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Greenlee JL, Putney JM, Hickey E, Winter MA, Hartley SL. An Exploratory Study of Resilience to Stressful Life Events in Autistic Children. Res Autism Spectr Disord 2024; 114:102371. [PMID: 38737198 PMCID: PMC11087040 DOI: 10.1016/j.rasd.2024.102371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Background Autistic children experience more stressful life events (SLEs) than their neurotypical peers, which are related to poor mental health outcomes in both neurotypical and autistic individuals. However, there is a lack of longitudinal research assessing the perceived impact of stressful life events on autistic children's mental health. Method Utilizing a novel statistical technique (Ratcliff et al., 2019), called 'area of resilience to stress events' or ARSE in R, we aimed to quantify aspects of resilience, growth, and non-resilience for 67 autistic children (6-13 years old) enrolled in a larger longitudinal study who experienced a SLE. Parents reported demographic information (e.g., child age, biological sex, household income) as well as the child's internalizing and externalizing symptoms and autism characteristics across multiple time points spaced one year apart (baseline, T2, T3, T4). Results There was substantial variability in the resilience process within the sample. Older children exhibited a less adaptive resilience process (i.e., higher total scaled scores or arsets). Perceived stress of the disruptive event was not correlated with resilience; however, there was a significant child age x stress severity interaction, suggesting that younger children in households that perceived the disruptive event as highly stressful exhibited more efficient resilience, or lower arsets scores, compared to other children. Conclusions This study introduces an innovative methodological approach to understanding the effects of stressful life events on the mental health of autistic children. Results have implications for family-based policy and practice and highlight for whom services may be most beneficial.
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Affiliation(s)
| | - Jennifer M Putney
- Department of Human Development and Family Studies, Washington State University
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Greenlee JL, Lorang E, Olson RH, Rodriquez G, Yoon DM, Hartley S. Comparative analysis of electrodermal activity metrics and their association with child behavior in autism spectrum disorder. Dev Psychobiol 2024; 66:e22461. [PMID: 38388193 PMCID: PMC10901449 DOI: 10.1002/dev.22461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/07/2023] [Accepted: 01/05/2024] [Indexed: 02/24/2024]
Abstract
Researchers are increasingly utilizing physiological data like electrodermal activity (EDA) to understand how stress "gets under the skin." Results of EDA studies in autistic children are mixed, with some suggesting autistic hyperarousal, others finding hypoarousal, and yet others detecting no difference compared to non-autistics. Some of this variability likely stems from the different techniques used to assess EDA. Therefore, the purpose of this study is to investigate and compare commonly used metrics of EDA (frequency of peaks, average amplitude of peaks, and standard deviation of skin conductance level) using two data processing programs (NeuroKit2 and Ledalab) and their link to observed child behavior. EDA data were collected using Empatica E4 wristbands from 60 autistic children and adolescents (5-18 years old) during a 7-min play interaction with their primary caregiver. The play interaction was coded for a range of child behaviors including mood, social responsiveness, dysregulation, and cooperation. Results indicate a strong correlation between NeuroKit2 and Ledalab and a weak correlation between metrics within each program. Furthermore, the frequency of peaks was associated with more positive child social behaviors, and the magnitude of peaks was associated with less adaptive child behaviors. Recommendations for replication and the need for generalizability of this research are given.
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Affiliation(s)
| | - Emily Lorang
- Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan, USA
| | - Robert H Olson
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Geovanna Rodriquez
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, Oregon, USA
| | - Dasoo Milton Yoon
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Sigan Hartley
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Abstract
LAY ABSTRACT Research shows that parents of autistic children, on average, are stressed; however, there is likely an array of factors that characterize the parenting experience in the context of autism other than stress. Understanding the diversity in the parenting experiences of both mothers and fathers of autistic children is important in the development of family-based intervention. A total of 188 co-habiting couples with an autistic child described their parenting experiences using a series of questionnaires examining their feelings of stress, parenting competence, and parenting attitudes and behaviors. We then sorted responses into profiles-three for mothers and four for fathers. We found that children of parents who reported the least amount of stress, highest feeling of competence, and use of responsive and directive parenting strategies (the Adaptive profile) had children with the least severe behavioral problems and autism symptoms. It was not necessary for both parents to be in the Adaptive category for child emotional and behavioral problems to less severe. We found that children did just as well when one parent was Adaptive compared with when both parents fell into this category.
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Greenlee JL, Stelter CR, Hickey E, Burton C, Carlson M, Winter MA. Using the Three-Minute Speech Sample to Examine the Parent-Adolescent Relationship in Autistic Youth: A Qualitative Analysis. J Autism Dev Disord 2023:10.1007/s10803-023-05942-7. [PMID: 37022577 DOI: 10.1007/s10803-023-05942-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE This qualitative study examines autistic adolescents' perception of the quality of their relationship with their parent using the Three Minute Speech Sample. METHODS Twenty autistic youth (13-17 years; 83% male) spoke, uninterrupted, for three minutes about their thoughts and feelings regarding their mothers. Audio-recorded speech samples were transcribed and coded for emergent themes. RESULTS Adolescents highlighted emotional support and acceptance in the context of their relationship, support mothers provide for mental health, love and caring, efforts to build the relationship through shared activities, and areas of adolescent-parent conflict. CONCLUSION The TMSS is a low cost, low burden method by which autistic adolescents can comfortably and effectively self-report the quality of their relationship with their parent/caregiver.
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Affiliation(s)
| | | | - Emily Hickey
- Waisman Center, University of Wisconsin-Madison, Madison, USA
| | - Casey Burton
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
| | - Megan Carlson
- Developmental and Behavioral Sciences, Children's Mercy Kansas City, 730 High St, Easton, PA, 18042, USA
| | - Marcia A Winter
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
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Lohr KD, Everhart RS, Greenlee JL, Winter MA. Caregiver Expressed Emotion and Pediatric Asthma: A Call for Culturally Specific Adaptations. Pediatr Allergy Immunol Pulmonol 2023; 36:1-4. [PMID: 36577054 PMCID: PMC10024584 DOI: 10.1089/ped.2022.0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/26/2022] [Indexed: 12/29/2022]
Abstract
Background: Expressed emotion is the affective attitudes and behaviors of an individual toward another. In this preliminary study, we described expressed emotion among caregivers of children with asthma living in low-income urban area and evaluated its association with child asthma control. Methods: Forty-one children (90.2% African American/Black) and their caregivers participated. Measures included the Childhood Asthma Control Test and the Five-Minute Speech Sample coded for overall expressed emotion, emotional over-involvement, and criticism. Results: Most caregivers were rated borderline (31.7%) or high (48.8%) for expressed emotion, borderline (31.7%) or high (39.0%) for emotional overinvolvement, and low for criticism (73.2%). The association between criticism and asthma control neared statistical significance [U(Nlow = 30, NB/high = 11) = 100, z = -1.922, P = 0.055]. Conclusion: Findings suggest an examination into expressed emotion coding procedures for caregivers in low-income urban areas, and culturally specific adaptations may be necessary. Future research should confirm findings in a larger sample and consider how parental criticism affects children's asthma management.
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Affiliation(s)
- Katherine D. Lohr
- Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Robin S. Everhart
- Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Marcia A. Winter
- Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
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Greenlee JL, Piro-Gambetti B, Putney J, Papp LM, Hartley SL. Marital satisfaction, parenting styles, and child outcomes in families of autistic children. Fam Process 2022; 61:941-961. [PMID: 34389976 PMCID: PMC8841000 DOI: 10.1111/famp.12708] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/17/2021] [Accepted: 06/28/2021] [Indexed: 06/03/2023]
Abstract
Theory and research on the general population suggest that parents' marital relationship quality is associated with children's emotional and behavioral functioning directly, as well as indirectly, by affecting parenting attitudes and behaviors. However, little has been done to investigate the potential connection among parent marital satisfaction, parenting styles, and outcomes for autistic children. Using longitudinal data collected from 188 couples parenting an autistic child, this study tested the time-ordered indirect effect of parent marital satisfaction (assessed at Time 1) on the internalizing and externalizing symptoms (assessed at Time 3) of autistic children (originally aged 5-12 years) via parenting styles (assessed at Time 2) using actor-partner interdependence modeling extended to mediation. Results indicated that a lower level of marital satisfaction at Time 1 predicted impaired child outcomes at Time 3 via its impact on parenting style at Time 2. For both parents, lower marital satisfaction predicted more child externalizing symptoms via reports of more authoritarian parenting style. Lower marital satisfaction in mothers at Time 1 was also associated with higher levels of child internalizing symptoms at Time 3 via increased authoritarian parenting in mothers. No partner effects were found. A family-wide approach that includes support for the parent marital relationship, which may have downstream effects on parenting, is important for promoting optimal emotional and behavioral health in autistic children.
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Affiliation(s)
- Jessica L Greenlee
- University of Wisconsin-Madison, Madison, Wisconsin, USA
- Waisman Center, Madison, Wisconsin, USA
| | - Brianna Piro-Gambetti
- University of Wisconsin-Madison, Madison, Wisconsin, USA
- Waisman Center, Madison, Wisconsin, USA
- Department of Human Development and Family Studies, University of Wisconsin, Madison, Wisconsin, USA
| | - Jennifer Putney
- University of Wisconsin-Madison, Madison, Wisconsin, USA
- Waisman Center, Madison, Wisconsin, USA
- Department of Human Development and Family Studies, University of Wisconsin, Madison, Wisconsin, USA
| | - Lauren M Papp
- University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Human Development and Family Studies, University of Wisconsin, Madison, Wisconsin, USA
| | - Sigan L Hartley
- University of Wisconsin-Madison, Madison, Wisconsin, USA
- Waisman Center, Madison, Wisconsin, USA
- Department of Human Development and Family Studies, University of Wisconsin, Madison, Wisconsin, USA
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Putney JM, Greenlee JL, Hartley SL. Use and Benefit of Dyadic Coping for Couple Relationship Satisfaction in Parents of Children with Autism. Fam Process 2021; 60:1331-1346. [PMID: 33247443 PMCID: PMC8155113 DOI: 10.1111/famp.12617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Parents of children with autism spectrum disorder (ASD) are at increased risk for unsatisfying and conflict-ridden couple relationships (i.e., marital or romantic partner relationships). There is a critical need to identify the couple-level processes that contribute to this risk. The current study examined the use of dyadic coping, defined as the appraisals and behaviors that partners in relationships use and receive to manage stressors, and to examine whether dyadic coping mediated the association between parenting stress and couple relationship satisfaction in parents who have a child with ASD and in parents who do not have a child with ASD. In total, 184 couples that had a child with ASD (aged 5-12 years) and comparison group of 183 couples who have a child without a neurodevelopmental condition participated in the study. A multivariate analysis of covariance indicated that parents of children with ASD reported less positive and more negative dyadic coping than did parents in the comparison group. Hierarchical linear modeling indicated that dyadic coping mediated the association between parenting stress and couple relationship satisfaction. Findings have important implications for programs aimed at enhancing parent couple relationship in families of children with ASD.
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Affiliation(s)
- Jennifer M. Putney
- Correspondence concerning this article should be addressed to Jennifer M. Putney, Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison, Nancy Nicholas Hall, 1300 Linden Dr, Madison, Wi 53706.
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Greenlee JL, Stelter CR, Piro-Gambetti B, Hartley SL. Trajectories of Dysregulation in Children with Autism Spectrum Disorder. J Clin Child Adolesc Psychol 2021; 50:858-873. [PMID: 33872096 DOI: 10.1080/15374416.2021.1907752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: This study determined whether child and family environment factors are associated with differences in developmental trajectories of emotional and behavioral dysregulation in children with autism spectrum disorder (ASD).Method: Participants included 186 families of a child with ASD (5-12 years old at baseline; 86% male; 83% non-Hispanic Caucasian; 35% comorbid intellectual disability). At each of the four time points (each spaced 12 months apart), mothers and fathers within each family completed well-validated measures on their own mental health, their child's dysregulation, their parent-child relationship, and their parent couple relationship. Longitudinal multi-level modeling was used to describe trajectories of dysregulation across 3 years and test whether parent depression, closeness in the parent-child relationship, and positive parent dyadic coping were associated with differences in child trajectories.Results: On average, child dysregulation decreased across time. Closer mother-child and father-child relationship quality was associated with lower baseline dysregulation. More severe child restricted and repetitive behaviors, fewer maternal depression symptoms, and more positive parent dyadic coping were associated with declines in child dysregulation over time.Conclusions: On average, children with ASD become less dysregulated across time. However, there is important variability in dysregulation trajectories of children with ASD. Children with ASD who have a high (versus low) severity of restricted and repetitive behaviors appear to be at risk for greater dysregulation. The family environment, and specifically a closer parent-child relationship, better maternal mental health, and more positive couple coping, may contribute to a pattern of improved child regulation across time in ASD.
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Greenlee JL, Winter MA, Marcovici IA. Brief Report: Gender Differences in Experiences of Peer Victimization Among Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:3790-3799. [PMID: 32124143 DOI: 10.1007/s10803-020-04437-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Peer victimization (PV) is a common problem for many adolescents with autism spectrum disorder (ASD) and can negatively impact the mental health and well-being of these youth. Results of the current study of 105 adolescents with ASD (n = 50 girls, 55 boys) indicated that girls and boys experience similar types of PV at similar frequencies. However, relational victimization accounted for a significant portion of variance in anxiety symptoms, above and beyond social communication deficits and restricted and repetitive behaviors, in girls but not in boys. Findings provide preliminary evidence suggesting that the impact of PV on mental health symptoms may be different for girls and boys with ASD, highlighting the need for more research focused on understanding potentially unique social processes for adolescent girls with ASD.
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Affiliation(s)
- Jessica L Greenlee
- The Waisman Center, The University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI, 53705, USA. .,Department of Psychology, Virginia Commonwealth University, 808 West Franklin St., Box 842018, Richmond, VA, 23284, USA.
| | - Marcia A Winter
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St., Box 842018, Richmond, VA, 23284, USA
| | - Isabel A Marcovici
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St., Box 842018, Richmond, VA, 23284, USA
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Greenlee JL, Winter MA, Everhart RS, Fiese BH. Parents' child-related schemas: Associations with children's asthma and mental health. J Fam Psychol 2019; 33:270-279. [PMID: 30652916 DOI: 10.1037/fam0000494] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The parent-child relationship, a key dyad of the family, can influence disease-related and psychological processes in children with asthma. Although the critical role of parenting behaviors in asthma outcomes is well established, less is known about the attitudes and beliefs underlying parents' interactions with their children and how those attitudes may relate to asthma outcomes. Thus, this study aimed to identify profiles of parents' schemas pertaining to their children with asthma and examine whether child mental and physical health outcomes differed by profile membership. Caregivers of children (n = 177; 5-12 years old) with asthma completed the Five Minute Speech Sample (Magaña et al., 1986), which was later coded for positive and negative attitudes and attributions about their children. Using a pattern-based approach, cluster analyses revealed three profiles of schemas: high negativity-low positivity, low negativity-low positivity, and low negativity-high positivity. Profiles differed in levels of externalizing and internalizing child symptoms, and lung function. Results support the growing body of research placing emphasis on the role of parenting in pediatric asthma outcomes. Caregiver schemas may constitute a point of intervention in families of children with asthma. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign
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Al Ghriwati N, Winter MA, Greenlee JL, Thompson EL. Discrepancies between parent and self-reports of adolescent psychosocial symptoms: Associations with family conflict and asthma outcomes. J Fam Psychol 2018; 32:992-997. [PMID: 30070570 DOI: 10.1037/fam0000459] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Discrepancies often exist between self-reported and parent-reported symptoms when assessing youth psychosocial functioning. Parent-child discrepancies in ratings may be important for understanding psychopathology and patterns of family functioning, particularly during adolescence and for youth with chronic illness. This study examined patterns of multirater reporting discrepancies in a pediatric asthma population. Adolescents (n = 707; 11-17 years old) and their primary caregivers completed ratings of adolescents' psychological symptoms. Latent profile analysis identified five profiles of parent-adolescent discrepancies, including one group with highly discordant ratings, two groups in agreement, and two groups with slightly discordant ratings. Adolescents who agreed with their parents on the presence of elevated symptoms and those who had significant discrepancies in ratings, such that parents reported elevated symptoms compared to youth self-report, had poor pulmonary functioning and elevated reports of parent-rated family conflict. Results suggest the need to assess internalizing and externalizing symptoms in adolescents with asthma using a multirater approach while also highlighting the complexity in interpreting patterns of discrepancies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Everhart RS, Greenlee JL, Winter MA, Fiese BH. Primary and Secondary Caregiver Reports of Quality of Life in Pediatric Asthma: Are They Comparable? Appl Res Qual Life 2018; 13:371-383. [PMID: 29910839 PMCID: PMC5998812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE This study aimed to compare primary and secondary caregiver QOL within families of children with asthma and determine the potential importance of including secondary caregiver QOL in clinical and research settings. METHODS Participants included 118 families of children with asthma that had primary and secondary caregivers. Families completed measures in a single research session. Caregivers reported on QOL, psychological functioning, and family burden; children completed a measure of QOL. Child lung function was determined from objective spirometry. Adherence to prescribed controller medication was measured for 6 weeks following the research visit. RESULTS Primary caregiver QOL was significantly lower than secondary caregiver QOL (Mean overall QOL of 5.85 versus 6.17, p < .05). Better medication adherence was associated with higher primary caregiver QOL (ρ = .22, p = .02); secondary caregiver QOL, not primary caregiver QOL, was positively associated with child QOL (ρ = .20, p = .03). Families with discrepant QOL scores between caregivers (difference in scores of at least .50) were characterized by more family burden and primary caregiver psychological symptoms. CONCLUSIONS Differences in QOL scores between caregivers may be a reflection of primary caregivers' greater investment in daily asthma management. In families reporting low burden and few psychological difficulties in the primary caregiver, QOL assessments from either caregiver may may be informative and representative of how parents are adapting to child asthma. In families experiencing high levels of burden or more primary caregiver psychological difficulties, QOL reports from secondary caregivers may not be as clinically meaningful.
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Affiliation(s)
- Robin S. Everhart
- Virginia Commonwealth University, Department of Psychology, P.O. Box 842018, Richmond, VA, 23284
| | - Jessica L. Greenlee
- Virginia Commonwealth University, Department of Psychology, P.O. Box 842018, Richmond, VA, 23284
| | - Marcia A. Winter
- Virginia Commonwealth University, Department of Psychology, P.O. Box 842018, Richmond, VA, 23284
| | - Barbara H. Fiese
- University of Illinois at Urbana-Champaign, Family Resiliency Center, Department of Human Development and Family Studies, 904 W. Nevada St., Urbana, IL 61801
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Greenlee JL, Mosley AS, Shui AM, Veenstra-VanderWeele J, Gotham KO. Medical and Behavioral Correlates of Depression History in Children and Adolescents With Autism Spectrum Disorder. Pediatrics 2016; 137 Suppl 2:S105-14. [PMID: 26908466 PMCID: PMC4915738 DOI: 10.1542/peds.2015-2851i] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Depression is commonly associated with autism spectrum disorder (ASD) across the life span. We sought to identify medical and behavioral problems associated with a history of a parent-reported diagnosis of depression in a large sample of school-aged children and adolescents with ASD. METHODS A sample of 1272 participants (aged 6-17 years; mean [SD]: 9.56 [2.79] years) from the Autism Speaks Autism Treatment Network consortium were divided into "ever-depressed" (n = 89) and "nondepressed" (n = 1183) groups on the basis of caregiver endorsement of children's current or previous diagnoses of depression. RESULTS In total, 7.0% of children with ASD (4.8% of those aged 6-12 years and 20.2% of those aged 13-17 years) were reported to have a history of a depression diagnosis. Positive depression history was associated with greater chronological age, higher IQ, and Asperger disorder diagnosis. After controlling for age, IQ, and within-spectrum categorical diagnosis, the ever-depressed group exhibited significantly greater rates of seizure disorders (odds ratio = 2.64) and gastrointestinal problems (odds ratio = 2.59) and trend-level differences in aggression, somatic complaints, and social impairments. The groups did not differ in autism severity, repetitive behaviors, sleep problems, eating problems, self-injurious behavior, or current intervention use. CONCLUSIONS Co-occurring depression is a particularly common problem in higher-functioning older children within the Autism Treatment Network. Our findings indicate that children with ASD and a history of a depression diagnosis are more likely to also have co-occurring medical problems, although the presence and direction of causality is unclear.
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Affiliation(s)
- Jessica L. Greenlee
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Angela S. Mosley
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Amy M. Shui
- Massachusetts General Hospital Biostatistics Center, Boston, Massachusetts; and
| | | | - Katherine O. Gotham
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee
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