Brief Report: Investigating Temporal Factors in the Context of Parenting an Autistic Child

The current study was a secondary analysis of cross-sectional data collected in New Zealand. Parents (n = 291) of an autistic child completed an online survey that included temporal/demographic questions relating to the parent and child, and parent ratings of the child's core ASD symptoms, their parenting stress, and psychological well-being. Child and parent ages were related to ASD core symptoms, parenting stress, and psychological well-being, the parent-child age gap was not. Diagnostic delay was only positively associated with parent depression and negatively associated with child communication impairment. Findings indicated that temporal variables can be predictive of parent well-being and child autism symptoms. The findings suggest that focusing interventions on communication abilities may have positive impacts parental mental health.

Stress and distress in New Zealand parents caring for a child with autism spectrum disorder

The aim of this cross-sectional study was to identify predictors of the mental health of parents of a child with autism spectrum disorder (ASD). A convenience sample of 658 parents residing in New Zealand completed an online questionnaire. Participants responded to questions probing parent and child characteristics, child ASD severity (the Autism Impact Measure: AIM), parenting stress (the Autism Parenting Stress Index: APSI), and parent mental health (the General Health Questionnaire: GHQ-28). The results indicated that the majority of the parents in our sample have reached clinical levels of psychiatric distress, in particular anxiety. Parent and child characteristics were poor predictors of parental mental health problems. Parenting stress, however, was found to be a significant predictor, also acting as a mediator variable between child ASD symptom severity and parental mental health problems. Our findings are interpreted in relation to their significance to clinical practice.

The Types and Functions of Social Supports Used by Parents Caring for a Child With Autism Spectrum Disorder

The challenges faced by parents caring for a child with Autism Spectrum Disorder (ASD) can amplify parenting stress, though the impacts of these challenges can be alleviated by social supports. A sample of 674 parent volunteers completed a survey probing the types of social supports currently being used, what function (i.e., tangible, emotional, financial, informational) they judged them to perform, and how each of the utilised supports reduced parenting stress and was considered helpful. Results indicated that informal social supports and social media were perceived as more helpful than formal supports, which were typically perceived in a neutral manner by parents. Overall, the study indicates that addressing the support needs of parents of a child with ASD remains a priority.

The Cold Shoulder or a Shoulder to Cry on? Mechanisms of Formal and Informal Social Support in the ASD Parenting Context

The underlying mechanisms by which social support exerts its (typically) positive effects on parental wellbeing are still being investigated in the autism spectrum disorder (ASD) context. Parents (n = 674) of a child with ASD responded to questions probing parenting stress, parent psychological health, their child's ASD symptoms, and the types of social supports they were currently utilising. Hierarchical multiple linear regression analyses examined whether social support moderated or mediated (or neither) the relationships between: (a) parent-rated child ASD symptoms and parenting stress, and (b) parenting stress and parent psychological health. The main findings were that none of the mediating models reached statistical significance, while 7/20 moderation analyses were significant, though significance was dependent upon how social support was operationalised.

Comparison of YouthCHAT, an Electronic Composite Psychosocial Screener, With a Clinician Interview Assessment for Young People: Randomized Controlled Trial

Background

Psychosocial problems such as depression, anxiety, and substance abuse are common and burdensome in young people. In New Zealand, screening for such problems is undertaken routinely only with year 9 students in low-decile schools and opportunistically in pediatric settings using a nonvalidated and time-consuming clinician-administered Home, Education, Eating, Activities, Drugs and Alcohol, Sexuality, Suicide and Depression, Safety (HEEADSSS) interview. The Youth version, Case-finding and Help Assessment Tool (YouthCHAT) is a relatively new, locally developed, electronic tablet–based composite screener for identifying similar psychosocial issues to HEEADSSS

Objective

This study aimed to compare the performance and acceptability of YouthCHAT with face-to-face HEEADSSS assessment among 13-year-old high school students.

Methods

A counterbalanced randomized trial of YouthCHAT screening either before or after face-to-face HEEADSSS assessment was undertaken with 129 13-year-old New Zealand high school students of predominantly Māori and Pacific Island ethnicity. Main outcome measures were comparability of YouthCHAT and HEEADSSS completion times, detection rates, and acceptability to students and school nurses.

Results

YouthCHAT screening was more than twice as fast as HEEADSSS assessment (mean 8.57 min vs mean 17.22 min; mean difference 8 min 25 seconds [range 6 min 20 seconds to 11 min 10 seconds]; P<.01) and detected more issues overall on comparable domains. For substance misuse and problems at home, both instruments were roughly comparable. YouthCHAT detected significantly more problems with eating or body image perception (70/110, 63.6% vs 25/110, 22.7%; P<.01), sexual health (24/110, 21.8% vs 10/110, 9.1%; P=.01), safety (65/110, 59.1% vs 17/110, 15.5%; P<.01), and physical inactivity (43/110, 39.1% vs 21/110, 19.1%; P<.01). HEEADSSS had a greater rate of detection for a broader set of mental health issues (30/110, 27%) than YouthCHAT (11/110, 10%; P=.001), which only assessed clinically relevant anxiety and depression. Assessment order made no significant difference to the duration of assessment or to the rates of YouthCHAT-detected positive screens for anxiety and depression. There were no significant differences in student acceptability survey results between the two assessments. Nurses identified that students found YouthCHAT easy to answer and that it helped students answer face-to-face questions, especially those of a sensitive nature. Difficulties encountered with YouthCHAT included occasional Wi-Fi connectivity and student literacy issues.

Conclusions

This study provides preliminary evidence regarding the shorter administration time, detection rates, and acceptability of YouthCHAT as a school-based psychosocial screener for young people. Although further research is needed to confirm its effectiveness in other age and ethnic groups, YouthCHAT shows promise for aiding earlier identification and treatment of common psychosocial problems in young people, including possible use as part of an annual, school-based, holistic health check.

Trial Registration

Australian New Zealand Clinical Trials Network Registry (ACTRN) ACTRN12616001243404p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371422.

Molecular analysis of prion strain variation and the aetiology of 'new variant' CJD

Strains of transmissible spongiform encephalopathies are distinguished by differing physicochemical properties of PrPSc, the disease-related isoform of prion protein, which can be maintained on transmission to transgenic mice. 'New variant' Creutzfeldt-Jakob disease (CJD) has strain characteristics distinct from other types of CJD and which resemble those of BSE transmitted to mice, domestic cat and macaque, consistent with BSE being the source of this new disease. Strain characteristics revealed here suggest that the prion protein may itself encode disease phenotype.

Unaltered susceptibility to BSE in transgenic mice expressing human prion protein

Prion diseases are transmissible neurodegenerative conditions of humans and animals. Prions consist principally of a post-translationally modified form of prion protein (PrP), PrP(Sc), which is partly protease resistant. Transmission of prion diseases between species is limited by a 'species barrier' determined in part by the degree of sequence homology between host PrP and inoculated PrP(Sc) (ref.3) and by prion strain type. The epidemic of bovine spongiform encephalopathy (BSE) in the United Kingdom and other countries has led to concerns that transmission to humans may occur by dietary exposure. BSE appears to be caused by a single strain, distinct from those of natural or experimental scrapie, which is also seen in the new prion diseases of cats and ruminants that have presumably arisen from dietary BSE exposure. Here we show that transgenic mice expressing human PrP in addition to mouse PrP can generate human PrP(Sc) and 'human' prions. These mice therefore provide a model to study experimentally the species barrier limiting BSE transmission to humans. Incubation periods to BSE in transgenic mice are not shortened by expression of human PrP, and only mouse PrP(Sc) is produced in response to such challenge.

Rescue of neurophysiological phenotype seen in PrP null mice by transgene encoding human prion protein

The prion protein (PrP) is central to the aetiology of the prion diseases, transmissible neurodegenerative conditions of humans and animals. PrP null mice show abnormalities of synaptic neurophysiology, in particular weakened GABAA receptor-mediated fast inhibition and impaired long-term potentiation in the hippocampus. Here we demonstrate that this PrP null phenotype is rescued in mice with a high copy number of a transgene encoding human PrP but not in low copy number mice, confirming the specificity of the phenotype for loss of function of PrP. The ability of human PrP to compensate for loss of murine PrP will allow direct study of the functional consequences of the 18 human PrP mutations, which cause the inherited prion diseases; this phenotype can now form the basis of the first functional assay for PrP.