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Hao Y, Banker S, Trayvick J, Barkley S, Peters A, Thinakaran A, McLaughlin C, Gu X, Foss-Feig J, Schiller D. Understanding Depression in Autism: The Role of Subjective Perception and Anterior Cingulate Cortex Volume. RESEARCH SQUARE 2024:rs.3.rs-4947599. [PMID: 39372931 PMCID: PMC11451742 DOI: 10.21203/rs.3.rs-4947599/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/08/2024]
Abstract
Background The prevalence of depression is elevated in individuals with autism spectrum disorder (ASD) compared to the general population, yet the reasons for this disparity remain unclear. While social deficits central to ASD may contribute to depression, it is uncertain whether social interaction behavior themselves or individuals' introspection about their social behaviors are more impactful. Although the anterior cingulate cortex (ACC) and amygdala are frequently implicated in ASD, depression, and social functioning, it is unknown if these regions explain differences between ASD adults with and without co-occurring depression. Methods The present study contrasted observed vs. subjective perception of autism symptoms and social performances assessed with both standardized measures and a lab task, in 65 sex-balanced (52.24% male) autistic young adults. We also quantified ACC and amygdala volume with 7-Tesla structural neuroimaging to examine correlations with depression and social functioning. Results We found that ASD individuals with depression exhibited differences in subjective evaluations including heightened self-awareness of ASD symptoms, lower subjective satisfaction with social relations, and less perceived affiliation during the social interaction task, yet no differences in corresponding observed measures, compared to those without depression. Larger ACC volume was related to depression, greater self-awareness of ASD symptoms, and worse subjective satisfaction with social interactions. In contrast, amygdala volume, despite its association with clinician-rated ASD symptoms, was not related to depression. Limitations Due to the cross-sectional nature of our study, we cannot determine the directionality of the observed relationships. Additionally, we included only individuals with an IQ over 60 to ensure participants could complete the social task, which excluded many on the autism spectrum. We also utilized self-reported depression indices instead of clinically diagnosed depression, which may limit the comprehensiveness of the findings. Conclusions Our approach highlights the unique role of subjective perception of autism symptoms and social interactions, beyond the observable manifestation of social interaction in ASD, in contributing to depression, with the ACC playing a crucial role. These findings imply possible heterogeneity of ASD concerning co-occurring depression. Using neuroimaging, we were able to demarcate depressive phenotypes co-occurring alongside autistic phenotypes.
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Affiliation(s)
- Yu Hao
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah Banker
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jadyn Trayvick
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah Barkley
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arabella Peters
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Abigael Thinakaran
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher McLaughlin
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaosi Gu
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jennifer Foss-Feig
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniela Schiller
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Dubreucq J, Coutelle R, Lajnef M, Godin O, Amestoy A, Atzori P, Baleyte JM, Bonnot O, Bouvard M, Coulon N, Da Fonseca D, Demily C, Delorme R, Fabrowski M, Givaudan M, Gollier-Briant F, Guenolé F, Humeau E, Leignier S, Lejuste F, Levy C, Rabot J, Schröder CM, Valette M, Leboyer M, Speranza M. Gender differences in psychosocial function and self-reported health status in late-diagnosed autistic adults: results from the FACE-ASD national cohort. Psychol Med 2023; 53:5674-5684. [PMID: 36177672 DOI: 10.1017/s0033291722002902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND While adult outcome in autism spectrum disorder (ASD) is generally measured using socially valued roles, it could also be understood in terms of aspects related to health status - an approach that could inform on potential gender differences. METHODS We investigated gender differences in two aspects of outcome related to health-status, i.e. general functioning and self-perceived health status, and co-occurring health conditions in a large multi-center sample of autistic adults. Three hundred and eighty-three participants were consecutively recruited from the FondaMental Advanced Centers of Expertise for ASD cohort (a French network of seven expert centers) between 2013 and 2020. Evaluation included a medical interview, standardized scales for autism diagnosis, clinical and functional outcomes, self-perceived health status and verbal ability. Psychosocial function was measured using the Global Assessment of Functioning scale. RESULTS While autistic women in this study were more likely than men to have socially valued roles, female gender was associated with poorer physical and mental health (e.g. a 7-fold risk for having three or more co-occurring physical health conditions) and a poorer self-perceived health status. Psychosocial function was negatively associated with depression and impairment in social communication. Half of the sample had multiple co-occurring health conditions but more than 70% reported that their visit at the Expert Center was their first contact with mental health services. CONCLUSIONS To improve objective and subjective aspects of health outcome, gender differences and a wide range of co-occurring health conditions should be taken into account when designing healthcare provision for autistic adults.
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Affiliation(s)
- Julien Dubreucq
- Fondation FondaMental, Créteil, France
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon, Lyon, France
- Centre Expert TSA-SDI, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
| | - Romain Coutelle
- Fondation FondaMental, Créteil, France
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre d'Excellence STRAS&ND, Centre Expert TSA-SDI, FHU NEUROGENΨCS, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, CNRS UPR 3212, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Mohamed Lajnef
- Fondation FondaMental, Créteil, France
- Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, F-94010 Créteil, France
| | - Ophélia Godin
- Fondation FondaMental, Créteil, France
- Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, F-94010 Créteil, France
| | - Anouck Amestoy
- Fondation FondaMental, Créteil, France
- CRA Aquitaine, 121 Rue de la Béchade, 33016 Bordeaux cedex; INCIA, UMR 5287, Neuroimaging and Human Cognition Team, Bordeaux, France
| | - Paola Atzori
- Fondation FondaMental, Créteil, France
- Unité de Psychopathologie de l'enfant et de l'adolescent, Hôpital Salvador, Assistance Public- Hopitaux de Marseille, Université Aix-Marseille II, 13009 Marseille, France
| | - Jean-Marc Baleyte
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital Intercommunal de Créteil, Créteil, France
| | - Olivier Bonnot
- Fondation FondaMental, Créteil, France
- Psychiatrie de l'Enfant et de l'Adolescent, CHU & Universite de Nantes, LPPL EA 4638 Centre Ressource Autisme Pays de la Loire, Nantes, France
| | - Manuel Bouvard
- Fondation FondaMental, Créteil, France
- CRA Aquitaine, 121 Rue de la Béchade, 33016 Bordeaux cedex; INCIA, UMR 5287, Neuroimaging and Human Cognition Team, Bordeaux, France
| | - Nathalie Coulon
- Fondation FondaMental, Créteil, France
- Centre Expert TSA-SDI, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
| | - David Da Fonseca
- Fondation FondaMental, Créteil, France
- Unité de Psychopathologie de l'enfant et de l'adolescent, Hôpital Salvador, Assistance Public- Hopitaux de Marseille, Université Aix-Marseille II, 13009 Marseille, France
| | - Caroline Demily
- Fondation FondaMental, Créteil, France
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon, Lyon, France
- Centre d'excellence I-Mind, Centre de référence maladies rares Génopsy, pôle ADIS, Centre hospitalier Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, Lyon, France
| | - Richard Delorme
- Fondation FondaMental, Créteil, France
- Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Aur p-HP, Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT) F-94010, Créteil, France
- Hôpital Robert Debré, Centre d'Excellence InoVAND, Service de Psychiatrie de l'enfant, Centre Expert TSA-SDI Paris, Paris, France
| | - Marine Fabrowski
- Fondation FondaMental, Créteil, France
- Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon, Lyon, France
- Centre d'excellence I-Mind, Centre de référence maladies rares Génopsy, pôle ADIS, Centre hospitalier Le Vinatier, UMR 5229, CNRS & Université Lyon 1, Université de Lyon, Lyon, France
| | - Marion Givaudan
- Fondation FondaMental, Créteil, France
- Unité de Psychopathologie de l'enfant et de l'adolescent, Hôpital Salvador, Assistance Public- Hopitaux de Marseille, Université Aix-Marseille II, 13009 Marseille, France
| | - Fanny Gollier-Briant
- Fondation FondaMental, Créteil, France
- Psychiatrie de l'Enfant et de l'Adolescent, CHU & Universite de Nantes, LPPL EA 4638 Centre Ressource Autisme Pays de la Loire, Nantes, France
| | - Fabian Guenolé
- Fondation FondaMental, Créteil, France
- Caen University Hospital - Head of the department of child and adolescent psychiatry, 14 Avenue Clemenceau CS 30001, 14033 Caen Cedex 9, France
| | - Elise Humeau
- Fondation FondaMental, Créteil, France
- Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Aur p-HP, Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT) F-94010, Créteil, France
- Hôpital Robert Debré, Centre d'Excellence InoVAND, Service de Psychiatrie de l'enfant, Centre Expert TSA-SDI Paris, Paris, France
| | - Sylvain Leignier
- Fondation FondaMental, Créteil, France
- Centre Expert TSA-SDI, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
| | - Florian Lejuste
- Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Aur p-HP, Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT) F-94010, Créteil, France
- Hôpital Robert Debré, Centre d'Excellence InoVAND, Service de Psychiatrie de l'enfant, Centre Expert TSA-SDI Paris, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Versailles, France
| | - Charlotte Levy
- Fondation FondaMental, Créteil, France
- CRA Aquitaine, 121 Rue de la Béchade, 33016 Bordeaux cedex; INCIA, UMR 5287, Neuroimaging and Human Cognition Team, Bordeaux, France
| | - Juliette Rabot
- Fondation FondaMental, Créteil, France
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre d'Excellence STRAS&ND, Centre Expert TSA-SDI, FHU NEUROGENΨCS, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, CNRS UPR 3212, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Carmen M Schröder
- Fondation FondaMental, Créteil, France
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre d'Excellence STRAS&ND, Centre Expert TSA-SDI, FHU NEUROGENΨCS, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, CNRS UPR 3212, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Marie Valette
- Fondation FondaMental, Créteil, France
- Service de Psychiatrie Infanto-Juvénile, Centre Hospitalier de Versailles - INSERM U669, UMR-S0669, Université Paris-Sud et Université Paris-Descartes, Paris, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France
- Univ Paris Est Créteil, INSERM U955, IMRB, Translational Neuro-Psychiatry, F-94010 Créteil, France
- Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Aur p-HP, Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT) F-94010, Créteil, France
- Hôpital Robert Debré, Centre d'Excellence InoVAND, Service de Psychiatrie de l'enfant, Centre Expert TSA-SDI Paris, Paris, France
| | - Mario Speranza
- Fondation FondaMental, Créteil, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Versailles, France
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, Versailles, France
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Eisinger J, Dall M, Fogler J, Holzinger D, Fellinger J. Intellectual Disability Profiles, Quality of Life and Maladaptive Behavior in Deaf Adults: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9919. [PMID: 36011569 PMCID: PMC9407810 DOI: 10.3390/ijerph19169919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/05/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
Individuals who are prelingually deaf and have intellectual disabilities experience great challenges in their language, cognitive and social development, leading to heterogeneous profiles of intellectual and adaptive functioning. The present study describes these profiles, paying particular attention to domain discrepancies, and explores their associations with quality of life and maladaptive behavior. Twenty-nine adults with prelingual deafness (31% female) and mild intellectual functioning deficits (mean IQ = 67.3, SD = 6.5) were administered the Vineland Adaptive Behavior Scales-II (VABS-II) and an adapted sign language version of a quality of life scale (EUROHIS-QOL 8). Intellectual disability domain discrepancies were characterized as at least one standard deviation difference between the social domain and IQ and the practical domain and IQ, and a significant difference, according to the VABS-II manual, between the social and practical domains. Domain discrepancies were found between intellectual functioning and both the practical (58.6%) and social domain (65.5%). A discrepancy between intellectual and social functioning was significantly associated with a higher level of internalizing maladaptive behavior (T = 1.89, p < 0.05). The heterogeneous profiles highlight the importance of comprehensive assessments for adequate service provision.
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Affiliation(s)
- Johanna Eisinger
- Research Institute for Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria
| | - Magdalena Dall
- Research Institute for Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria
| | - Jason Fogler
- Research Institute for Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Leadership Education in Neurodevelopmental and Related Disabilities/Institute for Community Inclusion (LEND/ICI), Boston Children’s Hospital, Boston, MA 02115, USA
| | - Daniel Holzinger
- Research Institute for Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Institute of Linguistics, University of Graz, 8010 Graz, Austria
| | - Johannes Fellinger
- Research Institute for Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Division of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria
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4
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Wong NM, Dipasquale O, Turkheimer F, Findon JL, Wichers RH, Dimitrov M, Murphy CM, Stoencheva V, Robertson DM, Murphy DG, Daly E, McAlonan GM. Differences in social brain function in autism spectrum disorder are linked to the serotonin transporter: A randomised placebo-controlled single-dose crossover trial. J Psychopharmacol 2022; 36:723-731. [PMID: 35491679 DOI: 10.1177/02698811221092509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Alterations in the serotonergic control of brain pathways responsible for facial emotion processing in people with autism spectrum disorder (ASD) may be a target for intervention. However, the molecular underpinnings of autistic-neurotypical serotonergic differences are challenging to access in vivo. Receptor-Enriched Analysis of functional Connectivity by Targets (REACT) has helped define molecular-enriched functional magnetic resonance imaging (fMRI) brain networks based on a priori information about the spatial distribution of neurochemical systems from available PET templates. METHODS We used REACT to estimate the dominant fMRI signal related to the serotonin (5-HT) transporter (SERT) distribution during processing of aversive facial emotion in adults with and without ASD. We first predicted a group difference in baseline (placebo) functioning of this system. We next used a single 20 mg oral dose of citalopram, a serotonin reuptake inhibitor, to test the hypothesis that network activity in people with and without ASD would respond differently to inhibition of SERT. To confirm the specificity of our findings, we also repeated the analysis with 5-HT1A, 5-HT1B, 5-HT2A and 5-HT4 receptor maps. RESULTS Using REACT with the SERT map, we found a baseline group difference in the SERT-enriched response to faces in the ventromedial prefrontal cortex. A single oral dose of citalopram 'shifted' the response in the ASD group towards the neurotypical baseline but did not alter response in the control group. Similar differences in SERT-enriched response were observed after controlling for other 5-HT maps. CONCLUSIONS Our findings suggest that the SERT-enriched functional network is dynamically different in ASD during processing of socially relevant stimuli. Whether this acute neurobiological response to citalopram in ASD translates to a clinical target will be an important next step.
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Affiliation(s)
- Nichol Ml Wong
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Biomedical Research Centre for Mental Health, Institute of Psychiatry, Psychology & Neuroscience, South London and Maudsley NHS Foundation Trust, UK.,Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ottavia Dipasquale
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Federico Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - James L Findon
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Robert H Wichers
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Behavioural Genetics Clinic, Adult Autism and ADHD Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Mihail Dimitrov
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Clodagh M Murphy
- Behavioural Genetics Clinic, Adult Autism and ADHD Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Vladimira Stoencheva
- Behavioural Genetics Clinic, Adult Autism and ADHD Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Dene M Robertson
- Behavioural Genetics Clinic, Adult Autism and ADHD Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Declan G Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Biomedical Research Centre for Mental Health, Institute of Psychiatry, Psychology & Neuroscience, South London and Maudsley NHS Foundation Trust, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Eileen Daly
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Grainne M McAlonan
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Biomedical Research Centre for Mental Health, Institute of Psychiatry, Psychology & Neuroscience, South London and Maudsley NHS Foundation Trust, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
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5
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Torres A, Lecusay D, Valdez D, Rosoli A, Garrido G, Cukier S, Paula CS, Garcia R, Rattazzi A, Montiel-Nava C. Use of allied-health services and medication among adults with ASD in Latin America. Autism Res 2021; 14:2200-2211. [PMID: 34338424 DOI: 10.1002/aur.2583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 07/04/2021] [Accepted: 07/17/2021] [Indexed: 11/10/2022]
Abstract
ASD is a neurodevelopmental disorder that affects people across the entire lifespan, yet most of the research identifying the health and medical needs for autistic individuals have been among minors. As individuals with ASD transition to emerging adulthood, the services, already limited, become less available. This study aimed to identify the use of services for Latin American adults on the spectrum. We surveyed 295 caregivers of adults with ASD from six Latin American countries. Comparing the results for all the possible services observed in this study, the adults in our sample were primarily underserved: 84.4%-95.9% were receiving zero hours per week, 3.7%-12.9% 1%-10 h, 0%-1.7% 11-20, and only 0%-1% above 20 h of services. Almost half of the sample used medication, and neurologists were the most consulted health providers. Next to inexistent health care usage in Latin American adults with ASD highlights socioeconomic and health disparities in service provision for ASD in the region. The lack of services places adults with ASD in Latin America at a higher risk of worse symptom severity than autistic adults from regions with broader access to services. LAY SUMMARY: This study aimed to identify the quantity of services received by adults with autism in Latin America. Most of our sample was not receiving health services yet almost half had access to medication. This could mean that adults with autism in Latin America are at higher risk for poorer health.
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Affiliation(s)
- Andy Torres
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Denise Lecusay
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Daniel Valdez
- Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Analía Rosoli
- Organización Estados Iberoamericanos para la Educación la Ciencia y la Cultura (OEI), Santo Domingo, Dominican Republic
| | | | - Sebastián Cukier
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista, Buenos Aires, Argentina
| | - Cristiane Silvestre Paula
- Programa de Pós-Graduação em Distúrbios do Desenvolvimento Universidade Presbiteriana Mackenzie (UPM), São Paulo, SP, Brazil
| | | | - Alexia Rattazzi
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista, Buenos Aires, Argentina
| | - Cecilia Montiel-Nava
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, Texas, USA
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6
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Enticott PG, Barlow K, Guastella AJ, Licari MK, Rogasch NC, Middeldorp CM, Clark SR, Vallence AM, Boulton KA, Hickie IB, Whitehouse AJO, Galletly C, Alvares GA, Fujiyama H, Heussler H, Craig JM, Kirkovski M, Mills NT, Rinehart NJ, Donaldson PH, Ford TC, Caeyenberghs K, Albein-Urios N, Bekkali S, Fitzgerald PB. Repetitive transcranial magnetic stimulation (rTMS) in autism spectrum disorder: protocol for a multicentre randomised controlled clinical trial. BMJ Open 2021; 11:e046830. [PMID: 34233985 PMCID: PMC8264904 DOI: 10.1136/bmjopen-2020-046830] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION There are no well-established biomedical treatments for the core symptoms of autism spectrum disorder (ASD). A small number of studies suggest that repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technique, may improve clinical and cognitive outcomes in ASD. We describe here the protocol for a funded multicentre randomised controlled clinical trial to investigate whether a course of rTMS to the right temporoparietal junction (rTPJ), which has demonstrated abnormal brain activation in ASD, can improve social communication in adolescents and young adults with ASD. METHODS AND ANALYSIS This study will evaluate the safety and efficacy of a 4-week course of intermittent theta burst stimulation (iTBS, a variant of rTMS) in ASD. Participants meeting criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ASD (n=150, aged 14-40 years) will receive 20 sessions of either active iTBS (600 pulses) or sham iTBS (in which a sham coil mimics the sensation of iTBS, but no active stimulation is delivered) to the rTPJ. Participants will undergo a range of clinical, cognitive, epi/genetic, and neurophysiological assessments before and at multiple time points up to 6 months after iTBS. Safety will be assessed via a structured questionnaire and adverse event reporting. The study will be conducted from November 2020 to October 2024. ETHICS AND DISSEMINATION The study was approved by the Human Research Ethics Committee of Monash Health (Melbourne, Australia) under Australia's National Mutual Acceptance scheme. The trial will be conducted according to Good Clinical Practice, and findings will be written up for scholarly publication. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12620000890932).
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Affiliation(s)
- Peter G Enticott
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Karen Barlow
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Adam J Guastella
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Melissa K Licari
- Telethon Kids Institute, Perth, Western Australia, Australia
- University of Western Australia, Crawley, Western Australia, Australia
| | - Nigel C Rogasch
- Discipline of Psychiatry, The University of Adelaide, Adelaide, South Australia, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Christel M Middeldorp
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Scott R Clark
- Discipline of Psychiatry, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ann-Maree Vallence
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Murdoch, Western Australia, Australia
- Discipline of Psychology, Murdoch University, Murdoch, Western Australia, Australia
| | - Kelsie A Boulton
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Centre, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Andrew J O Whitehouse
- Telethon Kids Institute, Perth, Western Australia, Australia
- University of Western Australia, Crawley, Western Australia, Australia
| | - Cherrie Galletly
- Discipline of Psychiatry, The University of Adelaide, Adelaide, South Australia, Australia
| | - Gail A Alvares
- Telethon Kids Institute, Perth, Western Australia, Australia
- University of Western Australia, Crawley, Western Australia, Australia
| | - Hakuei Fujiyama
- Discipline of Psychology, Murdoch University, Murdoch, Western Australia, Australia
| | - Helen Heussler
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Jeffrey M Craig
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Melissa Kirkovski
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Natalie T Mills
- Discipline of Psychiatry, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nicole J Rinehart
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Krongold Clinic, Monash Education, Monash University, Clayton, Victoria, Australia
| | - Peter H Donaldson
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Talitha C Ford
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre for Human Psychopharmacology, Faculty of Heath, Arts and Design, Swinburne University of Technology, Melbourne, Victoria, Australia
| | | | | | - Soukayna Bekkali
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Paul B Fitzgerald
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare, Camperwell, Victoria, Australia
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Dallman AR, Bailliard A, Harrop C. Identifying Predictors of Momentary Negative Affect and Depression Severity in Adolescents with Autism: An Exploratory Ecological Momentary Assessment Study. J Autism Dev Disord 2021; 52:291-303. [PMID: 33677729 PMCID: PMC7970812 DOI: 10.1007/s10803-021-04935-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/28/2022]
Abstract
Depression is a common comorbidity in autism spectrum disorder (ASD). Little is known about risk factors for depression and depressive symptoms in this population. Ecological momentary assessment (EMA) has been used in the typically developing population to identify risk factors for depression, but has been rarely applied in ASD populations. In this exploratory study, 17 autistic adolescents participated in an EMA protocol in which they reported on their current activities and emotions six times per day for seven consecutive days. Results suggested that negative affect is predicted by momentary quality of social interaction and enjoyment of the current activity (p < 0.05). Additionally, affective instability predicted depressive symptoms. These results provide insights into risk factors for depression in this vulnerable population.
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Affiliation(s)
- Aaron R Dallman
- Department of Occupational Therapy and Occupational Science, College of Health Professions, Towson University, 8000 York Rd, Towson, MD, USA.
| | - Antoine Bailliard
- Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Clare Harrop
- Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Depression symptoms in adolescents with autism spectrum disorder: A contextual approach to mental health comorbidities. J Adolesc 2020; 85:120-125. [PMID: 33176214 DOI: 10.1016/j.adolescence.2020.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Although research on mental health comorbidities in autism spectrum disorder (ASD) has increased in recent years, little has been done to evaluate potential individual × environment interactions associated with these comorbidities. The current study explored whether ASD-related characteristics (social-communication impairment) and environmental factors (peer and family contexts) had additive or interactive effects on the depression symptoms of youth with ASD. METHOD In a cross-sectional sample of adolescents with ASD (N = 176; 13-17 years old; 72.7% male), primary caregivers and adolescents responded to a series of surveys online pertaining to adolescents' mental health (Revised Child Anxiety and Depression Scale), family functioning (Self-Report of Family Inventory), and experiences of peer victimization (Peer Experiences Questionnaire-Revised). RESULTS There were statistically significant interactions between social-communication skills and the environment in both family (△R2 = 0.02) and peer (△R2 = 0.02) contexts. For youth with better social-communication skills, there was a positive association between peer victimization and depression symptoms and a negative association between family competence and depression symptoms. CONCLUSION Findings support social-push interactive models in which better social-communication skills are associated with fewer depression symptoms in the context of less-stressful peer and family environments, highlight the utility of ecologically informed approaches to the mental health of youth with ASD, and suggest several areas for future study.
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