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Grebe SC, Limon DL, McNeel MM, Guzick A, Peters SU, Tan WH, Sadhwani A, Bacino CA, Bird LM, Samaco RC, Berry LN, Goodman WK, Schneider SC, Storch EA. Anxiety in Angelman Syndrome. Am J Intellect Dev Disabil 2022; 127:1-10. [PMID: 34979033 PMCID: PMC8803540 DOI: 10.1352/1944-7558-127.1.1] [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: 11/16/2020] [Accepted: 04/20/2021] [Indexed: 06/14/2023]
Abstract
Angelman Syndrome (AS) is a neurodevelopmental disorder most commonly caused by the impaired expression of the maternal UBE3A gene on chromosome 15. Though anxiety has been identified as a frequently present characteristic in AS, there are limited studies examining anxiety in this population. Studies of anxiety in other neurodevelopmental disorders have found disorder specific symptoms of anxiety and age specific displays of anxiety symptoms. However, there is a consistent challenge in identifying anxiety in people with neurodevelopmental disorders given the lack of measurement instruments specifically designed for this population. Given the limited information about AS and anxiety, the aims of the current project were to (a) examine symptoms of anxiety in children with AS and (b) determine the correlates of anxiety in children with AS. Participants included 42 adult caregivers of youth with AS in the AS Natural History study who completed the Developmental Behavior Checklist (DBC). The results found that 26% of the sample demonstrated elevated symptoms of anxiety and established a relationship between elevated anxiety in youth with AS and higher levels of irritability, hyperactivity, self-absorbed behaviors, and disruptive/antisocial behaviors. Findings from this research provide a foundation for tailoring evidence-based assessments and treatments for youth with AS and anxiety.
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Affiliation(s)
- Stacey C Grebe
- Stacey C. Grebe, Danica L. Limon, Morgan M. McNeel, and Andrew Guzick, Baylor College of Medicine
| | - Danica L Limon
- Stacey C. Grebe, Danica L. Limon, Morgan M. McNeel, and Andrew Guzick, Baylor College of Medicine
| | - Morgan M McNeel
- Stacey C. Grebe, Danica L. Limon, Morgan M. McNeel, and Andrew Guzick, Baylor College of Medicine
| | - Andrew Guzick
- Stacey C. Grebe, Danica L. Limon, Morgan M. McNeel, and Andrew Guzick, Baylor College of Medicine
| | | | - Wen-Hann Tan
- Wen-Hann Tan and Anjali Sadhwani, Boston Children's Hospital
| | - Anjali Sadhwani
- Wen-Hann Tan and Anjali Sadhwani, Boston Children's Hospital
| | - Carlos A Bacino
- Carlos A. Bacino, Baylor College of Medicine and Texas Children's Hospital
| | - Lynne M Bird
- Lynne M. Bird, University of California and Boston Children's Hospital
| | | | - Leandra N Berry
- Leandra N. Berry, Baylor College of Medicine and Texas Children's Hospital
| | | | | | - Eric A Storch
- Sophie C. Schneider and Eric A. Storch, Baylor College of Medicine
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Grebe SC, Mire SS, Kim H, Keller-Margulis MA. Comparing Fathers' and Mothers' Perspectives About Their Child's Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:1841-1854. [PMID: 34027629 DOI: 10.1007/s10803-021-05077-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
Mothers are often the primary parent participants in autism spectrum disorder (ASD) research. As a result, little is known about fathers' perceptions regarding their children's ASD and whether these perceptions differ from mothers'. Given the limited information available regarding fathers' perceptions about their children's ASD, this study aimed to investigate father variables (stress, coping, support, and perception of disability) and how they compare to mothers'. Participants were 361 biological parents (294 mothers and 67 fathers) of children on the autism spectrum who participated in a larger study. Results revealed significant differences between mothers' and fathers' self-reported stress and coping. Understanding differences between parents' perspectives has both research and clinical implications for working with families raising children on the autism spectrum.
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Affiliation(s)
- Stacey C Grebe
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX, USA. .,Department of Psychological, Health, & Learning Sciences, University of Houston, 3657 Cullen Boulevard, Room 491, Houston, TX, USA.
| | - Sarah S Mire
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX, USA
| | - Hanjoe Kim
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX, USA
| | - Milena A Keller-Margulis
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX, USA
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Ramirez AC, Grebe SC, McNeel MM, Limon DL, Schneider SC, Berry LN, Goin-Kochel RP, Cepeda SL, Voigt RG, Salloum A, Storch EA. Parent-led, stepped-care cognitive-behavioral therapy for youth with autism and co-occurring anxiety: study rationale and method. Braz J Psychiatry 2020; 42:638-645. [PMID: 32520166 PMCID: PMC7678910 DOI: 10.1590/1516-4446-2020-0897] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 03/01/2020] [Indexed: 11/21/2022]
Abstract
Anxiety disorders affect up to 50% of individuals with autism spectrum disorder (ASD) and are significantly impairing to the person affected, as well as to their loved ones. Cognitive-behavioral therapy (CBT) has been established as the gold-standard treatment for anxiety disorders among typically developing youth and adults, and demonstrates similar efficacy among youth with high-functioning autism (HFA). Many CBT interventions utilize a "full-package" treatment approach to treat co-occurring anxiety in youth with ASD. However, these service delivery systems are often therapist-intensive, costly, and impractical, thereby compromising full engagement and treatment adherence. This paper describes the design, rationale, and methodology of a study examining stepped-care CBT for youth with HFA and co-occurring anxiety - a clinical trial examining the efficacy of low-intensity, parent-led CBT as the first line of treatment and utilizing a more intensive, therapist-led intervention for nonresponders. The study will evaluate the potential benefits of stepped-care and parent-led therapist-assisted interventions, predictors of treatment response, and the economic value of using a stepped-care model. Implications for practice will be discussed.
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Affiliation(s)
- Ana C. Ramirez
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Autism Center, Texas Children’s Hospital, Houston, TX, USA
| | - Stacey C. Grebe
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Morgan M. McNeel
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Danica L. Limon
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Autism Center, Texas Children’s Hospital, Houston, TX, USA
| | - Sophie C. Schneider
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Leandra N. Berry
- Autism Center, Texas Children’s Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Robin P. Goin-Kochel
- Autism Center, Texas Children’s Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Sandra L. Cepeda
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Robert G. Voigt
- Autism Center, Texas Children’s Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Meyer Center for Developmental Pediatrics, Texas Children’s Hospital, Houston, TX, USA
| | - Alison Salloum
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Eric A. Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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Storch EA, Schneider SC, De Nadai AS, Selles RR, McBride NM, Grebe SC, Bergez KC, Ramirez A, Viana AG, Lewin AB. A Pilot Study of Family-Based Exposure-Focused Treatment for Youth with Autism Spectrum Disorder and Anxiety. Child Psychiatry Hum Dev 2020; 51:209-219. [PMID: 31493105 DOI: 10.1007/s10578-019-00923-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Anxiety is a common and impairing condition in youth with autism spectrum disorders (ASD). Evidence supports the use of cognitive behavioral therapy for treating anxiety in this population; however, available treatment protocols may be difficult to implement outside of research settings. The present study examined the efficacy of family-based exposure-focused treatment (FET) compared to a treatment as usual (TAU) control in 32 youth aged 6-17 years with ASD and co-occurring anxiety. Fourteen youth were randomized to FET, which included 12 face-to-face weekly therapy sessions lasing 45-55 min, while 18 youth completed the TAU control where engagement in psychotherapy or pharmacotherapy was at the discretion of the families. Results strongly supported FET with a 79% (versus 0% in TAU) response rate, 86% (versus 0% in TAU) remission in primary anxiety diagnosis, and large between-group effects on clinician-rated anxiety severity and most parent-rated domains of anxiety-related impairment. Among treatment responders, 2-month follow-up supported maintenance of gains. Overall, the study supported FET as a relatively brief intervention for the treatment of anxiety in youth with ASD, although further research is needed to replicate these findings and compare FET outcomes to more comprehensive interventions.
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Affiliation(s)
- Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza MS:350, Houston, TX, 77030, USA.
| | - Sophie C Schneider
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza MS:350, Houston, TX, 77030, USA
| | | | - Robert R Selles
- University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada
| | - Nicole M McBride
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Stacey C Grebe
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza MS:350, Houston, TX, 77030, USA
| | - Katherine C Bergez
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza MS:350, Houston, TX, 77030, USA
| | - Ana Ramirez
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza MS:350, Houston, TX, 77030, USA
| | - Andres G Viana
- Department of Psychology, University of Houston, Houston, TX, USA.,Texas Institute of Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
| | - Adam B Lewin
- Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, Saint Petersburg, FL, USA
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Grebe SC, Bergez KC, Schneider SC. Career Counseling, Second Edition, by Mark L. Savickas. J Cogn Psychother 2019; 33:357-358. [PMID: 32746397 DOI: 10.1891/0889-8391.33.4.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Knudsen RC, Ahmed A, Longton RW, van Cleave M, Sell KW, Grebe SC. Specific activation of murine B cells by low molecular weight polyamino-polycarboxylic acids (ampholytes). Cell Immunol 1977; 34:340-53. [PMID: 22403 DOI: 10.1016/0008-8749(77)90256-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Ochiai T, Ahmed A, Grebe SC, Sell KW. Mechanism of polyclonal T-lymphocyte activation defined by use of specific heterologous antiserum against murine T cells. Transplant Proc 1977; 9:1049-54. [PMID: 301302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
In contrast to the traditional belief that the popliteal lymph node (PLN) assay of graft-versus-host (GVH) reactivity is a local phenomenon, this study describes significant systemic components of both donor and host lymphoid cell activity. Not only are host radiosensitive lymphocytes of systemic origin necessary for the manifestation of normal PLN hypertrophy, but as few as 2.5 X 10(6) parental lymph node cells (LNCs) injected into the hind footpad of adult F1 hybrid rats disseminate widely, provoking significant systemic GVH reactions, as measured by splenomegaly, and distant lymphadenopathy. Futhermore, locally injected donor LNCs ultimately engender three forms of attenuated GVH reactivity: (1) the dissipation of potentially unlimited GVH reactivity, (2) refractoriness of the host to subsequent rechallenge by GVH-inducing cells, and (3) progressive loss of GVH reactivity in donor LNCs when serially transferred to secondary F1 recipients. Whether this modulation of the cell-mediated immune response is the expression of an anti-recognition structure response by the host or the activation of some other immunoregulatory protein, it is absent or reduced in splenectomized recipients. The data suggest that the spleen provides an immunoregulatory microenvironment in which cell-mediated immune responses, such as the GVH reaction, are modulated.
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