n = 57); autistic participants without REDs (Autism; n = 69); and women with REDs who are not autistic (REDs; n = 80). We also included a group of women with high autistic traits (HATs) and REDs, but no formal autism diagnosis (HATs + REDs; n = 38). RESULTS Autism + REDs participants scored similarly to Autism participants in terms of autistic characteristics and to REDs participants in terms of experiencing traditional disordered eating symptoms. Autism + REDs participants were distinguished from both groups by having more restricted and repetitive behaviours and autism-specific eating behaviours related to sensory processing, flexibility and social differences. HATs + REDs participants showed a similar pattern of scores to Autism + REDs participants, and both also presented with high levels of co-occurring mental health difficulties, particularly social anxiety. CONCLUSION The presentation of autistic women with REDs is complex, including both traditional disordered eating symptoms and autism-related needs, as well as high levels of co-occurring mental health difficulties. In eating disorder services, the REDs presentation of autistic women and those with HATs should be formulated with reference to autism-specific eating behaviours and co-occurring difficulties. Treatment adaptations should be offered to accommodate autistic characteristics and related needs.
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Affiliation(s)
- Janina Brede
- Research Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Charli Babb
- School of Psychology, Cardiff University, UK
| | | | - Lucy Serpell
- Research Department of Clinical, Educational and Health Psychology, University College London, UK
- ; and Eating Disorder Service, North East London NHS Foundation Trust, London, UK
| | - Laura Hull
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - James Adamson
- Research Department of Clinical, Educational and Health Psychology, University College London, UK
| | - Hannah Baker
- Research Department of Clinical, Educational and Health Psychology, University College London, UK
| | - John R E Fox
- Doctorate in Clinical Psychology, Primary Care and Mental Health, University of Liverpool, UK
| | - Will Mandy
- Research Department of Clinical, Educational and Health Psychology, University College London, UK
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Abalde SF, Rigby A, Keller PE, Novembre G. A Framework for Joint Music Making: Behavioral Findings, Neural Processes, and Computational Models. Neurosci Biobehav Rev 2024:105816. [PMID: 39032841 DOI: 10.1016/j.neubiorev.2024.105816] [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: 10/20/2023] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
Across different epochs and societies, humans occasionally gather to jointly make music. This universal form of collective behavior is as fascinating as it is fragmentedly understood. As the interest in joint music making (JMM) rapidly grows, we review the state-of-the-art of this emerging science, blending behavioral, neural, and computational contributions. We present a conceptual framework synthesizing research on JMM within four components. The framework is centered upon interpersonal coordination, a crucial requirement for JMM. The other components imply the influence of individuals' (past) experience, (current) social factors, and (future) goals on real-time coordination. Our aim is to promote the development of JMM research by organizing existing work, inspiring new questions, and fostering accessibility for researchers belonging to other research communities.
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Affiliation(s)
- Sara F Abalde
- Neuroscience of Perception and Action Lab, Italian Institute of Technology, Rome, Italy; The Open University Affiliated Research Centre at the Istituto Italiano di Tecnologia, Italy.
| | - Alison Rigby
- Neurosciences Graduate Program, University of California, San Diego, US
| | - Peter E Keller
- Center for Music in the Brain, Aarhus University, Denmark; Department of Clinical Medicine, Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Denmark; The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Australia
| | - Giacomo Novembre
- Neuroscience of Perception and Action Lab, Italian Institute of Technology, Rome, Italy
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8
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Smith M, Ferguson HJ. Indistinguishable behavioural and neural correlates of perceptual self-other distinction in autistic and neurotypical adults. Cortex 2024; 176:242-259. [PMID: 38760243 DOI: 10.1016/j.cortex.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/23/2023] [Accepted: 03/11/2024] [Indexed: 05/19/2024]
Abstract
Previous research has suggested that self-bias (i.e., enhanced cognitive processing of self-versus other-relevant information) may be atypical in autism spectrum conditions (ASC), perhaps due to difficulties with self-other distinction. However, empirical evidence for this is inconsistent, and the neural basis of processing differences remains unknown. We present two experiments that aimed to test perceptual self-bias and familiarity effects in ASC using a perceptual-association task. Participants were asked to distinguish face/label associations of the self from those of other people of differing levels of familiarity (i.e., friend vs stranger). Experiment 1 took an individual differences approach by testing whether behavioural self-bias is associated with the number of autistic traits in a neurotypical adult sample (N = 59). Experiment 2 took a case-control approach by testing whether behavioural self-bias and associated ERP responses differ between neurotypical (N = 27) and autistic (N = 30) adults. Across both experiments, behavioural results showed that participants experienced a self-bias (self > friend and stranger) and a familiarity effect (e.g., friend > stranger); neither effect was affected by the number of autistic traits or autism diagnosis. In Experiment 2, analysis of N1, N2, and P3 ERP components revealed a typical self-bias in both groups (self distinct from friend and stranger), and only the autistic group showed evidence of a familiarity effect (N2 more negative-going for stranger than friend). The findings are discussed in relation to self-other distinction ability, and the relevance of other neuropsychological and psychiatric conditions such as anxiety and alexithymia are also considered.
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Affiliation(s)
- Marchella Smith
- School of Psychology, Keynes College, University of Kent, Canterbury, UK
| | - Heather J Ferguson
- School of Psychology, Keynes College, University of Kent, Canterbury, UK.
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Gao RR, Si SW, Lin XX, Wang YZ, Wang N, Wang JY, Luo F. Differential relationships between autistic traits and anthropomorphic tendencies in adults and early adolescents. Front Psychol 2024; 15:1281207. [PMID: 38899122 PMCID: PMC11186442 DOI: 10.3389/fpsyg.2024.1281207] [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: 08/22/2023] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Anthropomorphism, the attribution of human-like qualities (e.g., mental states) to nonhuman entities, is a universal but variable psychological experience. Adults with professionally diagnosed autism or high levels of subclinical autistic traits consistently show greater tendencies to anthropomorphize, which has been hypothesized to reflect 1) a compensatory mechanism for lack of social connectedness and 2) a persistence of childhood anthropomorphism into adulthood. Here, we directly tested these hypotheses in a general population sample consisting of both adults (N=685, 17-58 years old) and early adolescents (N=145, 12-14 years old) using the refined 9-item Anthropomorphism Questionnaire (AnthQ9), which measures both present and childhood anthropomorphic tendencies. We found that adults with heightened autistic traits reported increased present anthropomorphism (e.g., tend more to perceive computers as having minds), which held even after controlling for social connectedness. In contrast, adolescents with heightened autistic traits did not show increased present anthropomorphism, but rather reported reduced childhood anthropomorphism (e.g., less likely to perceive toys as having feelings) after controlling for social connectedness. We also found evidence that the present and childhood subscales of the AnthQ9 may tap into fundamentally different aspects of anthropomorphism. The results suggest that increased anthropomorphic tendencies in adults with heightened autistic traits cannot be explained solely by increased sociality motivation, but may be due to delayed development of anthropomorphism, although alternative possibilities of measurement problems cannot be ruled out. Implications for the measurement of anthropomorphism and its relation with theory of mind were also discussed.
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Affiliation(s)
- Rui-Rui Gao
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | | | - Xiao-Xiao Lin
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yu-Zheng Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ning Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jin-Yan Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fei Luo
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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10
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Bottini SB, Morton HE, Buchanan KA, Gould K. Moving from Disorder to Difference: A Systematic Review of Recent Language Use in Autism Research. AUTISM IN ADULTHOOD 2024; 6:128-140. [PMID: 39144072 PMCID: PMC11319857 DOI: 10.1089/aut.2023.0030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background The neurodiversity paradigm positions autism as a neurological difference that is disabling in the societal context, shifting away from the traditional medical view of a disorder. Several recent publications recommend use of alternative neuro-affirming language (ANL) instead of traditional medical language (TML) with the aim to increase acceptance of autistic people and reduce prejudice. Examining language use within recent autism literature, including by journal and study characteristics, may offer insight into the influence of these recommendations and current disability discourse. Methods A systematic review was conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines in autism research from 2021 (n = 2322 articles; 394 journals). Articles were coded according to topic, participants, and use of self-report. Journals were coded by topic, geographic region, and language guidelines. Terminology use was extracted using QDA Miner software. Results Many articles primarily used TML with a smaller subset primarily using ANL. There was a positive correlation between ANL use and publication date. More ANL was associated with articles on topics of autistic traits, diversity, equity, and inclusion (DEI), or lifespan and that included autistic adults or autistic self-report. More ANL was also found in journals from Australasia or Europe or those that had identify-first language (IFL) guidelines. Less ANL (more TML) was associated with articles on biology/causes or treatment and that included autistic or non-autistic parents, autistic youth, siblings, or other clinical groups, and were published in medical journals. Conclusion TML continues to largely dominate language choices in autism research, with an emerging shift toward ANL in recent literature. Increased ANL may be facilitated by journal and article language recommendations. Neuro-affirming language was also more likely in articles on topics prioritized by the autistic community, that included autistic adults, and may also be driven by cultural differences. Researchers and practitioners should consider the potential for their language use to impact individual and societal views of autistic people.
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Affiliation(s)
- Summer B. Bottini
- Marcus Autism Center, Atlanta, Georgia, USA
- Emory University School of Medicine, Atlanta, Georgia, USA
| | | | | | - Kait Gould
- The College of Saint Rose, Albany, New York, USA
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Apperly IA, Lee R, van der Kleij SW, Devine RT. A transdiagnostic approach to neurodiversity in a representative population sample: The N+ 4 model. JCPP ADVANCES 2024; 4:e12219. [PMID: 38827989 PMCID: PMC11143952 DOI: 10.1002/jcv2.12219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/21/2023] [Indexed: 06/05/2024] Open
Abstract
Background The concept of neurodiversity draws upon scientific research, and lessons from practice and lived experience to suggest new ways of thinking about neurodevelopmental conditions. Among the formative observations are that characteristics associated with neurodevelopmental conditions are part of a "broader phenotype" of variation across the whole population, and that there appear to be "transdiagnostic" similarities as well as differences in these characteristics. These observations raise important questions that have implications for understanding diversity in neurodevelopmental conditions and in neurocognitive phenotypes across the whole population. Method The present work examines broader phenotypes using seven widely used self-report assessments of traits associated with autism, ADHD, dyslexia, Developmental Coordination Disorder/dyspraxia, tic disorders/Tourette's, cortical hyperexcitability associated with subclinical epilepsy, and sensory sensitivities. A representative sample of 995 adults (aged 17-77) in the UK completed self-report measures of neurodiversity, wellbeing, generalized anxiety, and depression, and cognitive abilities (nonverbal intelligence and executive functioning). Results We used confirmatory factor analysis to test whether variation and covariation was better characterized (1) by traditional diagnostic labels, or (2) transdiagnostically according to similarities in functions, behaviours, or phenomena. Results indicated that neurodiversity characteristics were best explained using a bifactor model with one general "N" factor and four condition-specific factors. Conclusion This was the largest examination to date of the factor structure of broader phenotypes relevant to neurodevelopmental conditions. It provides critical benchmark data, and a framework approach for asking systematic questions about the structure of neurocognitive diversities seen in the whole population and in people with one or more diagnoses.
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Affiliation(s)
- Ian A. Apperly
- Centre for Developmental ScienceSchool of PsychologyUniversity of BirminghamBirminghamUK
| | - Robert Lee
- Centre for Developmental ScienceSchool of PsychologyUniversity of BirminghamBirminghamUK
| | - Sanne W. van der Kleij
- Centre for Developmental ScienceSchool of PsychologyUniversity of BirminghamBirminghamUK
| | - Rory T. Devine
- Centre for Developmental ScienceSchool of PsychologyUniversity of BirminghamBirminghamUK
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12
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Mandelli V, Severino I, Eyler L, Pierce K, Courchesne E, Lombardo MV. A 3D approach to understanding heterogeneity in early developing autisms. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.08.24307039. [PMID: 38766085 PMCID: PMC11100949 DOI: 10.1101/2024.05.08.24307039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Phenotypic heterogeneity in early language, intellectual, motor, and adaptive functioning (LIMA) features are amongst the most striking features that distinguish different types of autistic individuals. Yet the current diagnostic criteria uses a single label of autism and implicitly emphasizes what individuals have in common as core social-communicative and restricted repetitive behavior difficulties. Subtype labels based on the non-core LIMA features may help to more meaningfully distinguish types of autisms with differing developmental paths and differential underlying biology. Using relatively large (n=615) publicly available data from early developing (24-68 months) standardized clinical tests tapping LIMA features, we show that stability-based relative cluster validation analysis can identify two robust and replicable clusters in the autism population with high levels of generalization accuracy (98%). These clusters can be described as Type I versus Type II autisms differentiated by relatively high versus low scores on LIMA features. These two types of autisms are also distinguished by different developmental trajectories over the first decade of life. Finally, these two types of autisms reveal striking differences in functional and structural neuroimaging phenotypes and their relationships with gene expression. This work emphasizes the potential importance of stratifying autism by a Type I versus Type II distinction focused on LIMA features and which may be of high prognostic and biological significance.
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Berenguer C, Rosa E, De Stasio S, Choque Olsson N. Sleep quality relates to language impairment in children with autism spectrum disorder without intellectual disability. Sleep Med 2024; 117:99-106. [PMID: 38522116 DOI: 10.1016/j.sleep.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVES This study aimed to identify sleep quality profiles of children with autism spectrum disorder (ASD), to compare these profiles with those of typically developing (TD) children, and to verify whether there are differences between them in terms of language skills. METHODS We evaluated the sleep quality and language skills of 47 children with ASD without intellectual disability (ID) and 32 children with TD. Using a hierarchical cluster analysis, we identified two sleep quality ASD profiles (poor and good). We then performed a series of MANCOVAs and ANOVAs to compare the sleep quality and language skills of the two ASD clusters and the TD group. RESULTS A main group effect (TD, "poor" cluster, and "good" cluster) was found in the total sleep quality and all its dimensions. Significant differences were revealed between the "good" and "poor" clusters in the total structural language score (F1,46 = 10.75, p < 0.001) and three of its subscales (speech: F1,46 = 9.19, p < 0.001; syntax, F1,46 = 8.61, p = 0.001; coherence: F1,46 = 11.36, p < 0.001); the total pragmatic language score (F1,46 = 7.00, p = 0.001) and three of its subscales (inappropriate initiation: F1,46 = 8.02, p = 0.001; use of context: F1,46 = 8.07, p = 0.001; nonverbal communication: F1,46 = 7.35, p = 0.001); and the social relations score (F1,46 = 9.97, p = 0.003). CONCLUSIONS Sleep quality in children with ASD (especially a subgroup) is worse than in children with TD. There is an association between sleep quality and language skills, both at the pragmatic and structural levels.
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Affiliation(s)
- Carmen Berenguer
- Department of Developmental and Educational Psychology, ERI-Lectura Faculty of Psychology and Speech Therapy University of Valencia, Blasco Ibanez, 21, 46010, Valencia, Spain.
| | - Eva Rosa
- Department of Basic Psychology, ERI-Lectura, Faculty of Psychology and Speech Therapy, University of Valencia, Blasco Ibanez, 21, 46010, Valencia, Spain.
| | - Simona De Stasio
- Department of Human Studies, LUMSA University, Piazza Delle Vaschette, 101, 00193, Rome, Italy.
| | - Nora Choque Olsson
- Department of Psychology, Stockholm University, 106 91, Stockholm, Sweden.
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14
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O'Neill S, O'Donnell GM. Identifying autistic children: Priorities for research arising from a systematic review of parents' experiences of the assessment process. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241243107. [PMID: 38659201 DOI: 10.1177/13623613241243107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
LAY ABSTRACT Hearing about parents' experiences of having their child recognised as autistic could help improve the supports offered to parents. Our article may also help guide future research on this topic. We made a list of the type of research that interested us. We searched the studies already completed, only studying the research that matched our interests. After reading the studies, we rated their quality using the Critical Appraisal Skills Programme tool.It became clear that parents went through four phases during the identification process. The first phase occurred before their child was identified as autistic. The second involved the actual assessment of their child. Parents' emotional reactions to the news were the focus of the third phase. The final phase occurred after their child was identified as autistic. We discuss the findings of our research. As there are sensitivities involved in conducting research on this topic, we identify how researchers can ensure that their research is of the best quality. We are committed to respecting the human rights of all involved, so we emphasise the need for professionals to develop good relationships with the parents of autistic children. Researchers have recently come to see autism as typical of human diversity. We encourage the professionals involved to adopt this understanding of autistic children and make practical suggestions to enable them to do so.
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Layinka O, Hargitai LD, Shah P, Waldren LH, Leung FYN. Five interdisciplinary tensions and opportunities in neurodiversity research. eLife 2024; 13:e98461. [PMID: 38652018 PMCID: PMC11037914 DOI: 10.7554/elife.98461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
Improving our understanding of autism, ADHD, dyslexia and other neurodevelopmental conditions requires collaborations between genetics, psychiatry, the social sciences and other fields of research.
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Affiliation(s)
| | - Luca D Hargitai
- Department of Psychology, University of BathBathUnited Kingdom
| | - Punit Shah
- Department of Psychology, University of BathBathUnited Kingdom
| | - Lucy H Waldren
- Department of Psychology, University of BathBathUnited Kingdom
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16
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Martin J. Why are females less likely to be diagnosed with ADHD in childhood than males? Lancet Psychiatry 2024; 11:303-310. [PMID: 38340761 DOI: 10.1016/s2215-0366(24)00010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
ADHD is less likely to be diagnosed in females than males, especially in childhood. Females also typically receive the diagnosis later than males and are less likely to be prescribed ADHD medication. Understanding why these sex differences in clinical care and treatment for ADHD occur is key to improving timely diagnosis in people affected by ADHD. This Personal View is a conceptual review synthesising literature on this topic. This publication considers potential biological explanations (eg, genetic factors), influence of diagnostic practices (eg, criteria suitability, diagnostic overshadowing, and sex-specific diagnostic thresholds), and sociocultural explanations (eg, sex differences in presentation and compensatory behaviours), for the observed sex differences in ADHD clinical practice. This Personal View also outlines future research directions for improving understanding of sex differences in recognition and diagnosis of ADHD.
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Affiliation(s)
- Joanna Martin
- Centre for Neuropsychiatric Genetics and Genomics and Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK.
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17
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van der Putten WJ, Mol AJJ, Radhoe TA, Torenvliet C, Agelink van Rentergem JA, Groenman AP, Geurts HM. The relationship between camouflaging and mental health: Are there differences among subgroups in autistic adults? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:908-919. [PMID: 37497845 PMCID: PMC10981194 DOI: 10.1177/13623613231185402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
LAY ABSTRACT When autistic people use strategies to hide their autistic characteristics, we call this camouflaging. Autistic adults suggested that camouflaging can result in mental health difficulties. That is, people who report to camouflage also report mental health difficulties. However, since there are many differences between autistic people, this relationship may also differ between subgroups. Therefore, in this study we investigated whether camouflaging and mental health difficulties are related and whether this relationship is equal for all autistic adults. For this study, 352 autistic adults aged 30-84 years filled in the Dutch Camouflaging Autistic Traits Questionnaire to measure camouflaging and the Symptom Checklist-90 Revised to measure mental health difficulties. We found that camouflaging was moderately related to mental health difficulties. This means that people who report more camouflaging also report more mental health difficulties. When we looked closer, we found that this relationship was strong for only a small subgroup of autistic adults. In most other autistic adults, there was a small or no relationship between camouflaging and mental health difficulties. Therefore, it is important that clinicians are aware of camouflaging and its possible relationship with mental health difficulties, but that they do not generalize the negative consequences to everyone.
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Affiliation(s)
- Wikke J van der Putten
- Leo Kannerhuis (Youz/Parnassia Group), The Netherlands
- University of Amsterdam, The Netherlands
| | - Audrey JJ Mol
- Leo Kannerhuis (Youz/Parnassia Group), The Netherlands
| | | | | | | | | | - Hilde M Geurts
- Leo Kannerhuis (Youz/Parnassia Group), The Netherlands
- University of Amsterdam, The Netherlands
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18
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Waldren LH, Leung FYN, Hargitai LD, Burgoyne AP, Liceralde VRT, Livingston LA, Shah P. Unpacking the overlap between Autism and ADHD in adults: A multi-method approach. Cortex 2024; 173:120-137. [PMID: 38387375 DOI: 10.1016/j.cortex.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 02/24/2024]
Abstract
The overlap between Autism and Attention-Deficit Hyperactivity Disorder (ADHD) is widely observed in clinical settings, with growing interest in their co-occurrence in neurodiversity research. Until relatively recently, however, concurrent diagnoses of Autism and ADHD were not possible. This has limited the scope for large-scale research on their cross-condition associations, further stymied by a dearth of open science practices in the neurodiversity field. Additionally, almost all previous research linking Autism and ADHD has focused on children and adolescents, despite them being lifelong conditions. Tackling these limitations in previous research, 5504 adults - including a nationally representative sample of the UK (Study 1; n = 504) and a large pre-registered study (Study 2; n = 5000) - completed well-established self-report measures of Autism and ADHD traits. A series of network analyses unpacked the associations between Autism and ADHD at the individual trait level. Low inter-item connectivity was consistently found between conditions, supporting the distinction between Autism and ADHD as separable constructs. Subjective social enjoyment and hyperactivity-impulsivity traits were most condition-specific to Autism and ADHD, respectively. Traits related to attention control showed the greatest Bridge Expected Influence across conditions, revealing a potential transdiagnostic process underlying the overlap between Autism and ADHD. To investigate this further at the cognitive level, participants completed a large, well-powered, and pre-registered study measuring the relative contributions of Autism and ADHD traits to attention control (Study 3; n = 500). We detected age- and sex-related effects, however, attention control did not account for the covariance between Autism and ADHD traits. We situate our findings and discuss future directions in the cognitive science of Autism, ADHD, and neurodiversity, noting how our open datasets may be used in future research.
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Affiliation(s)
| | | | | | | | - Van Rynald T Liceralde
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Lucy A Livingston
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Punit Shah
- Department of Psychology, University of Bath, Bath, UK.
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19
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O'Connor RA, Doherty M, Ryan-Enright T, Gaynor K. Perspectives of autistic adolescent girls and women on the determinants of their mental health and social and emotional well-being: A systematic review and thematic synthesis of lived experience. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:816-830. [PMID: 38145308 DOI: 10.1177/13623613231215026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
LAY ABSTRACT Difficulties with mental health and low levels of well-being are more common among autistic girls and women than non-autistic people, but we do not fully understand why. Research does not focus enough on what autistic girls and women could tell us about this. This review aims to summarise the studies where autistic girls and women explain things that affect their mental health and well-being to help us understand how to prevent these difficulties from developing. Three research databases were searched to find possibly relevant studies. There were 877 studies found, which two researchers screened according to particular criteria. They found 52 studies that could be included in this review. One researcher evaluated the quality of these studies and extracted the key information from them. This review summarises the views of 973 autistic girls and women aged between 13 and 70+. The findings from the 52 studies were analysed, and we found many factors that affect the mental health and well-being of autistic girls and women. These factors fall into two categories: (1) difficulties living in a world not designed for autistic people and (2) the impact of stigma due to being autistic.
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Affiliation(s)
- Rachel Ag O'Connor
- School of Psychology, University College Dublin, Republic of Ireland
- Health Service Executive, Republic of Ireland
| | - Mary Doherty
- Brighton and Sussex Medical School, Brighton, UK
- Our Lady's Hospital, Navan, Republic of Ireland
| | - Theresa Ryan-Enright
- School of Psychology, University College Dublin, Republic of Ireland
- Health Service Executive, Republic of Ireland
| | - Keith Gaynor
- School of Psychology, University College Dublin, Republic of Ireland
- DETECT, Early Intervention Service, Blackrock, Republic of Ireland
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20
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Lin Y, Mason D, Hirsch C, Happé F. Intolerance of Uncertainty and Anxiety (but not Alexithymia) Mediate the Association Between Autistic Traits and Quality of Life. J Autism Dev Disord 2024:10.1007/s10803-024-06310-9. [PMID: 38446267 DOI: 10.1007/s10803-024-06310-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
Previous research has indicated that autistic individuals report lower quality of life (QoL) than non-autistic people. It is unclear whether it is the autism traits themselves or co-occurring thinking styles or mental health difficulties that most impair QoL. This study tested a hypothesised model to explore how 'intolerance of uncertainty' (IU), alexithymia (difficulty in identifying and describing own emotions), and anxiety play into the association between autistic traits and QoL. Online survey data were analysed from 116 autistic and 51 non-autistic adults who completed six standardised questionnaires measuring autistic traits, alexithymia, IU, anxiety and QoL (physical health, psychological health, social relations, and environment domains). The autistic group reported higher scores for alexithymia, IU and anxiety, and lower scores for QoL across domains, compared to the non-autistic group. Across the entire sample, autistic traits, alexithymia, IU and anxiety were positively correlated with one another, and negatively related to the four domains of QoL. Finally, IU and anxiety partially serially mediated the pathways from autistic traits to physical health and environment domains of QoL, and fully mediated the pathways from autistic traits to psychological health and social relations domains of QoL, across the full sample. The lower QoL experienced by autistic people may be explained in part by the mediating effect of both IU and anxiety (but not alexithymia). This study highlights the need for evidence-based interventions to address both IU and anxiety to improve QoL for autistic people/those with high levels of autistic traits.
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Affiliation(s)
- Yeju Lin
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
| | - David Mason
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Colette Hirsch
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Francesca Happé
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
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21
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Skaletski EC, Barry K, Dennis E, Donnelly R, Huerta C, Jones A, Schmidt K, Kabakov S, Ausderau KK, Li JJ, Travers BG. Sensorimotor Features and Daily Living Skills in Autistic Children With and Without ADHD. J Autism Dev Disord 2024:10.1007/s10803-024-06256-y. [PMID: 38443659 DOI: 10.1007/s10803-024-06256-y] [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: 01/18/2024] [Indexed: 03/07/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) commonly co-occurs in autistic children. However, additional research is needed to explore the differences in motor skills and sensory features in autistic children with and without ADHD, as well as the impacts of these factors on daily living skills (DLS). This observational study sought to fill this gap with 67 autistic children (6.14-10.84 years-old), 43 of whom had ADHD. Autistic children with ADHD demonstrated higher sensory features and lower motor skills than autistic children without ADHD. In examining autism and ADHD features dimensionally, we found that overall sensory features, seeking, and hyporesponsiveness were driven by both autism and ADHD features, whereas motor skills, enhanced perception, and hyperresponsiveness were driven by only autism features. Additionally, in using these dimensional variables of autism and ADHD features, we found that differences in motor skills, sensory and autism features, but not ADHD features, impact DLS of autistic children, with autism features and motor skills being the strongest individual predictors of DLS. Together, these results demonstrate the uniqueness of motor skills and sensory features in autistic children with and without ADHD, as well as how autism features, sensory features, and motor skills contribute to DLS, emphasizing the importance of a comprehensive understanding of each individual and complexities of human development when supporting autistic children.
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Affiliation(s)
- Emily C Skaletski
- Department of Kinesiology, University of Wisconsin-Madison, 1300 University Avenue, Madison, WI, 53706, USA
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| | - Kelly Barry
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Elizabeth Dennis
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Ryan Donnelly
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Celina Huerta
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Andrez Jones
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Kate Schmidt
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Sabrina Kabakov
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - Karla K Ausderau
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA
| | - James J Li
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
- Department of Psychology, University of Wisconsin-Madison, 1202 W Johnson St, Madison, WI, USA
| | - Brittany G Travers
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA.
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin- Madison, 1300 University Avenue, Madison, WI, 53706, USA.
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22
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Tyszkiewicz-Gromisz B, Burdzicka-Wołowik J, Tymosiewicz P, Gromisz W. Parental Competences and Stress Levels in Mothers of Children with Autism Spectrum Disorders and Children Developing Neurotypically. J Clin Med 2024; 13:1119. [PMID: 38398430 PMCID: PMC10889242 DOI: 10.3390/jcm13041119] [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: 12/13/2023] [Revised: 02/06/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: the aim of this study was to explore parental competences and stress levels in the mothers of children with autism in relation to the mothers of neurotypical children. (2) Methods: the study used the Parental Competence Test and the PSS-10 scale to assess the intensity of stress related to one's own life situation over the past month. Forty mothers of children with ASD (n = 20) and neurotypical children (n = 20) participated in the study. (3) Results: the mothers of children with ASD showed higher levels of stress (p = 0.0002). The mothers of neurotypical children achieved higher scores in parental competences (r = -0.49). The competence of mothers of children with ASD was correlated with rigour (r = 0.50), permissiveness (r = -0.60), overprotectiveness (r = 0.71), and helplessness (r = -0.77). (4) Conclusions: mothers of children with autism demonstrate lower parental competences than mothers of neurotypical children. Mothers of children with autism are less rigorous but more permissive, overprotective, and helpless. They tend to become heavily involved with their child. An overprotective attitude and greater tolerance for antisocial behaviours among parents of children with ASDs protect them from excessive stress.
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Affiliation(s)
- Beata Tyszkiewicz-Gromisz
- Department of Fundamentals of Physiotherapy, Faculty of Physical Education and Health in Biała Podlaska, Jozef Pilsudski University of Physical Education in Warsaw, 21-500 Biała Podlaska, Poland;
| | - Joanna Burdzicka-Wołowik
- Department of Pedagogy and Psychology, Faculty of Physical Education and Health in Biała Podlaska, Jozef Pilsudski University of Physical Education in Warsaw, 21-500 Biała Podlaska, Poland; (J.B.-W.); (P.T.)
| | - Piotr Tymosiewicz
- Department of Pedagogy and Psychology, Faculty of Physical Education and Health in Biała Podlaska, Jozef Pilsudski University of Physical Education in Warsaw, 21-500 Biała Podlaska, Poland; (J.B.-W.); (P.T.)
| | - Wilhelm Gromisz
- Department of Swimming, Faculty of Physical Education and Health in Biała Podlaska, Jozef Pilsudski University of Physical Education in Warsaw, 21-500 Biała Podlaska, Poland
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23
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Nijhof AD, Catmur C, Brewer R, Coll MP, Wiersema JR, Bird G. Differences in own-face but not own-name discrimination between autistic and neurotypical adults: A fast periodic visual stimulation-EEG study. Cortex 2024; 171:308-318. [PMID: 38070386 PMCID: PMC11068592 DOI: 10.1016/j.cortex.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/13/2023] [Accepted: 10/16/2023] [Indexed: 02/12/2024]
Abstract
Self-related processing is thought to be altered in autism, with several studies reporting that autistic individuals show a diminished neural response relative to neurotypicals for their own name and face. However, evidence remains scarce and is mostly based on event-related potential studies. Here, we used EEG to measure the neural activity of autistic adults (20 for faces, 27 for names) and neurotypical adults (24 for faces, 25 for names) while they were watching rapidly alternating faces and names, through a relatively new technique called Fast Periodic Visual Stimulation. We presented strangers' faces or names at a base frequency of 5.77 Hz, while one's own, a close other's, and a specific stranger's face/name was presented at an oddball frequency of 1.154 Hz. The neurotypical group showed a significantly greater response to their own face than both close other and stranger faces, and a greater response for close other than for stranger faces. In contrast, in the autism group, own and close other faces showed stronger responses than the stranger's face, but the difference between own and close other faces was not significant in a bilateral parieto-occipital cluster. No group differences in the enhanced response to familiar names were found. These results replicate and extend results obtained using traditional electroencephalographic techniques which suggest atypical responses to self-relevant stimuli in autism.
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Affiliation(s)
- Annabel D Nijhof
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Department of Experimental Clinical and Health Psychology. Ghent University, Belgium.
| | - Caroline Catmur
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | | | - Jan R Wiersema
- Department of Experimental Clinical and Health Psychology. Ghent University, Belgium
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, UK; School of Psychology, University of Birmingham, UK
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24
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Peralta-Marzal LN, Rojas-Velazquez D, Rigters D, Prince N, Garssen J, Kraneveld AD, Perez-Pardo P, Lopez-Rincon A. A robust microbiome signature for autism spectrum disorder across different studies using machine learning. Sci Rep 2024; 14:814. [PMID: 38191575 PMCID: PMC10774349 DOI: 10.1038/s41598-023-50601-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024] Open
Abstract
Autism spectrum disorder (ASD) is a highly complex neurodevelopmental disorder characterized by deficits in sociability and repetitive behaviour, however there is a great heterogeneity within other comorbidities that accompany ASD. Recently, gut microbiome has been pointed out as a plausible contributing factor for ASD development as individuals diagnosed with ASD often suffer from intestinal problems and show a differentiated intestinal microbial composition. Nevertheless, gut microbiome studies in ASD rarely agree on the specific bacterial taxa involved in this disorder. Regarding the potential role of gut microbiome in ASD pathophysiology, our aim is to investigate whether there is a set of bacterial taxa relevant for ASD classification by using a sibling-controlled dataset. Additionally, we aim to validate these results across two independent cohorts as several confounding factors, such as lifestyle, influence both ASD and gut microbiome studies. A machine learning approach, recursive ensemble feature selection (REFS), was applied to 16S rRNA gene sequencing data from 117 subjects (60 ASD cases and 57 siblings) identifying 26 bacterial taxa that discriminate ASD cases from controls. The average area under the curve (AUC) of this specific set of bacteria in the sibling-controlled dataset was 81.6%. Moreover, we applied the selected bacterial taxa in a tenfold cross-validation scheme using two independent cohorts (a total of 223 samples-125 ASD cases and 98 controls). We obtained average AUCs of 74.8% and 74%, respectively. Analysis of the gut microbiome using REFS identified a set of bacterial taxa that can be used to predict the ASD status of children in three distinct cohorts with AUC over 80% for the best-performing classifiers. Our results indicate that the gut microbiome has a strong association with ASD and should not be disregarded as a potential target for therapeutic interventions. Furthermore, our work can contribute to use the proposed approach for identifying microbiome signatures across other 16S rRNA gene sequencing datasets.
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Affiliation(s)
- Lucia N Peralta-Marzal
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, University of Utrecht, Utrecht, The Netherlands
| | - David Rojas-Velazquez
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, University of Utrecht, Utrecht, The Netherlands
- Department of Data Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Douwe Rigters
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, University of Utrecht, Utrecht, The Netherlands
| | - Naika Prince
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, University of Utrecht, Utrecht, The Netherlands
| | - Johan Garssen
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, University of Utrecht, Utrecht, The Netherlands
- Global Centre of Excellence Immunology, Danone Nutricia Research, Utrecht, The Netherlands
| | - Aletta D Kraneveld
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, University of Utrecht, Utrecht, The Netherlands
- Department of Neuroscience, Faculty of Science, VU University, Amsterdam, The Netherlands
| | - Paula Perez-Pardo
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, University of Utrecht, Utrecht, The Netherlands.
| | - Alejandro Lopez-Rincon
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, University of Utrecht, Utrecht, The Netherlands
- Department of Data Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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25
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Frith U, Frith C. What makes us social and what does it tell us about mental disorders? Cogn Neuropsychiatry 2024; 29:1-9. [PMID: 38281115 DOI: 10.1080/13546805.2024.2307958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/16/2024] [Indexed: 01/29/2024]
Affiliation(s)
- Uta Frith
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Chris Frith
- Institute of Philosophy, School of Advanced Study, University of London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
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26
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Chen K, Zhuang W, Zhang Y, Yin S, Liu Y, Chen Y, Kang X, Ma H, Zhang T. Alteration of the large-scale white-matter functional networks in autism spectrum disorder. Cereb Cortex 2023; 33:11582-11593. [PMID: 37851712 DOI: 10.1093/cercor/bhad392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
Autism spectrum disorder is a neurodevelopmental disorder whose core deficit is social dysfunction. Previous studies have indicated that structural changes in white matter are associated with autism spectrum disorder. However, few studies have explored the alteration of the large-scale white-matter functional networks in autism spectrum disorder. Here, we identified ten white-matter functional networks on resting-state functional magnetic resonance imaging data using the K-means clustering algorithm. Compared with the white matter and white-matter functional network connectivity of the healthy controls group, we found significantly decreased white matter and white-matter functional network connectivity mainly located within the Occipital network, Middle temporo-frontal network, and Deep network in autism spectrum disorder. Compared with healthy controls, findings from white-matter gray-matter functional network connectivity showed the decreased white-matter gray-matter functional network connectivity mainly distributing in the Occipital network and Deep network. Moreover, we compared the spontaneous activity of white-matter functional networks between the two groups. We found that the spontaneous activity of Middle temporo-frontal and Deep network was significantly decreased in autism spectrum disorder. Finally, the correlation analysis showed that the white matter and white-matter functional network connectivity between the Middle temporo-frontal network and others networks and the spontaneous activity of the Deep network were significantly correlated with the Social Responsiveness Scale scores of autism spectrum disorder. Together, our findings indicate that changes in the white-matter functional networks are associated behavioral deficits in autism spectrum disorder.
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Affiliation(s)
- Kai Chen
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
| | - Wenwen Zhuang
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
| | - Yanfang Zhang
- Department of Ultrasonic Medicine, Baiyun Branch, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Shunjie Yin
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
| | - Yinghua Liu
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
| | - Yuan Chen
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
| | - Xiaodong Kang
- The Department of Sichuan 81 Rehabilitation Center, Chengdu University of TCM, No. 81 Bayi Road, Yongning Street, Wenjiang District, Chengdu City 610075, China
| | - Hailin Ma
- Plateau Brain Science Research Center, Tibet University, 10 Zangda East Road, Lhasa City 510631, China
| | - Tao Zhang
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
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Petty S, Allen S, Pickup H, Woodier B. A Blog-Based Study of Autistic Adults' Experiences of Aloneness and Connection and the Interplay with Well-Being: Corpus-Based and Thematic Analyses. AUTISM IN ADULTHOOD 2023; 5:437-449. [PMID: 38116056 PMCID: PMC10726169 DOI: 10.1089/aut.2022.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Background Autistic adults appear to be more vulnerable to mental ill health, with loneliness being a variable associated with multiple outcomes of poorer well-being. However, a description of meaningful social connection that is suitable for autistic adults is missing from this research, along with a missing understanding of the conditions that contribute to well-being. Methods In this study, autistic adults' experiences of connectedness and aloneness were systematically searched for within data collected from blogs. This contributed a creative method to hear the viewpoint of autistic adults. Corpus-based and thematic analyses explored the descriptions and contexts of relationships. A total of 16 autistic authors contributed views. Results Social connection was desired and was achieved through self-acceptance and rejecting deficit-based views of being autistic, and selectively choosing important relationships. Meaningful social connection changed over time, being more difficult to attain in childhood, and benefiting from self-learning and effortfully applying neuro-normative skills in social communication. Loneliness was only described alongside other causes of unhappiness and was not associated with being autistic. Conclusions The findings offer some explanation for the high estimates of both loneliness and mental ill health for autistic adults. We consider the implications for autistic individuals, clinicians, educators, and researchers. We are also cautious not to imply that these views reflect all autistic people. The findings suggest that improvements are needed in society to share communication differences and relationship expectations for autistic individuals to be accepted and valued.
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Affiliation(s)
- Stephanie Petty
- Department of Psychology, School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Shannon Allen
- Department of Psychology, School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Hannah Pickup
- Department of Psychology, School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Bethannie Woodier
- Department of Psychology, School of Education, Language and Psychology, York St John University, York, United Kingdom
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28
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Burns EJ, Gaunt E, Kidane B, Hunter L, Pulford J. A new approach to diagnosing and researching developmental prosopagnosia: Excluded cases are impaired too. Behav Res Methods 2023; 55:4291-4314. [PMID: 36459376 PMCID: PMC9718472 DOI: 10.3758/s13428-022-02017-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 12/04/2022]
Abstract
Developmental prosopagnosia is characterized by severe, lifelong difficulties when recognizing facial identity. Unfortunately, the most common diagnostic assessment (Cambridge Face Memory Test) misses 50-65% of individuals who believe that they have this condition. This results in such excluded cases' absence from scientific knowledge, effect sizes of impairment potentially overestimated, treatment efficacy underrated, and may elicit in them a negative experience of research. To estimate their symptomology and group-level impairments in face processing, we recruited a large cohort who believes that they have prosopagnosia. Matching prior reports, 56% did not meet criteria on the Cambridge Face Memory Test. However, the severity of their prosopagnosia symptoms and holistic perception deficits were comparable to those who did meet criteria. Excluded cases also exhibited face perception and memory impairments that were roughly one standard deviation below neurotypical norms, indicating the presence of objective problems. As the prosopagnosia index correctly classified virtually every case, we propose it should be the primary method for providing a diagnosis, prior to subtype categorization. We present researchers with a plan on how they can analyze these excluded prosopagnosia cases in their future work without negatively impacting their traditional findings. We anticipate such inclusion will enhance scientific knowledge, more accurately estimate effect sizes of impairments and treatments, and identify commonalities and distinctions between these different forms of prosopagnosia. Owing to their atypicalities in visual perception, we recommend that the prosopagnosia index should be used to screen out potential prosopagnosia cases from broader vision research.
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Affiliation(s)
- Edwin J Burns
- Department of Psychology, Edge Hill University, Ormskirk, UK.
| | - Elizabeth Gaunt
- Department of Psychology, Edge Hill University, Ormskirk, UK
| | - Betiel Kidane
- Department of Psychology, Edge Hill University, Ormskirk, UK
| | - Lucy Hunter
- Department of Psychology, Edge Hill University, Ormskirk, UK
| | - Jaylea Pulford
- Department of Psychology, Edge Hill University, Ormskirk, UK
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29
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Wittkopf S, Langmann A, Roessner V, Roepke S, Poustka L, Nenadić I, Stroth S, Kamp-Becker I. Conceptualization of the latent structure of autism: further evidence and discussion of dimensional and hybrid models. Eur Child Adolesc Psychiatry 2023; 32:2247-2258. [PMID: 36006478 PMCID: PMC10576682 DOI: 10.1007/s00787-022-02062-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
Autism spectrum disorder (ASD) might be conceptualized as an essentially dimensional, categorical, or hybrid model. Yet, current empirical studies are inconclusive and the latent structure of ASD has explicitly been examined only in a few studies. The aim of our study was to identify and discuss the latent model structure of behavioral symptoms related to ASD and to address the question of whether categories and/or dimensions best represent ASD symptoms. We included data of 2920 participants (1-72 years of age), evaluated with the Autism Diagnostic Observation Schedule (Modules 1-4). We applied latent class analysis, confirmatory factor analysis, and factor mixture modeling and evaluated the model fit by a combination of criteria. Based on the model selection criteria, the model fits, the interpretability as well as the clinical utility we conclude that the hybrid model serves best for conceptualization and assessment of ASD symptoms. It is both grounded in empirical evidence and in clinical usefulness, is in line with the current classification system (DSM-5) and has the potential of being more specific than the dimensional approach (decreasing false positive diagnoses).
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Affiliation(s)
- Sarah Wittkopf
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany
| | - Anika Langmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Technical University Dresden, Dresden, Germany
| | - Stefan Roepke
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Medical Clinic, Philipps-University Marburg, Marburg, Germany
| | - Sanna Stroth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany.
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Clinic, Philipps-University, Marburg, Germany
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30
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Sáez-Suanes GP, García-Villamisar D, Del Pozo Armentia A. The role of intellectual disability and emotional regulation in the autism-depression relationship. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:1960-1967. [PMID: 36967538 DOI: 10.1177/13623613231161881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
LAY ABSTRACT Many people with autism and intellectual disability have significant levels of depressive symptoms. However, this relationship is not clear. For this reason, knowing the factors that are associated with having depression in autism and intellectual disability is important. Emotion regulation is associated with depression in autism spectrum disorder and intellectual disability. After evaluating a group of people with autism and intellectual disability, we found that people with mild intellectual disability have problems regulating their emotions which lead them to develop depressive symptoms. These findings suggest that interventions designed to prevent or reduce depressive symptoms in people with autism spectrum disorder and mild intellectual disability should include among their goals emotional regulation.
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31
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Newbutt N, Glaser N, Francois MS, Schmidt M, Cobb S. How are Autistic People Involved in the Design of Extended Reality Technologies? A Systematic Literature Review. J Autism Dev Disord 2023:10.1007/s10803-023-06130-3. [PMID: 37715864 DOI: 10.1007/s10803-023-06130-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 09/18/2023]
Abstract
The primary aim of this systematic review is to investigate the inclusion of autistic individuals in the design process of immersive technologies. This study follows the preferred reporting items for systematic reviews and meta-analyses standards for systematic literature reviews. To ensure the research questions and subsequent stages of the review incorporate pertinent parameters, the problem, interest, context framework has also been employed. Findings highlight that, while early proponents of immersive technology emphasized the importance of user involvement in design of new technology, immaturity of the technology often limited the implementation of direct user input to the design process. Nonetheless, analysis of the literature published between 2002-2022 identified 20 studies in which substantial influence of autistic individuals and stakeholders was found in the design process of immersive technologies. The roles of autistic individuals varied from active co-designers and co-creators to essential contributors in refining prototypes and providing critical feedback, ensuring the final products align with their needs and preferences. Results underscore the need to align research and design of immersive technologies more closely with the priorities and preferences of autistic individuals. Further is needed regarding actively involving autistic individuals in the design and implementation of immersive technology applications. On this basis, we maintain that more inclusive and effective deployment of immersive technologies is needed in order to ensure that resultant technologies are fit for purpose and address the actual needs of the autistic community.
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Affiliation(s)
- Nigel Newbutt
- School of Teaching and Learning, Institute of Advanced Learning Technologies, University of Florida, Gainesville, FL, USA.
| | - Noah Glaser
- School of Information Science & Learning Technologies, University of Missouri, Columbia, MO, USA
| | - Marc Sonley Francois
- School of Teaching and Learning, Institute of Advanced Learning Technologies, University of Florida, Gainesville, FL, USA
| | - Matthew Schmidt
- School of Teaching and Learning, Institute of Advanced Learning Technologies, University of Florida, Gainesville, FL, USA
| | - Sue Cobb
- Faculty of Engineering, University of Nottingham, Nottingham, UK
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32
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Zhou Q, Lei Y, Du H, Tao Y. Public concerns and attitudes towards autism on Chinese social media based on K-means algorithm. Sci Rep 2023; 13:15173. [PMID: 37704712 PMCID: PMC10499991 DOI: 10.1038/s41598-023-42396-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/09/2023] [Indexed: 09/15/2023] Open
Abstract
To investigate the hot topics and attitudes of autism in the larger community. In this study, we analyzed and summarized experimental texts from the social media platform Zhihu using the TF-IDF algorithm and K-means clustering approach. Based on the analysis of the 1,740,826-word experimental text, we found that the popularity of autism has steadily risen over recent years. Sufferers and their parents primarily discuss autism. The K-means clustering algorithm revealed that the most popular topics are divided into four categories: self-experience of individuals with autism, external views of individuals with autism, caring and stressful behaviors of caregivers, and information about autism. This study concluded that people with autism face more incredible negative emotions, external cognitive evaluations of the autistic group reflect stereotypes, the caregiver's family suffers high financial and psychological stress, and disorders caused by disease in autistic individuals.
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Affiliation(s)
- Qi Zhou
- Hangzhou Normal University, 2318th Yuhang Tang Avenue, Hangzhou, 311121, Zhejiang Province, China
| | - Yuling Lei
- Hangzhou Normal University, 2318th Yuhang Tang Avenue, Hangzhou, 311121, Zhejiang Province, China
| | - Hang Du
- Hangzhou Normal University, 2318th Yuhang Tang Avenue, Hangzhou, 311121, Zhejiang Province, China
| | - Yuexian Tao
- Hangzhou Normal University, 2318th Yuhang Tang Avenue, Hangzhou, 311121, Zhejiang Province, China.
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33
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Vicedo M. Autism's heterogeneity in historical perspective: from challenge to opportunity. Front Psychol 2023; 14:1188053. [PMID: 37599736 PMCID: PMC10435077 DOI: 10.3389/fpsyg.2023.1188053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Affiliation(s)
- Marga Vicedo
- Institute for the History and Philosophy of Science and Technology, University of Toronto, Toronto, ON, Canada
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34
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Adams D, Dargue N, Paynter J. Longitudinal studies of challenging behaviours in autistic children and adults: A systematic review and meta-analysis. Clin Psychol Rev 2023; 104:102320. [PMID: 37515997 DOI: 10.1016/j.cpr.2023.102320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/23/2023] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Abstract
Autistic children and adults are at increased risk of showing behaviours that may be described as challenging, however, little is known about whether or how these behaviours may change over time. Given the profound impact that challenging behaviour can have on both the autistic individual and their support network, it is critical that the trajectory of challenging behaviours be better understood. This systematic review and meta-analysis identified and synthesised observational longitudinal studies of challenging behaviour in autistic individuals. Fifty-six studies were included in the systematic review, and the effect sizes of 37 independent samples arising from 34 of these reports were examined through meta-analysis. Crucially, across the 37 samples, scores on the measures of challenging behaviour reduced by a small, yet significant, extent over time. Although age of the sample at baseline assessment did not moderate the effect, the time between the baseline assessment and final follow-up and age at final follow-up both moderated the magnitude of the effect, with challenging behaviour scores reducing to a larger extent in (a) studies with longer intervals between baseline and final follow-up and (b) studies with older samples at follow-up. The results from the current systematic review and meta-analysis have both theoretical and practical implications for understanding challenging behaviour over time in autistic individuals. Avenues for future research are also highlighted that may allow better understanding, and therefore support of, challenging behaviour in autistic individuals.
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Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia.
| | - Nicole Dargue
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia
| | - Jessica Paynter
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; School of Applied Psychology and Hopkins Centre, Griffith University, Gold Coast, QLD 4222, Australia
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35
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Curnow E, Rutherford M, Maciver D, Johnston L, Prior S, Boilson M, Shah P, Jenkins N, Meff T. Mental health in autistic adults: A rapid review of prevalence of psychiatric disorders and umbrella review of the effectiveness of interventions within a neurodiversity informed perspective. PLoS One 2023; 18:e0288275. [PMID: 37440543 PMCID: PMC10343158 DOI: 10.1371/journal.pone.0288275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Autistic adults have high risk of mental ill-health and some available interventions have been associated with increased psychiatric diagnoses. Understanding prevalence of psychiatric diagnoses is important to inform the development of individualised treatment and support for autistic adults which have been identified as a research priority by the autistic community. Interventions require to be evaluated both in terms of effectiveness and regarding their acceptability to the autistic community. OBJECTIVE This rapid review identified the prevalence of psychiatric disorders in autistic adults, then systematic reviews of interventions aimed at supporting autistic adults were examined. A rapid review of prevalence studies was completed concurrently with an umbrella review of interventions. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed, including protocol registration (PROSPERO#CRD42021283570). DATA SOURCES MEDLINE, CINAHL, PsycINFO, and Cochrane Database of Systematic Reviews. STUDY ELIGIBILITY CRITERIA English language; published 2011-2022; primary studies describing prevalence of psychiatric conditions in autistic adults; or systematic reviews evaluating interventions for autistic adults. APPRAISAL AND SYNTHESIS Bias was assessed using the Prevalence Critical Appraisal Instrument and AMSTAR2. Prevalence was grouped according to psychiatric diagnosis. Interventions were grouped into pharmacological, employment, psychological or mixed therapies. Strength of evidence for interventions was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Autistic researchers within the team supported interpretation. RESULTS Twenty prevalence studies were identified. Many included small sample sizes or failed to compare their sample group with the general population reducing validity. Prevalence of psychiatric diagnoses was variable with prevalence of any psychiatric diagnosis ranging from 15.4% to 79%. Heterogeneity was associated with age, diagnosis method, sampling methods, and country. Thirty-two systematic reviews of interventions were identified. Four reviews were high quality, four were moderate, five were low and nineteen critically low, indicating bias. Following synthesis, no intervention was rated as 'evidence based.' Acceptability of interventions to autistic adults and priorities of autistic adults were often not considered. CONCLUSIONS There is some understanding of the scope of mental ill-health in autism, but interventions are not tailored to the needs of autistic adults, not evidence based, and may focus on promoting neurotypical behaviours rather than the priorities of autistic people.
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Affiliation(s)
- Eleanor Curnow
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Marion Rutherford
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Lorna Johnston
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
- Additional Support for Learning Service, Communities and Families, City of Edinburgh Council, Edinburgh, United Kingdom
| | - Susan Prior
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Marie Boilson
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
- Fife Health and Social Care Partnership, Lynebank Hospital, Dunfermline, Fife, United Kingdom
| | - Premal Shah
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
- General Adult Psychiatry, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Natalie Jenkins
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
- University of Edinburgh, Edinburgh, United Kingdom
| | - Tamsin Meff
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
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36
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Rabot J, Rødgaard EM, Joober R, Dumas G, Bzdok D, Bernhardt B, Jacquemont S, Mottron L. Genesis, modelling and methodological remedies to autism heterogeneity. Neurosci Biobehav Rev 2023; 150:105201. [PMID: 37116771 DOI: 10.1016/j.neubiorev.2023.105201] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 04/30/2023]
Abstract
Diagnostic criteria used in autism research have undergone a shift towards the inclusion of a larger population, paralleled by increasing, but variable, estimates of autism prevalence across clinical settings and continents. A categorical diagnosis of autism spectrum disorder is now consistent with large variations in language, intelligence, comorbidity, and severity, leading to a heterogeneous sample of individuals, increasingly distant from the initial prototypical descriptions. We review the history of autism diagnosis and subtyping, and the evidence of heterogeneity in autism at the cognitive, neurological, and genetic levels. We describe two strategies to address the problem of heterogeneity: clustering, and truncated-compartmentalized enrollment strategy based on prototype recognition. The advances made using clustering methods have been modest. We present an alternative, new strategy for dissecting autism heterogeneity, emphasizing incorporation of prototypical samples in research cohorts, comparison of subgroups defined by specific ranges of values for the clinical specifiers, and retesting the generality of neurobiological results considered to be acquired from the entire autism spectrum on prototypical cohorts defined by narrow specifiers values.
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Affiliation(s)
| | - Eya-Mist Rødgaard
- Department of Psychology, Copenhagen University, Copenhagen, Denmark,.
| | - Ridha Joober
- Neurological Institute and Hospital, McGill University, Montreal, Quebec, H4H 1R3, Canada,.
| | - Guillaume Dumas
- Department of Psychiatry & Addictology, University of Montreal, Montreal, QC, H3T 1C5, Canada, Mila - Quebec Artificial Intelligence Institute, Montreal, QC, Canada,.
| | - Danilo Bzdok
- Mila - Quebec Artificial Intelligence Institute, Montreal, Canada, Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, H3A 2B4, QC, Canada,.
| | - Boris Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, McGill University, Montreal, QC, H3A 2B4, Canada,.
| | - Sebastien Jacquemont
- Department of Pediatrics, University of Montreal, Montréal, Quebec, H3T 1C5, Canada,.
| | - Laurent Mottron
- Department of Psychiatry & Addictology, University of Montreal, Montreal, QC, H3T 1C5, Canada, CIUSSS-NIM, Research Center, Montréal, QC, H1E 1A4, Canada,.
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Bylemans T, Heleven E, Asselman E, Baetens K, Deroost N, Baeken C, Van Overwalle F. Sex differences in autistic adults: A preliminary study showing differences in mentalizing, but not in narrative coherence. Acta Psychol (Amst) 2023; 236:103918. [PMID: 37071947 DOI: 10.1016/j.actpsy.2023.103918] [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: 12/29/2022] [Revised: 02/27/2023] [Accepted: 04/14/2023] [Indexed: 04/20/2023] Open
Abstract
Studying autism might be a complex endeavor due to its clinical heterogeneity. Little is currently known about potential sex differences in autistic adults, especially regarding mentalizing and narrative coherence. In this study, male and female participants told a personal story about one of their most positive and most negative life events and performed two mentalizing tasks. One of these mentalizing tasks was a recently developed Picture and Verbal Sequencing task that has shown cerebellar recruitment, and which requires mentalizing in a sequential context (i.e., participants chronologically ordered scenarios that required true and false belief mentalizing). Our preliminary comparison shows that males were faster and more accurate on the Picture Sequencing task compared to female participants when ordering sequences involving false beliefs, but not true beliefs. No sex differences were found for the other mentalizing and narrative tasks. These results highlight the importance of looking at sex differences in autistic adults and provide a possible explanation for sex-related differences in daily life mentalizing functions, which suggest a need for more sensitive diagnosis and tailored support.
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Affiliation(s)
- Tom Bylemans
- Brain Body and Cognition, Department of Psychology, and Center for Neuroscience, Vrije Universiteit Brussel, Belgium.
| | - Elien Heleven
- Brain Body and Cognition, Department of Psychology, and Center for Neuroscience, Vrije Universiteit Brussel, Belgium.
| | - Emma Asselman
- Brain Body and Cognition, Department of Psychology, and Center for Neuroscience, Vrije Universiteit Brussel, Belgium.
| | - Kris Baetens
- Brain Body and Cognition, Department of Psychology, and Center for Neuroscience, Vrije Universiteit Brussel, Belgium.
| | - Natacha Deroost
- Brain Body and Cognition, Department of Psychology, and Center for Neuroscience, Vrije Universiteit Brussel, Belgium.
| | - Chris Baeken
- Ghent University: Department of Head and Skin (UZGent), Ghent Experimental Psychiatry (GHEP) Lab, Belgium; Vrije Universiteit Brussel (VUB), Department of Psychiatry, University Hospital (UZ Brussel), Brussels, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, the Netherlands.
| | - Frank Van Overwalle
- Brain Body and Cognition, Department of Psychology, and Center for Neuroscience, Vrije Universiteit Brussel, Belgium.
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Ratto AB, Bascom J, daVanport S, Strang JF, Anthony LG, Verbalis A, Pugliese C, Nadwodny N, Brown LX, Cruz M, Hector BL, Kapp SK, Giwa Onaiwu M, Raymaker DM, Robison JE, Stewart C, Stone R, Whetsell E, Pelphrey K, Kenworthy L. Centering the Inner Experience of Autism: Development of the Self-Assessment of Autistic Traits. AUTISM IN ADULTHOOD 2023; 5:93-105. [PMID: 36941856 PMCID: PMC10024271 DOI: 10.1089/aut.2021.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Current tools for identifying autism are critiqued for their lack of specificity and sensitivity, especially in autistic people who are older, have higher verbal ability or significant compensatory skills, and are not cisgender boys. This may reflect the following: the historical focus of autism research on White (cisgender) male, upper and middle class children; limited interest in the inner, lived experience of autism; and the predominance of a deficit-based model of autism. We report here on the first attempt of which we are aware to develop a clinical self-report measure of autistic traits as described by autistic people. We believe this is an advance in methodology because prior work in the development of autistic trait/diagnostic measures has prioritized the perspectives of nonautistic clinicians and scientists. The measure was developed under the leadership of two autistic researchers and constructed by leveraging descriptions of autism by autistic people to generate items designed to encompass the range of the autistic experience, using strength-based, accessible language. The team utilized iterative feedback from a panel of autistic experts to refine and enhance the measure, called the Self Assessment of Autistic Traits (SAAT). It is intended for people 16 years or older and uses a format that is designed to increase its accessibility and acceptability for autistic respondents. Future work will report on the preliminary psychometrics of the SAAT, with a long-term goal of advancing our understanding of the inner autistic experience and enhancing the clinical and scientific assessment of autism.
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Affiliation(s)
- Allison B. Ratto
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
| | - Julia Bascom
- Autistic Self Advocacy Network, Washington, DC, USA
| | | | - John F. Strang
- Gender and Autism Program, Children's National Hospital, Washington, DC, USA
| | - Laura G. Anthony
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Denver, CO, USA
| | - Alyssa Verbalis
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
| | - Cara Pugliese
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
| | - Nicole Nadwodny
- Department of Developmental Medicine, Boston Children's Hospital, Brookline, MA, USA
| | - Lydia X.Z. Brown
- Department of Disability Studies and Women's and Gender Studies, Georgetown University, Washington, DC, USA
| | - Mallory Cruz
- Private Consultant, Hitachiomiya, Ibaraki, Japan
| | | | - Steven K. Kapp
- Department of Psychology, University of Portsmouth, Portsmouth, UK
| | - Morénike Giwa Onaiwu
- Center for the Study of Women, Gender, and Sexuality, Rice University, & Autistic Women & Nonbinary Network, Houston, TX, USA
| | - Dora M. Raymaker
- School of Social Work, Portland State University, Portland, OR, USA
| | - John Elder Robison
- Neurodiversity Working Group, The College of William and Mary, Williamsburg, VA, USA
| | | | - Ren Stone
- Autistic Women & Nonbinary Network, Washington, DC, USA
| | | | - Kevin Pelphrey
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Lauren Kenworthy
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
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Zivony A, Kardosh R, Timmins L, Reggev N. Ten simple rules for socially responsible science. PLoS Comput Biol 2023; 19:e1010954. [PMID: 36952443 PMCID: PMC10035751 DOI: 10.1371/journal.pcbi.1010954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
Guidelines concerning the potentially harmful effects of scientific studies have historically focused on ethical considerations for minimizing risk for participants. However, studies can also indirectly inflict harm on individuals and social groups through how they are designed, reported, and disseminated. As evidenced by recent criticisms and retractions of high-profile studies dealing with a wide variety of social issues, there is a scarcity of resources and guidance on how one can conduct research in a socially responsible manner. As such, even motivated researchers might publish work that has negative social impacts due to a lack of awareness. To address this, we propose 10 simple rules for researchers who wish to conduct socially responsible science. These rules, which cover major considerations throughout the life cycle of a study from inception to dissemination, are not aimed as a prescriptive list or a deterministic code of conduct. Rather, they are meant to help motivated scientists to reflect on their social responsibility as researchers and actively engage with the potential social impact of their research.
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Affiliation(s)
- Alon Zivony
- Department of Psychological Sciences, Birkbeck College, University of London, London, United Kingdom
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Rasha Kardosh
- Department of Psychology, New York University, New York, United States of America
| | - Liadh Timmins
- School of Psychology, Faculty of Medicine, Health and Life Sciences, Swansea University, Swansea, Wales, United Kingdom
| | - Niv Reggev
- Department of Psychology, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
- School of Brain Sciences and Cognition, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
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Wolstencroft J, Srinivasan R, Hall J, van den Bree MBM, Owen MJ, Raymond FL, Skuse D. Mental health impact of autism on families of children with intellectual and developmental disabilities of genetic origin. JCPP ADVANCES 2023; 3:e12128. [PMID: 37431317 PMCID: PMC10241472 DOI: 10.1002/jcv2.12128] [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] [Received: 05/20/2022] [Accepted: 11/10/2022] [Indexed: 01/15/2023] Open
Abstract
Background Many children with an intellectual or developmental disability (IDD) have associated autism spectrum disorders (ASD), as well as an increased risk of mental health difficulties. In a cohort with IDD of genetic aetiology, we tested the hypothesis that excess risk attached to those with ASD + IDD, in terms of both children's mental health and parental psychological distress. Methods Participants with a copy number variant or single nucleotide variant (5-19 years) were recruited via UK National Health Service. 1904 caregivers competed an online assessment of child mental health and reported on their own psychological wellbeing. We used regression to examine the association between IDD with and without co-occurring ASD, and co-occurring mental health difficulties, as well as with parental psychological distress. We adjusted for children's sex, developmental level, physical health, and socio-economic deprivation. Results Of the 1904 participants with IDD, 701 (36.8%) had co-occurring ASD. Children with both IDD and ASD were at higher risk of associated disorders than those with IDD alone (ADHD: OR = 1.84, 95% confidence interval [CI] 1.46-2.32, p < 0.0001; emotional disorders: OR = 1.85, 95%CI 1.36-2.5, p < 0.0001; disruptive behaviour disorders: OR = 1.79, 95%CI 1.36-2.37, p < 0.0001). The severity of associated symptoms was also greater in those with ASD (hyperactivity: B = 0.25, 95%CI 0.07-0.34, p = 0.006; emotional difficulties: B = 0.91, 95%CI 0.67 to 1.14, p < 0.0001; conduct problems: B = 0.25, 95%CI 0.05 to 0.46, p = 0.013). Parents of children with IDD and ASD also reported greater psychological distress than those with IDD alone (β = 0.1, 95% CI 0.85 to 2.21, p < 0.0001). Specifically, in those with ASD, symptoms of hyperactivity (β = 0.13, 95% CI 0.29-0.63, p < 0.0001), emotional difficulties (β = 0.15, 95% CI 0.26-0.51, p < 0.0001) and conduct difficulties (β = 0.07, 95% CI 0.07-0.37, p < 0.004) all significantly contributed to parental psychological distress. Conclusions Among children with IDD of genetic aetiology, one third have co-occurring ASD. Not only do those with co-occurring ASD present with a wider range of associated mental health disorders and more severe mental health difficulties than those with IDD alone, but their parents also experience more psychological distress. Our findings suggest that the additional mental health and behavioural symptoms in those with ASD contributed to the degree of parental psychological distress.
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Affiliation(s)
- Jeanne Wolstencroft
- UCL NIHR BRC Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Ramya Srinivasan
- UCL NIHR BRC Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
- UCL Division of PsychiatryUniversity College LondonLondonUK
| | - Jeremy Hall
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
- Neuroscience and Mental Health Research InstituteCardiff UniversityCardiffUK
| | - Marianne B. M. van den Bree
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
- Neuroscience and Mental Health Research InstituteCardiff UniversityCardiffUK
| | - Michael J. Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and GenomicsDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
- Neuroscience and Mental Health Research InstituteCardiff UniversityCardiffUK
| | | | - F. Lucy Raymond
- School of Clinical MedicineUniversity of CambridgeCambridgeUK
- Cambridge University Hospitals NHS Foundation TrustCambridge Biomedical CampusCambridgeUK
- NIHR BioresourceCambridge Biomedical CampusCambridgeUK
| | - David Skuse
- UCL NIHR BRC Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
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Lilley R, Lawson W, Hall G, Mahony J, Clapham H, Heyworth M, Arnold S, Trollor J, Yudell M, Pellicano E. "Peas in a pod": Oral History Reflections on Autistic Identity in Family and Community by Late-Diagnosed Adults. J Autism Dev Disord 2023; 53:1146-1161. [PMID: 35834048 PMCID: PMC9986211 DOI: 10.1007/s10803-022-05667-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Abstract
In this paper, we report on a participatory oral history study documenting the lives of late-diagnosed autistic adults in Australia. We interviewed 26 autistic adults about their life history and the impact of late diagnosis. All were diagnosed after the age of 35, growing up in an era when autism was not well known. Using reflexive thematic analysis, we uncovered a rich body of reflections on shared Autistic identity and identified three major themes within that data set: 'conceptualising the Autistic family', 'creating Autistic community', and 'contesting Autistic identity'. Overall, the study provides insights into the active creation of shared Autistic identity and the importance of Autistic community to these late-diagnosed autistic adults.
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Affiliation(s)
- Rozanna Lilley
- Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, NSW, 2109, Australia.
- Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia.
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, NSW, 2109, Australia
- Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
| | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, NSW, 2109, Australia
- Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
| | - Joanne Mahony
- Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, NSW, 2109, Australia
- Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
| | | | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, NSW, 2109, Australia
| | - Samuel Arnold
- Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
| | - Julian Trollor
- Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
| | - Michael Yudell
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, NSW, 2109, Australia
- Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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42
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Gough J. Does the Neurotypical Human Have a 'Theory of Mind'? J Autism Dev Disord 2023; 53:853-857. [PMID: 34853957 DOI: 10.1007/s10803-021-05381-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Joe Gough
- University of Sussex, Falmer, Brighton, BN1 9RH, UK.
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Xiao N, Shinwari K, Kiselev S, Huang X, Li B, Qi J. Effects of Equine-Assisted Activities and Therapies for Individuals with Autism Spectrum Disorder: Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2630. [PMID: 36767996 PMCID: PMC9915993 DOI: 10.3390/ijerph20032630] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Autism spectrum disorder (ASD) has become a critical public health issue that affects more than 78 million people. In many recent studies, the authors have demonstrated that equine-assisted activities and therapies (EAATs) can substantially improve the social and behavioral skills of children with ASD. However, the qualities of the studies differ, and some authors reached opposite conclusions. In this review, we systematically and objectively examined the effectiveness of EAATs for people with ASD, combining both qualitative and quantitative methods. We searched five databases (PubMed, Scopus, ERIC, ProQuest, and MEDLINE) and added relevant references, and we identified 25 articles for data extraction and analysis. According to our results, EAAT programs can substantially improve the social and behavioral functioning and language abilities of children with ASD. However, among the subdomains, the results were inconsistent. According to the meta-analyses, there were considerable improvements in the social cognition, communication, irritability, and hyperactivity domains, but not in the domains of social awareness, mannerisms, motivation, lethargy, stereotypy, or inappropriate speech. Moreover, there was a lack of sufficient comparative data to conclude that EAAT programs lead to substantial improvements in motor and sensory functioning. In addition, among the included studies, we noted the indicator of whether EAAT programs decreased parental stress and improved family functioning, and although there were four articles in which the researchers considered this aspect, we were unable to draw any conclusions because of the insufficient data and conflicting descriptive evidence. However, we need to consider the improvement in parental mental health as a factor in the effectiveness of this complementary intervention. We hope that in future studies, researchers will focus on family functioning and conduct more randomized controlled trials (RCTs) with blinded assessments using different scales and measures.
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Affiliation(s)
- Ningkun Xiao
- Department of Psychology, Institution of Humanities, Ural Federal University, Yekaterinburg 620075, Russia
| | - Khyber Shinwari
- Department of Immunochemistry, Institution of Chemical Engineering, Ural Federal University, Yekaterinburg 620075, Russia
| | - Sergey Kiselev
- Department of Psychology, Institution of Humanities, Ural Federal University, Yekaterinburg 620075, Russia
| | - Xinlin Huang
- Department of Psychology, Institution of Humanities, Ural Federal University, Yekaterinburg 620075, Russia
| | - Baoheng Li
- Engineering School of Information Technologies, Telecommunications and Control System, Ural Federal University, Yekaterinburg 620002, Russia
| | - Jingjing Qi
- Engineering School of Information Technologies, Telecommunications and Control System, Ural Federal University, Yekaterinburg 620002, Russia
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Advancing research on early autism through an integrated risk and resilience perspective. Dev Psychopathol 2023; 35:44-61. [PMID: 35379370 DOI: 10.1017/s0954579421001437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To date, a deficit-oriented approach dominates autism spectrum disorder (ASD) research, including studies of infant siblings of children with ASD at high risk (HR) for the disabilities associated with this disorder. Despite scientific advances regarding early ASD-related risk, there remains little systematic investigation of positive development, limiting the scope of research and quite possibly a deeper understanding of pathways toward and away from ASD-related impairments. In this paper, we argue that integrating a resilience framework into early ASD research has the potential to enhance knowledge on prodromal course, phenotypic heterogeneity, and developmental processes of risk and adaptation. We delineate a developmental systems resilience framework with particular reference to HR infants. To illustrate the utility of a resilience perspective, we consider the "female protective effect" and other evidence of adaptation in the face of ASD-related risk. We suggest that a resilience framework invites focal questions about the nature, timing, levels, interactions, and mechanisms by which positive adaptation occurs in relation to risk and developmental pathways toward and away from ASD-related difficulties. We conclude with recommendations for future research, including more focus on adaptive development and multisystem processes, pathways away from disorder, and reconsideration of extant evidence within an integrated risk-and-resilience framework.
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Waisman TC, Williams ZJ, Cage E, Santhanam SP, Magiati I, Dwyer P, Stockwell KM, Kofner B, Brown H, Davidson D, Herrell J, Shore SM, Caudel D, Gurbuz E, Gillespie-Lynch K. Learning from the experts: Evaluating a participatory autism and universal design training for university educators. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:356-370. [PMID: 35652315 DOI: 10.1177/13623613221097207] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Autistic university students have many strengths. They also go through difficulties that professors may not understand. Professors may not understand what college life is like for autistic students. They might judge autistic students. A team of autistic and non-autistic researchers made a training to help professors understand autistic students better. This training also gave professors ideas to help them teach all of their students. Ninety-eight professors did an online survey before the autism training. They shared how they felt about autism and teaching. Before our training, professors who knew more about autism appreciated autism more. Professors who thought people should be equal and women also appreciated autism more. Then, 89 of the professors did our training and another survey after the training. This helped us see what they learned from the training. They did one more survey a month later. This helped us see what they remembered. Our training helped professors understand and value autism. It also helped them understand how they can teach all students better. The professors remembered a lot of what we taught them. This study shows that a training that autistic people helped make can help professors understand their autistic students better.
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Botha M, Hanlon J, Williams GL. Does Language Matter? Identity-First Versus Person-First Language Use in Autism Research: A Response to Vivanti. J Autism Dev Disord 2023; 53:870-878. [PMID: 33474662 PMCID: PMC7817071 DOI: 10.1007/s10803-020-04858-w] [Citation(s) in RCA: 102] [Impact Index Per Article: 102.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 12/12/2022]
Abstract
In response to Vivanti's 'Ask The Editor…' paper [Journal of Autism and Developmental Disorders, 50(2), 691-693], we argue that the use of language in autism research has material consequences for autistic people including stigmatisation, dehumanisation, and violence. Further, that the debate in the use of person-first language versus identity-first language should centre first and foremost on the needs, autonomy, and rights of autistic people, so in to preserve their rights to self-determination. Lastly, we provide directions for future research.
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Affiliation(s)
- Monique Botha
- School of Psychology, University of Surrey, Stag Hill Campus, Guildford, Surrey, GU2 7XH, UK. .,Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UK.
| | - Jacqueline Hanlon
- LLM Gender, Conflict & Human Rights, Transitional Justice Institute, Ulster University, Jordanstown, UK
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47
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Reindal L, Nærland T, Weidle B, Lydersen S, Andreassen OA, Sund AM. Structural and Pragmatic Language Impairments in Children Evaluated for Autism Spectrum Disorder (ASD). J Autism Dev Disord 2023; 53:701-719. [PMID: 33515169 PMCID: PMC9944009 DOI: 10.1007/s10803-020-04853-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 12/30/2022]
Abstract
Pragmatic language impairments are common in neurodevelopmental disorders, especially in autism spectrum disorder (ASD). The relationship between structural language skills and pragmatic competence in children with autistic symptoms, however, is largely unknown. We investigated this relationship based on the Children's Communication Checklist-2 and early language delay among children (N = 177, 19% females) clinically evaluated for ASD, differentiated into ASD (n = 148) and non-ASD (n = 29). Structural language deficits were common and associated with reduced pragmatic competence in both groups. Pragmatic language impairments were most profound in children with ASD. Early language delay and structural language deficits were less common in females. Our findings suggest that assessment of structural language skills should be included in the evaluation of children with suspected ASD.
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Affiliation(s)
- Lise Reindal
- Department of Child and Adolescent Psychiatry, Møre og Romsdal Hospital Trust, Volda Hospital, Volda, Norway. .,Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Terje Nærland
- NevSom, Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway ,K.G Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Bernhard Weidle
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway ,Department of Child and Adolescent Psychiatry, St. Olavs University Hospital, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ole A. Andreassen
- K.G Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway ,NORMENT Centre, University of Oslo, Oslo, Norway ,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anne Mari Sund
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway ,Department of Child and Adolescent Psychiatry, St. Olavs University Hospital, Trondheim, Norway
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48
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Ferenc K, Byrka K, Król ME. The spectrum of attitudes towards the spectrum of autism and its relationship to psychological distress in mothers of children with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:54-64. [PMID: 35296156 DOI: 10.1177/13623613221081185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
LAY ABSTRACT Mothers of children on the autism spectrum experience high levels of emotional distress. Mothers cope with stress by having their own thoughts and opinions about their children. In this study, we tested whether the way mothers perceive autism may contribute to the level of distress they feel. Some mothers see autism as a developmental disorder that needs to be cured, but some see autism as a type of mind that needs to be accepted. Our findings showed that mothers who see autism more as a type of mind are generally less stressed. But we also showed that it matters how severe are the child's symptoms, and how heavy was the perceived burden of caring for the child. These results imply that it is worth working on attitudes towards autism to help mothers cope better. But at the same time, we argue that mothers should not be judged for their perceptions of autism, as there is a huge spectrum of a child's characteristics and family's life circumstances.
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Affiliation(s)
- Kinga Ferenc
- SWPS University of Social Sciences and Humanities, Poland
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Sáez-Suanes GP, García-Villamisar D, Pozo Armentia AD. Does the gender matter?: Anxiety symptoms and emotion dysregulation in adults with autism and intellectual disabilities. Autism Res 2023; 16:113-121. [PMID: 36271821 PMCID: PMC10092007 DOI: 10.1002/aur.2839] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/12/2022] [Indexed: 01/14/2023]
Abstract
Research shows high rates of anxious symptoms in people autistic spectrum disorder (ASD). Finding factors related to the development of anxiety in ASD is necessary. Emotion regulation (ER) is associated with anxiety in ASD. Moreover, some studies find higher rates of anxiety in women with ASD. A total of 121 adults (M = 35.46 years, SD = 9.46) with ASD and intellectual disabilities were evaluated to verify moderating role of gender and mediating role of ER. A moderated mediation analysis supported the moderated role of gender in the relationship mediated by emotional dysregulation between ASD and anxiety. These findings suggest that interventions designed to prevent or reduce anxiety symptoms in women with ASD should include among their goals emotional regulation. LAY SUMMARY: If we want to reduce or prevent anxiety symptoms in women with ASD we must work on emotional regulation.
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Affiliation(s)
- Gema P Sáez-Suanes
- Department of Developmental and Educational Psychology, Faculty of Teacher Training and Education, Universidad Autónoma de Madrid, Madrid, Spain
| | - Domingo García-Villamisar
- Departmental Unit of Personality, Assessment and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Araceli Del Pozo Armentia
- Departmental Unit of Personality, Assessment and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
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Sacco R, Camilleri N, Eberhardt J, Umla-Runge K, Newbury-Birch D. A systematic review and meta-analysis on the prevalence of mental disorders among children and adolescents in Europe. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-02131-2. [PMID: 36581685 PMCID: PMC9800241 DOI: 10.1007/s00787-022-02131-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022]
Abstract
Most mental disorders appear by age 14, but in most cases, they remain undiagnosed and untreated well into adulthood. A scoping review showed an absence of systematic reviews that address prevalence rates of mental disorders among children and adolescents in Europe that are based on community studies conducted between 2015 and 2020. To estimate the updated pooled prevalence of Anxiety Disorder, Depressive Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Autism Spectrum Disorder, Eating Disorders, Substance Use Disorders (SUD), among children and adolescents living in Europe, a search strategy was conducted using MEDLINE, Embase and Psych Info and studies were also identified from reference lists and gray literature. Eligible studies were evaluated for reliability, validity, and bias. Trends of prevalence rates for each mental disorder were calculated. Almost one in five young people in Europe were found to suffer from a mental disorder, with a pooled prevalence rate of 15.5%. Anxiety disorders had the highest pooled prevalence rate (7.9% (95% CI 5.1-11.8%, I2: 98.0%)), followed by ADHD (2.9% (95% CI 1.2-6.9%, I2 = 94.3%)), ODD (1.9% (95% CI 1.0-3.7%, I2 = 98.4%)), depressive disorder (1.7% (95% CI 1.0-2.9%, I2 = 97.7%)), CD (1.5% (95% CI 0.6-3.8%, I2 = 98.8%)) and ASD (1.4% (95% CI 0.4-5.4%, I2 = 99.7%). No studies on SUD were identified. The mental health of children and adolescents may be improved by introducing routine screening, refining diagnostic sensitivity, raising awareness of mental disorders, minimizing stigma and socioeconomic inequality, as well as developing early intervention services. These facilitators of good mental health need to be prioritized, especially at a time of unprecedented risk factors for poor mental health.
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Affiliation(s)
- Rosemarie Sacco
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK.
- School of Medicine, Cardiff University, Cardiff, Wales.
- School of Medicine and Surgery, University of Malta, Msida, Malta.
- Mental Health Services, Attard, Malta.
| | - Nigel Camilleri
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
- School of Medicine and Surgery, University of Malta, Msida, Malta
- Mental Health Services, Attard, Malta
| | - Judith Eberhardt
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
| | | | - Dorothy Newbury-Birch
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK
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