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Carty A, Green R, Goodman CV, McLaughlin JR, Hu H, Lanphear B, Muckle G, Till C. Performance of the Social Responsiveness Scale-2 for the Assessment of Autistic Behaviors in a Sample of Canadian Preschool-Aged Children. J Autism Dev Disord 2024:10.1007/s10803-024-06487-z. [PMID: 39102070 DOI: 10.1007/s10803-024-06487-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2024] [Indexed: 08/06/2024]
Abstract
Behavioral traits of autism spectrum disorder (ASD) typically present in early childhood, underscoring the importance of screening tools for the early identification of ASD. The current study compared scores on the Social Responsiveness Scale-Second Edition (SRS-2) Preschool Form between the US standardization sample (n = 247) and a Canadian cohort of preschool-aged children (n = 595) recruited from the Maternal-Infant Research on Environmental Chemicals (MIREC) study. In the MIREC sample, we examined whether ASD-like traits are correlated with sociodemographic characteristics and child intellectual abilities, and how maternal ratings of social skills assessed by the SRS-2 are associated with maternal ratings of general problem behaviors. Mean total SRS-2 raw score was significantly lower in the MIREC sample (mean = 29.7, SD = 15.8) compared to the US standardization sample (mean = 41.9, SD = 26.0). Total raw score in the US standardization sample did not significantly differ between males (mean = 40.6, SD = 23.1) and females (mean = 42.8, SD = 28.7), whereas in the MIREC sample the total raw score was significantly higher among males (mean = 33.0, SD = 17.1) than females (mean = 26.6, SD = 13.9). A significantly larger proportion of the MIREC sample was White, younger in age, and had more educated parents compared to the US standardization sample. ASD-like traits were correlated with lower intellectual abilities, a less enriched home environment, more behavioral problems, and poorer adaptive skills. SRS-2 Preschool Form scores were significantly lower in the Canadian sample compared to the US standardization sample, which may reflect demographic differences between the two groups. Girls may be under-identified when SRS-2 Preschool Form norms are used for screening ASD.
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Affiliation(s)
- Adele Carty
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rivka Green
- Department of Psychology, Faculty of Health, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Carly V Goodman
- Department of Psychology, Faculty of Health, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - John R McLaughlin
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Howard Hu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Bruce Lanphear
- Child and Family Research Institute, Faculty of Health Sciences, BC Children's Hospital Research Institute, Simon Fraser University, Vancouver, BC, Canada
| | - Gina Muckle
- Centre Hospitalier Universitaire (CHU) de Québec Research Centre, School of Psychology, Laval University, Quebec, QC, Canada
| | - Christine Till
- Department of Psychology, Faculty of Health, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada.
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Isfandnia F, El Masri S, Radua J, Rubia K. The effects of chronic administration of stimulant and non-stimulant medications on executive functions in ADHD: A systematic review and meta-analysis. Neurosci Biobehav Rev 2024; 162:105703. [PMID: 38718988 DOI: 10.1016/j.neubiorev.2024.105703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/28/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with executive function deficits that are improved with medications. However, meta-analyses of stimulant effects on cognition have mostly tested single-dose effects, and there is no meta-analysis of non-stimulant effects. This systematic review and meta-analysis tested the clinically more relevant longer-term effects of Methylphenidate (20 studies; minimum 1 week) and Atomoxetine (8 studies; minimum 3 weeks) on reaction time, attention, inhibition, and working memory, searching papers on PubMed, Embase, Ovid MEDLINE, and PsycINFO. The meta-analysis of 18 studies in 1667 subjects showed that methylphenidate was superior to placebo in all cognitive domains with small to medium effect sizes (Hedges g of 0.34-0.59). The meta-analysis of atomoxetine included 7 studies in 829 subjects and showed no effects in working memory, but superior effects in the other domains with medium to large effect sizes (Hedge's g of 0.36-0.64). Meta-regression analysis showed no drug differences on cognitive effects. The meta-analyses show for the first time that chronic Methylphenidate and Atomoxetine have comparable effects of improving executive functions in people with ADHD.
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Affiliation(s)
- Ferdous Isfandnia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Sahid El Masri
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Child & Adolescent Psychiatry, University Hospital Carl Gustav Dresden, Dresden University of Technology, Germany.
| | - Joaquim Radua
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Child & Adolescent Psychiatry, University Hospital Carl Gustav Dresden, Dresden University of Technology, Germany.
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Dehnavi F, Khan A. Time-Based and Event-Based Prospective Memory in Adults with Autism Spectrum Disorder: A Virtual Week Investigation. J Autism Dev Disord 2024; 54:2298-2306. [PMID: 37079178 DOI: 10.1007/s10803-023-05975-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Autism spectrum disorder (ASD) is a complex developmental condition including persistent challenges with social communication, restricted interests, and repetitive behavior. Though prospective memory failures are commonly observed in ASD population it has been less studied among adults with ASD. Prospective memory (PM) refers to the execution of delayed intentions. There are contradictory findings of regular and irregular prospective memory task among autistic adults. The present study is an attempt to investigate prospective memory performance among adults with autism spectrum disorder using the Virtual Week board game. METHOD Virtual Week (Rendell & Craik, 2000) (3-day Version) is a computerized board game in which participants after rolling a die move token clockwise around the board. Each round of the board represents one virtual "day." Adults between 16 and 25 years of age who were diagnosed with ASD (N = 23) were compared with non-ASD (N = 26) adults. RESULTS Analyses of variance were used to analyze the data. Results revealed that autistic adults as compared to normal adults showed poorer performance on time-based task than on event-based task. A significant difference was evident between regular and irregular prospective memory tasks across both tasks among autistic adults. Results also revealed that ASD difficulties are associated with the prospective component of the irregular task. CONCLUSIONS Prospective memory failures are widely observed in ASD group, and have important implications for functional independence. The findings of this study provide insight into prospective memory challenges that adults with autism spectrum disorder face in a daily basis.
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Affiliation(s)
- Farangis Dehnavi
- Psychophysiology Laboratory, Department of Humanities and Social Sciences, Indian Institute of Technology Bombay Powai, Mumbai, 400 076, Maharashtra, India
| | - Azizuddin Khan
- Psychophysiology Laboratory, Department of Humanities and Social Sciences, Indian Institute of Technology Bombay Powai, Mumbai, 400 076, Maharashtra, India.
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Holeva V, Nikopoulou VA, Lytridis C, Bazinas C, Kechayas P, Sidiropoulos G, Papadopoulou M, Kerasidou MD, Karatsioras C, Geronikola N, Papakostas GA, Kaburlasos VG, Evangeliou A. Effectiveness of a Robot-Assisted Psychological Intervention for Children with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:577-593. [PMID: 36331688 PMCID: PMC9638397 DOI: 10.1007/s10803-022-05796-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
Difficulties with social interaction characterise children with Autism Spectrum Disorders and have a negative impact in their everyday life. Integrating a social-humanoid robot within the standard clinical treatment has been proven promising. The main aim of this randomised controlled study was to evaluate the effectiveness of a robot-assisted psychosocial intervention and the secondary aim was to investigate potential differences between a robot-assisted intervention group and a control group receiving intervention by humans only. The analysis of the results showed that robot-assisted intervention could be beneficial by improving children's psychosocial skills. This improvement was highlighted by neuropsychological testing and parent reporting. Group comparison only presented minimal statistically significant differences. The study underpins the potential of robot-assisted interventions to augment standard care.
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Grants
- Τ1ΕDΚ-00929 Action "RESEARCH - DEVELOP - INNOVATE", cycle A, Intervention II, Operational Programme "Competitiveness, Entrepreneurship and Innovation", NSRF (National Strategic Reference Framework) of Greece 2014-2020
- Action “RESEARCH – DEVELOP - INNOVATE”, cycle A, Intervention II, Operational Programme “Competitiveness, Entrepreneurship and Innovation”, NSRF (National Strategic Reference Framework) of Greece 2014-2020
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Affiliation(s)
- Vasiliki Holeva
- Clinical Psychology Department, Papageorgiou General Hospital, Periferiaki Odos, Ring Road, N. Efkarpia, 54603, Thessaloniki, Greece.
| | - V A Nikopoulou
- Clinical Psychology Department, Papageorgiou General Hospital, Periferiaki Odos, Ring Road, N. Efkarpia, 54603, Thessaloniki, Greece
| | - C Lytridis
- HUman-MAchines INteraction Laboratory (HUMAIN-Lab), International Hellenic University, Agios Loukas, Kavala, Greece
| | - C Bazinas
- HUman-MAchines INteraction Laboratory (HUMAIN-Lab), International Hellenic University, Agios Loukas, Kavala, Greece
| | - P Kechayas
- Clinical Psychology Department, Papageorgiou General Hospital, Periferiaki Odos, Ring Road, N. Efkarpia, 54603, Thessaloniki, Greece
| | - G Sidiropoulos
- HUman-MAchines INteraction Laboratory (HUMAIN-Lab), International Hellenic University, Agios Loukas, Kavala, Greece
| | - M Papadopoulou
- Division of Child Neurology and Metabolic Disorders, 4th Department of Paediatrics, AUTH, Papageorgiou General Hospital, Periferiaki Odos, N. Efkarpia, Thessaloniki, Greece
| | - M D Kerasidou
- Clinical Psychology Department, Papageorgiou General Hospital, Periferiaki Odos, Ring Road, N. Efkarpia, 54603, Thessaloniki, Greece
| | - C Karatsioras
- "Praxis" Novel Consulting and Therapy Centre for Children, Kavala, Greece
| | | | - G A Papakostas
- HUman-MAchines INteraction Laboratory (HUMAIN-Lab), International Hellenic University, Agios Loukas, Kavala, Greece
| | - V G Kaburlasos
- HUman-MAchines INteraction Laboratory (HUMAIN-Lab), International Hellenic University, Agios Loukas, Kavala, Greece
| | - A Evangeliou
- Division of Child Neurology and Metabolic Disorders, 4th Department of Paediatrics, AUTH, Papageorgiou General Hospital, Periferiaki Odos, N. Efkarpia, Thessaloniki, Greece
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5
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Ehrler M, Bellinger DC, Cassidy AR, Newburger JW, Calderon J. Social cognition and behavioral outcomes in congenital heart disease: profiles and neuropsychiatric comorbidities. Child Neuropsychol 2023; 29:1041-1063. [PMID: 37017255 DOI: 10.1080/09297049.2023.2196398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 03/17/2023] [Indexed: 04/06/2023]
Abstract
Autism spectrum disorders are more prevalent in children with congenital heart disease (CHD) than in the general population. Children with CHD without diagnosed autism are also at increased risk for neurodevelopmental and psychiatric impairments. We characterized social and behavioral outcomes in children with CHD and examined neurodevelopmental and psychiatric comorbidities. Children without diagnosed autism who underwent infant open-heart surgery were eligible. Parent-reports assessed social communication, unusual behaviors, self-regulation, anxiety, and executive function (EF). Neuropsychological tests assessing theory of mind (ToM), working memory, and verbal comprehension were administered. Outcomes were compared to normative data. Linear regressions were estimated with parent-reported scores and ToM abilities as outcomes. Predictors were anxiety symptoms, parent-reported EF, and working memory scores. Covariates were age, parental education, ADHD diagnosis, and verbal comprehension. Clinically relevant comorbidities were identified (N children scoring ≥1SD below the norm). Fifty-six children (10.8 ± 1.8 years) participated virtually. Compared to norms, children with CHD had impaired ToM, more unusual behaviors (p = .002), and less self-regulation (p = .018), but better social communication (p = .014). "Autism-like" traits were positively associated with anxiety symptoms (ß(95% CI) = 0.28(0.08-0.49), p = .008) and worse working memory (ß(95% CI) = -0.36(-0.59-0.13), p = .003). Twenty-one out of 22 children who displayed clinically relevant social and behavioral scores also showed anxiety symptoms (n = 4), impaired EF (n = 7), or both (n = 10). Children with CHD without diagnosed autism have elevated unusual behaviors, lower self-regulation, and impaired ToM. There is a high risk of co-existing anxiety and impaired EF which may increase disease burden. Targeted therapeutic interventions are needed to reduce long-term psychosocial risks in these children.AbbreviationAttention deficit/hyperactivity disorder (ADHD), Autism Spectrum Rating Scale (ASRS), Behavior Rating Inventory of Executive Functions for school-aged children, 2nd Edition (BRIEF-2), cardiopulmonary bypass (CPB), congenital heart disease (CHD), Empathy/Systematizing Quotient Child Version (ESQ-C), Multidimensional Anxiety Scale for Children, 2nd Edition (MASC-2), Social Responsiveness Scale (School-age form), 2nd Edition (SRS-2), theory of mind (ToM), Theory of Mind Task Battery (ToM-TB), Wechsler Intelligence Scale for Children, 5th edition (WISC-V).
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Affiliation(s)
- Melanie Ehrler
- Child Development Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
- Departments of Cardiology, Cardiac Neurodevelopmental Program, Boston Children's Hospital, Boston, MA, USA
| | - David C Bellinger
- Departments of Psychiatry, Cardiac Neurodevelopmental Program, Boston Children's Hospital, Boston, MA, USA
- Departments of Neurology, Cardiac Neurodevelopmental Program, Boston Children's Hospital, Boston, MA, USA
- Departments of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, USA
- Departments of Neurology, Harvard Medical School, Harvard University, Boston, MA, USA
| | - Adam R Cassidy
- Departments of Psychiatry, Cardiac Neurodevelopmental Program, Boston Children's Hospital, Boston, MA, USA
- Departments of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, USA
- Departments of Psychiatry and Psychology & Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jane W Newburger
- Departments of Cardiology, Cardiac Neurodevelopmental Program, Boston Children's Hospital, Boston, MA, USA
- Pediatrics, Harvard Medical School, Harvard University, Boston, USA
| | - Johanna Calderon
- Departments of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, USA
- National Institute of Health and Medical Research, Inserm U1046 PhyMedExp, Cardiac Neurodevelopment Research, University of Montpellier, Montpellier, France
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García-Galant M, Blasco M, Laporta-Hoyos O, Berenguer-González A, Moral-Salicrú P, Ballester-Plané J, Caldú X, Miralbell J, Alonso X, Medina-Cantillo J, Povedano-Bulló E, Leiva D, Boyd RN, Pueyo R. A randomized controlled trial of a home-based computerized executive function intervention for children with cerebral palsy. Eur J Pediatr 2023; 182:4351-4363. [PMID: 37462799 PMCID: PMC10587273 DOI: 10.1007/s00431-023-05072-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/27/2023] [Accepted: 06/17/2023] [Indexed: 10/20/2023]
Abstract
Children with cerebral palsy (CP) often show executive function (EF) impairments that are key to quality of life. The aim of this study was to assess whether a home-based computerized intervention program improves executive functions (EFs) compared to usual care. Sixty participants (30 females) with CP (8-12 years old) were paired by age, sex, motor ability, and intelligence quotient score and then randomized to intervention and waitlist control groups. The intervention group received a 12-week home-based computerized EF intervention (5 days/week, 30 min/day, total dose 30 h). Core and higher-order EFs were assessed before, immediately after, and 9 months after completing the intervention. The intervention group performed better than the waitlist control group in the three core EFs (immediately and 9 months after the intervention): inhibitory control (F = 7.58, p = 0.13 and F = 7.85, p = 0.12), working memory (F = 8.34, p = 0.14 and F = 7.55, p = 0.13), and cognitive flexibility (F = 4.87, p = 0.09 and F = 4.19, p = 0.08). No differences were found between the groups in higher-order EFs or EF manifestations in daily life. CONCLUSIONS A home-based computerized EF intervention improved core EFs in children with CP, but further research is needed to identify strategies that allow the transfer of these improvements to everyday life. TRIAL REGISTRATION NCT04025749 retrospectively registered on 19 July 2019. WHAT IS KNOWN • One in two children with cerebral palsy has an intellectual impairment. Visual perception and executive functions are the most reported specific cognitive deficits. • The majority of interventions for cerebral palsy focus on motor impairments, but only a few randomized controlled trials have explored the effect of interventions on executive functions. WHAT IS NEW • A home-based computerized cognitive intervention can improve the core executive functions of children with cerebral palsy. • Short- and long-term effects on core executive functions have been found.
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Affiliation(s)
- María García-Galant
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Montse Blasco
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Alba Berenguer-González
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Paula Moral-Salicrú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Xavier Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Júlia Miralbell
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Xènia Alonso
- Servei de Neurologia, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Julita Medina-Cantillo
- Servei de Rehabilitació i Medicina Física, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08035, Barcelona, Spain
| | - Elsa Povedano-Bulló
- Servei de Rehabilitació i Medicina Física, Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08035, Barcelona, Spain
| | - David Leiva
- Departament de Psicologia Social i Psicologia Quantitativa, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
| | - Roslyn N Boyd
- Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, 62 Graham St, Brisbane, QLD, 4101, Australia
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.
- Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.
- Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain.
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Coelho B, Mota B, Viana V, Igreja AI, Candeias L, Rocha H, Rocha DFD, Guardiano M. Theory of mind in children with attention deficit hyperactivity disorder. Rev Neurol 2023; 77:109-114. [PMID: 37612827 PMCID: PMC10662233 DOI: 10.33588/rn.7705.2023099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Theory of mind (TM) is involved in social cognition, as it evaluates our ability to impute our mental states to the others in order to predict and explain behaviour. In the literature, it has been noticed that children with attention deficit hyperactivity disorder (ADHD) show some impairments of TM when compared with children not neurodevelopmental impaired. Our goal in this study was to compare the TM in two groups: schooler children with normal development and schooler children with ADHD. SUBJECTS AND METHODS A total of 35 children, aged between 6 and 12 years, were recruited: 17 with ADHD and 18 not neurodevelopmental impaired. TM was evaluated using an assessment method validated for the Portuguese population: Turtle on the Island-Battery of Assessment of Executive Functions in Children. RESULTS We obtained two comparable groups concerning sociodemographic data. There were no significant differences between the two groups regarding TM. CONCLUSION The TM assessment in Portuguese children did not reveal significant impairment regarding this cognitive skill in children with ADHD.
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Affiliation(s)
- Beatriz Coelho
- Faculty of MedicineFaculty of MedicineFaculty of MedicinePortoPortugal
| | - Bárbara Mota
- Centro Hospitalar Universitário São João. PortoCentro Hospitalar Universitário São JoãoCentro Hospitalar Universitário São JoãoPortoPortugal
| | - Victor Viana
- Faculty of Food Sciences and Nutrition SciencesFaculty of Food Sciences and Nutrition SciencesFaculty of Food Sciences and Nutrition SciencesPortoPortugal
- Centro Hospitalar Universitário São João. PortoCentro Hospitalar Universitário São JoãoCentro Hospitalar Universitário São JoãoPortoPortugal
| | - Ana I. Igreja
- Centro Hospitalar Universitário São João. PortoCentro Hospitalar Universitário São JoãoCentro Hospitalar Universitário São JoãoPortoPortugal
| | - Linda Candeias
- Prisma-Centro de Desenvolvimento e Terapias. Custóias, PortugalPrisma-Centro de Desenvolvimento e TerapiasPrisma-Centro de Desenvolvimento e TerapiasCustóiasPortugal
| | - Hélia Rocha
- Psychology Center. Universidade do PortoUniversidade do PortoUniversidade do PortoPortoPortugal
| | - Diogo Fernandes-da Rocha
- Centro Hospitalar Universitário São João. PortoCentro Hospitalar Universitário São JoãoCentro Hospitalar Universitário São JoãoPortoPortugal
| | - Micaela Guardiano
- Centro Hospitalar Universitário São João. PortoCentro Hospitalar Universitário São JoãoCentro Hospitalar Universitário São JoãoPortoPortugal
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Caldani S, Humeau E, Delorme R, Bucci MP. Inhibition functions can be improved in children with autism spectrum disorders: An eye-tracking study. Int J Dev Neurosci 2023; 83:431-441. [PMID: 37218472 DOI: 10.1002/jdn.10276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/17/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
Cognitive remediation therapy interventions could improve cognitive functioning in subjects with autism. To investigate the benefit of a short cognitive training rehabilitation in children with autism spectrum disorder (ASD) on pursuit and fixation performances. We recruited two groups (G1 and G2) of 30 children with ASD, sex-, IQ- and age-matched (mean 11.6 ± 0.5 years), and pursuit and fixation eye movements were recorded twice at T1 and T2. Between T1 and T2, a 10-min cognitive training was performed by the G1 group only, whereas the G2 group had a 10-min of rest. For all children with ASD enrolled in the study, there was a positive correlation between restricted and repetitive behaviour scores of both Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) and the number of saccades recorded during the fixation task at T1. At T1, oculomotor performances were similar for both groups of ASD children (G1 and G2). At T2, we observed a significant reduction in the number of saccades made during both pursuit and fixation tasks. Our findings underlined the importance to promote cognitive training rehabilitation for children with ASD, leading to a better performance in inhibitory and attention functioning responsible for pursuit and fixation eye movement's performance.
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Affiliation(s)
- Simona Caldani
- MoDyCo, UMR 7114 CNRS, Paris Nanterre University, Nanterre, France
- EFEE-Center for the Functional Exploration of Balance in Children, Robert Debré Hospital, Paris, France
| | - Elise Humeau
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
- High Functioning Autism Expert Centre, Fundamental Fondation, Paris, France
- Paris University, Paris, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
- High Functioning Autism Expert Centre, Fundamental Fondation, Paris, France
- Paris University, Paris, France
| | - Maria Pia Bucci
- MoDyCo, UMR 7114 CNRS, Paris Nanterre University, Nanterre, France
- EFEE-Center for the Functional Exploration of Balance in Children, Robert Debré Hospital, Paris, France
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9
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Lee JH, Hwang H, Yun J, Kim HJ, Yoo SK, Chung US, Han DH. Developing an Attention Assessment Tool for Individuals With Autism Spectrum Disorder Using Timbre, Rhythm, and Pitch. J Korean Med Sci 2023; 38:e228. [PMID: 37489717 PMCID: PMC10366410 DOI: 10.3346/jkms.2023.38.e228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/28/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Music is regarded as a beneficial tool for assessing the clinical symptoms and communication skills in individuals with autism spectrum disorder (ASD) or autism. The present study developed a music-based attention test (MAT) for individuals with autism using music parameters and the algorithm of the comprehensive attention test (CAT). METHODS We recruited 51 autistic individuals and 50 neurotypical individuals to participate in the CAT, MAT, and social intelligence tests. The reliability and validity of the MAT were assessed using exploratory factor analysis, concurrent validity, and criterion-related validity. RESULTS The MAT had sound internal consistency (high Cronbach's α = 0.948). In addition, the MAT had suitable concurrent validity in the correlation between CAT and MAT, as well as good criterion validity when attention was measured using the MAT and was compared between autistic individuals and neurotypical individuals. Attention evaluated using the MAT was associated with the social quotient in individuals with autism. CONCLUSIONS The MAT could be a relevant tool for gauging attention in individuals with ASD. Furthermore, attention determined using the MAT may be correlated with social quotient in autistic individuals. Future studies should consider that using music in the field of attention could improve the social quotient of individuals with autism.
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Affiliation(s)
- Jin Hyung Lee
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea
| | - Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea
| | - Juri Yun
- Department of Music Therapy, Ewha Womans University, Seoul, Korea
| | - Hee Jun Kim
- Department of Oncology, Chung-Ang University Hospital, Seoul, Korea
| | - Seo-Koo Yoo
- School of Social Welfare, Soongsil University, Seoul, Korea
| | - Un Sun Chung
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Korea.
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10
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Arango-Tobón OE, Guevara Solórzano A, Orejarena Serrano SJ, Olivera-La Rosa A. Social Cognition and Prosocial Behavior in Children with Attention Deficit Hyperactivity Disorder: A Systematic Review. Healthcare (Basel) 2023; 11:healthcare11101366. [PMID: 37239652 DOI: 10.3390/healthcare11101366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/21/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
The purpose of this research is to analyze the empirical evidence on the relationship between social cognition and prosocial behavior in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD). A systematic review was carried out following the PRISMA guidelines of empirical studies found in PubMed and Scopus databases, including a total of 51 research studies. The results indicate that children and adolescents with ADHD have deficits in social cognition and prosocial behavior. For children with ADHD, their deficits in social cognition highlight their difficulty in the process of theory of mind, emotional self-regulation, emotion recognition and empathy, affecting prosocial behavior, evidencing difficulty in personal relationships, and the creation of emotional bonds with their peers.
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Affiliation(s)
- Olber Eduardo Arango-Tobón
- Basic and Applied Neuroscience, Faculty of Psychology, Luis Amigó Catholic University, Medellin 680001, Colombia
| | - Alexandra Guevara Solórzano
- Basic and Applied Neuroscience, Faculty of Psychology, Luis Amigó Catholic University, Medellin 680001, Colombia
| | | | - Antonio Olivera-La Rosa
- Basic and Applied Neuroscience, Faculty of Psychology, Luis Amigó Catholic University, Medellin 680001, Colombia
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11
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Lavigne-Cerván R, Sánchez-Muñoz de León M, Juárez-Ruiz de Mier R, Romero-González M, Gamboa-Ternero S, Rodríguez-Infante G, Romero-Pérez JF. Proposal for an Integrative Cognitive-Emotional Conception of ADHD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15421. [PMID: 36430140 PMCID: PMC9691192 DOI: 10.3390/ijerph192215421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 06/16/2023]
Abstract
Although numerous efforts have been made to deepen our understanding of the etiology of Attention Deficit Hyperactivity Disorder (ADHD), no explanation of its origins, nor of its consequences, has yet found a consensus within the scientific community. This study performs a theoretical review of various research studies and provides a reflection on the role of emotions in the origin of the disorder, at the neuroanatomical and functional level. To this end, theoretical models (single and multiple origin) and applied studies are reviewed in order to broaden the perspective on the relevance of the executive system in ADHD; it is suggested that this construct is not only composed and activated by cognitive processes and functions, but also includes elements of an emotional and motivational nature. Consequently, it is shown that ADHD is involved in social development and in a person's ability to adapt to the environment.
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Affiliation(s)
- Rocío Lavigne-Cerván
- Department of Developmental and Educational Psychology, University of Malaga, 29071 Malaga, Spain
| | | | | | - Marta Romero-González
- Department of Developmental and Educational Psychology, University of Malaga, 29071 Malaga, Spain
| | - Sara Gamboa-Ternero
- Department of Developmental and Educational Psychology, University of Alicante, 03690 Alicante, Spain
| | - Gemma Rodríguez-Infante
- Department of Developmental and Educational Psychology, University of Malaga, 29071 Malaga, Spain
| | - Juan F. Romero-Pérez
- Department of Developmental and Educational Psychology, University of Malaga, 29071 Malaga, Spain
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12
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Nejati V. Reading mind from the eyes in individuals with attention deficit-hyperactivity disorder (ADHD): A meta-analysis. Expert Rev Neurother 2022; 22:889-896. [PMID: 36420829 DOI: 10.1080/14737175.2022.2151899] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Individuals with ADHD struggle with social impairments. The present study aimed to find out the inconsistent results of theory of mind skill in individuals with ADHD. METHODS The current meta-analysis reviewed 17 empirical studies that compared theory of mind in individuals with and without ADHD based on reading mind from the eyes test (RMET). RESULTS Finding from 1620 participants with ADHD and 1249 healthy controls showed a significant impairment in theory of mind in individuals with ADHD (Hedges' g = 0.66). Moderator analyses indicated that the impaired theory of mind was not affected by age and gender. CONCLUSION These findings describe impaired theory of mind in individuals with ADHD and provide an insight to pay attention to theory of mind in respective clinical assessments and treatments.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, 1983969411 Tehran, Iran
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13
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Narvekar HN, Ghani S. Animal-Assisted Therapy for the Promotion of Social Competence: a Conceptual Framework. HUMAN ARENAS 2022. [DOI: 10.1007/s42087-022-00313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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14
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Sawrikar V, Macbeth A, Gillespie-Smith K, Brown M, Lopez-Williams A, Boulton K, Guestella A, Hickie I. Transdiagnostic Clinical Staging for Childhood Mental Health: An Adjunctive Tool for Classifying Internalizing and Externalizing Syndromes that Emerge in Children Aged 5-11 Years. Clin Child Fam Psychol Rev 2022; 25:613-626. [PMID: 35598197 PMCID: PMC9427921 DOI: 10.1007/s10567-022-00399-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2022] [Indexed: 11/20/2022]
Abstract
Clinical staging is now recognized as a key tool for facilitating innovation in personalized and preventative mental health care. It places a strong emphasis on the salience of indicated prevention, early intervention, and secondary prevention of major mental disorders. By contrast to established models for major mood and psychotic syndromes that emerge after puberty, developments in clinical staging for childhood-onset disorders lags significantly behind. In this article, criteria for a transdiagnostic staging model for those internalizing and externalizing disorders that emerge in childhood is presented. This sits alongside three putative pathophysiological profiles (developmental, circadian, and anxious-arousal) that may underpin these common illness trajectories. Given available evidence, we argue that it is now timely to develop a transdiagnostic staging model for childhood-onset syndromes. It is further argued that a transdiagnostic staging model has the potential to capture more precisely the dimensional, fluctuating developmental patterns of illness progression of childhood psychopathology. Given potential improvements in modelling etiological processes, and delivering more personalized interventions, transdiagnostic clinical staging for childhood holds much promise for assisting to improve outcomes. We finish by presenting an agenda for research in developments of transdiagnostic clinical staging for childhood mental health.
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Affiliation(s)
- Vilas Sawrikar
- Centre of Applied Developmental Psychology, University of Edinburgh, Edinburgh, UK.
- Department of Clinical & Health Psychology, School of Health in Social Sciences, The University of Edinburgh, Medical School (Doorway 6), Room 1M.8, Teviot Place, Edinburgh, EH8 9AG, UK.
| | - Angus Macbeth
- Centre of Applied Developmental Psychology, University of Edinburgh, Edinburgh, UK
- Department of Clinical & Health Psychology, School of Health in Social Sciences, The University of Edinburgh, Medical School (Doorway 6), Room 1M.8, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Karri Gillespie-Smith
- Centre of Applied Developmental Psychology, University of Edinburgh, Edinburgh, UK
- Department of Clinical & Health Psychology, School of Health in Social Sciences, The University of Edinburgh, Medical School (Doorway 6), Room 1M.8, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Megan Brown
- ADHD & Autism Psychological Services and Advocacy, Utica, NY, USA
| | | | - Kelsie Boulton
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Adam Guestella
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Ian Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia
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15
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Crooke PJ, Winner MG. Social Thinking Metacognitive Strategies to Support Self-Determined Social Goals in Autistic Youth. Semin Speech Lang 2022; 43:277-298. [PMID: 35896406 DOI: 10.1055/s-0042-1750815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
On any given day, the social mind is taxed with attending to and making sense of a myriad of social events. The social mind is at work when trying to imagine the experiences of others and their inner mental worlds, and is equally active when people seek to approach, connect with, and sometimes avoid one another. Ultimately, the social mind is responsible for thinking about (social) thinking, or social metacognition. Social metacognitive teaching strategies can be helpful for supporting social learners as they observe social landscapes, interpret what is observed to problem solve, or decide whether and how to produce social responses. This article describes how social metacognitive strategies from the Social Thinking Methodology have been used to support the self-determined social goals of two autistic students. Visual frameworks and their underlying theories are provided as evidence-aligned tools for supporting clinical journeys.
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16
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Hajdúk M, Pinkham AE, Penn DL, Harvey PD, Sasson NJ. Heterogeneity of social cognitive performance in autism and schizophrenia. Autism Res 2022; 15:1522-1534. [PMID: 35460541 DOI: 10.1002/aur.2730] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/16/2022] [Accepted: 04/11/2022] [Indexed: 11/06/2022]
Abstract
Autistic adults and those with schizophrenia (SCZ) demonstrate similar levels of reduced social cognitive performance at the group level, but it is unclear whether these patterns are relatively consistent or highly variable within and between the two conditions. Seventy-two adults with SCZ (52 male, Mage = 28.2 years) and 94 with diagnoses on the autism spectrum (83 male, Mage = 24.2 years) without intellectual disability completed a comprehensive social cognitive battery. Latent profile analysis identified four homogeneous subgroups that were compared on their diagnosis, independent living skills, neurocognition, and symptomatology. Two groups showed normative performance across most social cognitive tasks but were differentiated by one having significantly higher hostility and blaming biases. Autistic participants were more likely to demonstrate fully normative performance (46.8%) than participants with SCZ, whereas normative performance in SCZ was more likely to co-occur with increased hostility and blaming biases (36.1%). Approximately 43% of participants in the full sample were classified into the remaining two groups showing low or very low performance. These participants tended to perform worse on neurocognitive tests and have lower IQ and fewer independent living skills. The prevalence of low performance on social cognitive tasks was comparable across clinical groups. However, nearly half of autistic participants demonstrated normative social cognitive performance, challenging assumptions that reduced social cognitive performance is inherent to the condition. Subgrouping also revealed a meaningful distinction between the clinical groups: participants with SCZ were more likely to demonstrate hostility biases than autistic participants, even when social cognitive performance was otherwise in the typical range. LAY SUMMARY: Social cognition refers to the perception and interpretation of social information. Previous research has shown that both autistic people and those with schizophrenia demonstrate reduced performance on traditional social cognitive tasks, which we replicate here at the group level. However, we also found that almost half of autistic participants performed in the normal range. Over a third of participants with schizophrenia did as well, but for them this performance was accompanied by a hostility bias not commonly found in the autistic sample. Taken together, findings challenge assumptions that difficulties in social cognition are a uniform characteristic of these clinical conditions in those without intellectual disability.
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Affiliation(s)
- Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Bratislava, Slovakia.,Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia.,Science Park UK, Center for Psychiatric Disorders Research, Bratislava, Slovakia
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA.,Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - David L Penn
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.,Research Service, Miami VA Healthcare System, Miami, Florida, USA
| | - Noah J Sasson
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA
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17
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Hajri M, Abbes Z, Yahia HB, Jelili S, Halayem S, Mrabet A, Bouden A. Cognitive deficits in children with autism spectrum disorders: Toward an integrative approach combining social and non-social cognition. Front Psychiatry 2022; 13:917121. [PMID: 36003981 PMCID: PMC9393361 DOI: 10.3389/fpsyt.2022.917121] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Autism spectrum disorder (ASD) is associated with neurocognitive impairment, including executive dysfunctioning and social cognition (SC) deficits. Cognitive remediation (CR) is a behavioral training-based intervention aiming to improve cognitive processes. Its first use in psychiatry interested patients with schizophrenia, in whom promising results have been shown. Integrated CR programs targeting both social and non-social cognition have demonstrated to be effective in improving both cognitive domains and functional outcomes. CR studies in children and adolescents with ASD are still new, those regarding CR approaches combining social and executive functioning remediation are scares. One study examining the efficacy of cognitive enhancement therapy (CET) for improving cognitive abilities in ADS adults, showed significant differential increases in neurocognitive function and large social-cognitive improvements. Therefore, taking into account the overlap between ASD and schizophrenia, and considering the close link between executive functions (EF) and SC, we suggest that integrative approach in ASD could result in better outcomes. The present perspective aimed to highlight cognitive remediation (CR) programs contributions in ASD (especially in children and adolescents), and to discuss the value of combining social and non-social programs.
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Affiliation(s)
- Melek Hajri
- Razi Hospital Child and Adolescent Psychiatry Department, Faculty of Medicine of Tunis, Tunis El Manar University, Manouba, Tunisia
| | - Zeineb Abbes
- Razi Hospital Child and Adolescent Psychiatry Department, Faculty of Medicine of Tunis, Tunis El Manar University, Manouba, Tunisia
| | - Houda Ben Yahia
- Razi Hospital Child and Adolescent Psychiatry Department, Manouba, Tunisia
| | - Selima Jelili
- Razi Hospital Child and Adolescent Psychiatry Department, Faculty of Medicine of Tunis, Tunis El Manar University, Manouba, Tunisia
| | - Soumeyya Halayem
- Razi Hospital Child and Adolescent Psychiatry Department, Faculty of Medicine of Tunis, Tunis El Manar University, Manouba, Tunisia
| | - Ali Mrabet
- Health Minsitery, General Directorate of Military Health, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Asma Bouden
- Razi Hospital Child and Adolescent Psychiatry Department, Faculty of Medicine of Tunis, Tunis El Manar University, Manouba, Tunisia
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18
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Hemmers J, Baethge C, Vogeley K, Falter-Wagner CM. Are Executive Dysfunctions Relevant for the Autism-Specific Cognitive Profile? Front Psychiatry 2022; 13:886588. [PMID: 35923452 PMCID: PMC9342604 DOI: 10.3389/fpsyt.2022.886588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Executive functions (EF) have been shown to be important for the understanding of Autism Spectrum Disorder (ASD), but dysfunctions of EF are not autism-specific. The specific role of EF in ASD, its relationship to core autism characteristics, such as mentalizing, needs to be explored. Medline- and PsychINFO databases were searched for studies published between 1990 and 2020 that included measures of EF in ASD and typically developing control persons (TD) in combination with either Theory of Mind (ToM) or Weak Central Coherence (WCC) tasks. A pre-registered meta-analysis and cross-study regression was performed including a total of 42 studies (ASD n = 1,546, TD n = 1,206). Results were reported according to PRISMA guidelines. In all cognitive domains, the ASD group showed significantly reduced performance. Importantly, EF subdomains and ToM were not significantly correlated. This finding rules out a significant association between EF subdomains and ToM and questions the relevance of EF dysfunctions for the autism-specific feature of reduced mentalizing.
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Affiliation(s)
- Julia Hemmers
- Department of Psychiatry, Medical Faculty, Ludwig Maximillians Universitaet (LMU) Munich, Munich, Germany
| | - Christopher Baethge
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Hospital of Cologne, University of Cologne, Cologne, Germany.,Institute of Neurosciences and Medicine-Cognitive Neuroscience, Research Center Juelich, Jülich, Germany
| | - Christine M Falter-Wagner
- Department of Psychiatry, Medical Faculty, Ludwig Maximillians Universitaet (LMU) Munich, Munich, Germany.,Department of Psychology, University of Cologne, Cologne, Germany
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19
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Akça ÖF, Wall K, Sharp C. Divergent mentalization types in adolescent borderline personality disorder and attention deficit/hyperactivity disorder. Nord J Psychiatry 2021; 75:479-486. [PMID: 33635183 DOI: 10.1080/08039488.2021.1887349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) have several similarities and it is difficult to distinguish these disorders in adolescents. We aimed to identify the unique correlates of mentalization abilities that may distinguish these two disorders, and to investigate the mentalization abilities of adolescents with ADHD, BPD and ADHD + BPD in an inpatient sample to determine the effect of co-morbidity on mentalization abilities. METHODS We have explored the relationship between Child Eye Test (CET) scores, Movie for the Assessment of Social Cognition (MASC) subscales, and ADHD and BPD symptoms in adolescent inpatients. In addition, we compared ADHD, BPD and ADHD + BPD groups in terms of their mentalization abilities. RESULTS Correct MASC scores were negatively associated with both ADHD and BPD symptoms in girls, and negatively associated with ADHD symptoms in boys. In addition, hypermentalization scores were associated with BPD symptoms in girls, and hypomentalization and no mentalization scores were associated with ADHD symptoms in girls. CET scores were negatively associated with ADHD symptoms in girls, but no relations with BPD were found. Group comparisons revealed no significant difference among groups. LIMITATIONS We included only inpatient sample without considering their medication condition, we did not compare the mentalization scores of the patient groups with healthy controls and we used self-report measures for several assessments. CONCLUSION Mentalization patterns in ADHD and BPD are distinct. ADHD may be related to hypomentalization, instead, BPD may be related to hypermentalization.
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Affiliation(s)
- Ömer Faruk Akça
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Kiana Wall
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, USA
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20
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Psychometric Evaluation of Social Cognition and Behavior Measures in Children and Adolescents with Down Syndrome. Brain Sci 2021; 11:brainsci11070836. [PMID: 34202453 PMCID: PMC8301941 DOI: 10.3390/brainsci11070836] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/12/2021] [Accepted: 06/22/2021] [Indexed: 11/17/2022] Open
Abstract
Individuals with Down syndrome (DS) are often described as socially engaged; however, challenges with social cognition, expressive language, and social interaction are also common in DS and are prospective outcomes of interest for clinical trials. The current study evaluates the psychometric properties of standardized measurements of social cognition and social behavior for potential use as outcome measures for children and adolescents with DS. Seventy-three youth ages 6 to 17 years old (M = 12.67, SD = 3.16) with DS were assessed on social cognition subtests of a neuropsychological assessment at two time points. Caregivers also completed a parent-report measure of social behavior. Measures were evaluated for feasibility, test-retest reliability, practice effects, convergent validity, and associations with broader developmental domains (i.e., age, cognition, and language). All social cognition and behavior measures met criteria for a portion of the psychometric indices evaluated, yet feasibility limitations were identified for the Developmental Neuropsychological Assessment, Second Edition (NEPSY-II) Affect Recognition subtest, and the NEPSY-II Theory of Mind subtest had problematic floor effects for percentile ranks. The Social Responsiveness Scale, Second Edition (SRS-2; T-scores) had high feasibility, moderate to excellent test-retest reliability, and no practice effects, suggesting this measure could be appropriate for use in clinical trials involving youth with DS.
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21
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Block G, Jannati A, Maynard TR, Pascual-Leone A, O’Connor MG. Personality in Autism Spectrum Disorder: Associations With Face Memory Deficit and Theory of Mind. Cogn Behav Neurol 2021; 34:117-128. [PMID: 34074866 PMCID: PMC8186733 DOI: 10.1097/wnn.0000000000000271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/28/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the personality profiles of adults with autism spectrum disorder (ASD) using a standard personality assessment and to investigate the association between personality, ASD-related face memory deficit (FMD), and theory of mind (ToM). In a broader context, to examine whether there are distinct clinical phenotypes in the ASD population that have implications for personality development and treatment. METHOD Fifty-five adults with ASD and 22 neurotypical (NT) adults underwent a battery of neuropsychological tests, including measures of personality, face memory, and ToM. We compared ASD and NT groups in terms of their Personality Assessment Inventory (PAI) profiles. Additional analyses focused on the association between specific PAI scales and FMD. Performance on the Eyes Test was compared across groups and was examined in relation to FMD. RESULTS Adults with ASD demonstrated significant elevations on several PAI scales compared with NT adults. The presence of FMD was associated with differing PAI profiles among the ASD adults. The ASD adults with FMD scored significantly higher on scales that are sensitive to positive impression management and treatment rejection and significantly lower on scales that are sensitive to borderline personality, anxiety, depression, schizophrenia, and stress. There was a significant association between performance on the Eyes Test and FMD in the ASD group. CONCLUSION Adults with ASD have a unique personality profile. Further, ASD adults with FMD have reduced insight into their difficulties with emotional processing and may not be as sensitive as ASD adults without FMD to the emotions of others.
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Affiliation(s)
- Gabrielle Block
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Ali Jannati
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Taylor R. Maynard
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA
- Hinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA
- Institut Guttman de Neurorehabilitació, Universitat Autónoma de Barcelona, Badalona, Barcelona, Spain
| | - Margaret G. O’Connor
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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22
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Ayyildiz D, Bikmazer A, Cahid Örengül A, Perdahlı Fiş N. Executive Functions and Social Responsiveness in Children and Adolescents With Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder. PSYCHIAT CLIN PSYCH 2021; 31:165-172. [PMID: 38765227 PMCID: PMC11079678 DOI: 10.5152/pcp.2021.20167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 01/10/2021] [Indexed: 05/21/2024] Open
Abstract
Objective To evaluate the executive functions and social reciprocity of children and adolescents diagnosed with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) and compared them with healthy controls. Material and Method Patients aged 6-17 years diagnosed with ASD (n = 33) and ADHD (n = 37) and healthy controls in the same age range (n = 33) were included in the study. Behavioral Rating Inventory of Executive Functions (BRIEF) sub-scales and Social Responsiveness Scale (SRS) were used for evaluating executive function areas and social responsiveness. Results Our results revealed that children and adolescents with ASD and ADHD were significantly impaired for all BRIEF sub-scales except emotional control and that the significant increase in sub-scale scores expressing deterioration continued after adjustment for SES, verbal IQ scores, and gender. ASD patients received significantly higher SRS scores compared to ADHD and control groups and ADHD patients also had significantly higher values compared to the controls. Conclusion Further studies with parent-report scales that allow easier and faster evaluation of executive functions and social reciprocity will contribute to better understanding of the personal needs of children with neurodevelopmental disorders and the finding of new treatments.
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Affiliation(s)
- Didem Ayyildiz
- Department of Child and Adolescent Psychiatry, Bursa Dörtçelik Child Hospital, Bursa, Turkey
| | - Alperen Bikmazer
- Department of Child and Adolescent Psychiatry, İstanbul Medeniyet University School of Medicine, İstanbul, Turkey
| | - Abdurrahman Cahid Örengül
- Department of Child and Adolescent Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Neşe Perdahlı Fiş
- Department of Child and Adolescent Psychiatry, Marmara University School of Medicine, İstanbul, Turkey
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van den Berg L, de Weerd AW, Reuvekamp MHF, van der Meere JJ. Associating executive dysfunction with behavioral and socioemotional problems in children with epilepsy. A systematic review. Child Neuropsychol 2021; 27:661-708. [PMID: 33726631 DOI: 10.1080/09297049.2021.1888906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
As children with epilepsy may have a number of learning and behavioral problems, it is important that insight into the underlying neurocognitive differences in these children, which may underlie these areas of challenge is gained. Executive function (EF) problems particularly are associated with specific learning abilities as well as behavioral problems. We aim to review systematically the current status of empirical studies on the association between EF problems and behavior and socioemotional problems in children with epilepsy. After search, 26 empirical studies were identified, most of them of moderate quality. Overall, attention problems were the most reported cognitive deficit in test assessment and the most reported problem by parents. In 54% of the studies, children with epilepsy scored below average compared to controls/normative samples on different aspects of EF. Most studies reported behavior problems, which ranged from mild to severe. Forty-two percent of the studies specifically reported relationships between EF deficits and behavioral problems. In the remaining studies, below average neuropsychological functioning seemed to be accompanied by above average reported behavioral problems. The association was most pronounced for cognitive control and attention in relation to externalizing behavior problems. This cognitive control is also associated with social functioning. Relevant epilepsy variables in this relationship were early age at onset and high seizure frequency.Future research should distinguish specific aspects of EF and take age into account, as this provides more insight on the association between EF and behavior in pediatric epilepsy, which makes it possible to develop appropriate and early intervention.
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Affiliation(s)
- Lydia van den Berg
- Psychology Department, Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands.,RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Groningen, Netherlands
| | - Al W de Weerd
- Psychology Department, Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands
| | - Marieke H F Reuvekamp
- Psychology Department, Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands
| | - Jaap J van der Meere
- RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Groningen, Netherlands
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24
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Jahromi LB, Kirkman KS, Friedman MA, Nunnally AD. Associations Between Emotional Competence and Prosocial Behaviors With Peers Among Children With Autism Spectrum Disorder. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:79-96. [PMID: 33651889 PMCID: PMC8881999 DOI: 10.1352/1944-7558-126.2.79] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 05/12/2020] [Indexed: 06/12/2023]
Abstract
Children with autism spectrum disorder (ASD) are at risk for disrupted peer interactions. This study contributes to our understanding of how multiple foundational elements of emotional competence are related to children's prosocial behaviors with peers. Children with ASD demonstrated significantly lower non-stereotypical affective perspective taking, had lower ratings of emotion regulation, and showed differences from their typical peers in the use of discrete coping strategies during peer interactions. Children's emotion regulation and use of discrete coping strategies in the context of peers were associated with their prosocial behaviors one year later. The findings add to our understanding of how emotional development contributes to individual differences in the social-emotional behaviors of children with ASD. Implications for intervention are discussed.
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Affiliation(s)
- Laudan B Jahromi
- Laudan B. Jahromi and Katherine S. Kirkman, Teachers College, Columbia University
| | - Katherine S Kirkman
- Laudan B. Jahromi and Katherine S. Kirkman, Teachers College, Columbia University
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25
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Dağdelen F. Decreased Theory of Mind Abilities and Increased Emotional Dysregulation in Adolescents With ASD and ADHD. ALPHA PSYCHIATRY 2021; 22:100-105. [PMID: 36425929 PMCID: PMC9590665 DOI: 10.5455/apd.135050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/25/2020] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the possible relationship theory of mind (ToM) and emotion regulation (ER) skills in adolescents diagnosed with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). METHODS This study comprised 60 individuals with ADHD and 60 individuals with ASD according to DSM-5 and between the ages of 12-16, and 60 adolescents without any psychiatric diagnosis. The Turkish version of the schedule for affective disorders and schizophrenia for school-age children, both present and lifetime versions, was applied to assess psychopathology and comorbidity. The intelligence level of the patients was assessed with the Wechsler Intelligence Scale for Children-Revised. Reading the mind in the eyes test, the Faux Pas Test, and the hinting task were given to patients to evaluate the ToM skills. The difficulties in ER Scale were also used to evaluate the skills of regulating emotions. RESULTS Adolescent patients with ADHD and ASD have difficulties in ToM and ER skills. Adolescents diagnosed with ASD had more difficulty in ToM and ER than adolescents with ADHD. DISCUSSION This study supports the idea that ADHD and ASD are related to deficits in ToM and ER skills. Therefore, further studies are required to confirm the findings of this study.
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Affiliation(s)
- Fatih Dağdelen
- Department of Child and Adolescent Psychiatry, Tekirdağ State Hospital, Tekirdağ, Turkey
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26
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Corbett BA, Schwartzman JM, Libsack EJ, Muscatello RA, Lerner MD, Simmons GL, White SW. Camouflaging in Autism: Examining Sex-Based and Compensatory Models in Social Cognition and Communication. Autism Res 2021; 14:127-142. [PMID: 33220170 PMCID: PMC7986572 DOI: 10.1002/aur.2440] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/16/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022]
Abstract
Camouflaging refers to behavioral adaptations that individuals with autism spectrum disorder (ASD), especially females, use to mask symptoms during social situations. Compensation is a component of camouflaging in which an individual's observed behavior is considerably better than actual ability. The study explored diagnostic, sex-based, and compensatory differences using the Contextual Assessment of Social Skills (CASS). The sample included 161 youth 10:0-to-16:11 years (115 males, 46 females). T-tests were performed based on sex (female, male) or High (good ADOS + poor Theory of Mind (TOM)) compared to Low (poor ADOS + poor TOM) Compensation groups. Comparisons were examined for Social Affect (SA), Restricted Repetitive Behavior, (RRB), IQ, social behavior (Positive Affect, Overall Involvement) and communication (Vocal Expression, Gestures). Females exhibited fewer RRB t(158) = 3.05, P = 0.003, d = 0.54. For the CASS, females evidenced more Vocal Expressiveness t(157) = -2.03, P = 0.05, d = 0.35, which corroborates sex-based differences in the literature. Compensation group differences indicated the High compared to Low group showed stronger Social and Communication behaviors on the CASS for Vocal Expression t(72) = 2.56, P = 0.01, d = 0.62, and overall rapport t(72) = 2.36, P = 0.02, d = 0.56. Several differences were observed when the groups were stratified based on level of compensation, with the High compensation participants showing stronger social engagement and communication behaviors. Findings may inform efforts to understand camouflaging, compensation, and clinical practices for male and female adolescents with ASD. A more nuanced consideration of camouflaging alongside compensation models reveals subtle differences in cognition, behavior, and affect that may reflect underlying profiles of challenge and strength in youth with ASD. LAY SUMMARY: Camouflaging refers to ways individuals with autism spectrum disorder (ASD), especially females, mask symptoms. Compensation occurs when a person's observed behavior appears more typical than what would be expected based on underlying ability and symptoms. The study explored camouflaging and compensation differences in 161 youth with ASD. Findings suggest sex-based differences with females showing better vocal expression. However, several compensation differences were observed with the High compensators showing stronger social communication and rapport. A more nuanced consideration of camouflaging using compensation models reveal subtle differences in underlying challenge and strength.
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27
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Werninger I, Ehrler M, Wehrle FM, Landolt MA, Polentarutti S, Valsangiacomo Buechel ER, Latal B. Social and Behavioral Difficulties in 10-Year-Old Children With Congenital Heart Disease: Prevalence and Risk Factors. Front Pediatr 2020; 8:604918. [PMID: 33363068 PMCID: PMC7759662 DOI: 10.3389/fped.2020.604918] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/20/2020] [Indexed: 12/14/2022] Open
Abstract
Children with congenital heart disease (CHD) may be at increased risk for neurodevelopmental impairments. Long-term behavioral profiles and respective risk factors are less frequently described. The aim of this study was to evaluate multidimensional behavioral outcomes and associated medical, psychological, and social risk factors in children with complex CHD. At 10-years of age, 125 children with CHD were assessed for general behavioral difficulties, attention deficit hyperactivity disorder (ADHD)-related behavior, and social interaction problems and were compared to normative data. Medical and cardiac factors, IQ, maternal mental health at 4 years of age and parental socioeconomic status were tested as predictors for all behavioral outcomes. Children with CHD showed no significant differences in general behavioral difficulties. However, increased ADHD-related symptoms (p < 0.05) and difficulties in social interaction (p < 0.05) were observed. In 23% of the children, a combination of ADHD-related symptoms and social interaction problems was reported by parents. In multivariate analyses, IQ (p < 0.01) and maternal mental health (p < 0.03) at 4 years of age were found to be predictive for all behavioral outcomes at 10 years while medical and cardiac risk factors were not. Our findings reveal significant difficulties in ADHD-related symptoms and social interaction problems with a significant comorbidity. Behavioral difficulties were not detected with a screening tool but with disorder-specific questionnaires. Furthermore, we demonstrate the importance of maternal mental health during early childhood on later behavioral outcomes of children with CHD. This underlines the importance of identifying and supporting parents with mental health issues at an early stage in order to support the family and improve the child's neurodevelopment.
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Affiliation(s)
- Isabelle Werninger
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Melanie Ehrler
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Flavia M. Wehrle
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Neonatology and Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland
| | - Markus A. Landolt
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
- Division of Child and Adolescence Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Susanne Polentarutti
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Emanuela R. Valsangiacomo Buechel
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Division of Cardiology, Pediatric Heart Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Beatrice Latal
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
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28
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Ilzarbe D, Lukito S, Moessnang C, O'Daly OG, Lythgoe DJ, Murphy CM, Ashwood K, Stoencheva V, Rubia K, Simonoff E. Neural Correlates of Theory of Mind in Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, and the Comorbid Condition. Front Psychiatry 2020; 11:544482. [PMID: 33240117 PMCID: PMC7677232 DOI: 10.3389/fpsyt.2020.544482] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/25/2020] [Indexed: 11/18/2022] Open
Abstract
Theory of mind (ToM) or mentalizing difficulties is reported in attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), but the mechanism underpinning these apparently shared deficits is relatively unknown. Eighty-three young adult males, 19 with ASD alone, 21 with ADHD alone, 18 with dual diagnosis of ASD and ADHD, and 25 typically developing (TD) controls completed the functional magnetic resonance imaging version of the Frith-Happé animated-triangle ToM task. We compared neural function during ToM with two non-ToM conditions, random and goal directed motions, using whole-brain and region-of-interest analysis of brain activation and functional connectivity analyses. The groups showed comparable ToM task performance. All three clinical groups lacked local connectivity increase shown by TD controls during ToM in the right temporoparietal cortex, a key mentalizing region, with a differentially increased activation pattern in both ASD and comorbid groups relative to ADHD. Both ASD groups also showed reduced connectivity between right inferior lateral prefrontal and posterior cingulate cortices that could reflect an atypical information transmission to the mentalizing network. In contrast, with mentalizing both ADHD groups showed decreasing connectivity between the medial prefrontal and left temporoparietal cortices when compared to TD controls. Therefore, despite the complex pattern of atypical brain function underpinning ToM across the three disorders, some neurofunctional abnormalities during ToM are associated with ASD and appeared differentiable from those associated with ADHD, with the comorbid group displaying combined abnormalities found in each condition.
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Affiliation(s)
- Daniel Ilzarbe
- Department of Child and Adolescent Psychiatry, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, United Kingdom
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic de Barcelona, Institute of Neuroscience, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Steve Lukito
- Department of Child and Adolescent Psychiatry, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, United Kingdom
| | - Carolin Moessnang
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Owen G. O'Daly
- Centre for Neuroimaging Sciences, King's College London, London, United Kingdom
| | - David J. Lythgoe
- Centre for Neuroimaging Sciences, King's College London, London, United Kingdom
| | - Clodagh M. Murphy
- Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, Adult Autism and Attention Deficit Hyperactivity Disorder Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Karen Ashwood
- Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, Adult Autism and Attention Deficit Hyperactivity Disorder Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Vladimira Stoencheva
- Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, Adult Autism and Attention Deficit Hyperactivity Disorder Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, United Kingdom
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, United Kingdom
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29
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Rosello B, Berenguer C, Baixauli I, García R, Miranda A. Theory of Mind Profiles in Children With Autism Spectrum Disorder: Adaptive/Social Skills and Pragmatic Competence. Front Psychol 2020; 11:567401. [PMID: 33041932 PMCID: PMC7527531 DOI: 10.3389/fpsyg.2020.567401] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/20/2020] [Indexed: 11/13/2022] Open
Abstract
Theory of Mind (ToM) is one of the most relevant concepts in the field of social cognition, particularly in the case of Autism Spectrum Disorders (ASD). Literature showing that individuals with ASD display deficits in ToM is extensive and robust. However, some related issues deserve more research: the heterogeneous profile of ToM abilities in children with ASD and the association between different levels of ToM development and social, pragmatic, and adaptive behaviors in everyday life. The first objective of this study was to identify profiles of children with ASD without intellectual disability (ID), based on explicit and applied ToM knowledge, and compare these profiles with a group of children with typical development (TD). A second objective was to determine differences in symptom severity, adaptive/social behavior, and pragmatic abilities between the profiles identified. Fifty-two children with a clinical diagnosis of ASD without ID and 37 children with TD performed neuropsychological ToM tasks and two vocabulary and memory tests. In addition, all of their mothers completed different questionnaires about applied ToM abilities, severity of ASD symptoms, adaptive/social skills, and pragmatic competence. Two subgroups were identified in the cluster analysis carried out with explicit and applied ToM indicators. The “Lower ToM abilities” profile obtained significantly lower scores than the “Higher ToM abilities” profile on all the ToM measures. Furthermore, the analysis of covariance, controlling for vocabulary and working memory (ANCOVAs), showed statistically significant differences in applied ToM abilities between the two groups of children with ASD without ID and the group with TD. However, only the group with “Higher ToM abilities” achieved similar performance to the TD group on the verbal task of explicit ToM knowledge. Finally, the “Lower ToM abilities” cluster obtained significantly higher scores on autism symptoms (social and communication domains) and lower scores on adaptive behavior and pragmatic skills than the cluster with “Higher ToM abilities.” Taken together, these findings have implications for understanding the heterogeneity in ToM skills in children with ASD without ID, and their differential impact on social, communicative, and adaptive behaviors.
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Affiliation(s)
- Belen Rosello
- Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Carmen Berenguer
- Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Inmaculada Baixauli
- Occupational Sciences, Speech Language Therapy, Developmental and Educational Psychology Department, Catholic University of Valencia, Valencia, Spain
| | - Rosa García
- Developmental, Social, Educational Psychology and Methodology, Universitat Jaume I, Castellón de la Plana, Spain
| | - Ana Miranda
- Developmental and Educational Psychology, University of Valencia, Valencia, Spain
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Operto FF, Pastorino GMG, Mazza R, Di Bonaventura C, Marotta R, Pastorino N, Matricardi S, Verrotti A, Carotenuto M, Roccella M. Social cognition and executive functions in children and adolescents with focal epilepsy. Eur J Paediatr Neurol 2020; 28:167-175. [PMID: 32718867 DOI: 10.1016/j.ejpn.2020.06.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Deficits in facial emotion recognition and Theory of Mind are frequent in patients with epilepsy. Although this evidence, studies on pediatric age are few and the relation between these abilities and other cognitive domain remains to be better elucidated. The purpose of our study is to evaluate facial emotion recognition and Theory of Mind in children and adolescents with focal epilepsy, and correlate them with intelligence and executive functions. MATERIALS AND METHODS Our work is a cross-sectional observational study. Sixty-two children and adolescents aged between 7-16 years diagnosed by focal epilepsy and 32 sex/age-matched controls were recruited. All participants were administered a standardized battery tests to assess social cognition (NEPSY-II), executive functions (EpiTrack Junior) and cognitive non-verbal level (Raven Progressive Matrices). RESULTS Emotion recognition mean score was significantly lower in the epilepsy group than in the controls to Student's t-test (p<0.05). Epilepsy group showed an impairment in happiness, sadness, anger and fear recognition, compared to controls (p<0.05). Theory of Mind mean score was also significantly lower in epilepsy group than controls (p<0.05). Deficits in emotion recognition seemed to be related to low age at onset of epilepsy, long duration of disease, low executive functions and low non-verbal intelligence. Deficits in Theory of Mind seemed to be related to a high seizure frequency. CONCLUSIONS Our results suggest that children and adolescents with focal epilepsy had deficit in facial emotion recognition and Theory of Mind, compared to their peer. Both these difficulties seem to be related to some features of epilepsy itself. Our results also suggest that deficits in facial emotion recognition are potentially related to difficulties in executive functions and non-verbal intelligence. More studies are needed to confirm these hypotheses.
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Affiliation(s)
- Francesca Felicia Operto
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy.
| | - Grazia Maria Giovanna Pastorino
- Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy; Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Roberta Mazza
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Carlo Di Bonaventura
- Epilepsy Unit, Department of Neurosciences/Mental Health, "Sapienza" University, Rome, Italy
| | - Rosa Marotta
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Nazareno Pastorino
- Department of Cultural Heritage Sciences, University of Salerno, Salerno, Italy
| | - Sara Matricardi
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy
| | - Marco Carotenuto
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Michele Roccella
- Department of Psychological, Pedagogical and Educational Sciences, University of Palermo, Palermo, Italy
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31
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Fong VC, Iarocci G. The Role of Executive Functioning in Predicting Social Competence in Children with and without Autism Spectrum Disorder. Autism Res 2020; 13:1856-1866. [PMID: 33460309 DOI: 10.1002/aur.2350] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/21/2020] [Accepted: 06/15/2020] [Indexed: 11/07/2022]
Abstract
All children with autism spectrum disorder (ASD) experience social difficulties but they differ with regard to the type and severity of their challenges. Potentially powerful interventions targeting social skills in children with ASD may have limited effectiveness if they are not tailored to the child's specific needs. One factor that may influence social competence is executive functioning (EF). EF may impact social competence by facilitating higher-order strategies such as emotional and cognitive regulation which are necessary for social interactions. Participants included 132 children and adolescents, aged 7-13, including 77 with ASD (M = 10.11, SD = 1.94), and 55 without ASD (M = 9.54, SD = 1.67). Caregivers completed the Behavior Rating Inventory of Executive Functioning, Version 2 (BRIEF-2) Parent Form, assessing everyday EF skills, and the Multidimensional Social Competence Scale (MSCS). Hierarchical multiple regression analyses were conducted separately for the group without ASD and the group with ASD, with MSCS entered as the dependent variables and EF indices and scales of the BRIEF-2 as the main predictor variables. EF deficits in emotional control predicted poor emotion regulation for both children with and without ASD. For the group without ASD, better emotional control and initiation skills predicted empathic concern and social knowledge, respectively. Challenges in self-monitoring significantly predicted difficulties with social inferencing and social knowledge for children with ASD. The findings highlight the importance of targeting specific EF skills that contribute to various aspects of social competence to increase the effectiveness of interventions for children with ASD. Autism Res 2020, 13: 1856-1866. © 2020 International Society for Autism Research and Wiley Periodicals LLC LAY SUMMARY: We examined whether parents' ratings of their children's higher-order thinking skills (e.g., paying attention, organizing and planning, initiating tasks, regulating emotions, self-monitoring) predicted social competence among children with and without autism spectrum disorder (ASD). For children without ASD, emotional control and initiation skills were strongly linked to their displays of empathy and social knowledge, respectively. For children with ASD, their abilities to be aware of their own behaviors and its impact on others were strongly related to their ability to interpret social cues and their social knowledge. For both groups, the ability to regulate their emotions were important predictors of their ability to modulate their emotions in social contexts.
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Affiliation(s)
- Vanessa Clarisse Fong
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Grace Iarocci
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
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32
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Cristofani C, Sesso G, Cristofani P, Fantozzi P, Inguaggiato E, Muratori P, Narzisi A, Pfanner C, Pisano S, Polidori L, Ruglioni L, Valente E, Masi G, Milone A. The Role of Executive Functions in the Development of Empathy and Its Association with Externalizing Behaviors in Children with Neurodevelopmental Disorders and Other Psychiatric Comorbidities. Brain Sci 2020; 10:E489. [PMID: 32731515 PMCID: PMC7465618 DOI: 10.3390/brainsci10080489] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022] Open
Abstract
Executive functions have been previously shown to correlate with empathic attitudes and prosocial behaviors. People with higher levels of executive functions, as a whole, may better regulate their emotions and reduce perceived distress during the empathetic processes. Our goal was to explore the relationship between empathy and executive functioning in a sample of children and adolescents diagnosed with Attention Deficit and Hyperactivity Disorder alone or associated with comorbid Disruptive Behavior Disorders and/or Autism Spectrum Disorder. We also aimed to examine the role of empathic dimensions and executive skills in regulating externalizing behaviors. The 151 participants with ADHD were assigned to four groups according to their psychiatric comorbidity (either "pure" or with ASD and/or ODD/CD) and assessed by means of either parent- or self-reported questionnaires, namely the BRIEF-2, the BES, and the IRI. No questionnaire was found to discriminate between the four groups. Affective Empathy was found to positively correlate with Emotional and Behavioral Regulation competences. Furthermore, Aggressiveness and Oppositional Defiant Problems were positively associated with Executive Emotional and Behavioral Regulation competences. On the other hand, Rule-Breaking Behaviors and Conduct Problems were negatively associated with Affective Empathy and with Behavioral skills. Our study provides an additional contribution for a better understanding of the complex relationship between empathic competence and executive functions, showing that executive functioning and empathic attitudes interact with each other to regulate aggressive behaviors. This study further corroborates developmental models of empathy and their clinical implications, for which externalizing behaviors could be attenuated by enhancing executive functioning skills.
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Affiliation(s)
- Chiara Cristofani
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Gianluca Sesso
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Paola Cristofani
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Pamela Fantozzi
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Emanuela Inguaggiato
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Pietro Muratori
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Antonio Narzisi
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Chiara Pfanner
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Simone Pisano
- Department of Neuroscience, AORN Santobono-Pausilipon, 80122 Naples, Italy;
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Lisa Polidori
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Laura Ruglioni
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Elena Valente
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Annarita Milone
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
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Yuk V, Anagnostou E, Taylor MJ. Altered Connectivity During a False-Belief Task in Adults With Autism Spectrum Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:901-912. [PMID: 32600899 DOI: 10.1016/j.bpsc.2020.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Deficits in social communication are one of the main features of autism spectrum disorder (ASD). Adults with ASD show atypical brain activity during false-belief understanding, an aspect of social communication involving the ability to infer that an individual can have an incorrect belief about a situation. Our study is the first to investigate whether adults with ASD exhibit differences in frequency-specific functional connectivity patterns during false-belief reasoning. METHODS We used magnetoencephalography to contrast functional connectivity underlying false-belief understanding between 40 adults with ASD and 39 control adults. We examined whole-brain phase synchrony measures during a false-belief task in 3 frequency bands: theta (4-7 Hz), alpha (8-14 Hz), and beta (15-30 Hz). RESULTS Adults with ASD demonstrated reduced theta-band connectivity compared with control adults between several right-lateralized and midline regions such as the medial prefrontal cortex, right temporoparietal junction, right inferior frontal gyrus, and right superior temporal gyrus. During false-belief trials, they also recruited a network in the beta band that included primary visual regions such as the bilateral inferior occipital gyri and the left anterior temporoparietal junction. CONCLUSIONS Reduced theta-band synchrony between areas associated with mentalizing, inhibition, and visual processing implies some difficulty in communication among these functions in ASD. This impairment in top-down control in the theta band may be counterbalanced by their engagement of a beta-band network because both the left anterior temporoparietal junction and beta-band oscillations are associated with attentional processes. Thus, adults with ASD demonstrate alternative neural mechanisms for successful false-belief reasoning.
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Affiliation(s)
- Veronica Yuk
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences and Mental Health Program, SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychology, University of Toronto, Toronto, Ontario, Canada.
| | - Evdokia Anagnostou
- Department of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Margot J Taylor
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences and Mental Health Program, SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychology, University of Toronto, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
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Bednarz HM, Trapani JA, Kana RK. Metacognition and behavioral regulation predict distinct aspects of social functioning in autism spectrum disorder. Child Neuropsychol 2020; 26:953-981. [PMID: 32253979 DOI: 10.1080/09297049.2020.1745166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Executive function (EF) deficits are common in autism spectrum disorder (ASD), and previous studies suggest that EF may influence or predict social functioning. Thus, EF is a potential treatment target in this population. However, the nature of how specific metacognition and behavioral regulation components of EF may differentially impact social function remains unclear. The goal of the current study was to examine the relationships between sub-components of EF (e.g., working memory, shifting, inhibition, etc.) and social functioning as measured by parent ratings on the Behavior Rating Inventory of Executive Functioning (BRIEF) and the Social Responsiveness Scale (SRS), while controlling for the influence of age, sex, and IQ. A second goal was to examine whether BRIEF scores were predictive of clinician-rated measures of ASD symptoms. Behavioral data were acquired from the Autism Brain Imaging Data Exchange-II database and included 106 children with ASD (ages 5-13). Based on analysis of parent ratings, self-monitoring skills predicted social awareness; shifting ability predicted social cognition; working memory and monitoring skills predicted social communication; initiation predicted social motivation; and shifting ability predicted restrictive and repetitive behaviors among children with ASD. Parent ratings on the BRIEF did not predict clinician-rated measures of ASD symptoms; this requires further study. Overall, the current findings indicate that metacognition and behavioral regulation both contribute to social functioning in ASD, although they each have distinct patterns of influence on different aspects of social functioning. These findings have promising implications for tailoring social interventions for ASD that target specific EF skills.
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Affiliation(s)
- Haley M Bednarz
- Department of Psychology, University of Alabama at Birmingham , Birmingham, AL, USA
| | - Julie A Trapani
- Department of Psychology, University of Alabama at Birmingham , Birmingham, AL, USA
| | - Rajesh K Kana
- Department of Psychology, University of Alabama at Birmingham , Birmingham, AL, USA
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Yaojin LI, Wei ZHANG, Bei FU, Bingping ZHOU. Adult attention deficit hyperactivity disorder in internal and external conflicts: Evidence from Saccade task. ACTA PSYCHOLOGICA SINICA 2020. [DOI: 10.3724/sp.j.1041.2020.00777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- LI Yaojin
- School of Psychology, Central China Normal University, Key Laboratory of Human Development and Mental Health of Hubei Province, Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
| | - ZHANG Wei
- School of Psychology, Central China Normal University, Key Laboratory of Human Development and Mental Health of Hubei Province, Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
| | - FU Bei
- School of Psychology, Central China Normal University, Key Laboratory of Human Development and Mental Health of Hubei Province, Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
| | - ZHOU Bingping
- School of Psychology, Central China Normal University, Key Laboratory of Human Development and Mental Health of Hubei Province, Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
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36
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Mira Á, Berenguer C, Roselló B, Baixauli I, Miranda A. Exploring the profiles of children with autism spectrum disorder: association with family factors. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 68:14-24. [PMID: 35173960 PMCID: PMC8843342 DOI: 10.1080/20473869.2019.1679459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/07/2019] [Accepted: 10/07/2019] [Indexed: 06/14/2023]
Abstract
This study aimed to identify different profiles of children with autism spectrum disorder (ASD) without intellectual disability (ID) and maternal factors characteristic of these profiles. Participants were 89 children between 7 and 11 years old and their mothers, distributed in two groups, 52 children with ASD and 37 with typical development (TD). Based on the children's adaptive, behavioral, and pragmatic manifestations, three clusters were obtained in the ASD group. Children with the most serious difficulties in all the domains assessed were assigned to Cluster 1, whereas the children in Cluster 3 were characterized by relatively minor problems. Cluster 2 comprised children with moderate difficulties in the different domains. Compared to the TD group, group 1, with 'Serious Difficulties', and group 2, with 'Moderate Difficulties', showed significant differences on all the variables evaluated. Group 3, 'Slight Difficulties', was only significantly differentiated from the group with TD on ASD and attention deficit hyperactivity disorder (ADHD) symptoms, pragmatic competence, and applied theory of mind. Therefore, it was outlined as the purest group and basically manifested core ASD symptoms. In addition, mothers of children in the 'Serious Difficulties' group showed higher stress levels and less use of emotional and instrumental support and acceptance strategies, as well as more mental health problems, than mothers of children in the 'Slight Difficulties' group. The results support the need to assess the presentation of other possible problems in ASD children without ID, and design interventions for parents who may be at risk of experiencing higher levels of stress and have fewer coping strategies.
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Affiliation(s)
- Álvaro Mira
- Predoctoral Student of Research in Psychology Doctoral Program, Faculty of Psychology, University of Valencia, Valencia, Spain
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37
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Corbett BA, Ioannou S, Key AP, Coke C, Muscatello R, Vandekar S, Muse I. Treatment Effects in Social Cognition and Behavior following a Theater-based Intervention for Youth with Autism. Dev Neuropsychol 2019; 44:481-494. [PMID: 31589087 DOI: 10.1080/87565641.2019.1676244] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This randomized clinical trial ( www.clinicaltrials.gov ID# NCT02276534) examined the impact of a peer-mediated, theater-based social skills intervention, SENSE Theater®, on social cognition and behavior in 77 youth (ages 8-16) with high-functioning autism spectrum disorder. Analysis of Covariance models revealed that post-treatment, the experimental group (n = 44) performed significantly better than the controls (n = 33) on NEPSY theory of mind (verbal) subtest, demonstrated increased neural evidence of memory for faces, and engaged in more cooperative play and verbal interaction with novel peers. The study extends previous findings showing that SENSE Theater® contributes to improvement in social cognition and behavior.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Sara Ioannou
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Alexandra P Key
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA.,Department of Hearing and Speech Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Catherine Coke
- University School of Nashville, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Rachael Muscatello
- Vanderbilt Brain Institute, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Ian Muse
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA
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Waugh DT. Fluoride Exposure Induces Inhibition of Sodium-and Potassium-Activated Adenosine Triphosphatase (Na +, K +-ATPase) Enzyme Activity: Molecular Mechanisms and Implications for Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1427. [PMID: 31010095 PMCID: PMC6518254 DOI: 10.3390/ijerph16081427] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 12/24/2022]
Abstract
In this study, several lines of evidence are provided to show that Na + , K + -ATPase activity exerts vital roles in normal brain development and function and that loss of enzyme activity is implicated in neurodevelopmental, neuropsychiatric and neurodegenerative disorders, as well as increased risk of cancer, metabolic, pulmonary and cardiovascular disease. Evidence is presented to show that fluoride (F) inhibits Na + , K + -ATPase activity by altering biological pathways through modifying the expression of genes and the activity of glycolytic enzymes, metalloenzymes, hormones, proteins, neuropeptides and cytokines, as well as biological interface interactions that rely on the bioavailability of chemical elements magnesium and manganese to modulate ATP and Na + , K + -ATPase enzyme activity. Taken together, the findings of this study provide unprecedented insights into the molecular mechanisms and biological pathways by which F inhibits Na + , K + -ATPase activity and contributes to the etiology and pathophysiology of diseases associated with impairment of this essential enzyme. Moreover, the findings of this study further suggest that there are windows of susceptibility over the life course where chronic F exposure in pregnancy and early infancy may impair Na + , K + -ATPase activity with both short- and long-term implications for disease and inequalities in health. These findings would warrant considerable attention and potential intervention, not to mention additional research on the potential effects of F intake in contributing to chronic disease.
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Affiliation(s)
- Declan Timothy Waugh
- EnviroManagement Services, 11 Riverview, Doherty's Rd, P72 YF10 Bandon, Co. Cork, Ireland.
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Dai M, Lin L, Liang J, Wang Z, Jing J. Gender Difference in the Association Between Executive Function and Autistic Traits in Typically Developing Children. J Autism Dev Disord 2019; 49:1182-1192. [PMID: 30443698 DOI: 10.1007/s10803-018-3813-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Autistic traits and executive function (EF) were assessed in 413 typically developing children aged 6-9 years. The children were divided into the high- autistic-trait (HAT) and low-autistic-trait (LAT) groups based on their total autistic traits. Results suggested that there were gender differences in specific autistic traits in children with LAT. There were gender-specific associations between EF and autistic traits in children with HAT: the set shifting of EF predicted difficulties in social awareness in boys; whereas all the EF components predicted difficulties in social communication and social cognition in girls. These findings may have implications for developing customized interventions that are targeted at specific autistic deficits in males and females.
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Affiliation(s)
- Meixia Dai
- Faculty of Maternal and Child Health, School of Public Health, Sun Yat-sen University, 74 Zhong-shan Road 2, Guangzhou, 510080, China
| | - Lizi Lin
- Faculty of Maternal and Child Health, School of Public Health, Sun Yat-sen University, 74 Zhong-shan Road 2, Guangzhou, 510080, China
- School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Jingjing Liang
- Faculty of Maternal and Child Health, School of Public Health, Sun Yat-sen University, 74 Zhong-shan Road 2, Guangzhou, 510080, China
| | - Zengjian Wang
- Faculty of Maternal and Child Health, School of Public Health, Sun Yat-sen University, 74 Zhong-shan Road 2, Guangzhou, 510080, China.
| | - Jin Jing
- Faculty of Maternal and Child Health, School of Public Health, Sun Yat-sen University, 74 Zhong-shan Road 2, Guangzhou, 510080, China.
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40
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Mikami AY, Miller M, Lerner MD. Social functioning in youth with attention-deficit/hyperactivity disorder and autism spectrum disorder: transdiagnostic commonalities and differences. Clin Psychol Rev 2019; 68:54-70. [PMID: 30658861 DOI: 10.1016/j.cpr.2018.12.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/12/2018] [Accepted: 12/31/2018] [Indexed: 12/21/2022]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are both neurodevelopmental disorders originating in childhood with high associated impairments and public health significance. There has been growing recognition of the frequent co-occurrence, and potential interrelatedness, between ADHD and ASD without intellectual disability. In fact, the most recent (5th) edition of the DSM is the first to allow ADHD and ASD to be diagnosed in the same individual. The study of transdiagnostic features in ADHD and ASD is important for understanding, and treating, these commonly co-occurring disorders. Social impairment is central to the description and prognosis of both disorders, and many youth with some combination of ADHD and ASD present to clinics for social skills training interventions. However, the aspects of social functioning that are impaired may have both shared and distinct features between the two disorders, relating to some overlapping and some diverse etiologies of social problems in ADHD compared to ASD. These findings have implications for interventions to address social problems in youth with these conditions. We conclude with a discussion about areas for future research and novel intervention targets in youth with ADHD, ASD, and their comorbidity.
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Affiliation(s)
| | - Meghan Miller
- University of California Davis MIND Institute, Sacramento, CA, USA
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41
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Berenguer C, Roselló B, Colomer C, Baixauli I, Miranda A. Children with autism and attention deficit hyperactivity disorder. Relationships between symptoms and executive function, theory of mind, and behavioral problems. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 83:260-269. [PMID: 30368089 DOI: 10.1016/j.ridd.2018.10.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 08/14/2018] [Accepted: 10/06/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The underlying mechanisms of comorbidity between autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are still unknown. Executive function (EF) deficits and theory of mind (ToM) have been the most investigated cognitive processes. AIMS This study proposed to analyze EF, ToM and behavioral problems in children with ASD + ADHD, ADHD, ASD and typical development (TD). The relationship between ADHD and ASD symptoms with EF, ToM and behavioral problems in children with ASD + ADHD was also explored. METHODS AND PROCEDURES Participants were 124 children between 7 and 11 years old (22 ASD + ADHD, 35 ADHD, 30 ASD, and 37 TD), matched on age and IQ. Teachers evaluated EF, and parents assessed ToM skills and behavioral problems through Strengths and Difficulties Questionnaire (SDQ). OUTCOMES AND RESULTS Children with ASD + ADHD and ADHD showed impairments in EF whereas the difficulties in ToM skills of ASD + ADHD group were similar to ASD group. Inattention symptoms were significantly associated with EF metacognitive deficits and ToM difficulties in ASD + ADHD, while ASD symptoms were associated with total score in behavioral problems. CONCLUSIONS AND IMPLICATIONS These findings show the complex difficulties of children with both ASD and ADHD and support the need to take these difficulties into account when designing the treatments.
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Affiliation(s)
- Carmen Berenguer
- Department of Educational Psychology, Faculty of Psychology - University of Valencia, Avda. Blasco Ibáñez, 21, 46010, Valencia, Spain.
| | - Belén Roselló
- Department of Educational Psychology, Faculty of Psychology - University of Valencia, Avda. Blasco Ibáñez, 21, 46010, Valencia, Spain.
| | - Carla Colomer
- Department of Education, Didactics and School Organization, University Jaume I, Av. de Vicent Sos Baynat, s/n, 12071, Castellón de la Plana, 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", C/Guillem de Castro, 175, 46008, Valencia, Spain.
| | - Ana Miranda
- Department of Educational Psychology, Faculty of Psychology - University of Valencia, Avda. Blasco Ibáñez, 21, 46010, Valencia, Spain.
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42
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Şahin B, Karabekiroğlu K, Bozkurt A, Usta MB, Aydın M, Çobanoğlu C. The Relationship of Clinical Symptoms with Social Cognition in Children Diagnosed with Attention Deficit Hyperactivity Disorder, Specific Learning Disorder or Autism Spectrum Disorder. Psychiatry Investig 2018; 15:1144-1153. [PMID: 30518170 PMCID: PMC6318495 DOI: 10.30773/pi.2018.10.01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 10/01/2018] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE One of the areas of social cognition is Theory of Mind (ToM) is defined as the capacity to interpret, infer and explain mental states underlying the behavior of others. When social cognition studies on neurodevelopmental disorders are examined, it can be seen that this skill has not been studied sufficiently in children with Specific Learning Disorder (SLD). METHODS In this study, social cognition skills in children diagnosed with attention deficit hyperactivity disorder (ADHD), SLD or Autism Spectrum Disorder (ASD) evaluated before puberty and compared with controls. To evaluate the ToM skills, the first and secondorder false belief tasks, the Hinting Task, the Faux Pas Test and the Reading the Mind in the Eyes Task were used. RESULTS We found that children with neurodevelopmental disorders as ADHD, ASD, and SLD had ToM deficits independent of intelligence and language development. There was a significant correlation between social cognition deficits and problems experienced in many areas such as social communication and interaction, attention, behavior, and learning. CONCLUSION Social cognition is an important area of impairment in SLD and there is a strong relationship between clinical symptoms and impaired functionality.
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Affiliation(s)
- Berkan Şahin
- Department of Child and Adolescent Psychiatry, Iğdır State Hospital, Iğdır, Turkey
| | - Koray Karabekiroğlu
- Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Abdullah Bozkurt
- Department of Child and Adolescent Psychiatry, Konya Training And Research Hospital, Konya, Turkey
| | - Miraç BarıŞ Usta
- Department of Child and Adolescent Psychiatry, Samsun Training And Research Hospital, Samsun, Turkey
| | - Muazzez Aydın
- Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Cansu Çobanoğlu
- Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
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Pineda-Alhucema W, Aristizabal E, Escudero-Cabarcas J, Acosta-López JE, Vélez JI. Executive Function and Theory of Mind in Children with ADHD: a Systematic Review. Neuropsychol Rev 2018; 28:341-358. [PMID: 30168020 DOI: 10.1007/s11065-018-9381-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 08/06/2018] [Indexed: 01/27/2023]
Abstract
In developmental research, the relationship between Executive Function (EF) and Theory of Mind (ToM) has been extensively assessed, and EF has been considered a condition for ToM. However, few researchers have studied the relationship between EF and ToM in clinical populations, especially that of Attention Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental disorder characterized by symptoms of inattention and motor hyperactivity/impulsivity, in which EF is largely impaired. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model, 201 English and Spanish articles evaluating EF and ToM in ADHD were chosen. Fifteen papers met the inclusion criteria and were selected for further analysis. The first study dates from 2001. Most of the studies' designs are cross-sectional, include mostly male children, have a small sample size, and were conducted in European countries. Unlike tasks assessing EF, tasks assessing ToM were heterogeneous across studies. The EFs most correlated with ToM were inhibitory control, working memory, cognitive flexibility, and attention. Interest in studying the relationship between EF and ToM in ADHD is recent,but increasing based on new findings and tuning of ToM instruments. However, while an association between EF and ToM is indicated in ADHD, the degree of prediction and predictability of one over the other cannot yet be established because of the studies' heterogeneity.
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Affiliation(s)
- Wilmar Pineda-Alhucema
- Grupo de Neurociencias del Caribe, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Barranquilla, Colombia.
| | | | | | - Johan E Acosta-López
- Grupo de Neurociencias del Caribe, Unidad de Neurociencias Cognitivas, Universidad Simón Bolívar, Barranquilla, Colombia
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Frye RE. Social Skills Deficits in Autism Spectrum Disorder: Potential Biological Origins and Progress in Developing Therapeutic Agents. CNS Drugs 2018; 32:713-734. [PMID: 30105528 PMCID: PMC6105175 DOI: 10.1007/s40263-018-0556-y] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Autism spectrum disorder is defined by two core symptoms: a deficit in social communication and the presence of repetitive behaviors and/or restricted interests. Currently, there is no US Food and Drug Administration-approved drug for these core symptoms. This article reviews the biological origins of the social function deficit associated with autism spectrum disorder and the drug therapies with the potential to treat this deficit. A review of the history of autism demonstrates that a deficit in social interaction has been the defining feature of the concept of autism from its conception. Abnormalities identified in early social skill development and an overview of the pathophysiology abnormalities associated with autism spectrum disorder are discussed as are the abnormalities in brain circuits associated with the social function deficit. Previous and ongoing clinical trials examining agents that have the potential to improve social deficits associated with autism spectrum disorder are discussed in detail. This discussion reveals that agents such as oxytocin and propranolol are particularly promising and undergoing active investigation, while other agents such as vasopressin agonists and antagonists are being activity investigated but have limited published evidence at this time. In addition, agents such as bumetanide and manipulation of the enteric microbiome using microbiota transfer therapy appear to have promising effects on core autism spectrum disorder symptoms including social function. Other pertinent issues associated with developing treatments in autism spectrum disorder, such as disease heterogeneity, high placebo response rates, trial design, and the most appropriate way of assessing effects on social skills (outcome measures), are also discussed.
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Affiliation(s)
- Richard E Frye
- Division of Neurodevelopmental Disorders, Department of Neurology, Barrow Neurological Institute, Phoenix Children's Hospital, 1919 E Thomas St, Phoenix, AZ, 85016, USA.
- Department of Child Health, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, 85004, USA.
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Khorashad BS, Khazai B, Roshan GM, Hiradfar M, Afkhamizadeh M, van de Grift TC. Prenatal testosterone and theory of mind development: Findings from disorders of sex development. Psychoneuroendocrinology 2018; 89:250-255. [PMID: 29398092 DOI: 10.1016/j.psyneuen.2017.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/21/2017] [Accepted: 12/12/2017] [Indexed: 01/13/2023]
Abstract
Women on average perform better than men on the "Reading the Mind in the Eyes" test (RMET) which is a measure of Theory of Mind (ToM). The aim of this study was to assess whether these sex differences are influenced by differences in prenatal testosterone levels through a study on individuals with Disorders of Sex Development and matched controls. ToM performance was examined using the RMET in female-assigned-at-birth individuals with increased prenatal testosterone exposure (Congenital Adrenal Hyperplasia (CAH) and 5-alpha Reductase type-2 Deficiency (5α-RD-2)), female-assigned-at-birth individuals with testosterone insensitivity (Complete Androgen Insensitivity Syndrome (CAIS)), and their age-matched unaffected male and female relatives. A total number of 158 individuals participated in the study; 19 with 5α-RD-2, 17 with CAH, 18 women with CAIS, 52 matched unaffected men and 52 matched unaffected women. All subgroups were around 20 years of age. Women with CAH scored significantly lower on RMET than control women and CAIS individuals. CAIS individuals scored significantly higher than control men and participants with 5α-RD. Statistically, CAIS individuals' performance on RMET was similar to control women's, women with CAH did not differ significantly from control men and 5α-RD-2 individuals scored significantly lower than control men. These results, which are in line with previous theories, illustrate that performance on the RMET, as an index of ToM, may be influenced by variations in prenatal androgens levels.
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Affiliation(s)
- Behzad S Khorashad
- Transgender Studies Center, Mashhad University of Medical Sciences, Mashhad, Iran; Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behnaz Khazai
- Transgender Studies Center, Mashhad University of Medical Sciences, Mashhad, Iran; Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ghasem M Roshan
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehran Hiradfar
- Department of Pediatric Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mozhgan Afkhamizadeh
- Endocrine Research Center, Department of Endocrinology, Iman Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tim C van de Grift
- Department of Medical Psychology (Gender and Sexology), VU University Medical Center, Amsterdam, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands
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