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Corbett BA, McGonigle T, Muscatello RA, Liu J, Vandekar S. The developmental trajectory of diurnal cortisol in autistic and neurotypical youth. Dev Psychopathol 2023:1-12. [PMID: 37435752 PMCID: PMC10784411 DOI: 10.1017/s0954579423000810] [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: 07/13/2023]
Abstract
Increasing age and puberty affect the hypothalamic pituitary adrenal (HPA) axis maturation, which is likely associated with an increase in environmental demands (e.g., social) and vulnerability for the onset of psychiatric conditions (e.g., depression). There is limited research as to whether such patterns are consonant in youth with autism spectrum disorder (ASD), a condition marked by social challenges, dysregulation of the HPA axis, and higher rates of depression setting the stage for enhanced vulnerability during this developmental period.The current study interrogated diurnal cortisol by examining (1) cortisol expression longitudinally over the pubertal transition between autistic and neurotypical youth, (2) the trajectory of diurnal cortisol and the unique contributions of age vs. puberty, and (3) potential sex differences. As hypothesized, results indicate autistic compared to typically developing youth demonstrate a shallower diurnal slope and elevated evening cortisol. These differences were in the context of higher cortisol and flatter rhythms based on age and pubertal development. Also, sex-based differences emerged such that females in both groups had higher cortisol, flatter slopes, and higher evening cortisol than males. The results show that despite the trait-like stability of diurnal cortisol, HPA maturation is impacted by age, puberty, sex, as well as an ASD diagnosis.
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Affiliation(s)
- Blythe A. Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Trey McGonigle
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachael A. Muscatello
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jinyuan Liu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
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Corbett BA, Muscatello RA, Klemencic ME, West M, Kim A, Strang JF. Greater gender diversity among autistic children by self-report and parent-report. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:158-172. [PMID: 35363085 PMCID: PMC9525458 DOI: 10.1177/13623613221085337] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
LAY ABSTRACT Gender diversity broadly refers to the way in which an individual experiences (expressions and/or identities) their gender distinctly to that which would be expected based upon social norms for their gender assigned at birth. Recent research has shown a higher representation of gender diversity among autistic youth. Previous research in this area has relied on parent-report based on a single question from the Child Behavior Checklist Item-110, asking whether their child "Wishes to be the opposite sex." The Gender Diversity Screening Questionnaire Self-Report and Parent-Report were used to assess the experience of gender diversity in 244 children (140 autism spectrum disorder and 104 typically developing) between 10 and 13 years. The Item-110 was also collected. Results showed that autistic children endorsed much higher rates of Binary Gender Diversity (less identification with their designated sex and more with the other binary sex) and Nonbinary Gender Diversity (identification as neither male nor female) than typically developing children. Similarly, parents of autistic children reported significantly more gender-body incongruence experienced by their child than parents of typically developing children. Specifically, parents of autistic females-assigned-at-birth reported significantly more gender-body incongruence than autistic males-assigned-at-birth. Parent- and self-report measures were largely related. Moreover, statistical comparisons between and within the groups revealed associations between gender profiles and symptoms of anxiety, depression, and suicidality. Results extend previous reports showing increased rates of gender diversity in autistic children, now based on both self-report and parent-report, and highlight the need to better understand and support the unique and complex needs of autistic children who experience gender diversity.
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Affiliation(s)
- Blythe A. Corbett
- Vanderbilt University Medical Center, Department of
Psychiatry and Behavioral Sciences,Vanderbilt Kennedy Center
| | - Rachael A. Muscatello
- Vanderbilt University Medical Center, Department of
Psychiatry and Behavioral Sciences
| | - Mark E. Klemencic
- Vanderbilt University Medical Center, Department of
Psychiatry and Behavioral Sciences
| | - Millicent West
- Vanderbilt University Medical Center, Department of
Psychiatry and Behavioral Sciences
| | - Ahra Kim
- Vanderbilt University Medical Center, Department of
Biostatistics
| | - John F. Strang
- Gender and Autism Program, Children’s National
Hospital,Departments of Pediatrics, Psychiatry, and Behavioral
Science, George Washington University School of Medicine
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Rinaldi A, Martins MCM, Maioli M, Rinaldi S, Fontani V. REAC Noninvasive Neurobiological Stimulation in Autism Spectrum Disorder for Alleviating Stress Impact. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 7:244-251. [PMID: 36213521 PMCID: PMC9525921 DOI: 10.1007/s41252-022-00293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 05/05/2023]
Abstract
Objectives Autism spectrum disorder (ASD) symptoms can become more evident because of different factors. Among these, depression, anxiety, and stress play an important role. Additionally, several studies have revealed the impact of the COVID-19 pandemic on participants with ASD. In previous studies, two noninvasive neurobiological stimulation treatments with radio electric asymmetric conveyer (REAC) technology, called neuropostural optimization (NPO) and neuropsychophysical optimization (NPPO), were shown to be effective in improving the subjective response to environmental stressors in the general population and in ASD population. Based on the proven efficacy of REAC NPO and NPPOs treatments in alleviating anxiety, stress, and depression, the purpose of this study is to verify how these treatments can reduce the severity of ASD symptoms expression, which is aggravated by depression, anxiety, and stress. The treatments' effects were perceived by caregivers and assessed by the Autism Treatment Evaluation Checklist (ATEC). Methods This study involved 46 children with a previous diagnosis of ASD made using the Autism Diagnostic Observation Schedule and Autism Diagnostic Interview-Revised. The participants received one session of NPO treatment and one NPPOs treatment cycle of 18 sessions, administered within approximately 3 weeks. The Autism Treatment Evaluation Checklist (ATEC) was used to evaluate the efficacy of the REAC treatments. ATEC allows to evaluate four clusters (speech or language communication; sociability; sensory or cognitive awareness; and health/physical/behavior) through a numerical scale that measures increasing levels of ASD severity. Results The comparison between the scores of the ATEC administered pre- and post-REAC treatments highlighted an improvement of ASD symptoms in each of the four clusters of ATEC. Conclusions The results confirm the usefulness of REAC treatments to optimize the individual response to environmental stressors and reduce the symptomatic expression and deficits present in ASD.
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Affiliation(s)
- Arianna Rinaldi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
| | - Márcia C. Marins Martins
- International Scientific Society of Neuro Psycho Physical Optimization With REAC Technology, Brazilian Branch, São Paulo, Brazil
| | - Margherita Maioli
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Salvatore Rinaldi
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
- Research Department, Rinaldi Fontani Foundation, Florence, Italy
| | - Vania Fontani
- Department of Adaptive Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy
- Research Department, Rinaldi Fontani Foundation, Florence, Italy
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Corbett BA, Muscatello RA, Kim A, Vandekar S, Duffus S, Sparks S, Tanguturi Y. Examination of pubertal timing and tempo in females and males with autism spectrum disorder compared to typically developing youth. Autism Res 2022; 15:1894-1908. [PMID: 35912944 PMCID: PMC9561009 DOI: 10.1002/aur.2786] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/15/2022] [Indexed: 11/11/2022]
Abstract
Autism spectrum disorder (ASD) is characterized by impaired social communication and poor adaptation to change; thus, pubertal development may be precarious. Pubertal timing and tempo were measured in 244 youth (7.9% Black, 83.3% White, and 8.7% multiracial) with ASD (N = 140) and typical development (N = 104). Pubertal development was measured using Tanner staging of Genital (G, males), Breast (B, females), and pubic hair (PH) in both sexes at Year 1 (10-13 years), Year 2 (11-14 years), and Year 3 (12-15 years). Nonlinear mixed effects models analyzed interindividual differences in timing and tempo. For both sexes, ASD and higher body mass index were associated with earlier pubertal timing. Males generally exhibited faster tempo than females. Linear regression models did not show associations between pubertal timing and internalizing symptoms at time three. Findings showing advanced pubertal maturation in ASD youth suggest greater risk of psychological, social, and physiological challenges. LAY SUMMARY: Youth with ASD have difficulty in social communication and adaption to change, thus puberty may be a challenging transition. The study examined onset (timing) and progression (tempo) of puberty over three years, using physical exam, in 244 adolescents with and without ASD, enrolled at ages 10-13. ASD youth started puberty earlier, while males generally progressed at a faster pace. Further examination of puberty in ASD should identify impact on social, behavioral, and mental health outcomes.
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Affiliation(s)
- Blythe A. Corbett
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center
- Vanderbilt University, Department of Psychology
| | - Rachael A. Muscatello
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
| | - Ahra Kim
- Vanderbilt University Medical Center, Department of Biostatistics
| | - Simon Vandekar
- Vanderbilt University Medical Center, Department of Biostatistics
| | - Sara Duffus
- Vanderbilt University Medical Center, Department of Pediatrics
| | - Sloane Sparks
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
| | - Yasas Tanguturi
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
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Muscatello RA, Kim A, Vandekar S, Corbett BA. Diagnostic and Physical Effects in Parasympathetic Response to Social Evaluation in Youth With and Without Autism Spectrum Disorder. J Autism Dev Disord 2022; 52:3427-3442. [PMID: 34342805 PMCID: PMC8810894 DOI: 10.1007/s10803-021-05224-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 01/06/2023]
Abstract
Individuals with autism spectrum disorder (ASD) may demonstrate atypical autonomic (ANS) responses; however, research remains inconsistent. This study examined parasympathetic response during social evaluation in 241 youth (10-13 years) with ASD (n = 138) or typical development (TD; n = 103). Diagnosis, age, pubertal development, and body mass index (BMI) were hypothesized to be associated with ANS function. Linear mixed effects models demonstrated lower RSA in ASD relative to TD in a base model with no covariates. However, when accounting for differences in BMI, there was no evidence of atypical parasympathetic regulation in youth with ASD. As lower parasympathetic regulation may increase susceptibility for a number of conditions, it will be important to elucidate the link between BMI and the ANS, especially in ASD.
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Affiliation(s)
- Rachael A. Muscatello
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, Nashville, TN,Correspondence to: Rachael A. Muscatello, Ph.D., Vanderbilt University Medical Center, 1500 21 Avenue South, Nashville, TN 37212, , Tel: (615) 343-2207, Fax: (615) 322-8236
| | - Ahra Kim
- Vanderbilt University Medical Center, Department of Biostatistics, Nashville, TN
| | - Simon Vandekar
- Vanderbilt University Medical Center, Department of Biostatistics, Nashville, TN
| | - Blythe A. Corbett
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, Nashville, TN,Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN,Vanderbilt University, Department of Psychology, Nashville, TN
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Wong ASK, Burns S, Woodruff E. Examining the impact of social stressor stimuli in eliciting physiological reactivity in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e060048. [PMID: 35768097 PMCID: PMC9244685 DOI: 10.1136/bmjopen-2021-060048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Stress is not experienced the same by everyone. Some individuals, such as individuals with autism spectrum disorder (ASD), are at risk of heightened sensitivity to stress responses. ASD is a neurodevelopmental disorder commonly characterised by deficits in social communication and social interaction. Among different stressor stimuli, social stressors are particularly worth our attention due to the social and communication challenges inherent in ASD. This study aims to systematically evaluate different social stressor stimuli in eliciting physiological reactivity in ASD, focusing on the children and adolescent population. METHODS AND ANALYSIS We designed a study protocol for this study and submitted it to PROSPERO for systematic review registration. Any studies with children and adolescents with ASD between the ages of 0 and 18 in clinical and community settings will be included. All types of social stressor interventions will be included. The outcome of interest will include studies with physiological activity of the participants being measured, for example, measures related to autonomic functioning, electrodermal functioning and cortisol level. The primary literature sources will be across four electronic databases: MEDLINE, Embase, PsycInfo and CINAHL in August 2021. The second source of literature will be across grey literature, including ProQuest Dissertations & Theses Global and across clinical trial registries in August 2021. Hand searching of references will be performed on the reference lists of all included studies. Two volunteers pursuing postgraduate-level studies will independently search and screen potential studies for eligibility. Finally, all references considered by hand searching will be reviewed by two researchers. The methodological quality of the research will be assessed by adopting the quality assessment used by a previous study. The assessment consists of four primary categories: descriptive validity, internal validity, external validity and statistical conclusion validity. ETHICS AND DISSEMINATION No ethical approval is required for this study. Results will be disseminated through conferences and publications in relevant peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42021244039.
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Affiliation(s)
- Agnes S K Wong
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Samantha Burns
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Earl Woodruff
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
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Tajik-Parvinchi D, Rosenbaum P, Hidecker MJC, Duku E, Zwaigenbaum L, Roncadin C, Georgiades S, Gentles S, Fang H, Di Rezze B. Construct Validity of the Autism Classification System of Functioning: Social Communication (ACSF:SC) Across Childhood and Adolescence. J Autism Dev Disord 2022:10.1007/s10803-022-05608-w. [PMID: 35666330 DOI: 10.1007/s10803-022-05608-w] [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: 05/07/2022] [Indexed: 11/24/2022]
Abstract
This study examined the construct validity of the Autism Classification System of Functioning: Social Communication (ACSF). Participants included 145 parents of children with autism (2-19 years). The degree of convergent and discriminant validity between parent reported ACSF and subscales from Social Responsiveness Scale 2nd edition and Behavior Assessment System for Children, 3rd Edition were examined against a priori hypotheses. We examined construct validity in the entire sample as well as in specific age cohorts. Our findings suggest that ACSF can provide a valid classification system of social communication ability in children with autism 2-19 years of age, and its two subscales may be used to examine different aspects of social communication ability.
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Affiliation(s)
- Diana Tajik-Parvinchi
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 436, L8S 1C7, Hamilton, ON, Canada.
- School of Rehabilitation Sciences, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, Room 436, 1400 Main St. W, L8S 1C7, Hamilton, ON, Canada.
| | - Peter Rosenbaum
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 408, L8S 1C7, Hamilton, Ontario, Canada
| | - Mary Jo Cooley Hidecker
- Department of Communication Science & Disorders, College of Health Sciences, University of Kentucky, 900 South Limestone, 40508, Lexington, KY, USA
| | - Eric Duku
- Department of Psychiatry & Behavioural Neurosciences, Faulty of Health Sciences, 1280 Main Street West, L8S 4L8, McMaster, Hamilton, Ontario, Canada
| | - Lonnie Zwaigenbaum
- Autism Research Center, Glenrose Rehabilitation Hospital, Room E209, 10230 111 Avenue, T5G 0B7, Edmonton, Alberta, Canada
| | - Caroline Roncadin
- Ron Joyce Children's Health Centre, Hamilton Health Sciences, 325 Wellington Street North, L8L 0A4, Hamilton, Ontario, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, 1280 Main Street West, MIP 201A, L8P 0A1, Hamilton, Ontario, Canada
| | - Stephen Gentles
- Department of Community Health, Faculty of Human and Social Sciences, Wilfrid Laurier University, 75 University Avenue West, N2L 3C5, Waterloo, Ontario, Canada
| | - Hanna Fang
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 436, L8S 1C7, Hamilton, ON, Canada
| | - Briano Di Rezze
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 436, L8S 1C7, Hamilton, ON, Canada
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Makris G, Agorastos A, Chrousos GP, Pervanidou P. Stress System Activation in Children and Adolescents With Autism Spectrum Disorder. Front Neurosci 2022; 15:756628. [PMID: 35095389 PMCID: PMC8793840 DOI: 10.3389/fnins.2021.756628] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
The mission of the human stress system is the maintenance of homeostasis in the presence of real or perceived, acute or chronic stressors. The hypothalamic–pituitary–adrenal (HPA) axis and the autonomic nervous system (ANS) are the stress system-related neuroendocrine pathways. There is abundant evidence that children and adolescents with autism spectrum disorder (ASD) may exhibit atypical function within the HPA axis and the ANS both at the resting state and during the presence of social and/or non-social stressors. The aim of this review is to provide an up-to-date summary of the findings regarding stress system alterations in children and adolescents with ASD. We focus on the variations of stress hormones circadian rhythms, specifically cortisol and alpha-amylase (i.e., a surrogate index of epinephrine/norepinephrine secretion), and on the alterations of stress system responsivity to different stressors. Also, we present imaging and immunological findings that have been associated with stress system dysregulation in children and adolescents with ASD. Finally, we review the pivotal role of HPA axis-ANS coordination, the developmental trajectory of the stress system in ASD, and the possible role of early life stress in the dysregulation of the stress system demonstrated in children and adolescents with ASD. This synthesis will hopefully provide researchers with a foundation for an integrated approach to future research into stress system variations in children and adolescents with ASD.
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Affiliation(s)
- Gerasimos Makris
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, “Aghia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- *Correspondence: Gerasimos Makris,
| | - Agorastos Agorastos
- Department of Psychiatry II, Division of Neurosciences, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George P. Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, “Aghia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Zhao L, Li Y, Kou X, Chen B, Cao J, Li J, Zhang J, Wang H, Zhao J, Shi S. OUP accepted manuscript. Stem Cells Transl Med 2022; 11:778-789. [PMID: 35608372 PMCID: PMC9299510 DOI: 10.1093/stcltm/szac028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/01/2022] [Indexed: 11/14/2022] Open
Abstract
Mesenchymal stem cell-based therapy has emerged as a great potential approach to treat individuals with autism spectrum disorders (ASD), a group of developmental disabilities characterized by impairments in social interaction and communication. Stem cells from human exfoliated deciduous teeth (SHED), holding earlier developing characteristics, have immune-modulatory and anti-inflammatory properties. To investigate whether SHED transplantation can rescue autistic-like symptoms in SHANK3 mutant beagle dogs, 12 SHANK3 mutant beagle dogs were randomly assigned into 2 groups according to their behavior evaluated by social interaction tests. Six mutant dogs received 6 intravenous infusions of SHED and were followed up for 3 months by testing social interaction and inflammatory cytokine levels. We found that infusion of SHED significantly improved impaired social novel preference of SHANK3 mutant beagle dogs at 1- and 3-month follow-ups. Social intimacies (following, sniffing, and licking) between mutant beagle dogs and human experimenters were partly improved. Stressed tail posture, indicating social stress, was also significantly alleviated. In addition, we showed that the levels of serum interferon-γ and interleukin-10 were notably increased and decreased, respectively, in SHANK3 mutant beagle dogs. Infusion of SHED was able to rescue altered interferon-γ and interleukin-10 levels. We failed to observe any serious adverse events after infusion of SHED. In summary, SHED transplantation may be a safe and effective therapy for ASD. The correction in the levels of serum interferon-γ and interleukin-10 may serve as an index to predict autistic severity and therapeutic outcomes.
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Affiliation(s)
- Lu Zhao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, South China Center of Craniofacial Stem Cell Research, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, People’s Republic of China
| | - Yuan Li
- Beijing Sinogene Biotechnology Co. Ltd, Changping District, Beijing, People’s Republic of China
| | - Xiaoxing Kou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, South China Center of Craniofacial Stem Cell Research, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, People’s Republic of China
- Key Laboratory of Stem Cells and Tissue Engineering (Sun Yat-sen University), Ministry of Education, Guangzhou, People’s Republic of China
| | - Benchi Chen
- Beijing Sinogene Biotechnology Co. Ltd, Changping District, Beijing, People’s Republic of China
| | - Jing Cao
- CAR-T (Shanghai) Biotechnology Co. Ltd, Yangpu District, Shanghai, People’s Republic of China
| | - Jun Li
- Key Laboratory of Stem Cells and Tissue Engineering (Sun Yat-sen University), Ministry of Education, Guangzhou, People’s Republic of China
| | - Jianqi Zhang
- Beijing Sinogene Biotechnology Co. Ltd, Changping District, Beijing, People’s Republic of China
| | - Heng Wang
- Beijing Sinogene Biotechnology Co. Ltd, Changping District, Beijing, People’s Republic of China
| | - Jianping Zhao
- Beijing Sinogene Biotechnology Co. Ltd, Changping District, Beijing, People’s Republic of China
| | - Songtao Shi
- Corresponding author: Songtao Shi, South China Center of Craniofacial Stem Cell Research, Guanghua School and Hospital of Stomatology, Sun Yat-sen University, 74 Zhongshan 2 Road, Guangzhou, Guangdong 510080, People’s Republic of China. Tel: +86 020 83811509; Fax: +86 020 83811509;
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A huggable device can reduce the stress of calling an unfamiliar person on the phone for individuals with ASD. PLoS One 2021; 16:e0254675. [PMID: 34297735 PMCID: PMC8301655 DOI: 10.1371/journal.pone.0254675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/30/2021] [Indexed: 11/19/2022] Open
Abstract
Individuals with autism spectrum disorders (ASD) are often not comfortable during mobile-phone conversations with unfamiliar people. “Hugvie” is a pillow with a human-like shape that has been designed to provide users with the tactile sensation of hugging another person during phone conversations to promote feelings of comfort and trust in the speaker toward their conversation partners. Our primary aim was to examine whether physical contact by hugging a Hugvie could reduce the stress of speaking with an unfamiliar person on the phone in individuals with ASD. We enrolled 24 individuals and requested them to carry out phone conversations either using only a mobile phone or using a mobile phone along with the Hugvie. All participants in both groups completed questionnaires designed to evaluate their self-confidence while talking on the phone, and also provided salivary cortisol samples four times each day. Our analysis revealed that the medium of communication was a significant factor, indicating that individuals with ASD who spoke with an unfamiliar person on the phone while hugging a Hugvie had stronger self-confidence and lower stress levels than those who did not use Hugvie. Hence, we recommend that huggable devices be used as adjunctive tools to support individuals with ASD during telephonic conversations with unfamiliar people.
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11
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Corbett BA, Muscatello RA, Klemencic ME, Schwartzman JM. The impact of COVID-19 on stress, anxiety, and coping in youth with and without autism and their parents. Autism Res 2021; 14:1496-1511. [PMID: 33913261 PMCID: PMC8237027 DOI: 10.1002/aur.2521] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/06/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022]
Abstract
In the wake of COVID-19, the world has become a more uncertain environment-a breeding ground for stress and anxiety, especially for individuals with autism spectrum disorder (ASD). The study examined stress, anxiety, and coping in a data-driven, real-time assessment of 122 youth with and without ASD and their parents at the height of the COVID-19 shutdown and three-months later. Standardized measures were administered to ascertain stress and coping explicitly related to the pandemic (RSQ COVID-19-Child [self-report], Adult [self-report from the guardian of youth], Parent [report about child]) and anxiety (STAI-C, STAI-A). Multivariate, univariate analyses of variance and hierarchical regression were used. ASD youth endorsed more Trait anxiety and response to specific stressors (e.g., virus). Caregivers of youth with ASD (Adults) self-reported higher anxiety, yet scores were elevated for both groups. Adults of youth with ASD reported more stress, especially related to the virus, access to healthcare, and concern for the future. In the TD group, youth and adults used more Primary and Secondary Control Coping whereas ASD youth and adults used more Disengagement Coping. Adult stress was the primary predictor of parent perception of child stress as well as Child self-reported stress. While the ASD group was consistently high compared to the TD group, there were no significant changes over time for stress or anxiety. Results reveal striking differences in youth with ASD and their parents regarding stress, anxiety, and coping. Findings highlight the need for essential support, access to services, and strategies to enhance psychological and emotional well-being. LAY SUMMARY: This study examined stress, anxiety, and coping related to the COVID-19 pandemic in 61 youth with autism spectrum disorder (ASD) and 61 youth with typical development (TD) and their parents. Results showed that ASD youth reported more anxiety and stress. Adults of youth with ASD indicated higher self-reported anxiety and stress than adults of TD youth. TD youth and their parents reported using more adaptive coping strategies. Findings highlight the need for strategies to enhance psychological and emotional well-being.
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Affiliation(s)
- Blythe A. Corbett
- Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt University Medical Center, Vanderbilt Kennedy CenterNashvilleTennesseeUSA
- Department of PsychologyVanderbilt UniversityNashvilleTennesseeUSA
| | - Rachael A. Muscatello
- Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Mark E. Klemencic
- Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Jessica M. Schwartzman
- Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
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Operationalizing Social Communication in Autism and Related Neurodevelopmental Research: a Scoping Review Over 20 Years. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2021. [DOI: 10.1007/s40474-021-00224-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Corbett BA, Muscatello RA, Kim A, Patel K, Vandekar S. Developmental effects in physiological stress in early adolescents with and without autism spectrum disorder. Psychoneuroendocrinology 2021; 125:105115. [PMID: 33352474 PMCID: PMC7904615 DOI: 10.1016/j.psyneuen.2020.105115] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/10/2020] [Accepted: 12/13/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Humans place high value on how they are socially evaluated by others. The Trier Social Stress Test (TSST) is a well-established measure of social evaluative threat that promotes activation of the hypothalamic pituitary adrenal (HPA) axis and release of cortisol. Higher cortisol responses in typically developing (TD) adolescents are influenced by age and pubertal development especially in later stages. Children with ASD have been shown to exhibit blunted cortisol in response to the TSST although adults with ASD show a more prototypical response. The current study examined physiological stress in early adolescents with ASD and TD. It was hypothesized that TD youth would show elevated cortisol in response to the TSST influenced by age and pubertal stage. In contrast, youth with ASD would show a more diminished stress response yet still show effects for age and pubertal development METHODS: The sample included 241 youth, 138 with ASD (median age=11.25) and 103 TD (median age=11.67). Standardized diagnostic and pubertal development (genital/breast (GB), and pubic hair (PH) stage) physical exams were performed. Salivary cortisol was collected before and after the TSST. Linear mixed effects models examined the effects of baseline cortisol, time, age, sex, pubertal stage, and diagnosis. RESULTS We did not find an effect of early pubertal development stage (GB or PH) on cortisol response. There was an interaction between age and TSST timepoint, showing stronger effects for older children across the timeline especially during the stressor. Finally, there was a significant diagnosis by TSST timepoint interaction characterized by a blunted cortisol stress response in youth with ASD compared to TD participants who showed higher cortisol. DISCUSSION We found evidence that age contributes to an increase in cortisol in response to social evaluative threat during early adolescence. TD youth exhibit an adaptive elevated stress response to psychosocial threat whereas youth with ASD do not. There may exist a developmental lag in the perception of and stress responsivity to social evaluation which may emerge in older adolescents with ASD.
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Affiliation(s)
- Blythe A. Corbett
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences,Vanderbilt University Medical Center, Vanderbilt Kennedy Center,Vanderbilt University, Department of Psychology
| | - Rachael A. Muscatello
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
| | - Ahra Kim
- Vanderbilt University Medical Center, Department of Biostatistics
| | | | - Simon Vandekar
- Vanderbilt University Medical Center, Department of Biostatistics
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14
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Anesiadou S, Makris G, Michou M, Bali P, Papassotiriou I, Apostolakou F, Korkoliakou P, Papageorgiou C, Chrousos G, Pervanidou P. Salivary cortisol and alpha-amylase daily profiles and stress responses to an academic performance test and a moral cognition task in children with neurodevelopmental disorders. Stress Health 2021; 37:45-59. [PMID: 32608561 DOI: 10.1002/smi.2971] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/16/2020] [Accepted: 06/11/2020] [Indexed: 11/07/2022]
Abstract
There is evidence that children with neurodevelopmental disorders may exhibit atypical responses to stress and alterations in concentrations and diurnal secretion of stress hormones. We assessed diurnal profiles and stress responses of salivary cortisol and alpha-amylase (sAA) in children with attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and specific learning disorder (SLD) compared to typically developing children (TD). A total of 157 children of both sexes, aged between 6 and 12 years old, took part in the study distributed into four groups: ADHD (N = 34), ASD (N = 56), SLD (N = 43) and TD (N = 24). Salivary samples were collected at three time points during a day, as well as before and 5 min after an academic performance test and a moral cognition task. ADHD children had lower evening and diurnal sAA levels, adjusted for age. Also, ASD children showed lower diurnal sAA secretion, adjusted for age. The mean percentage change for salivary cortisol and sAA after both tests did not differ between the groups. In conclusion, we demonstrated alterations in diurnal autonomic functioning in children with ADHD and ASD, while hypothalamic-pituitary-adrenal axis functioning did not differ between the clinical and the comparison groups.
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Affiliation(s)
- Sophia Anesiadou
- Laboratory of Developmental Psychophysiology and Stress Research, Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Gerasimos Makris
- Laboratory of Developmental Psychophysiology and Stress Research, Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Maria Michou
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
| | - Paraskevi Bali
- Laboratory of Developmental Psychophysiology and Stress Research, Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Filia Apostolakou
- Department of Clinical Biochemistry, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Panagiota Korkoliakou
- Second Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Athens, Greece
| | - Charalampos Papageorgiou
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, 'Eginition' University Hospital, Athens, Greece
| | - George Chrousos
- Laboratory of Developmental Psychophysiology and Stress Research, Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Panagiota Pervanidou
- Laboratory of Developmental Psychophysiology and Stress Research, Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
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15
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Albantakis L, Brandi ML, Brückl T, Gebert D, Auer M, Kopczak A, Stalla G, Neumann I, Schilbach L. Oxytocin and cortisol concentrations in adults with and without autism spectrum disorder in response to physical exercise. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 5:100027. [PMID: 35754449 PMCID: PMC9216704 DOI: 10.1016/j.cpnec.2021.100027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/05/2021] [Indexed: 11/18/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder, whose core symptoms consist of deficits in social interaction and communication as well as restricted and repetitive behavior. Brain oxytocin (OXT) has been associated with various prosocial behaviors, and might, therefore, be involved in the pathogenesis of disorders associated with socio-emotional dysfunctions such as ASD. However, significant associations between central and peripheral OXT levels may only be present in response to physiological or stressful stimuli but were not shown under baseline conditions. In this study, we, therefore, investigated salivary and plasma OXT in response to physical exercise in adults with ASD (n = 33, mean age: 36.8 ± 10.7 years) without intellectual impairment (IQ > 70) and neurotypical controls (n = 31, mean age: 31.0 ± 11.7 years). To stimulate the OXT system, we used rapid cycling and measured cortisol (CORT) concentrations to monitor the physiological stress response. When controlling for age, neither salivary OXT (p = .469), plasma OXT (p = .297) nor CORT (p = .667) concentrations significantly differed between groups at baseline. In addition, neither OXT nor CORT concentrations significantly differed between groups after physical exercise. Social anxiety traits were negatively correlated with plasma, but not saliva OXT concentrations in neurotypicals at baseline, while empathetic traits were positively correlated with saliva, but not plasma concentrations in autistic patients at baseline. No significant correlations between salivary and plasma OXT concentrations were found at any time point. Future studies including adult participants should investigate the effect of age on CORT and OXT concentrations in response to stress. Basal levels of cortisol and oxytocin did not differ in adults with ASD from controls. After physical exercise plasma oxytocin increased in ASD with low cortisol-response. Cortisol and oxytocin levels post-task did not significantly differ between groups. Social phobic traits predicted lower plasma oxytocin concentrations in controls. Empathetic traits predicted higher salivary oxytocin levels in ASD.
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Affiliation(s)
- L. Albantakis
- Max Planck Institute of Psychiatry – Independent Max Planck Research Group for Social Neuroscience, Kraepelinstr. 2-10, 80804, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Kraepelinstr. 2-10, 80804, Munich, Germany
- Corresponding author. Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804, Munich, Germany.
| | - M.-L. Brandi
- Max Planck Institute of Psychiatry – Independent Max Planck Research Group for Social Neuroscience, Kraepelinstr. 2-10, 80804, Munich, Germany
| | - T. Brückl
- Max Planck Institute of Psychiatry – Translational Research in Psychiatry, Kraepelinstr. 2-10, 80804, Munich, Germany
| | - D. Gebert
- Neurological Specialty Hospital for Movement Disorders/Parkinson’s Disease, Straße Nach Fichtenwalde 16, 14547, Beelitz, Germany
| | - M.K. Auer
- Medizinische Klinik and Poliklinik IV, LMU Klinikum, Ziemssenstr. 1, 80336, Munich, Germany
| | - A. Kopczak
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Feodor-Lynen-Straße 17, 81377, Munich, Germany
| | - G.K. Stalla
- Medizinische Klinik and Poliklinik IV, LMU Klinikum, Ziemssenstr. 1, 80336, Munich, Germany
- Medicover Neuroendokrinologie, Orleansplatz 3, 81667, Munich, Germany
| | - I.D. Neumann
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, Universitätsstr. 31, 93053, Regensburg, Germany
| | - L. Schilbach
- Max Planck Institute of Psychiatry – Independent Max Planck Research Group for Social Neuroscience, Kraepelinstr. 2-10, 80804, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Kraepelinstr. 2-10, 80804, Munich, Germany
- Ludwig-Maximilians-Universität München, Geschwister-Scholl-Platz 1, 80539, Munich, Germany
- Graduate School of Systemic Neurosciences, LMU Munich, Großhaderner Str. 2, 82152 Planegg, Germany
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16
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Woodard CR, Harmony C, Groden J, Audet K. A Comparison of the Stress Survey Schedule in Children with Autism and Typically Developing Children: A Brief Report. J Autism Dev Disord 2020; 51:1375-1384. [PMID: 32681205 DOI: 10.1007/s10803-020-04616-y] [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] [Indexed: 11/24/2022]
Abstract
Past research suggests that stress and anxiety are more prevalent in persons with autism as compared to typically developing persons. The Stress Survey Schedule (SSS) was developed in 2001 as a means to measure stressors common to persons with Autism Spectrum Disorder (ASD). The present study compared SSS responses of a sample of students diagnosed with ASD and intellectual disability with a group of typically developing students to explore the divergent validity and internal consistency of this measure, and to assess changes in scores among pre-adolescent and adolescent populations. Results indicated significant mean differences in SSS scores between persons with ASD and persons who are typically developing, and mean score differences among identified ASD age groups.
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Affiliation(s)
| | - Colin Harmony
- The Groden Center, 86 Mt. Hope Ave, Providence, RI, 02906, USA
| | - June Groden
- The Groden Center, 86 Mt. Hope Ave, Providence, RI, 02906, USA
| | - Kristen Audet
- The Groden Center, 86 Mt. Hope Ave, Providence, RI, 02906, USA
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17
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Ioannou S, Key AP, Muscatello RA, Klemencic M, Corbett BA. Peer Actors and Theater Techniques Play Pivotal Roles in Improving Social Play and Anxiety for Children With Autism. Front Psychol 2020; 11:908. [PMID: 32536887 PMCID: PMC7269006 DOI: 10.3389/fpsyg.2020.00908] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/14/2020] [Indexed: 12/23/2022] Open
Abstract
Children with autism spectrum disorder (ASD) have significant difficulty in social functioning to include engaging in natural play with peers. Many children with ASD exhibit significantly less interactive play and more physiological stress during benign social encounters with same-age peers on a playground. Theatrical role-playing and performance with expert role models may provide a unique opportunity for children with ASD to learn to engage with other children in a safe, supportive environment. SENSE Theatre® is a peer-mediated, theater-based program aimed at improving social competence in youth with ASD. Previous studies have shown significant improvements in social and communication skills following SENSE Theatre® intervention. The current project examined play with novel peers and self-reported anxiety before and after participation in SENSE Theatre®. Participants included 77 children between 8 and 16 years with high-functioning (IQ ≥ 70) ASD. The combined sample of three cohorts was randomized to the experimental (EXP, N = 44) or waitlist control (WLC, N = 33) group. Participants in the EXP group received 40 h (10, 4-h sessions) of SENSE Theatre®. The Peer Interaction Paradigm (PIP), an ecologically valid measure of natural play, was administered before and after the intervention. Group Play and Self Play on the playground equipment during solicited (T4) and unsolicited (T1) play were used in the current study. The State Trait Anxiety Scale for Children (STAIC; Spielberger et al., 1983) was used to measure self-reported current and persistent anxiety, respectively. Following treatment, children in the EXP group engaged in significantly more Group Play with novel peers [F(2,73) = 7.78, p = 0.007] and much less Self Play [F(2,73) = 6.70, p = 0.01] during solicited play compared to the WLC group. Regression analysis revealed that pretreatment play and group status were significant predictors of solicited Group Play. Children in the EXP group reported significantly less Trait anxiety following intervention [F(2,71) = 6.87, p = 0.01]; however, State anxiety was comparable. Results corroborate previous findings of significant changes in social and play behavior in children with ASD following the peer-mediated, theater-based intervention. Acting and theatrical performance with supportive role models facilitates social engagement in everyday settings with novel peers and reductions in self-reported anxiety.
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Affiliation(s)
- Sara Ioannou
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Alexandra P. Key
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | | | - Mark Klemencic
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Blythe A. Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
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18
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Kumazaki H, Muramatsu T, Kobayashi K, Watanabe T, Terada K, Higashida H, Yuhi T, Mimura M, Kikuchi M. Feasibility of autism-focused public speech training using a simple virtual audience for autism spectrum disorder. Psychiatry Clin Neurosci 2020; 74:124-131. [PMID: 31657508 DOI: 10.1111/pcn.12949] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/20/2019] [Accepted: 10/23/2019] [Indexed: 01/05/2023]
Abstract
AIM Public speaking seems to be one of the most anxiety-provoking situations for individuals with autism spectrum disorder (ASD). However, there are few evidence-based interventions. We developed Autism-Focused Public Speech Training using Simple Virtual Audiences (APSV), which differs from a general virtual audience in terms of its simple facial expressions and emphasis on the importance of the eyes. The present study aimed to evaluate the feasibility of APSV as an educational method for individuals with ASD. METHODS Fifteen male individuals with ASD were randomly assigned to two groups: one group received APSV (n = 8), and the other group (n = 7) received independent study (IS). From Days 2 to 6, participants in the APSV and IS groups were encouraged to read and answer questions often asked in actual public speaking events. Participants in the APSV study group performed this activity in front of the APSV system, while those in the IS group performed in an empty room. Before and after the intervention (Days 1 and 7), the participants in the two groups had a mock public speaking experience in front of 10 people for approximately 10 min. RESULTS After the training sessions, the participants' self-confidence had improved and salivary cortisol levels were significantly decreased in the APSV group as compared to those in the IS group. APSV improved self-confidence and decreased public speaking stress in individuals with ASD. CONCLUSION APSV appears to be useful in improving self-confidence and decreasing public speaking stress in individuals with ASD.
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Affiliation(s)
- Hirokazu Kumazaki
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Taro Muramatsu
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Tetsuyou Watanabe
- Institute of Science and Engineering, Kanazawa University, Kanazawa, Japan
| | - Kazunori Terada
- Faculty of Engineering and Graduate School of Engineering, Gifu University, Gifu, Japan
| | - Haruhiro Higashida
- Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
| | - Teruko Yuhi
- Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuru Kikuchi
- Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
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Corbett BA, Muscatello RA, Tanguturi Y, McGinn E, Ioannou S. Pubertal Development Measurement in Children With and Without Autism Spectrum Disorder: A Comparison Between Physical Exam, Parent- and Self-Report. J Autism Dev Disord 2020; 49:4807-4819. [PMID: 31448383 DOI: 10.1007/s10803-019-04192-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Adolescence is a time of remarkable biopsychosocial change, which may be particularly challenging for youth with autism spectrum disorder (ASD), necessitating enhanced understanding and accurate assessment of pubertal maturation. The study compared physical examination to parent- and self-report measures in 200 participants (134 males and 66 females) ages 10.0-13.5 years. Both participants with typical development (TD, n = 78) and ASD (n = 122) were included. Concordance ranged from slight-to-fair for self-assessments (κ = .17-.32) and slight-to-moderate for parent-report (κ = .21-.44). Concordance of physical exam with self- and parent-report of the ASD group was somewhat lower than for the TD group. Findings indicate pubertal assessments by parent or child are not reliable indices of precise pubertal staging.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA. .,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, PMB 40, 230 Appleton Place, Nashville, TN, 37203, USA.
| | | | - Yasas Tanguturi
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emily McGinn
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sara Ioannou
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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20
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O'Connor RAG, Stockmann L, Rieffe C. Spontaneous helping behavior of autistic and non-autistic (Pre-)adolescents: A matter of motivation? Autism Res 2019; 12:1796-1804. [PMID: 31364313 PMCID: PMC6916565 DOI: 10.1002/aur.2182] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/18/2019] [Accepted: 07/09/2019] [Indexed: 01/05/2023]
Abstract
Young autistic people have a range of social difficulties, but it is not yet clear how these difficulties can be explained. In addition, emerging research is suggesting that autistic girls may differ from boys in terms of their social behaviors, but yet unknown is if they differ in terms of their pro-social behavior, such as helping. The present study investigated spontaneous helping behavior using an in vivo paradigm and related this to participants' levels of social motivation (based on parent reports). Participants were 233 autistic and non-autistic (pre-)adolescents (M = 12.46 years, SD = 15.54 months). Our results demonstrated that autistic girls and boys have lower levels of social motivation compared to their non-autistic peers, but social motivation was unrelated to helping behavior in both groups. Furthermore, when the experimenter needed help, the autistic boys and girls looked and smiled to the same extent as their peers of the same gender, but they actually helped significantly less than their non-autistic peers. However, most autistic youngsters did help, highlighting the great individual differences in autistic individuals. We discuss the possibility that lower levels of helping behavior are due to difficulty initiating action in a social context, rather than lower social motivation. Autism Res 2019, 12: 1796-1804. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: This study examined the helping behavior of autistic boys and girls (aged 9-16). Many autistic young people did help, but compared to non-autistic individuals, autistic people did not help as much. This study also showed that when people did/did not help, it was not related to their interest in social relationships. It is important to teach young autistic people when and how to help others, to support them making friends.
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Affiliation(s)
| | - Lex Stockmann
- Institute of PsychologyLeiden UniversityLeidenThe Netherlands
| | - Carolien Rieffe
- Institute of PsychologyLeiden UniversityLeidenThe Netherlands
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21
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Kumazaki H, Muramatsu T, Yoshikawa Y, Corbett BA, Matsumoto Y, Higashida H, Yuhi T, Ishiguro H, Mimura M, Kikuchi M. Job interview training targeting nonverbal communication using an android robot for individuals with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1586-1595. [DOI: 10.1177/1362361319827134] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Job interviews are significant barriers for individuals with autism spectrum disorder because these individuals lack good nonverbal communication skills. We developed a job interview training program using an android robot. The job interview training program using an android robot consists the following three stages: (1) tele-operating an android robot and conversing with others through the android robot, (2) a face-to-face mock job interview with the android robot, and (3) feedback based on the mock job interview and nonverbal communication exercises using the android robot. The participants were randomly assigned to the following two groups: one group received a combined intervention with “interview guidance by teachers and job interview training program using an android robot” ( n = 13), and the other group received an intervention with interview guidance by teachers alone ( n = 16). Before and after the intervention, the participants in both groups underwent a mock job interview with a human interviewer, who provided outcome measurements of nonverbal communication, self-confidence, and salivary cortisol. After the training sessions, the participants who received the combined interview guidance by teachers and the job interview training program using an android robot intervention displayed improved nonverbal communication skills and self-confidence and had significantly lower levels of salivary cortisol than the participants who only received interview guidance by teachers. The job interview training program using an android robot improved various measures of job interview skills in individuals with autism spectrum disorder.
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Affiliation(s)
| | | | - Yuichiro Yoshikawa
- Osaka University, Japan
- JST ERATO Ishiguro Symbiotic Human-Robot Interaction, Japan
| | | | - Yoshio Matsumoto
- National Institute of Advanced Industrial Science and Technology, Japan
| | | | | | - Hiroshi Ishiguro
- Osaka University, Japan
- JST ERATO Ishiguro Symbiotic Human-Robot Interaction, Japan
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22
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Miranda A, Berenguer C, Roselló B, Baixauli I. Relationships between the social communication questionnaire and pragmatic language, socialization skills, and behavioral problems in children with autism spectrum disorders. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 9:141-152. [PMID: 30638069 DOI: 10.1080/21622965.2018.1550403] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The Social Communication Questionnaire (SCQ) is one of the most widely used screening instruments for autism spectrum disorder (ASD). This study examined the relationships between the reciprocal social interaction, communication, and repetitive/stereotyped factors on the Strength and Difficulties Questionnaire (SDQ) and pragmatic, socialization, and behavioral problems in children with ASD and children with typical development (TD). Participants were seven- to 11-year-old children with ASD without intellectual disability (n = 52) and with TD (n = 37). The two groups were matched on age and intelligence quotient. Significant differences were found between the two groups on the SCQ domains and the outcome measures (pragmatic language, socialization skills, and behavioral problems). Furthermore, multiple regression analysis exploring the relationships between the SCQ and the criterion variables showed that reciprocal social interaction and repetitive/stereotyped behaviors had an important weight in the prediction of daily life social skills in typically developing children (34%). However, the model with the highest percentage of explained variance in children with ASD involved pragmatic language, with reciprocal social interaction as the best predictor, even reaching 41%. The findings highlight the suitability of routinely including the SCQ in the first stage of assessment protocols for ASD, and, in particular, they show its capacity to predict a valuable repertoire of behaviors.
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Affiliation(s)
- Ana Miranda
- Department of Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Carmen Berenguer
- Department of Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Belén Roselló
- Department of Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Inmaculada Baixauli
- Department of Occupational Sciences, Speech Therapy, Evolutionary and Educational Psychology, Faculty of Psychology Teaching and Education Sciences, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
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23
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Corbett BA, Muscatello RA, Baldinger C. Comparing stress and arousal systems in response to different social contexts in children with ASD. Biol Psychol 2019; 140:119-130. [PMID: 30557600 PMCID: PMC6471662 DOI: 10.1016/j.biopsycho.2018.12.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 12/13/2018] [Accepted: 12/13/2018] [Indexed: 12/28/2022]
Abstract
Response to psychological stress can vary based on the extent to which the context is perceived as stressful, especially under different social conditions. The purpose of this preliminary study was to compare physiological stress (cortisol) and regulation (respiratory sinus arrhythmia, RSA) of 10-12 year old children with autism spectrum disorder (ASD, n = 31) or typical development (TD, n = 25) when exposed to two social stress protocols. The extent to which perceived emotion (affect recognition) and anxiety (state and trait) mediate the stress response was also explored. Results revealed different patterns of stress responses dependent on the type of stressor. During a friendly social interaction, both groups generally showed an adaptive, synergistic response between cortisol and RSA. In response to social evaluation, however, the ASD group did not show correlating responses between physiological systems, which was likely due to a blunted stress response to the social evaluative stressor. The ability to recognize neutral faces mediated the relationship between diagnostic group and physiological response to social evaluation, indicating that perception of threat is essential to triggering a stress response. The current study emphasizes the need to consider the important role of social context, social perception, and perceived anxiety when examining social interaction and stress.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States.
| | | | - Charles Baldinger
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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Taylor JL, Muscatello RA, Corbett BA. Differences in anticipatory versus reactive stress to social evaluative threat in adults versus adolescents with autism. Autism Res 2018; 11:1276-1285. [PMID: 30145834 DOI: 10.1002/aur.1998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/08/2018] [Accepted: 06/17/2018] [Indexed: 01/14/2023]
Abstract
Social evaluative threat is a potent activator of the hypothalamic-pituitary-adrenocortical (HPA) axis in typically developing (TD) populations. Studies have shown that children and adolescents with autism spectrum disorder (ASD) show a blunted cortisol response to this type of stressor; yet, a previous study in adults with ASD reported a more prototypical stress response. The current study compared 24 adolescents and 17 adults with ASD to investigate a possible developmental lag in autism resulting in a more adaptive stress response to social evaluation with development. Participants were exposed to the trier social stress test (TSST), and salivary cortisol was collected before and after stress induction. Multilevel modeling revealed that relative to adolescents, young adults with ASD evidenced a significant increase in cortisol in response to anticipatory stress, and 23.5% were classified as anticipatory responders. Adolescents, however, had a significant change in slope in response to the TSST, with 37.5% classified as reactive responders. In both groups, the majority of participants did not have a robust stress response to the TSST as would be expected in TD participants. Findings suggest significant differences in the cortisol trajectory; adults with ASD were more likely to show an anticipatory response to being socially evaluated, which was maintained throughout the stressor, whereas the adolescents had a more reactive response pattern with no anticipatory response. Further research is needed to determine if such patterns are adaptive or deleterious, and to determine underlying factors that may contribute to distinct stress profiles and to the overall diminished stress responses. Autism Res 2018, 11: 1276-1285. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Many individuals have increased stress when being socially evaluated. The current study shows that adults with ASD have increased stress in anticipation of a task in which individuals are required to give a speech to unfamiliar raters, while adolescents with ASD tend to show a stress response only during the task itself. Further research is necessary to understand whether developmental influences on stress response in ASD have significant impacts on other areas of functioning often affected by stress.
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Affiliation(s)
- Julie Lounds Taylor
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Blythe A Corbett
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
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Psychophysiological and Behavioral Responses to a Novel Intruder Threat Task for Children on the Autism Spectrum. J Autism Dev Disord 2018. [PMID: 28646372 DOI: 10.1007/s10803-017-3195-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
We measured skin conductance response (SCR) to escalating levels of a direct social threat from a novel, ecologically-relevant experimental paradigm, the Intruder Threat Task. We simultaneously evaluated the contribution of social symptom severity and behavioral movement. Children with AS group showed less psychophysiological reactivity to social threat than controls across all three phases of the experiment. In the AS group, greater social impairment was significantly associated with reduced SCR. However, movement activity predicted SCR while diagnosis did not. Research and treatment need to account for the complex interplay of emotional reactivity and social behavior in AS. Psychophysiology studies of AS should consider the impact of possible confounds such as movement.
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26
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Aggernæs B. Autism: a transdiagnostic, dimensional, construct of reasoning? Eur J Neurosci 2018; 47:515-533. [PMID: 28452080 PMCID: PMC6084350 DOI: 10.1111/ejn.13599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/17/2017] [Accepted: 04/19/2017] [Indexed: 12/11/2022]
Abstract
The concept of autism has changed across time, from the Bleulerian concept, which defined it as one of several symptoms of dementia praecox, to the present-day concept representing a pervasive development disorder. The present theoretical contribution to this special issue of EJN on autism introduces new theoretical ideas and discusses them in light of selected prior theories, clinical examples, and recent empirical evidence. The overall aim is to identify some present challenges of diagnostic practice and autism research and to suggest new pathways that may help direct future research. Future research must agree on the definitions of core concepts such as autism and psychosis. A possible redefinition of the concept of autism may be a condition in which the rationale of an individual's behaviour differs qualitatively from that of the social environment due to characteristic cognitive impairments affecting reasoning. A broad concept of psychosis could focus on deviances in the experience of reality resulting from impairments of reasoning. In this light and consistent with recent empirical evidence, it may be appropriate to redefine dementia praecox as a developmental disorder of reasoning. A future challenge of autism research may be to develop theoretical models that can account for the impact of complex processes acting at the social level in addition to complex neurobiological and psychological processes. Such models could profit from a distinction among processes related to (i) basic susceptibility, (ii) adaptive processes and (iii) decompensating factors involved in the development of manifest illness.
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Affiliation(s)
- Bodil Aggernæs
- Department of Child and Adolescent PsychiatryPsychiatry Region ZealandNy Østergade 12DK‐4000RoskildeDenmark
- Faculty of Medical and Health SciencesDepartment of Clinical MedicineUniversity of CopenhagenBlegdamsvej 3BDK‐2200 Copenhagen NDenmark
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Muscatello RA, Corbett BA. Comparing the effects of age, pubertal development, and symptom profile on cortisol rhythm in children and adolescents with autism spectrum disorder. Autism Res 2018; 11:110-120. [PMID: 29030905 PMCID: PMC6453123 DOI: 10.1002/aur.1879] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 09/06/2017] [Accepted: 09/27/2017] [Indexed: 11/11/2022]
Abstract
Previous studies in children with autism spectrum disorder (ASD) have shown elevated evening cortisol; however, few studies have examined diurnal rhythm in adolescents with ASD. Adolescence is a time of significant physical and psychological change, and dysregulation of the hypothalamic-pituitary-adrenal axis may put adolescents with ASD at increased risk for internalizing disorders, such as anxiety and depression. The extent to which cortisol levels are associated with age, puberty and symptom profile was examined in 113 youth (ages 7-17) with ASD and typical development. Salivary samples were collected over 3 days in the home, 4 times per day (waking, 30-min post-waking, afternoon, evening). Results showed youth with ASD had higher evening cortisol and a blunted diurnal slope relative to TD youth. Pubertal development and age were significant predictors of evening cortisol, and adolescents with ASD had higher evening cortisol levels compared to children with ASD. The study extends previous reports of elevated evening cortisol in children with ASD to reveal high levels in adolescence as well. Adolescents with ASD also show a significantly blunted diurnal slope, which may be associated with risk of internalizing symptoms. Findings suggest elevated evening cortisol persists across development in youth with ASD, thus emphasizing a need to identify potential negative effects of excess cortisol exposure on health in ASD individuals. Autism Res 2018, 11: 110-120. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Elevations in stress hormone, cortisol, during the evening may indicate increased stress from changes throughout the day in youth with autism spectrum disorder (ASD). The current study shows that age and pubertal development are also related to increases in evening cortisol, and this maladaptive elevation in cortisol in ASD is not going away with age. These cortisol elevations may also be associated with other psychological symptoms and warrant further investigation in adolescents with ASD.
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Affiliation(s)
- Rachael A. Muscatello
- Neuroscience Graduate Program, Vanderbilt University, U-1205 Medical Research Building III, 465 21 Avenue South, Nashville, TN 37232-2050
| | - Blythe A. Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, PMB 40, 230 Appleton Place, Nashville, TN 37203, United States
- Department of Psychology, Vanderbilt University, PMB 40, 230 Appleton Place, Nashville, TN 37203
- Vanderbilt Kennedy Center, Vanderbilt University, PMB 40, 230 Appleton Place, Nashville, TN 37203
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Matherly SM, Klusek J, Thurman AJ, McDuffie A, Abbeduto L, Roberts JE. Cortisol profiles differentiated in adolescents and young adult males with fragile X syndrome versus autism spectrum disorder. Dev Psychobiol 2018; 60:78-89. [PMID: 29171019 PMCID: PMC5747975 DOI: 10.1002/dev.21578] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 09/27/2017] [Indexed: 11/12/2022]
Abstract
BACKGROUND Fragile X syndrome (FXS) and non-syndromic autism spectrum disorder (ASD) are distinct disorders with overlapping behavioral features. Both disorders are also highly associated with anxiety with abnormal physiological regulation implied mechanistically. Some reports suggest atypical hypothalamus-pituitary-adrenal (HPA) axis function, indexed via aberrant cortisol reactivity, in both FXS and non-syndromic ASD. However, no study has compared cortisol reactivity across these two disorders, or its relationship to ASD symptom severity. METHODS Cortisol reactivity (prior to and following a day of assessments) was measured in 54 adolescent/young adult males with FXS contrasted to 15 males with non-syndromic ASD who had low cognitive abilities. RESULTS Greater ASD symptom severity was related to increased cortisol reactivity and higher levels at the end of the day, but only in the non-syndromic ASD group. Elevated anxiety was associated with increased HPA activation in the group with FXS alone. CONCLUSIONS Taken together, findings suggest a unique neuroendocrine profile that distinguishes adolescent/young adult males with FXS from those with non-syndromic ASD. Severity of ASD symptoms appears to be related to cortisol reactivity in the non-syndromic ASD sample, but not in FXS; while anxiety symptoms are associated with HPA activation in the FXS sample, but not in ASD despite a high prevalence of ASD, anxiety and physiological dysregulation characteristic in both populations.
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Affiliation(s)
- Sara M Matherly
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Jessica Klusek
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina
| | - Angela J Thurman
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, California
| | - Andrea McDuffie
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, California
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, California
| | - Jane E Roberts
- Department of Psychology, University of South Carolina, Columbia, South Carolina
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Physiological Response to Social Evaluative Threat in Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2017; 46:2992-3005. [PMID: 27318810 DOI: 10.1007/s10803-016-2842-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The Trier Social Stress Test (TSST) was employed to study response to social evaluative threat in male adolescents with Autism Spectrum Disorder (ASD, n = 21) and typical development (n = 13). Participants wore a mobile electrocardiogram to collect heart rate data. There were significant group effects on respiratory sinus arrhythmia (RSA), a measure of parasympathetic nervous system function, with lower values in ASD (F = 4.97). Bivariate correlations also showed a significant relationship between parent reports of social problems and RSA response to the TSST (r = -0.586). These findings suggest that autonomic dysregulation may contribute to social deficits in adolescents with ASD.
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30
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Hollocks MJ, Pickles A, Howlin P, Simonoff E. Dual Cognitive and Biological Correlates of Anxiety in Autism Spectrum Disorders. J Autism Dev Disord 2017; 46:3295-307. [PMID: 27465243 DOI: 10.1007/s10803-016-2878-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Young people with autism spectrum disorder (ASD) have a high prevalence (~40 %) of anxiety disorders compared to their non-ASD peers. It is unclear whether cognitive and biological processes associated with anxiety in ASD are analogous to anxiety in typically developing (TD) populations. In this study 55 boys with ASD (34 with a co-occurring anxiety disorder, 21 without) and 28 male controls, aged 10-16 years and with a full-scale IQ ≥ 70, completed a series of clinical, cognitive (attention bias/interpretation bias) and biological measures (salivary cortisol/HR response to social stress) associated with anxiety in TD populations. Structural equation modelling was used to reveal that that both attentional biases and physiological responsiveness were significant, but unrelated, predictors of anxiety in ASD.
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Affiliation(s)
- Matthew J Hollocks
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,Neurology Unit, R3, Department of Clinical Neurosciences, University of Cambridge, Box 83, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK. .,Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK.
| | - Andrew Pickles
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Patricia Howlin
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry and Biomedical Research Centre for Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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31
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Gillberg C, Fernell E, Kočovská E, Minnis H, Bourgeron T, Thompson L, Allely CS. The role of cholesterol metabolism and various steroid abnormalities in autism spectrum disorders: A hypothesis paper. Autism Res 2017; 10:1022-1044. [PMID: 28401679 PMCID: PMC5485071 DOI: 10.1002/aur.1777] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 12/15/2016] [Accepted: 01/30/2017] [Indexed: 01/25/2023]
Abstract
Based on evidence from the relevant research literature, we present a hypothesis that there may be a link between cholesterol, vitamin D, and steroid hormones which subsequently impacts on the development of at least some of the "autisms" [Coleman & Gillberg]. Our hypothesis, driven by the peer reviewed literature, posits that there may be links between cholesterol metabolism, which we will refer to as "steroid metabolism" and findings of steroid abnormalities of various kinds (cortisol, testosterone, estrogens, progesterone, vitamin D) in autism spectrum disorder (ASD). Further research investigating these potential links is warranted to further our understanding of the biological mechanisms underlying ASD. Autism Res 2017. © 2017 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research. Autism Res 2017, 10: 1022-1044. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Eva Kočovská
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Barts and London School of Medicine, Queen Mary University of London, Blizard Institute58 Turner StreetE1 2ABLondon
| | - Helen Minnis
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Institute of Health and Wellbeing, University of Glasgow, RHSC YorkhillGlasgowScotlandG3 8SJUnited Kingdom
| | - Thomas Bourgeron
- Institut Pasteur, Human Genetics and Cognitive Functions UnitParisFrance
- CNRS UMR 3571: Genes, Synapses and Cognition, Institut PasteurParisFrance
- Université Paris Diderot, Sorbonne Paris CitéHuman Genetics and Cognitive FunctionsParisFrance
- FondaMental FoundationCréteilFrance
| | - Lucy Thompson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Institute of Health and Wellbeing, University of Glasgow, RHSC YorkhillGlasgowScotlandG3 8SJUnited Kingdom
| | - Clare S. Allely
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- School of Health SciencesUniversity of SalfordManchesterEngland
- Honorary Research Fellow in the College of MedicalVeterinary and Life Sciences affiliated to the Institute of Health and Wellbeing at the University of Glasgow
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32
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Corbett BA, Blain SD, Kale Edmiston E. The Role of Context in Psychosocial Stress among Adolescents with Autism Spectrum Disorder: Piloting a Semi-structured, Videogame-based Paradigm. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2017; 43:20-28. [PMID: 31205447 PMCID: PMC6570405 DOI: 10.3109/13668250.2017.1310824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) is characterised by altered social patterns, often associated with increased stress. While puberty is associated with increased stress, there is limited research on stress response to social interaction in adolescents with ASD. The study investigated stress response to semi-structured, videogame-based interaction in adolescents with and without ASD, and the impact of puberty. METHOD Twelve adolescents with ASD and 12 typically developing (TD) peers participated in a semi-structured, videogame-based social interaction. Stress was measured via salivary cortisol. RESULTS There were no significant between-group differences in cortisol. Pubertal development was correlated with cortisol in ASD (r = -0.901, p < 0.0001), but not TD (r = 0.022, p = 0.949). CONCLUSIONS Findings contribute to a fuller picture of the developmental trajectories of physiological stress in ASD, including the importance of context, structure, and puberty. The current investigation underscores the necessity of incorporating varied social contexts when assessing stress and social interaction.
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Affiliation(s)
- Blythe A. Corbett
- Vanderbilt University, Department of Psychiatry
- Vanderbilt University, Department of Psychology
- Vanderbilt Brain Institute
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33
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Reducing Listening-Related Stress in School-Aged Children with Autism Spectrum Disorder. J Autism Dev Disord 2017; 47:2010-2022. [DOI: 10.1007/s10803-017-3114-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Edmiston EK, Muscatello RA, Corbett BA. Altered Pre-Ejection Period Response to Social Evaluative Threat in Adolescents with Autism Spectrum Disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2017; 36:57-65. [PMID: 29177005 PMCID: PMC5699479 DOI: 10.1016/j.rasd.2017.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The autonomic nervous system (ANS) is involved in regulating social behavior; Autism Spectrum Disorder (ASD) is characterized by alterations in social behavior and reduced physiological response to threat. We hypothesized that adolescents with ASD would show reduced ANS response to social threat. METHODS Eighteen males with ASD and thirteen males with typical development (TD), ages 12 to 17, completed a social threat paradigm while wearing an impedance cardiography apparatus. We calculated pre-ejection period (PEP) and tested for between-group differences in PEP response to social threat. We also conducted correlation analyses between PEP change scores and clinical symptom scales. RESULTS There was an effect of diagnosis on change in PEP from baseline to the onset of social threat (F=7.60, p=0.01), with greater changes in PEP in TD compared to ASD. PEP change score and the Social Communication Questionnaire (r=0.634, p=0.005) and the ADHD Problems Subscale of the Child Behavior Checklist (r=0.568, p=0.014) were correlated. CONCLUSIONS These findings suggest reduced arousal in response to social threat in ASD, with preliminary evidence that reduced sympathetic activation is associated with increased social behavior symptoms.
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Affiliation(s)
- E. Kale Edmiston
- Neuroscience Graduate Program, Vanderbilt University, U-1205 Medical Research Building III, 465 21st Avenue South, Nashville, TN 37232-2050
| | - Rachael A. Muscatello
- Neuroscience Graduate Program, Vanderbilt University, U-1205 Medical Research Building III, 465 21st Avenue South, Nashville, TN 37232-2050
| | - Blythe A. Corbett
- Department of Psychiatry, Vanderbilt University, PMB 40, 230 Appleton Place, Nashville, TN 37203
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Qualls LR, Corbett BA. Examining the relationship between social communication on the ADOS and real-world reciprocal social communication in children with ASD. RESEARCH IN AUTISM SPECTRUM DISORDERS 2017; 33:1-9. [PMID: 28947912 PMCID: PMC5609470 DOI: 10.1016/j.rasd.2016.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND While many children with autism spectrum disorders (ASDs) communicate better with adults than peers, diagnostic measures are given by adult examiners. These measures may not accurately capture the deficits that children with ASD have in communicating with their peers. METHOD This study examined the ability of the Autism Diagnostic Observation Schedule (ADOS) Social Communication scale to predict reciprocal communication in children with ASD during natural play with peers using the Peer Interaction Paradigm (PIP). Thirty participants with ASD were given the ADOS and then participated in the PIP, after which their behavior was analyzed. RESULTS Using linear regression, we found that Social Communication was the primary significant predictor for reciprocal communication during play, and that reciprocal communication was not predicted by Verbal IQ or the Restrictive and Repetitive Behaviors scale on the ADOS. CONCLUSIONS The findings suggest that the ADOS measures naturally-occurring social communication patterns with peers and can be used to inform treatment options for children with ASD based on an accurate measure of their level of impairment in social communication.
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Affiliation(s)
- Lydia R Qualls
- Vanderbilt University Department of Psychiatry, 465 21st Ave S, Nashville, TN 37232
- Virginia Consortium Program for Clinical Psychology, 700 Park Ave, Norfolk, VA 23504 (present address)
| | - Blythe A Corbett
- Vanderbilt University Department of Psychiatry, 465 21st Ave S, Nashville, TN 37232
- Vanderbilt Kennedy Center for Research on Human Development, 110 Magnolia Circle, Nashville, TN 37203
- Vanderbilt University Department of Psychology, 2301 Vanderbilt Pl, Nashville, TN 37240
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Kumazaki H, Warren Z, Corbett BA, Yoshikawa Y, Matsumoto Y, Higashida H, Yuhi T, Ikeda T, Ishiguro H, Kikuchi M. Android Robot-Mediated Mock Job Interview Sessions for Young Adults with Autism Spectrum Disorder: A Pilot Study. Front Psychiatry 2017; 8:169. [PMID: 28955254 PMCID: PMC5601082 DOI: 10.3389/fpsyt.2017.00169] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 08/25/2017] [Indexed: 11/13/2022] Open
Abstract
The feasibility and preliminary efficacy of an android robot-mediated mock job interview training in terms of both bolstering self-confidence and reducing biological levels of stress in comparison to a psycho-educational approach human interview was assessed in a randomized study. Young adults (ages 18-25 years) with autism spectrum disorder (ASD) were randomized to participate either in a mock job interview training with our android robot system (n = 7) or a self-paced review of materials about job-interviewing skills (n = 8). Baseline and outcome measurements of self-reported performance/efficacy and salivary cortisol were obtained after a mock job interview with a human interviewer. After training sessions, individuals with ASD participating in the android robot-mediated sessions reported marginally improved self-confidence and demonstrated significantly lower levels of salivary cortisol as compared to the control condition. These results provide preliminary support for the feasibility and efficacy of android robot-mediated learning.
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Affiliation(s)
- Hirokazu Kumazaki
- Department of Clinical Research on Social Recognition and Memory, Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
| | - Zachary Warren
- Departments of Pediatrics and Psychiatry, Vanderbilt University, Nashville, TN, United States
| | - Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University, Nashville, TN, United States
| | - Yuichiro Yoshikawa
- Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, Osaka, Japan.,JST ERATO ISHIGURO Symbiotic Human-Robot Interaction, Osaka, Japan
| | - Yoshio Matsumoto
- Service Robotics Research Group, Intelligent Systems Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan
| | - Haruhiro Higashida
- Department of Clinical Research on Social Recognition and Memory, Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
| | - Teruko Yuhi
- Department of Clinical Research on Social Recognition and Memory, Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
| | - Takashi Ikeda
- Department of Clinical Research on Social Recognition and Memory, Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
| | - Hiroshi Ishiguro
- Department of Systems Innovation, Graduate School of Engineering Science, Osaka University, Osaka, Japan.,JST ERATO ISHIGURO Symbiotic Human-Robot Interaction, Osaka, Japan
| | - Mitsuru Kikuchi
- Department of Clinical Research on Social Recognition and Memory, Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan
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Lydon S, Healy O, Reed P, Mulhern T, Hughes BM, Goodwin MS. A systematic review of physiological reactivity to stimuli in autism. Dev Neurorehabil 2016; 19:335-355. [PMID: 25356589 DOI: 10.3109/17518423.2014.971975] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The prevalence of abnormal behavioural responses to a variety of stimuli among individuals with autism has led researchers to examine whether physiological reactivity (PR) is typical in this population. This article reviewed studies assessing PR to sensory, social and emotional, and stressor stimuli in individuals with autism. METHODS Systematic searches of electronic databases identified 57 studies that met our inclusion criteria. Studies were analysed to determine: (a) participant characteristics; (b) physiological measures used; (c) PR to sensory, social and emotional or stressor stimuli; (d) the relation between PR and behavioural or psychological variables and (e) baseline physiological activity. A novel measure of methodological quality suitable for use with non-randomized, non-interventional, psychophysiological studies was also developed and applied. RESULTS Individuals with autism were found to respond differently than typically developing controls in 78.6%, 66.7% and 71.4% of sensory, social and emotional, and stressor stimulus classes, respectively. However, this extant literature is characterized by variable and inconsistent findings, which do not appear to be accounted for by varying methodological quality, making it difficult to determine what specific factors differentiate individuals with autism who present with atypical PR from those who do not. CONCLUSIONS Despite this uncertainty, individual differences in PR are clearly present in autism, suggesting additional research is needed to determine the variables relating to PR among those with ASD and to examine the possible existence of physiological subtype responders in the population.
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Affiliation(s)
- Sinéad Lydon
- a School of Psychology, Trinity College Dublin , Dublin , Ireland
| | - Olive Healy
- a School of Psychology, Trinity College Dublin , Dublin , Ireland
| | - Phil Reed
- b Department of Psychology , Swansea University , Swansea , UK
| | - Teresa Mulhern
- c School of Psychology, National University of Ireland , Galway , Ireland , and
| | - Brian M Hughes
- c School of Psychology, National University of Ireland , Galway , Ireland , and
| | - Matthew S Goodwin
- d Department of Health Sciences , Northeastern University , Boston , MA , USA
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Corbett BA, Bales KL, Swain D, Sanders K, Weinstein TAR, Muglia LJ. Comparing oxytocin and cortisol regulation in a double-blind, placebo-controlled, hydrocortisone challenge pilot study in children with autism and typical development. J Neurodev Disord 2016; 8:32. [PMID: 27540420 PMCID: PMC4989357 DOI: 10.1186/s11689-016-9165-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 08/05/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) show marked impairment in social functioning and poor adaptation to new and changing contexts, which may be influenced by underlying regulatory processes. Oxytocin (OT) and cortisol are key neuromodulators of biological and behavioral responses, show a synergistic effect, and have been implicated in the neuropathological profile in ASD. However, they are rarely investigated together. The purpose of the pilot study was to evaluate the relationship between cortisol and OT in children with ASD under baseline and physiological stress (hydrocortisone challenge) conditions. Arginine vasopressin (AVP), structurally similar to OT, was also examined. METHODS A double-blind, placebo-controlled, randomly assigned, crossover design was employed in 25 children 8-to-12 years with ASD (N = 14) or typical development (TD, N = 11). A low dose of hydrocortisone and placebo were administered via liquid suspension. Analysis of variance (ANOVA) was used to examine the within-subject factor "Condition" (hydrocortisone/placebo) and "Time" (pre and post) and the between-subject factor "Group" (ASD vs. TD). Pearson correlations examined the relationship between hormone levels and clinical profile. RESULTS There was a significant Time × Condition × Group interaction F (1.23) = 4.18, p = 0.05 showing a rise in OT during the experimental condition (hydrocortisone) and a drop during the placebo condition for the TD group but not the ASD group. There were no group differences for AVP. Hormone levels were associated with social profiles. CONCLUSIONS For the TD group, an inverse relationship was observed. OT increased during physiological challenge suggesting that OT played a stress-buffering role during cortisol administration. In contrast for the ASD group, OT remained unchanged or decreased during both the physiological challenge and the placebo condition, suggesting that OT failed to serve as a stress buffer under conditions of physiological stress. While OT has been tied to the social ability of children with ASD, the diminished moderating effect of OT on cortisol may also play a contributory role in the heightened stress often observed in children with ASD. These results contribute to our understanding of the growing complexity of the effects of OT on social behavior as well as the functional interplay and differential regulation OT may have on stress modulation.
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Affiliation(s)
- Blythe A. Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University, PMB 40, 230 Appleton Place, Nashville, TN 37203 USA
- Vanderbilt Kennedy Center for Research on Human Development, Nashville, TN USA
- Department of Psychology, Vanderbilt University, Nasvhille, TN USA
| | | | - Deanna Swain
- Virginia Polytechnic Institute and State University, Blacksburg, VA USA
| | - Kevin Sanders
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University, PMB 40, 230 Appleton Place, Nashville, TN 37203 USA
| | | | - Louis J. Muglia
- Department of Pediatrics, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH USA
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Edmiston EK, Blain SD, Corbett BA. Salivary cortisol and behavioral response to social evaluative threat in adolescents with autism spectrum disorder. Autism Res 2016; 10:346-358. [PMID: 27417507 DOI: 10.1002/aur.1660] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/18/2016] [Accepted: 06/02/2016] [Indexed: 12/28/2022]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social behavior. One possible explanation for social communication deficits in ASD could be differences in biological systems that support responses to environmental stimuli. If so, it is unclear if differences in the arousal response to social stimuli in ASD are due to reduced interest in social information, or to an increased stress response. The hypothalamic pituitary adrenal axis facilitates arousal and the stress response to sensory input, including social stimuli. Previous research shows blunted cortisol response to social evaluative threat in children with ASD. The majority of prior work has focused on children with ASD, but adolescents with ASD are understudied. The adolescent period is of interest, as this developmental epoch is associated with increased salience of social evaluative threat in typically developing (TD) populations. In this study, we employed the Trier Social Stress Test (TSST), a laboratory paradigm that involves exposure to social evaluative threat, to study the cortisol and behavioral response to social evaluative threat in ASD and TD adolescents. Salivary cortisol data were collected at six time points before and after the TSST. Behavioral data were collected using video recordings of the TSST, which were then operationalized and coded. Paired sample t-tests were used to calculate within-group cortisol response to the TSST. Cortisol significantly increased in response to the TSST in the TD group but not the ASD group. The TD group showed a trend for more self-soothing behaviors during the stressor than the ASD group. The lack of a cortisol response to the TSST in the ASD group suggests that the TSST is not interpreted as stressful or salient for ASD adolescents. Autism Res 2017, 10: 346-358. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- E Kale Edmiston
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN.,Department of Psychiatry, Vanderbilt University, Nashville, TN
| | - Scott D Blain
- Department of Psychology, Vanderbilt University, Nashville, TN.,Department of Psychiatry, Vanderbilt University, Nashville, TN
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Corbett BA, Blain SD, Ioannou S, Balser M. Changes in anxiety following a randomized control trial of a theatre-based intervention for youth with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:333-343. [PMID: 27154909 DOI: 10.1177/1362361316643623] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Increased anxiety and stress are frequently found in children with autism spectrum disorder and are associated with social challenges. Recently, we reported changes in social competence following peer-mediated, theatre-based intervention. The purpose of this study was to examine the impact of the intervention on reducing anxiety and stress. Participants included 30 youth with autism spectrum disorder (8-14 years old) randomly assigned to the experimental (17) or waitlist control (13) group. Pretest adjusted, between-group differences were analyzed for state-anxiety, trait-anxiety, play-based cortisol, and diurnal cortisol. Pearson correlations were conducted between anxiety, cortisol, and group play. Significant pretest-adjusted between-group differences at posttest were observed on trait-anxiety (F(1, 27) = 9.16, p = 0.005) but not state-anxiety (F(1, 27) = 0.03, p = 0.86), showing lower trait-anxiety in the experimental group. There were no between-group differences on cortisol. There was a significant negative correlation between group play and trait-anxiety (r = -0.362, p = 0.05). Playground cortisol correlated with group play, for the experimental group (r = 0.55, p = 0.03). The theatre-based, peer-mediated intervention not only contributes to improvement in social competence in youth with autism spectrum disorder but also contributes to reductions in trait-anxiety associated with more social interaction with peers. Results suggest that some degree of physiological arousal is essential for social interaction.
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Corbett BA, Muscatello RA, Blain SD. Impact of Sensory Sensitivity on Physiological Stress Response and Novel Peer Interaction in Children with and without Autism Spectrum Disorder. Front Neurosci 2016; 10:278. [PMID: 27445653 PMCID: PMC4917546 DOI: 10.3389/fnins.2016.00278] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/06/2016] [Indexed: 01/29/2023] Open
Abstract
Background: For many children with Autism Spectrum Disorder (ASD), social interactions can be stressful. Previous research shows that youth with ASD exhibit greater physiological stress response during peer interaction, compared to typically developing (TD) peers. Heightened sensory sensitivity may contribute to maladaptive patterns of stress and anxiety. The current study investigated between-group differences in stress response to peer interaction, as well as the role of sensory sensitivity. Methods: Participants included 80 children (40 ASD) between 8 and 12 years. Children participated in the peer interaction paradigm (PIP), an ecologically valid protocol that simulates real-world social interaction. Salivary cortisol was collected before and after the 20 min PIP. Parents completed questionnaires pertaining to child stress (Stress Survey Schedule) and sensory sensitivity (Short Sensory Profile). Statistical analyses included t-tests and ANCOVA models to examine between-group differences in cortisol and play; Pearson correlations to determine relations between cortisol, play, and questionnaire scores; and moderation analyses to investigate interactions among variables. Results: Controlling for baseline cortisol values, children with ASD showed significantly higher cortisol levels than TD peers, in response to the PIP [F(1, 77) = 5.77, p = 0.02]. Cortisol during play was negatively correlated with scores on the SSP (r = −0.242, p = 0.03), and positively correlated with SSS (r = 0.273, p = 0.02) indicating that higher cortisol was associated with greater sensory sensitivity (lower SSP reflects more impairment) and enhanced stress in various contexts (higher SSS reflects more stress). Furthermore, diagnosis was a significant moderator of the relation between cortisol and SSP, at multiple time points during the PIP (p < 0.05). Conclusions: The current study extends previous findings by showing that higher physiological arousal during play is associated with heightened sensory sensitivity and a pattern of increased stress in various contexts. Results are discussed in a broader context, emphasizing the need to examine relationships between social, behavioral, and physiological profiles in ASD to enhance understanding and improve treatments aimed at ameliorating stress and sensory dysfunction, while enhancing social skills.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt UniversityNashville, TN, USA; Vanderbilt Brain Institute, Neuroscience Graduate Program, Vanderbilt UniversityNashville, TN, USA
| | - Rachael A Muscatello
- Vanderbilt Brain Institute, Neuroscience Graduate Program, Vanderbilt University Nashville, TN, USA
| | - Scott D Blain
- Department of Psychology and Human Development, Vanderbilt University Nashville, TN, USA
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Sharpley CF, Bitsika V, Andronicos NM, Agnew LL. Is afternoon cortisol more reliable than waking cortisol in association studies of children with an ASD? Physiol Behav 2016; 155:218-23. [PMID: 26717863 DOI: 10.1016/j.physbeh.2015.12.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/16/2015] [Accepted: 12/20/2015] [Indexed: 12/28/2022]
Abstract
Salivary cortisol may be used as a biomarker of stress and anxiety in children with an Autism Spectrum Disorder (ASD) and is particularly valuable in studies of the association between stress-related cortisol concentrations and other factors such as comorbid disorders or aspects of the ASD phenotype. Although protocols for the collection of cortisol shortly after waking are often based on the assumption of the presence of a diurnal rhythm in cortisol, that rhythm may not be as reliable in children with an ASD as in non-ASD children. Alternatively, collecting cortisol during the afternoon may represent a more reliable procedure with less inter-participant variability.
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Affiliation(s)
- Christopher F Sharpley
- Centre for Autism Spectrum Disorders, Bond University, Robina, Queensland, Australia; Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
| | - Vicki Bitsika
- Centre for Autism Spectrum Disorders, Bond University, Robina, Queensland, Australia
| | - Nicholas M Andronicos
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
| | - Linda L Agnew
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
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Grossman RB. Judgments of social awkwardness from brief exposure to children with and without high-functioning autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 19:580-7. [PMID: 24923894 PMCID: PMC4485991 DOI: 10.1177/1362361314536937] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We form first impressions of many traits based on very short interactions. This study examines whether typical adults judge children with high-functioning autism to be more socially awkward than their typically developing peers based on very brief exposure to still images, audio-visual, video-only, or audio-only information. We used video and audio recordings of children with and without high-functioning autism captured during a story-retelling task. Typically developing adults were presented with 1 s and 3 s clips of these children, as well as still images, and asked to judge whether the person in the clip was socially awkward. Our findings show that participants who are naïve to diagnostic differences between the children in the clips judged children with high-functioning autism to be socially awkward at a significantly higher rate than their typically developing peers. These results remain consistent for exposures as short as 1 s to visual and/or auditory information, as well as for still images. These data suggest that typical adults use subtle nonverbal and non-linguistic cues produced by children with high-functioning autism to form rapid judgments of social awkwardness with the potential for significant repercussions in social interactions.
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Affiliation(s)
- Ruth B Grossman
- Department of Communication Sciences and Disorders, Emerson College, USA Department of Psychiatry, University of Massachusetts Medical School, USA
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Hirschler-Guttenberg Y, Golan O, Ostfeld-Etzion S, Feldman R. Mothering, fathering, and the regulation of negative and positive emotions in high-functioning preschoolers with autism spectrum disorder. J Child Psychol Psychiatry 2015; 56:530-9. [PMID: 25123380 DOI: 10.1111/jcpp.12311] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) exhibit difficulties in regulating emotions and authors have called to study the specific processes underpinning emotion regulation (ER) in ASD. Yet, little observational research examined the strategies preschoolers with ASD use to regulate negative and positive emotions in the presence of their mothers and fathers. METHODS Forty preschoolers with ASD and 40 matched typically developing children and their mothers and fathers participated. Families were visited twice for identical battery of paradigms with mother or father. Parent-child interactions were coded for parent and child behaviors and children engaged in ER paradigms eliciting negative (fear) and positive (joy) emotions with each parent. ER paradigms were microcoded for negative and positive emotionality, ER strategies, and parent regulation facilitation. RESULTS During free play, mothers' and fathers' sensitivity and warm discipline were comparable across groups; however, children with ASD displayed lower positive engagement and higher withdrawal. During ER paradigms, children with ASD expressed less positive emotionality overall and more negative emotionality during fear with father. Children with ASD used more simple self-regulatory strategies, particularly during fear, but expressed comparable levels of assistance seeking behavior toward mother and father in negative and positive contexts. Parents of children with ASD used less complex regulation facilitation strategies, including cognitive reappraisal and emotional reframing, and employed simple tactics, such as physical comforting to manage fear and social gaze to maintain joy. CONCLUSION Findings describe general and parent- and emotion-specific processes of child ER and parent regulation facilitation in preschoolers with ASD. Results underscore the ability of such children to seek parental assistance during moments of high arousal and the parents' sensitive adaptation to their children's needs. Reduced positive emotionality, rather than increased negative reactivity and self-regulatory efforts, emerges as the consistent element associated with ER processes in this group.
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Altered mRNA Levels of Glucocorticoid Receptor, Mineralocorticoid Receptor, and Co-Chaperones (FKBP5 and PTGES3) in the Middle Frontal Gyrus of Autism Spectrum Disorder Subjects. Mol Neurobiol 2015; 53:2090-9. [DOI: 10.1007/s12035-015-9178-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/13/2015] [Indexed: 01/20/2023]
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46
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Jacobson L. Hypothalamic-pituitary-adrenocortical axis: neuropsychiatric aspects. Compr Physiol 2014; 4:715-38. [PMID: 24715565 DOI: 10.1002/cphy.c130036] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Evidence of aberrant hypothalamic-pituitary-adrenocortical (HPA) activity in many psychiatric disorders, although not universal, has sparked long-standing interest in HPA hormones as biomarkers of disease or treatment response. HPA activity may be chronically elevated in melancholic depression, panic disorder, obsessive-compulsive disorder, and schizophrenia. The HPA axis may be more reactive to stress in social anxiety disorder and autism spectrum disorders. In contrast, HPA activity is more likely to be low in PTSD and atypical depression. Antidepressants are widely considered to inhibit HPA activity, although inhibition is not unanimously reported in the literature. There is evidence, also uneven, that the mood stabilizers lithium and carbamazepine have the potential to augment HPA measures, while benzodiazepines, atypical antipsychotics, and to some extent, typical antipsychotics have the potential to inhibit HPA activity. Currently, the most reliable use of HPA measures in most disorders is to predict the likelihood of relapse, although changes in HPA activity have also been proposed to play a role in the clinical benefits of psychiatric treatments. Greater attention to patient heterogeneity and more consistent approaches to assessing treatment effects on HPA function may solidify the value of HPA measures in predicting treatment response or developing novel strategies to manage psychiatric disease.
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Tordjman S, Anderson GM, Kermarrec S, Bonnot O, Geoffray MM, Brailly-Tabard S, Chaouch A, Colliot I, Trabado S, Bronsard G, Coulon N, Botbol M, Charbuy H, Camus F, Touitou Y. Altered circadian patterns of salivary cortisol in low-functioning children and adolescents with autism. Psychoneuroendocrinology 2014; 50:227-45. [PMID: 25244637 DOI: 10.1016/j.psyneuen.2014.08.010] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 08/14/2014] [Accepted: 08/18/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND Reports of higher stress responsivity, altered sleep-wake cycle and a melatonin deficit in autism have stimulated interest in the cortisol circadian rhythm in individuals with autism. METHODS The study was conducted on 55 low-functioning children and adolescents with autism (11.3 ± 4.1 years-old) and 32 typically developing controls (11.7 ± 4.9 years-old) matched for age, sex and puberty. Behavioral assessment was performed using the Autism Diagnostic Observation Schedule (ADOS). Salivary samples for measurement of cortisol were collected during a 24-h period (at least 0800 h-Day 1, 1600 h, 0800 h-Day 2 for 46 individuals with autism and 27 controls, and 0800 h-Day 1, 1100 h, 1600 h, 2400 h, 0800 h-Day 2 for 13 individuals with autism and 20 controls). Overnight (2000 h-0800 h) urinary cortisol excretion was also measured. RESULTS The autism group displayed significantly higher levels of salivary cortisol at all time-points, flatter daytime and nighttime slopes, higher 0800 h cortisol levels on Day 2 compared to Day 1, and greater variances of salivary and urinary cortisol. There was a significant relationship between salivary cortisol levels and impairments in social interaction and verbal language. Overnight urinary cortisol excretion was similar in the autism and control groups. CONCLUSION Anticipation of the stressful collection procedure appears to contribute to the higher 0800 h-Day 2 versus 0800 h-Day 1 salivary cortisol levels in autism. This sensitization to stressors might be as, or even more, important clinically than exposure to novelty in autism. The similar group means for overnight urinary cortisol excretion indicate that basal HPA axis functioning is unaltered in low-functioning autism. The elevated salivary cortisol levels observed in autism over the 24-h period in a repeated stressful condition, flattened diurnal cortisol patterns and the apparent effect of anticipation are consistent with prior findings in high trait anxiety.
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Affiliation(s)
- Sylvie Tordjman
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Rennes (PHUPEA), CHGR et Université de Rennes 1, Rennes, France; Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Paris, France.
| | - George M Anderson
- Child Study Center, Yale University School of Medicine, New-Haven, CT, USA
| | - Solenn Kermarrec
- Pôle Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Rennes (PHUPEA), CHGR et Université de Rennes 1, Rennes, France; Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Paris, France
| | - Olivier Bonnot
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Nantes, Nantes, France
| | - Marie-Maude Geoffray
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital le Vinatier, Bron, France
| | - Sylvie Brailly-Tabard
- INSERM U 693, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, CHU Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France
| | - Amel Chaouch
- AP-HP, CHU Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France
| | - Isabelle Colliot
- AP-HP, CHU Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France
| | - Severine Trabado
- INSERM U 693, Université Paris-Sud, Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre, France; AP-HP, CHU Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France
| | - Guillaume Bronsard
- Maison Départementale de l'Adolescent et Centre Médico-Psycho-Pédagogique, Conseil Général des Bouches-du-Rhône, France; Laboratoire de Santé Publique EA3279, Faculté de Médecine de Marseille, France
| | - Nathalie Coulon
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Paris, France
| | - Michel Botbol
- Service Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Brest, EA4686, UBO, Brest, France
| | - Henriette Charbuy
- Medical Biochemistry and Molecular Biology, Paris 6 School of Medicine, Paris, France
| | | | - Yvan Touitou
- Chronobiology Unit, Rothschild Foundation, Paris, France
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A review of rhythm and responsiveness of cortisol in individuals with autism spectrum disorders. Psychoneuroendocrinology 2014; 49:207-28. [PMID: 25108163 PMCID: PMC4165710 DOI: 10.1016/j.psyneuen.2014.07.015] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 07/11/2014] [Accepted: 07/14/2014] [Indexed: 11/21/2022]
Abstract
Examination of the hypothalamic-pituitary-adrenal (HPA) axis via cortisol among individuals with autism spectrum disorder (ASD) has been a growing area of research interest. The following review includes investigations of cortisol conducted with cohorts of individuals with ASD across the lifespan over the past four decades. In general, studies find dysregulation when examining the diurnal rhythm as a whole in lower functioning children with ASD; however, limited evidence exists for alterations in higher functioning individuals and in specific aspects of the diurnal cycle (cortisol awakening response, daily decline, variability) relative to typically developing individuals. Studies examining the responsiveness of cortisol in ASD suggest an overall sluggishness of the HPA axis in responding to physiological or physical manipulation. Hypo-responsiveness was observed in stressors that involve social evaluative threat, however, hyper-responsiveness of the HPA axis was observed in situations involving unpleasant stimuli or relatively benign social situations. A number of important considerations when conducting studies of cortisol in ASD cohorts are discussed.
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Differences in HPA-axis and heart rate responsiveness to psychosocial stress in children with autism spectrum disorders with and without co-morbid anxiety. Psychoneuroendocrinology 2014; 46:32-45. [PMID: 24882156 DOI: 10.1016/j.psyneuen.2014.04.004] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 04/06/2014] [Accepted: 04/07/2014] [Indexed: 12/27/2022]
Abstract
Children and adolescents with autism spectrum disorder (ASD) have much higher rates of anxiety disorders relative to their typically developing peers. However, there have been few attempts to investigate what physiological parameters may be associated with this elevated rate of anxiety. Therefore, this study investigated the physiological correlates of anxiety in ASD, with a focus on whether measures of heart rate and cortisol responsiveness to psychosocial stress differentiate those participants with ASD with and without a co-occurring anxiety disorder. A total of 75 male participants aged 10-16 years with normal intellectual ability underwent a psychosocial stress test. The participants included healthy controls (n=23), ASD only (ASD; n=20) and ASD with a comorbid anxiety disorder (ASDanx; n=32). Heart rate, heart rate variability and salivary cortisol were compared by fitting a piecewise regression model to examine baseline levels and change over time within and between the rest, stress and recovery phases of the stress test. The ASDanx group had different response patterns from both the ASD and control groups. The ASDanx group was characterized by a blunted cortisol and heart rate response to psychosocial stress. Furthermore, in the ASDanx group, reduced heart rate and cortisol responsiveness were significantly related to increased anxiety symptoms. This is the first study to report a possible physiological basis for co-occurring anxiety disorders in children and adolescents with ASD. It is possible that a non-adaptive physiological response to psychosocial stress may be related to the high prevalence of co-occurring anxiety disorders in people with ASD.
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Corbett BA, Swain DM, Newsom C, Wang L, Song Y, Edgerton D. Biobehavioral profiles of arousal and social motivation in autism spectrum disorders. J Child Psychol Psychiatry 2014; 55:924-34. [PMID: 24329926 PMCID: PMC4055549 DOI: 10.1111/jcpp.12184] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) are impaired in social communication and interaction with peers, which may reflect diminished social motivation. Many children with ASD show enhanced stress when playing with other children. This study investigated social and stress profiles of children with ASD during play. METHODS We utilized a peer interaction paradigm in a natural playground setting with 66 unmedicated, prepubertal, children aged 8-12 years [38 with ASD, 28 with typical development (TD)]. Salivary cortisol was collected before and after a 20-min playground interaction that was divided into periods of free and solicited play facilitated by a confederate child. Statistical analyses included Wilcoxon rank-sum tests, mixed effects models, and Spearman correlations to assess the between-group differences in social and stress functioning, identify stress responders, and explore associations between variables, respectively. RESULTS There were no differences between the groups during unsolicited free play; however, during solicited play by the confederate, significant differences emerged such that children with ASD engaged in fewer verbal interactions and more self-play than the TD group. Regarding physiological arousal, children with ASD as a group showed relatively higher cortisol in response to social play; however, there was a broad range of responses. Moreover, those with the highest cortisol levels engaged in less social communication. CONCLUSIONS The social interaction of children with ASD can be facilitated by peer solicitation; however, it may be accompanied by increased stress. The children with ASD that have the highest level of cortisol show less social motivation; yet, it is unclear if it reflects an underlying state of heightened arousal or enhanced reactivity to social engagement, or both.
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Affiliation(s)
- Blythe A. Corbett
- Vanderbilt University, Department of Psychiatry, Nashville, TN,
United States
- Vanderbilt University, Department of Psychology, Nashville, TN,
United States
- Vanderbilt University, Vanderbilt Kennedy Center, Nashville, TN,
United States
| | - Deanna M. Swain
- Vanderbilt University, Vanderbilt Kennedy Center, Nashville, TN,
United States
| | - Cassandra Newsom
- Vanderbilt University, Department of Psychiatry, Nashville, TN,
United States
- Vanderbilt University, Vanderbilt Kennedy Center, Nashville, TN,
United States
| | - Lily Wang
- Vanderbilt University, Vanderbilt Kennedy Center, Nashville, TN,
United States
- Vanderbilt University, Department of Biostatistics, Nashville, TN,
United States
| | - Yanna Song
- Vanderbilt University, Department of Biostatistics, Nashville, TN,
United States
| | - Dale Edgerton
- Vanderbilt University, Department of Molecular Physiology and
Biophysics, Nashville. TN, United States
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