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Dardani C, Schalbroeck R, Madley-Dowd P, Jones HJ, Strelchuk D, Hammerton G, Croft J, Sullivan SA, Zammit S, Selten JP, Rai D. Childhood Trauma As a Mediator of the Association Between Autistic Traits and Psychotic Experiences: Evidence From the Avon Longitudinal Study of Parents and Children Cohort. Schizophr Bull 2023; 49:364-374. [PMID: 36434745 PMCID: PMC10016398 DOI: 10.1093/schbul/sbac167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little is known on whether associations between childhood autistic traits and psychotic experiences persist into adulthood and whether genetic confounding and childhood trauma influence them. Here we investigate the associations between childhood autistic traits and psychotic experiences until young adulthood and assess the influence of schizophrenia polygenic risk and childhood traumatic experiences, using the Avon Longitudinal Study of Parents and Children (ALSPAC) population-based birth cohort. STUDY DESIGN We used a measure of broad autistic traits (autism factor mean score), and four dichotomised measures of autistic traits capturing social communication difficulties (age 7), repetitive behaviours (age 5), sociability (age 3), and pragmatic language (age 9). Psychotic experiences were assessed at ages 18 and 24 using the semi-structured Psychosis-Like Symptoms interview (PLIKSi). Traumatic experiences between ages 5 and 11 were assessed with questionnaires and interviews administered to children and parents at multiple ages. STUDY RESULTS Broad autistic traits, as well as social communication difficulties, were associated with psychotic experiences that were distressing and/or frequent until age 24 (autism factor mean score, n = 3707: OR 1.19, 95%CI 1.01-1.39; social communication difficulties, n = 3384: OR 1.54, 95%CI 0.97-2.45). Childhood trauma mediated a substantial proportion of the identified associations (~28% and 36% respectively, maximum n = 3577). Schizophrenia polygenic risk did not appear to confound the associations. Multiple imputation analyses (maximum n = 13 105) yielded comparable results. CONCLUSIONS Childhood trauma may be an important, potentially modifiable pathway between autistic features and later onset of psychotic psychopathology.
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Affiliation(s)
- Christina Dardani
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rik Schalbroeck
- Rivierduinen Institute for Mental Healthcare, Leiden, The Netherlands
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul Madley-Dowd
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hannah J Jones
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Daniela Strelchuk
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gemma Hammerton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jazz Croft
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah A Sullivan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Stan Zammit
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Healthcare, Leiden, The Netherlands
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Dheeraj Rai
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
- Avon and Wiltshire Partnership NHS Mental Health Trust, Bath, UK
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2
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Misdiagnosis of Psychosis and Obsessive-Compulsive Disorder in a Young Patient with Autism Spectrum Disorder. Case Rep Psychiatry 2023; 2023:7705913. [PMID: 36824478 PMCID: PMC9943599 DOI: 10.1155/2023/7705913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interaction and the presence of restricted and repetitive patterns of behavior. Making a first diagnosis of ASD in adults has certain difficulties, including inaccurate recall of developmental history and overlapping behaviors with other psychiatric conditions. This case study presents a young man who was assessed to have no major mental illness during his first visit to emergency services in a psychiatric hospital. During his second visit, he was initially assessed to have first episode psychosis, due to his possible delusional beliefs related to the insurance payout, social withdrawal, and strange behaviors, and then later he was assessed to have obsessive-compulsive disorder (OCD) instead of psychosis, because of his recurrent and intrusive thoughts. Eventually, his diagnosis was revised to ASD during outpatient follow-up after more comprehensive assessment. It is not easy to differentiate ASD from psychosis among some adult patients, even for expert psychiatrists. Cognitive rigidity in ASD may be similar to delusions in psychosis. Unusual behaviors in ASD can be confused with disorganized behaviors in psychosis. Differentiating ASD from OCD can be a complicated task as well, due to similarities between ASD and OCD. Restricted interests and repetitive behaviors in ASD may be perceived as obsessions and compulsions in OCD. Overall, diagnosis of ASD in adults requires comprehensive evaluation. Distinguishing symptoms of OCD and psychosis from autistic traits is critical for accurate diagnosis and optimal treatment. Although research in adult ASD has expanded alongside increased prevalence statistics over the past few years, more efforts to enhance the diagnostic processes in adult ASD are needed to reduce the challenges in this field.
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Talcer MC, Duffy O, Pedlow K. A Qualitative Exploration into the Sensory Experiences of Autistic Mothers. J Autism Dev Disord 2023; 53:834-849. [PMID: 34251566 PMCID: PMC9944021 DOI: 10.1007/s10803-021-05188-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 12/22/2022]
Abstract
Research has found 96% of autistic individuals experience sensory processing difficulties, and being a parent presents many sensory demands that may be especially challenging for autistic mothers. Despite the high prevalence, no research exists exploring the sensory experiences of autistic mothers, highlighting the gap in current knowledge. Semi-structured interviews were conducted with 7 autistic mothers, data were analysed using thematic analysis identifying 5 major themes: antenatal experiences, sensory experiences in motherhood, the impact of sensory processing difficulties, strategies and needs, diagnosis. This research provides greater insight and understanding into the sensory experiences of autistic mothers which can influence earlier diagnosis and inform appropriate support and adaptations for autistic mothers in a variety of different sectors and highlights a possible emerging role for Occupational Therapists.
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Affiliation(s)
| | - Orla Duffy
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, Ulster University, Shore Road, Newtownabbey, BT37 0QB, UK.
| | - Katy Pedlow
- grid.12641.300000000105519715Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health Research, Ulster University, Shore Road, Newtownabbey , BT37 0QB UK
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4
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Tao Z, Deng H, Chu H, Wiederhold M, Wiederhold B, Zhong H, Kang Z, Zhao J, Xiong M, Zhu M, Lin Z, Wang J. Exploring the Relationship Between Binocular Imbalance and Myopia: Refraction with a Virtual Reality Platform. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2022; 25:672-677. [PMID: 35914075 DOI: 10.1089/cyber.2022.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To explore the relationship between binocular imbalance (BI) and the abnormal development of binocular refraction. BI data were collected by enrolling the first 1,000 adolescents and children aged 6-18 years in Shenzhen Eye Hospital from April 2020 to January 2021. In this cross-sectional study, the imbalance value (IV) did not show a statistical correlation with the spherical equivalent (SE) (oculus dexter [OD]: r = 0.022, p = 0.586; oculus sinister [OS]: r = -0.021, p = 0.606), and had little correlation with the uncorrected visual acuity (VA) (OD: r = -0.084, p = 0.039; OS: r = -0.034, p = 0.408). The proportion of binocular contrast imbalance (BCI) (the absolute value) maintained the highest level (from 54.42 to 79.17 percent) with the increase of bilateral SE difference in the four subcategories (binocular balance, monocular suppression, binocular rivalry, and BCI). From -100 to +100 of IV, the SE of the left eye tends to increase negatively when compared with the right eye (from -95 < IV ≦ -80, SE difference = -0.83 ± 1.58, to -20 < IV ≦ -10, SE difference = -0.14 ± 0.61; from 10 ≦ IV <20, SE difference = -0.05 ± 0.80, to 80 ≦ IV <95, SE difference = 1.48 ± 2.77). BI widely exists within the general pediatric population. The BI did not show significant correlation with the unilateral eye refractive state and the VA. However, the BI may be accompanied by imbalanced development of the eye refractive system. Furthermore, the SE of the dominant eye (from the prospective of BI) tends to be more negative than that of the opposite eye as the value increases. Clinical Trial Registration number: ChiCTR2100045457.
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Affiliation(s)
- Zhengyang Tao
- Department of Strabismus & Pediatric Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen University of Medicine, Shenzhen, China
| | - Hongwei Deng
- Department of Strabismus & Pediatric Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen University of Medicine, Shenzhen, China
| | - Hang Chu
- National Engineering Research Center for Healthcare Devices, Guangzhou, China
| | - Mark Wiederhold
- Virtual Reality Medical Center, Scripps Memorial Hospital, La Jolla, California, USA
| | - Brenda Wiederhold
- Virtual Reality Medical Center, Scripps Memorial Hospital, La Jolla, California, USA
| | - Huahong Zhong
- Department of Strabismus & Pediatric Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen University of Medicine, Shenzhen, China
| | - Zefeng Kang
- Department of Ophthalmology, Ophthalmic Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, China
| | - Jun Zhao
- Department of Ophthalmology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Mei Xiong
- Department of Strabismus & Pediatric Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen University of Medicine, Shenzhen, China
| | - Minjuan Zhu
- Department of Strabismus & Pediatric Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen University of Medicine, Shenzhen, China
| | - Zhihong Lin
- Department of Strabismus & Pediatric Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen University of Medicine, Shenzhen, China
| | - Jiao Wang
- Department of Strabismus & Pediatric Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen University of Medicine, Shenzhen, China
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5
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Ribolsi M, Fiori Nastro F, Pelle M, Medici C, Sacchetto S, Lisi G, Riccioni A, Siracusano M, Mazzone L, Di Lorenzo G. Recognizing Psychosis in Autism Spectrum Disorder. Front Psychiatry 2022; 13:768586. [PMID: 35295770 PMCID: PMC8918655 DOI: 10.3389/fpsyt.2022.768586] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/03/2022] [Indexed: 11/15/2022] Open
Abstract
There is strong evidence for the existence of a high comorbidity between autism and psychosis with percentages reaching up to 34. 8% and several significant implications for treatment and prognosis of these patients. However, the identification of comorbid psychosis in patients with Autism Spectrum Disorder represents a complex challenge from a psychopathological point of view, in particular in patients with greater deficits in verbal communication. Intercepting the onset of a psychotic breakdown in autism may be very difficult, both disorders in fact occur along a phenotypic continuum of clinical severity and in many cases, psychotic symptoms are present in an attenuated form. In this paper, we reviewed the available scientific literature about comorbidity between psychosis and autism, focusing our attention on four specific dimensions: delusions, hallucinations, negative symptoms, and clinical course. The aim of this paper is to provide clinical tools to identify these psychotic phenomena in autistic patients, even when they occur in their attenuated form.
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Affiliation(s)
- Michele Ribolsi
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
| | - Federico Fiori Nastro
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Martina Pelle
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Caterina Medici
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Silvia Sacchetto
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Giulia Lisi
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1, Rome, Italy
| | - Assia Riccioni
- Child Neurology and Psychiatry Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Martina Siracusano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Luigi Mazzone
- Child Neurology and Psychiatry Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy.,IRCCS-Fondazione Santa Lucia, Rome, Italy
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6
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Martinez AP, Wickham S, Rowse G, Milne E, Bentall RP. Robust association between autistic traits and psychotic-like experiences in the adult general population: epidemiological study from the 2007 Adult Psychiatric Morbidity Survey and replication with the 2014 APMS. Psychol Med 2021; 51:2707-2713. [PMID: 32441234 DOI: 10.1017/s0033291720001373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Studies have shown that there are overlapping traits and symptoms between autism and psychosis but no study to date has addressed this association from an epidemiological approach in the adult general population. Furthermore, it is not clear whether autistic traits are associated with specific symptoms of psychosis or with psychosis in general. We assess these associations for the first time by using the Adult Psychiatric Morbidity Survey (APMS) 2007 and the APMS 2014, predicting an association between autistic traits and probable psychosis, and specific associations between autistic traits and paranoia and strange experiences. METHODS Participants (N = 7353 in 2007 and 7500 in 2014) completed the Psychosis Screening Questionnaire (PSQ) and a 20-item version of the Autism Quotient (AQ-20). Binomial logistic regressions were performed using AQ-20 as the independent variable and probable psychosis and specific symptoms as dependent variables. RESULTS In the APMS 2007 dataset, significant associations were found between autism traits and probable psychosis, paranoia, thought insertion, and strange experiences. These results were replicated in APMS 2014 but with the additional significant association between autistic traits and hallucinations. Participants in the highest quartile of the AQ-20, compared with the lowest quartile, had an increased risk of probable psychosis of odds ratio (OR) = 15.5 [95% confidence interval (CI) 4.57-52.6] in APMS 2007 and OR = 22.5 (95% CI 7.64-66.3) in APMS 2014. CONCLUSIONS Autistic traits are strongly associated with probable psychosis and psychotic experiences with the exception of mania. Limitations such as the cross-sectional nature of the study are discussed.
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Affiliation(s)
- Anton P Martinez
- Psychology Department, The University of Sheffield, Cathedral Court, Sheffield S1 2LT, UK
| | - Sophie Wickham
- Department of Public Health and Policy, University of Liverpool, Waterhouse Building Block F, Liverpool L69 3GL, UK
| | - Georgina Rowse
- Psychology Department, The University of Sheffield, Cathedral Court, Sheffield S1 2LT, UK
| | - Elizabeth Milne
- Psychology Department, The University of Sheffield, Cathedral Court, Sheffield S1 2LT, UK
| | - Richard P Bentall
- Psychology Department, The University of Sheffield, Cathedral Court, Sheffield S1 2LT, UK
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7
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Strålin P, Hetta J. First episode psychosis: register-based study of comorbid psychiatric disorders and medications before and after. Eur Arch Psychiatry Clin Neurosci 2021; 271:303-313. [PMID: 32458108 PMCID: PMC7960599 DOI: 10.1007/s00406-020-01139-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/04/2020] [Indexed: 01/02/2023]
Abstract
Comorbid psychiatric disorders are common in first episode psychosis. We investigated comorbid disorders before, at, and after a first hospital-treated psychosis in a naturalistic nation-wide cohort (n = 2091) with a first psychosis hospitalization between 2007 and 2011, and at ages between 16 and 25. Swedish population registers were used to identify the cohort and to collect data on diagnoses at hospitalizations and medications. The proportions of cases with hospitalizations or medications increased year by year before and decreased in the years after the first psychosis hospitalization. In the 2 years before, 30% had hospitalizations with other psychiatric diagnoses and 60% had psychiatric medications. At the first psychosis hospitalization, 46% had other comorbid psychiatric diagnoses or self-harm. In the 2 years before or at the first psychosis hospitalization, 17% had anxiety or stress disorders at hospitalizations, 12% depressive disorders, 5.4% manic or bipolar disorders, 8.6% personality disorders, 26% substance use disorders, and 15% neurodevelopmental disorders. 8.2% had hospitalizations for self-harm. At most, around 30% of the cases were estimated not to have had any comorbid psychiatric disorders before or at the first psychosis presentation. Early comorbid affective, anxiety or personality disorders or self-harm were associated with a worse outcome, as measured by new psychiatric hospitalizations. The outcome was worst for personality disorders with 73% re-hospitalizations within 1 year and for patients with self-harm with 70% re-hospitalizations. In conclusion, most cases with a first psychosis hospitalization had clinical presentations indicating comorbid psychiatric disorders. Cases with comorbidity had a higher risk for re-hospitalizations.
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Affiliation(s)
- Pontus Strålin
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Jerker Hetta
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
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8
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Dunn S, Jones M. Binocular rivalry dynamics associated with high levels of self-reported autistic traits suggest an imbalance of cortical excitation and inhibition. Behav Brain Res 2020; 388:112603. [PMID: 32222380 DOI: 10.1016/j.bbr.2020.112603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/13/2020] [Accepted: 03/05/2020] [Indexed: 10/24/2022]
Abstract
An imbalance in cortical excitation and inhibition (E/I) may underlie both social and non-social symptoms of autism spectrum conditions (ASC). Recent work suggests that an E/I imbalance may underlie some of the sensory differences that are characteristic of ASCs such as anomalous perception. Binocular rivalry dynamics are thought to reflect the balance of E/I in the brain and could serve as a behavioural biomarker for ASC. Previous studies of clinical ASC populations have found a slower rate of binocular rivalry transitions; increased duration of the mixed percept and reduced perceptual suppression. There are some mixed reports of altered rivalry dynamics in the neurotypical population with high self-reported levels of autistic traits. Therefore, we used simple grating stimuli to measure binocular rivalry dynamics in a sample of seventy-nine adults aged 18-55 years. We additionally measured the level of autistic traits with the AQ-10 and used CAPS as a measure of anomalous perception. Bayesian correlations showed that those with higher AQ scores had a slower rate of perceptual switching and a longer mixed percept duration. Significant regression models with CAPS and AQ score revealed that AQ score was a significant predictor of switch rate and mixed percept duration, whereas CAPS was not. We also report that CAPS significantly predicted perceptual suppression, whereas AQ score did not. Overall, our findings suggest that in a non-clinical population, autistic traits are a predictor of binocular rivalry dynamics and the cortical E/I imbalance thought to underlie symptoms of ASC may extend to the broader phenotype.
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Affiliation(s)
- Stephanie Dunn
- Department of Psychology, The University of Sheffield, Cathedral Court, 1 Vicar Lane, S1 2LT, United Kingdom.
| | - Myles Jones
- Department of Psychology, The University of Sheffield, Cathedral Court, 1 Vicar Lane, S1 2LT, United Kingdom.
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9
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Seo M, Anderson G. Gut-Amygdala Interactions in Autism Spectrum Disorders: Developmental Roles via regulating Mitochondria, Exosomes, Immunity and microRNAs. Curr Pharm Des 2020; 25:4344-4356. [PMID: 31692435 DOI: 10.2174/1381612825666191105102545] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/01/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Autism Spectrum Disorders (ASD) have long been conceived as developmental disorder. A growing body of data highlights a role for alterations in the gut in the pathoetiology and/or pathophysiology of ASD. Recent work shows alterations in the gut microbiome to have a significant impact on amygdala development in infancy, suggesting that the alterations in the gut microbiome may act to modulate not only amygdala development but how the amygdala modulates the development of the frontal cortex and other brain regions. METHODS This article reviews wide bodies of data pertaining to the developmental roles of the maternal and foetal gut and immune systems in the regulation of offspring brain development. RESULTS A number of processes seem to be important in mediating how genetic, epigenetic and environmental factors interact in early development to regulate such gut-mediated changes in the amygdala, wider brain functioning and inter-area connectivity, including via regulation of microRNA (miR)-451, 14-3-3 proteins, cytochrome P450 (CYP)1B1 and the melatonergic pathways. As well as a decrease in the activity of monoamine oxidase, heightened levels of in miR-451 and CYP1B1, coupled to decreased 14-3-3 act to inhibit the synthesis of N-acetylserotonin and melatonin, contributing to the hyperserotonemia that is often evident in ASD, with consequences for mitochondria functioning and the content of released exosomes. These same factors are likely to play a role in regulating placental changes that underpin the association of ASD with preeclampsia and other perinatal risk factors, including exposure to heavy metals and air pollutants. Such alterations in placental and gut processes act to change the amygdala-driven biological underpinnings of affect-cognitive and affect-sensory interactions in the brain. CONCLUSION Such a perspective readily incorporates previously disparate bodies of data in ASD, including the role of the mu-opioid receptor, dopamine signaling and dopamine receptors, as well as the changes occurring to oxytocin and taurine levels. This has a number of treatment implications, the most readily applicable being the utilization of sodium butyrate and melatonin.
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Affiliation(s)
- Moonsang Seo
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - George Anderson
- CRC Scotland & London, Eccleston Square, London, United Kingdom
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10
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Shepherd AJ, Patterson AJK. Exploration of anomalous perceptual experiences in migraine between attacks using the Cardiff Anomalous Perceptions Scale. Conscious Cogn 2020; 82:102945. [PMID: 32422548 DOI: 10.1016/j.concog.2020.102945] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 02/04/2023]
Abstract
Distortions in sensory experiences that precede a migraine attack have been extensively documented, the most well-known being the visual aura. Distortions in the experience of other senses are also reported as part of an aura, albeit less frequently, together with changes in the perception or ownership of the body or body parts. There are many examples of differences in aspects of visual perception between migraine and control groups, between attacks, but not as much on unusual experiences involving other senses, the sense of the body or the experience of the environment. Seventy-seven migraine (33 with aura) and 74 control participants took part. Anomalous perceptions were experienced by both migraine and control groups, but more with migraine experienced them and rated them as more distressing, intrusive and frequent. Associations with reports of visual triggers of migraine and visual discomfort are presented. This study is the first to show relationships between these factors.
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Affiliation(s)
- Alex J Shepherd
- Department of Psychological Sciences, Birkbeck College, University of London, UK.
| | - Adam J K Patterson
- Department of Psychological Sciences, Birkbeck College, University of London, UK
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11
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Westby C. Screen Time and Children with Autism Spectrum Disorder. Folia Phoniatr Logop 2020; 73:233-240. [PMID: 32229733 DOI: 10.1159/000506682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/19/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Research is increasingly raising concerns regarding the negative consequences of children's use of screens. SUMMARY This article reviews the literature on the benefits and risks of screen time with attention to explaining possible reasons that children with autism are more at risk for the negative effects of screen time. Based on the science of learning literature, a framework for choosing appropriate digital media for children with autism is described. The 3-component framework considers the characteristics of the child, the context in which digital media are used, and the content of the media. Key Message: Using the framework, the speech-language pathologist will be better able to select appropriate digital media content for children with autism that is engaging (while not being distracting), encourages the child to be actively involved with the media, is meaningful in the child's life, and incorporates social interactions with others.
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Affiliation(s)
- Carol Westby
- Bilingual Multicultural Services, Albuquerque, New Mexico, USA,
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12
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Shomrat T, Nesher N. Updated View on the Relation of the Pineal Gland to Autism Spectrum Disorders. Front Endocrinol (Lausanne) 2019; 10:37. [PMID: 30804889 PMCID: PMC6370651 DOI: 10.3389/fendo.2019.00037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/16/2019] [Indexed: 12/20/2022] Open
Abstract
Identification of the biological features of autism is essential for designing an efficient treatment and for prevention of the disorder. Though the subject of extensive research, the neurophysiological features of autism remain unclear. One of the proposed biological causes of autism is malfunction of the pineal gland and deficiency of its principal hormone, melatonin. The main function of melatonin is to link and synchronize the body's homeostasis processes to the circadian and seasonal rhythms, and to regulate the sleep-wake cycle. Therefore, pineal dysfunction has been implicated based on the common observation of low melatonin levels and sleep disorders associated with autism. In this perspective, we highlight several recent findings that support the hypothesis of pineal gland/melatonin involvement in autism. Another common symptom of autism is abnormal neuroplasticity, such as cortical overgrowth and dendritic spine dysgenesis. Here, we synthesize recent information and speculate on the possibility that this abnormal neuroplasticity is caused by hyperactivity of endogenous N,N-dimethyltryptamine (DMT). The pineal gland was proposed as the source of DMT in the brain and therefore, our assumption is that besides melatonin deficiency, pineal dysfunction might also play a part in the development of autism through abnormal metabolism of DMT. We hope that this manuscript will encourage future research of the DMT hypothesis and reexamination of several observations that were previously attributed to other factors, to see if they could be related to pineal gland/melatonin malfunction. Such research could contribute to the development of autism treatment by exogenous melatonin and monitored light exposure.
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13
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Milne E, Dunn S, Zhao C, Jones M. Altered neural dynamics in people who report spontaneous out of body experiences. Cortex 2018; 111:87-99. [PMID: 30472385 DOI: 10.1016/j.cortex.2018.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 09/22/2018] [Accepted: 10/23/2018] [Indexed: 11/18/2022]
Abstract
It has been suggested that individual differences in cortical excitability leading to disruption of the timing and integration of sensory information processing may explain why some people have out of body experiences (OBE) in the absence of any known pathological or psychiatric condition. Here we recorded EEG from people who either had, or had not experienced an OBE in order to investigate the neural dynamics of OBE in the non-clinical population. A screening questionnaire was completed by 551 people, 24% of whom reported having at least one OBE. Participants who were free of any psychiatric or neurological diagnoses, including migraines, were invited to take part in subsequent EEG recording. EEG data were obtained from 19 people who had had an OBE and 20 who had not. Amplitude of the visual P1 ERP deflection and consistency of alpha-band phase locking were significantly reduced in the participants who had had an OBE. We did not find any group differences in resting state power or in visually induced gamma oscillations. These results provide support for the claim that cortical differences, particularly with respect to the timing of visual information processing, may give rise to OBE in clinically healthy individuals. To our knowledge, this study is the first to compare EEG variables obtained from people who have, and have not, had an OBE.
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Affiliation(s)
- Elizabeth Milne
- Department of Psychology, The University of Sheffield, Sheffield, UK.
| | - Stephanie Dunn
- Department of Psychology, The University of Sheffield, Sheffield, UK
| | - Chen Zhao
- Department of Psychology, The University of Sheffield, Sheffield, UK
| | - Myles Jones
- Department of Psychology, The University of Sheffield, Sheffield, UK
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14
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Upthegrove R, Abu-Akel A, Chisholm K, Lin A, Zahid S, Pelton M, Apperly I, Hansen PC, Wood SJ. Autism and psychosis: Clinical implications for depression and suicide. Schizophr Res 2018; 195:80-85. [PMID: 28823724 DOI: 10.1016/j.schres.2017.08.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 12/30/2022]
Abstract
There is increasing recognition of the co-occurrence of autism and schizophrenia spectrum disorders. However, the clinical significance of this on outcomes such as depression and suicidal thinking has not been explored. This study examines the association of autism spectrum traits, depressive symptoms and suicidal behaviour in individuals with psychotic experiences. In two cross sectional studies, individuals from a non-help seeking university student sample and patients with first episode psychosis (FEP) service completed standardized measures of autism spectrum traits, psychotic experiences, depressive symptoms and suicidal thinking. In healthy non-help seeking students, increased autism traits and increased subclinical psychotic experiences were significantly associated with depressive symptoms; a significant interaction effect suggests their combined presence has a greater impact on depression. In FEP, high autism traits and positive symptoms were associated with increased depression, hopelessness and suicidality, however there was no significant interaction effect. In FEP a multiple mediation model revealed that the relationship between autism traits and risk for suicidality was mediated through hopelessness. Young people with subclinical psychotic experiences and all patients with FEP should be screened for autism spectrum traits, which may have significant impact on clinical outcomes. Tailored interventions for patients with high levels of autistic spectrum co-morbidities in FEP should be a priority for future research.
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Affiliation(s)
- Rachel Upthegrove
- University of Birmingham, School of Psychology, Edgbaston, Birmingham B15 2TT, United Kingdom; University of Birmingham, Institute of Clinical Sciences, College of Medical and Dental Science, Edgbaston, Birmingham B15 2TT, United Kingdom; Forward Thinking Birmingham and Birmingham and Solihull Mental Health Foundation Trust, 1 Printing House Street, Birmingham B4 6DF, United Kingdom.
| | - Ahmad Abu-Akel
- University of Lausanne, Institute of Psychology, UNIL - Mouline, Géopolis - office 4129, CH-1015 Lausanne, Switzerland
| | - Katharine Chisholm
- University of Birmingham, School of Psychology, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Rd, Subiaco, WA 6008, Australia
| | - Sofia Zahid
- University of Birmingham, School of Psychology, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Mirabel Pelton
- University of Birmingham, School of Psychology, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Ian Apperly
- University of Birmingham, School of Psychology, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Peter C Hansen
- University of Birmingham, School of Psychology, Edgbaston, Birmingham B15 2TT, United Kingdom
| | - Stephen J Wood
- University of Birmingham, School of Psychology, Edgbaston, Birmingham B15 2TT, United Kingdom; University of Melbourne, Centre for Youth Mental Health, 35 Poplar Rd, Parkville, VIC 3052, Australia; Orygen, National Centre of Excellence in Youth Mental Health, 2a/2A Hartington Street, Glenroy, Victoria 3046, Australia
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15
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Panagiotidi M, Overton PG, Stafford T. The relationship between ADHD traits and sensory sensitivity in the general population. Compr Psychiatry 2018; 80:179-185. [PMID: 29121555 DOI: 10.1016/j.comppsych.2017.10.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 02/04/2023] Open
Abstract
Preliminary studies in children and adults with Attention Deficit Hyperactivity Disorder (ADHD) report both hypo-responsiveness and hyper-responsiveness to sensory stimuli, as well as problems modulating sensory input. As it has been suggested that those with ADHD exist at the extreme end of a continuum of ADHD traits, which are also evident in the general population, we investigated the link between ADHD and sensory sensitivity in the general population. Two online questionnaires measuring ADHD traits and sensory responsivity across various sensory domains were administered to 234 participants. Results showed a highly significant positive correlation between the number of ADHD traits and the frequency of reported sensory processing problems. An increased number of sensory difficulties across all modalities were associated with the level of ADHD. Furthermore, ADHD traits predicted sensory difficulties and exploratory factor analysis revealed a factor that combined ADHD trait and sensory processing items. This is the first study to identify a positive relationship between sensory processing and ADHD traits in the general population. Our results suggest that sensory difficulties could be part of the ADHD phenotype.
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Affiliation(s)
- Maria Panagiotidi
- School of Psychology, Sport and Exercise, Staffordshire University, College Road, Stoke-on-Trent, Staffordshire ST4 2DE, UK.
| | - Paul G Overton
- Department of Psychology, University of Sheffield, Western Bank, Sheffield S10 2TN, UK
| | - Tom Stafford
- Department of Psychology, University of Sheffield, Western Bank, Sheffield S10 2TN, UK
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16
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The Glasgow Sensory Questionnaire: Validation of a French Language Version and Refinement of Sensory Profiles of People with High Autism-Spectrum Quotient. J Autism Dev Disord 2017; 48:1549-1565. [DOI: 10.1007/s10803-017-3422-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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