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O'Loghlen J, McKenzie M, Lang C, Paynter J. Repetitive Behaviors in Autism and Obsessive-Compulsive Disorder: A Systematic Review. J Autism Dev Disord 2025; 55:2307-2321. [PMID: 38652373 DOI: 10.1007/s10803-024-06357-8] [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] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE Obsessive-compulsive disorder (OCD) and autism are characterized by the presence of repetitive behaviors. Differentiating between repetitive behaviors attributable to a diagnosis of autism, and those attributable to OCD, poses challenges for differential and co-occurring diagnosis. Differentiation is important to inform appropriate supports and interventions for phenotypically similar but functionally distinct behaviors. In this systematic review, the quantitative literature was examined to explore the similarities and differences in repetitive behaviors (including restricted and repetitive behaviors and interests, and obsessive-compulsive behaviors) in autistic individuals and those with OCD, and those with co-occurring diagnoses, in terms of: (1) expression, (2) content, and (3) associated factors. METHODS Thirty-one studies were identified that compared repetitive behaviors in autistic individuals, individuals with OCD, or individuals with both diagnoses. RESULTS The results suggest considerable overlap in the intensity and content of repetitive behaviors between groups. The findings of this review highlight that research aimed specifically at understanding similarities and differences in repetitive behaviors between autistic individuals and individuals with OCD is limited and frequently only compare at total score or composite measure levels. CONCLUSION Further research into differences in the presentation of repetitive behaviors at a subscale and item level is required to inform clearer differentiation of specific behaviors in autism versus OCD. Understanding and more accurately differentiating is essential for efficient diagnosis, effective treatment, and better outcomes.
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Affiliation(s)
- Jessica O'Loghlen
- , Building N23, -1.03, 170 Kessels Road, Nathan, QLD, 4111, Australia.
| | - Matthew McKenzie
- School of Applied Psychology, Griffith University, 58 Parklands Drive, Southport, QLD, 4215, Australia
| | - Cathryne Lang
- School of Applied Psychology, Griffith University, 58 Parklands Drive, Southport, QLD, 4215, Australia
| | - Jessica Paynter
- School of Applied Psychology, Griffith University, 58 Parklands Drive, Southport, QLD, 4215, Australia
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2
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Derin S, Tetik M, Bora E. Autistic traits in obsessive compulsive disorder: A systematic review and meta-analysis. J Psychiatr Res 2025; 187:181-191. [PMID: 40378691 DOI: 10.1016/j.jpsychires.2025.05.006] [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] [Received: 08/03/2024] [Revised: 03/11/2025] [Accepted: 05/05/2025] [Indexed: 05/19/2025]
Abstract
BACKGROUND Several lines of evidence point to a strong association between OCD and autism-spectrum disorder and broader autism phenotype. However, the extent and nature of overlapping autistic traits has not been completely understood. METHOD A systematic review in Pubmed and Scopus databases was performed to compare autistic traits between OCD patients and healthy controls (December 1990 to March 2025). A random-effects meta-analyses were conducted. RESULTS Current meta-analysis included 27 studies consisting of 1677 patients with OCD and 1239 healthy controls. Compared to healthy controls, total autistic traits (g = 1.27, CI = 1.02, 1.53), also ratings in social-communication domain (g = 0.98, CI = 0.66, 1.31), and restricted/repetitive behaviors (RRBs) domain (g = 1.65, CI = 1.27, 2.04) were increased in OCD patients. OCD symptoms were more strongly related to RRBs domain scores (r = 0.34, CI = 0.19, 0.48) than social-communication domain scores (r = 0.18, CI = 0.09, 0.27). CONCLUSIONS OCD is associated with significant increases in both RRBs and social-communication domains. A substantial subset of OCD emerges in youth who have autistic traits, particularly RRBs. In adults, elevated social-communication scores might, at least partly, reflect the effect of chronic OCD symptoms on social functioning rather than true increase in this domain.
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Affiliation(s)
- Sıla Derin
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey
| | - Melike Tetik
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Emre Bora
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria, 3053, Australia.
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3
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Kirsch L, Evans TC, Fry R, Campbell A, DeGutis J. Social Interaction Anxiety in Developmental Prosopagnosia: Prevalence, Severity, and Individual Differences. Arch Clin Neuropsychol 2025; 40:409-424. [PMID: 39348824 DOI: 10.1093/arclin/acae074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/31/2024] [Accepted: 09/06/2024] [Indexed: 10/02/2024] Open
Abstract
OBJECTIVE Although elevated social anxiety in developmental prosopagnosia (DP) has been reported in anecdotal and qualitative studies, the current study sought to better quantify the prevalence, severity, and moderators of social anxiety in a large DP sample. METHOD A total of 88 DPs and 58 controls completed the validated Social Interaction Anxiety Scale and assessments of face recognition, autism traits, personality (Big Five Inventory), and coping strategies. RESULTS DPs reported greater social anxiety symptoms (M = 30.25) than controls (M = 17.19), with 44% of DPs above a probable clinical cutoff compared with 14% of controls. Exploratory analyses revealed that DPs' social anxiety was more specific to items pertaining to mixing socially or interacting with unfamiliar people. Notably, several DPs reported minimal social anxiety, which was associated with being more extraverted and having fewer autism traits. A follow-up survey revealed that extraverted DPs more openly disclosed face recognition inabilities than introverted DPs, which may be a factor in their reduced social anxiety. CONCLUSION These results better quantify the potential serious psychosocial consequences of DP and highlight the importance of individual differences as well as targeted intervention.
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Affiliation(s)
- Leah Kirsch
- Boston Attention and Learning Laboratory, VA Boston Healthcare System, Boston MA, USA
- Department of Psychiatry, Harvard Medical School, Boston MA, USA
| | - Travis C Evans
- Boston Attention and Learning Laboratory, VA Boston Healthcare System, Boston MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston MA, USA
| | - Regan Fry
- Boston Attention and Learning Laboratory, VA Boston Healthcare System, Boston MA, USA
- Department of Psychiatry, Harvard Medical School, Boston MA, USA
| | - Alison Campbell
- Boston Attention and Learning Laboratory, VA Boston Healthcare System, Boston MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston MA, USA
| | - Joseph DeGutis
- Boston Attention and Learning Laboratory, VA Boston Healthcare System, Boston MA, USA
- Department of Psychiatry, Harvard Medical School, Boston MA, USA
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Retzler C, Retzler J. Brief Report: Local-Global Processing and Co-occurrence of Anxiety, Autistic and Obsessive-Compulsive Traits in a Non-clinical Sample. J Autism Dev Disord 2025; 55:764-771. [PMID: 36738422 DOI: 10.1007/s10803-022-05886-4] [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] [Accepted: 12/17/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE Increased local-to-global interference has been found in those with ASD, AD and OCD, and as such, may represent a transdiagnostic marker. As a first step to investigating this, we aimed to assess the overlap in traits of these disorders in a non-clinical sample, and whether local-global processing relates to the traits of the three conditions. METHODS Participants (n = 149) completed questionnaires including the Autism Quotient (AQ), the Obsessive-Compulsive Inventory (OCI-R) and the Zung Self-rating Anxiety Scale (SAS) and an online version of the Navon task. Behavioural metrics of interference and precedence were extracted from the task and correlated with trait scores. RESULTS We found moderate to strong correlations between the total scores for ASD, anxiety and OCD. Most local-global processing indices did not relate to traits. CONCLUSION The study found evidence for an overlap in autism, anxiety and obsessive-compulsive traits in a non-clinical sample. However, local-global processing, as measured by the Navon task, did not appear to underpin symptomatology in the sample and could not be considered a transdiagnostic marker. Future research should investigate the value of alternate metrics.
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Affiliation(s)
- Chris Retzler
- Department of Psychology, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK.
| | - Jenny Retzler
- Department of Psychology, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
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5
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Jakob IM, Roessner V, Ring M. Validation of the German Glasgow Sensory Questionnaire in autistic adults. BMC Psychiatry 2025; 25:86. [PMID: 39891105 PMCID: PMC11786423 DOI: 10.1186/s12888-025-06504-0] [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: 09/19/2024] [Accepted: 01/14/2025] [Indexed: 02/03/2025] Open
Abstract
BACKGROUND We validated the German version of the Glasgow Sensory Questionnaire (GSQ), a self-report questionnaire for adults assessing the processing of stimuli regarding hypo- and hypersensitivity in seven sensory modalities. Since the GSQ is intended for the use in autistic adults, we aimed to complement our previous study on students with high and low Autism Spectrum Quotient (AQ; Zeisel et al., BMC Psychiatry 23:426, 2023), by surveying groups of autistic and non-autistic adults, to present the sensory processing profiles of the two groups, to identify the factor structure of the questionnaire in a group of autistic individuals and to identify the diagnostic value of a cut-off score for heightened sensory sensitivity in German autistic adults. METHODS A sample of autistic and non-autistic adults (each n = 86) completed the same German version of the GSQ as used in Zeisel et al. (BMC Psychiatry 23:426, 2023), the AQ and the Symptom Checklist-90-Revised. Factor analyses were applied. RESULTS The German GSQ showed good to excellent reliability. While the factor structure could not be confirmed, main findings of other validation studies were replicated: AQ and GSQ scores were moderately to strongly associated, with higher AQ and GSQ scores for autistic than for non-autistic individuals. Autistic individuals also showed more consistency in their sensitivity across sensory modalities. A third of the autistic participants had heightened sensory sensitivity, when a cut-off was set at the 95th percentile of the non-autism group. CONCLUSIONS Overall, this German version of the GSQ can be considered a validated self-report questionnaire assessing sensory sensitivity particularly in autistic individuals. It can be used to assess sensory sensitivity in the diagnostic process of autism spectrum disorder and to assess an individual's sensory needs and strengths for best possible support. Further studies are required, especially to assess the internal structure of the GSQ.
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Affiliation(s)
- Isabel Marie Jakob
- Department of Child and Adolescent Psychiatry, Medical Faculty, TUD Dresden, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Medical Faculty, TUD Dresden, Technische Universität Dresden, Dresden, Germany
- Department of Child and Adolescent Psychiatry, Medical Faculty, Technische Universität Dresden, German Center for Child and Adolescent Health (DZKJ), partner site Leipzig/Dresden, Dresden, Germany
| | - Melanie Ring
- Department of Child and Adolescent Psychiatry, Medical Faculty, TUD Dresden, Technische Universität Dresden, Dresden, Germany.
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Zukerman G, Tikochinsky S, Yahav G, Ben-Itzchak E. Distinguishing autism spectrum disorder and social anxiety: Exploring adaptive skills among university students. Psychiatry Res 2025; 343:116304. [PMID: 39637760 DOI: 10.1016/j.psychres.2024.116304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 11/28/2024] [Accepted: 11/29/2024] [Indexed: 12/07/2024]
Abstract
High comorbidity and diagnostic overlap between autism spectrum disorder and social anxiety disorder have been documented. We examined if differences in adaptive behavior, essential for daily functioning, could differentiate these conditions among young university students. Eighty-eight autistic and 123 non-autistic undergraduates were categorized into four groups: autistic individuals: with low (n = 26)/high (n = 62) social anxiety (SA) symptoms; non-autistic: with low (n = 63)/high (n = 60) SA. The Adaptive Behavior Assessment System (ABAS) was utilized to assess three domains of adaptive skills essential for daily functioning: conceptual (academic and communication abilities), social (relationships and understanding social cues), and practical (everyday tasks such as self-care and work). Autistic students, regardless of SA level, reported ABAS scores within the low average range for the conceptual adaptive behavior domain, while non-autistic students had average scores. In terms of ABAS social adaptive behavior scores, both autistic and non-autistic groups with high levels of SA had low average scores. Conversely, those with low SA, whether autistic or non-autistic, exhibited average scores. These results were supported by the regression analyses outcomes. While autism traits and social anxiety showed medium (β=-0.37) and small (β=-0.27) effects, respectively, on conceptual adaptive scores, only social anxiety exhibited significant (medium) effects on social (β=-0.41) and practical (β=-0.34) adaptive scores. Reduced conceptual skills, previously linked to communication and executive function, may distinguish autism from social anxiety. Implications for research and practice are discussed.
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Affiliation(s)
- Gil Zukerman
- Department of Communication, Disorders School of Health Sciences Ariel University, Israel.
| | - Sigal Tikochinsky
- Department of Communication, Disorders School of Health Sciences Ariel University, Israel.
| | - Gili Yahav
- Department of Communication, Disorders School of Health Sciences Ariel University, Israel.
| | - Ester Ben-Itzchak
- Department of Communication, Disorders School of Health Sciences, The Bruckner Autism Research Center Ariel University, Israel.
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Demartini B, Ingrosso G, Serio F, Nisticò V, Broglia G, Bertani A, Faggioli R, Gambini O, Massimetti G, Dell’Osso L, Carpita B. Prevalence of autistic traits and their relationships with other psychopathological domains in young adults seeking psychiatric attention: a cluster analysis. Eur Psychiatry 2024; 67:e71. [PMID: 39439414 PMCID: PMC11730063 DOI: 10.1192/j.eurpsy.2024.1791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 09/11/2024] [Accepted: 09/26/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND Nearly two-thirds of individuals with a mental disorder start experiencing symptoms during adolescence or early adulthood, and the onset of a mental disorder during this critical life stage strongly predicts adverse socioeconomic and health outcomes. Subthreshold manifestations of autism spectrum disorders (ASDs), also called autistic traits (ATs), are known to be associated with a higher vulnerability to the development of other psychiatric disorders. This study aimed to assess the presence of ATs in a population of young adults seeking specialist assistance and to evaluate the study population across various psychopathological domains in order to determine their links with ATs. METHODS We recruited a sample of 263 adolescents and young adults referring to a specialized outpatient clinic, and we administered them several self-report questionnaires for the evaluation of various psychopathological domains. We conducted a cluster analysis based on the prevalence of ATs, empathy, and sensory sensitivity scores. RESULTS The cluster analysis identified three distinct groups in the sample: an AT cluster (22.43%), an intermediate cluster (45.25%), and a no-AT cluster (32.32%). Moreover, subjects with higher ATs exhibited greater symptomatology across multiple domains, including mood, anxiety, eating disorder severity, psychotic symptoms, and personality traits such as detachment and vulnerable narcissism. CONCLUSIONS This study highlights the importance of identifying ATs in young individuals struggling with mental health concerns. Additionally, our findings underscore the necessity of adopting a dimensional approach to psychopathology to better understand the complex interplay of symptoms and facilitate tailored interventions.
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Affiliation(s)
- Benedetta Demartini
- Unità di Psichiatria 51-52, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
- “Aldo Ravelli” Research Centre for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | | | - Francesca Serio
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Veronica Nisticò
- “Aldo Ravelli” Research Centre for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Giovanni Broglia
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Angelo Bertani
- Centro Giovani “Ettore Ponti”, Mental Health and Dependences Department, ASST Santi Paolo e Carlo, Milan, Italy
| | - Raffaella Faggioli
- Unità di Psichiatria 51-52, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Orsola Gambini
- Unità di Psichiatria 51-52, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
- “Aldo Ravelli” Research Centre for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa56127, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa56127, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, Pisa56127, Italy
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Bulonza R, Watkins K, Parsons R, Sunderland B, Whitehouse A, Caccetta R. The use of psychotropic medications in autistic individuals (21 years and younger) in Western Australia: A preliminary investigation. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2002-2013. [PMID: 38385262 PMCID: PMC11301957 DOI: 10.1177/13623613231226099] [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] [Indexed: 02/23/2024]
Abstract
LAY ABSTRACT Prescriptions and use of medications to treat mental health conditions in young autistic populations are inconsistent worldwide. This makes it hard to compare findings from international studies to the Australian autistic population, where there are limited relevant studies. Apart from risperidone, there are no other medications specified for direct use in autistic persons. This study aims to gain initial broad understanding of the use of medications, commonly prescribed for mental health conditions, specifically by autistics under the age of 21 years. We analysed data that were previously collected as part of the Western Australian Autism Biological Registry between 2011 and 2015 which amounted to 239 surveys completed on young persons with diagnosed autism. The questionnaires included information on co-occurring conditions, current or previous use of medications and reasons for use of the medications. Only one-quarter of the participants in this study reported using at least one mental health-related medication in their lifetime. The most reported medications were stimulants, antidepressants and antiepileptics. The reasons for using medication included managing attention deficit hyperactivity disorder, challenging behaviours, seizures, sleep difficulties and symptoms of anxiety and depression. The number of individuals reporting medication use in this study was lower compared to other developed countries. Nevertheless, these medications should be monitored due to limited understanding of their use to manage co-occurring symptoms in young autistic persons. The findings highlight the importance of ongoing research to better understand mental health-related medications and inform best practice.
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Affiliation(s)
| | | | | | | | - Andrew Whitehouse
- Perth Children’s Hospital, Australia
- The University of Western Australia, Australia
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Carpita B, Nardi B, Bonelli C, Pascariello L, Massimetti G, Cremone IM, Pini S, Palego L, Betti L, Giannaccini G, Dell’Osso L. Platelet Levels of Brain-Derived Neurotrophic Factor in Adults with Autism Spectrum Disorder: Is There a Specific Association with Autism Spectrum Psychopathology? Biomedicines 2024; 12:1529. [PMID: 39062102 PMCID: PMC11274613 DOI: 10.3390/biomedicines12071529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/05/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024] Open
Abstract
To date, although several studies have investigated the circulating levels of brain-derived neurotrophic factor (BDNF) in children with autism spectrum disorder (ASD), only a few authors have addressed their evaluation in adults. Furthermore, an important limitation of these studies lies in the fact that circulating BDNF is stored in platelets and released into the circulation when needed. To the best of our knowledge, a very limited number of studies have related peripheral BDNF values to platelet counts, and yet no study has evaluated intra-platelet BDNF levels in adults with ASD. In this framework, the aim of the present work is to pave the way in this field and evaluate platelet BNDF levels in adult ASD patients, as well as their correlation with autistic symptoms and related psychopathological dimensions. We recruited 22 ASD and 22 healthy controls, evaluated with the Adult autism subthreshold spectrum (AdAS Spectrum), the Social Anxiety Spectrum-self report (SHY-SR), the Trauma and loss spectrum-self report (TALS-SR), the Work and Social Adjustment Scale (WSAS), and the Mood Spectrum-self report for suicidality. Intra-platelet BDNF levels were also assessed. The results highlighted lower BDNF levels in the ASD group; moreover, AdAS Spectrum and WSAS total score as well as AdAS Spectrum Restricted interest and rumination, WSAS Private leisure activities, TALS-SR Arousal, and SHY-SR Childhood domains were significant negative predictors of platelet BDNF levels.
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Affiliation(s)
- Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.C.); (C.B.); (L.P.); (G.M.); (I.M.C.); (S.P.); (L.D.)
| | - Benedetta Nardi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.C.); (C.B.); (L.P.); (G.M.); (I.M.C.); (S.P.); (L.D.)
| | - Chiara Bonelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.C.); (C.B.); (L.P.); (G.M.); (I.M.C.); (S.P.); (L.D.)
| | - Lavinia Pascariello
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.C.); (C.B.); (L.P.); (G.M.); (I.M.C.); (S.P.); (L.D.)
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.C.); (C.B.); (L.P.); (G.M.); (I.M.C.); (S.P.); (L.D.)
| | - Ivan Mirko Cremone
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.C.); (C.B.); (L.P.); (G.M.); (I.M.C.); (S.P.); (L.D.)
| | - Stefano Pini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.C.); (C.B.); (L.P.); (G.M.); (I.M.C.); (S.P.); (L.D.)
| | - Lionella Palego
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy; (L.P.); (L.B.); (G.G.)
| | - Laura Betti
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy; (L.P.); (L.B.); (G.G.)
| | - Gino Giannaccini
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy; (L.P.); (L.B.); (G.G.)
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.C.); (C.B.); (L.P.); (G.M.); (I.M.C.); (S.P.); (L.D.)
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Kentrou V, Livingston LA, Grove R, Hoekstra RA, Begeer S. Perceived misdiagnosis of psychiatric conditions in autistic adults. EClinicalMedicine 2024; 71:102586. [PMID: 38596613 PMCID: PMC11001629 DOI: 10.1016/j.eclinm.2024.102586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024] Open
Abstract
Background Many autistic people, particularly women, do not receive an autism diagnosis until adulthood, delaying their access to timely support and clinical care. One possible explanation is that autistic traits may initially be misinterpreted as symptoms of other psychiatric conditions, leading some individuals to experience misdiagnosis of other psychiatric conditions prior to their autism diagnosis. However, little is currently known about the frequency and nature of psychiatric misdiagnoses in autistic adults. Methods Using data collected in the first half of 2019 from an ongoing longitudinal register of autistic adults in the Netherlands, this study explored the frequency of perceived psychiatric misdiagnoses before receiving an autism diagnosis. Gender differences were also explored. A sample of 1211 autistic adults (52.6% women, mean age 42.3 years), the majority of whom were Dutch and relatively highly educated, was evaluated. Findings Results showed that 24.6% (n = 298) of participants reported at least one previous psychiatric diagnosis that was perceived as a misdiagnosis. Personality disorders were the most frequent perceived misdiagnoses, followed by anxiety disorders, mood disorders, chronic fatigue syndrome/burnout-related disorders, and attention-deficit/hyperactivity disorder. Autistic women (31.7%) reported perceived misdiagnoses more frequently than men (16.7%). Women were specifically more likely than men to report perceived misdiagnoses of personality disorders, anxiety disorders, and mood disorders. Women also reported prior psychiatric diagnoses more often in general (65.8% versus 34.2% in men). Within the group of individuals with a prior diagnosis, perceived misdiagnoses were equally likely for men and women. Interpretation One in four autistic adults, and one in three autistic women, reported at least one psychiatric diagnosis, obtained prior to being diagnosed with autism, that was perceived as a misdiagnosis. Inaccurate diagnoses are linked to long diagnostic pathways and delayed recognition of autism. These findings highlight the need for improved training of mental health practitioners, in order to improve their awareness of the presentation of autism in adulthood and of the complex relationship between autism and co-occurring conditions. The current study constitutes a first step towards showing that autistic adults, and particularly women, may be at greater risk of experiencing misdiagnoses. Future studies based on larger, more representative samples are required, to replicate current findings and provide more reliable estimates of the overall frequency of misdiagnoses as well as the frequency of misdiagnoses for specific psychiatric conditions. Funding This study was made possible by funding from the Netherlands Organisation for Health Research and Development (ZonMW), project number 60-63600-98-834.
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Affiliation(s)
- Vasiliki Kentrou
- Department of Experimental and Applied Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Lucy A Livingston
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rachel Grove
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Rosa A Hoekstra
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sander Begeer
- Department of Clinical Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
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11
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Jaiswal A, Washington P. Using #ActuallyAutistic on Twitter for Precision Diagnosis of Autism Spectrum Disorder: Machine Learning Study. JMIR Form Res 2024; 8:e52660. [PMID: 38354045 PMCID: PMC10902768 DOI: 10.2196/52660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/19/2023] [Accepted: 12/10/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The increasing use of social media platforms has given rise to an unprecedented surge in user-generated content, with millions of individuals publicly sharing their thoughts, experiences, and health-related information. Social media can serve as a useful means to study and understand public health. Twitter (subsequently rebranded as "X") is one such social media platform that has proven to be a valuable source of rich information for both the general public and health officials. We conducted the first study applying Twitter data mining to autism screening. OBJECTIVE This study used Twitter as the primary source of data to study the behavioral characteristics and real-time emotional projections of individuals identifying with autism spectrum disorder (ASD). We aimed to improve the rigor of ASD analytics research by using the digital footprint of an individual to study the linguistic patterns of individuals with ASD. METHODS We developed a machine learning model to distinguish individuals with autism from their neurotypical peers based on the textual patterns from their public communications on Twitter. We collected 6,515,470 tweets from users' self-identification with autism using "#ActuallyAutistic" and a separate control group to identify linguistic markers associated with ASD traits. To construct the data set, we targeted English-language tweets using the search query "#ActuallyAutistic" posted from January 1, 2014, to December 31, 2022. From these tweets, we identified unique users who used keywords such as "autism" OR "autistic" OR "neurodiverse" in their profile description and collected all the tweets from their timeline. To build the control group data set, we formulated a search query excluding the hashtag, "-#ActuallyAutistic," and collected 1000 tweets per day during the same time period. We trained a word2vec model and an attention-based, bidirectional long short-term memory model to validate the performance of per-tweet and per-profile classification models. We also illustrate the utility of the data set through common natural language processing tasks such as sentiment analysis and topic modeling. RESULTS Our tweet classifier reached a 73% accuracy, a 0.728 area under the receiver operating characteristic curve score, and an 0.71 F1-score using word2vec representations fed into a logistic regression model, while the user profile classifier achieved an 0.78 area under the receiver operating characteristic curve score and an F1-score of 0.805 using an attention-based, bidirectional long short-term memory model. This is a promising start, demonstrating the potential for effective digital phenotyping studies and large-scale intervention using text data mined from social media. CONCLUSIONS Textual differences in social media communications can help researchers and clinicians conduct symptomatology studies in natural settings.
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Affiliation(s)
- Aditi Jaiswal
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Peter Washington
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
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12
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Carpita B, Nardi B, Bonelli C, Massimetti E, Amatori G, Cremone IM, Pini S, Dell’Osso L. Presence and correlates of autistic traits among patients with social anxiety disorder. Front Psychiatry 2024; 14:1320558. [PMID: 38312918 PMCID: PMC10834675 DOI: 10.3389/fpsyt.2023.1320558] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/29/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Due to their similar behavioral presentation, it can sometimes be challenging to distinguish between a social anxiety disorder (SAD) and the social avoidance that is frequently described in autism spectrum disorder (ASD). Moreover, a growing body of evidences is reporting that a significant proportion of subjects with ASD also meet the requirements for SAD and, vice versa, subjects with SAD tend to exhibit a higher prevalence of autistic traits. Aim In this framework, the current study aims to evaluate prevalence and correlates of autistic traits in a sample of adult subjects diagnosed with SAD and healthy controls (HC), also evaluating which autism spectrum dimensions may statistically predict higher SAD symptoms. Methods 56 subjects with a clinical diagnosis of SAD and 56 gender and age matched HC were recruited from the Psychiatric Clinic of the University of Pisa. Subjects were assessed with the SCID-5, the Social Anxiety Spectrum - Short Version (SHY- SV) and the Adult Autism Subthreshold Spectrum (AdAS Spectrum). Results SAD group scored significantly higher in all AdAS Spectrum and SHY-SV domains and total score compared to the HC group with no significant gender difference. SHY-SV total and domain scores, were strongly and positively and strongly correlated with all AdAS Spectrum domains and total score. AdAS Spectrum total score and Childhood/Adolescence, Non-Verbal Communication, Empathy and Restricted interests and Rumination domain scores score were significant predictors of higher SHY-SV score. Conclusion Our results confirm the link between SAD and autistic traits also in adult population, describing not only high levels of autistic traits in SAD adults, but also significant correlations between many core features of the two disorders and a predictive role of autistic traits on higher SAD symptoms.
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Affiliation(s)
- Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Benedetta Nardi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Chiara Bonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Enrico Massimetti
- North-Western Tuscany Region NHS Local Health Unit, Department of Psychiatry, Pisa, Italy
| | - Giulia Amatori
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ivan Mirko Cremone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Stefano Pini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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13
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Namlı Z, Tamam L, Demirkol ME, Karaytuğ MO, Sun T. The Relationship Among Autistic Traits, Impulsivity, and Functionality in Patients With Obsessive-Compulsive Disorder. J Nerv Ment Dis 2023; 211:195-202. [PMID: 36191327 DOI: 10.1097/nmd.0000000000001601] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Obsessive-compulsive disorder (OCD) is a chronic mental disorder that causes disabilities. This study investigated the relationship among impulsivity, autistic traits, and disabilities in patients with OCD. We included 88 patients with OCD and 90 healthy volunteers without any mental disorders. The participants were evaluated using the Yale-Brown Obsessive-Compulsive Scale, Autism Spectrum Quotient (AQ), Barratt Impulsiveness Scale-11 (BIS-11), and World Health Organization Disability Assessment Schedule (WHODAS 2.0). Regression analyses revealed that AQ-attention switching and BIS-attentional subscale scores were associated with WHODAS-overall score in the OCD group ( p = 0.017 and p = 0.034, respectively). In the OCD group, AQ total, social skills, and communication subdomain scores partially mediated the relationship between impulsivity and disability. BIS total, attentional, and nonplanning subscale scores partially mediated the relationship between autistic traits and disability. Developing new treatment strategies for cognitive recovery, in addition to traditional treatment approaches in patients with OCD, may help increase functionality in patients with OCD.
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Affiliation(s)
- Zeynep Namlı
- Department of Psychiatry, Çukurova University Medical School, Adana, Turkey
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14
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Updating implicit contextual priors with explicit learning for the prediction of social and physical events. Brain Cogn 2022; 160:105876. [DOI: 10.1016/j.bandc.2022.105876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/16/2022] [Accepted: 04/12/2022] [Indexed: 11/21/2022]
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15
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Wittkopf S, Stroth S, Langmann A, Wolff N, Roessner V, Roepke S, Poustka L, Kamp-Becker I. Differentiation of autism spectrum disorder and mood or anxiety disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1056-1069. [PMID: 34404245 PMCID: PMC9340140 DOI: 10.1177/13623613211039673] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
LAY ABSTRACT Symptoms of mood and anxiety disorders overlap with symptoms of autism spectrum disorder, making the diagnostic process challenging. This study found that a combination of communicational deficits and unusual and/or inappropriate social overtures facilitates differentiation between autism spectrum disorder and mood and anxiety disorders. Furthermore, the results confirm the essential need of a behavioral observation with the Autism Diagnostic Observation Schedule in combination with a full Autism Diagnostic Interview-Revised to support diagnostic decisions.
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16
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Frigaux A, Vacant C, Evrard R. Le devenir autiste au féminin : difficultés diagnostiques et ressources subjectives. Une revue de littérature. EVOLUTION PSYCHIATRIQUE 2022. [DOI: 10.1016/j.evopsy.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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17
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Islam MT, Maejima T, Matsui A, Mieda M. Paraventricular hypothalamic vasopressin neurons induce self-grooming in mice. Mol Brain 2022; 15:47. [PMID: 35606816 PMCID: PMC9125887 DOI: 10.1186/s13041-022-00932-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
Self-grooming plays an essential role in hygiene maintenance, thermoregulation, and stress response. However, the neural populations involved in self-grooming remain largely unknown. The paraventricular hypothalamic nucleus (PVH) has been implicated in the regulation of self-grooming. Arginine vasopressin-producing neurons are among the major neuronal populations in the PVH (PVHAVP), which play important roles in water homeostasis, blood pressure regulation, feeding, and stress response. Here, we report the critical role of PVHAVP neurons in the induction of self-grooming. Optogenetic activation of PVHAVP neurons immediately induced self-grooming in freely moving mice. Chemogenetic activation of these neurons also increased time spent self-grooming. In contrast, their chemogenetic inhibition significantly reduced naturally occurring self-grooming, suggesting that PVHAVP-induced grooming has physiological relevance. Notably, optogenetic activation of PVHAVP neurons triggered self-grooming over other adaptive behaviors, such as voracious feeding induced by fasting and social interaction with female mice. Thus, our study proposes the novel role of PVHAVP neurons in regulating self-grooming behavior and, consequently, hygiene maintenance and stress response. Furthermore, uncontrolled activation of these neurons may be potentially relevant to diseases characterized by compulsive behaviors and impaired social interaction, such as autism, obsessive–compulsive disorder, and anorexia nervosa.
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Affiliation(s)
- Md Tarikul Islam
- Department of Integrative Neurophysiology, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Takashi Maejima
- Department of Integrative Neurophysiology, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Ayako Matsui
- Department of Integrative Neurophysiology, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Michihiro Mieda
- Department of Integrative Neurophysiology, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan.
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18
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Gaziel-Guttman M, Anaki D, Mashal N. Social Anxiety and Shame Among Young Adults with Autism Spectrum Disorder Compared to Typical Adults. J Autism Dev Disord 2022; 53:2490-2498. [PMID: 35394242 DOI: 10.1007/s10803-022-05526-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 11/26/2022]
Abstract
Social anxiety (SA) is common among young adults with autism spectrum disorder (ASD). While shame feelings predict SA among typical adults, the relationship between shame and SA in ASD remains unclear. The current study compared the relationship between SA and shame in ASD. SA, shame, and autistic self-assessment questionnaires were administered to 33 young adults with ASD (28 M/5F) and 38 typical young adults (32 M/6F, Mage = 24 years, range = 20-28 in both groups). Results showed higher SA levels in ASD than typical adults, but lower levels of shame characteristics in the former than in the latter group. Moreover, a significant moderation model showed that some aspects of shame were related to SA only in the typical group but not in ASD.
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Affiliation(s)
- Meyrav Gaziel-Guttman
- School of Education, Bar-Ilan University, Max & Anna Webb St, 5290002, Ramat-Gan, Israel
| | - David Anaki
- Department of Psychology, Bar-Ilan University, Max & Anna Webb St, 5290002, Ramat-Gan, Israel.
| | - Nira Mashal
- School of Education, Bar-Ilan University, Max & Anna Webb St, 5290002, Ramat-Gan, Israel.
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19
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Jolliffe R, Adams D, Simpson K. Trait Anxiety in Individuals on the Autism Spectrum: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00308-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractAlthough anxiety is commonly researched in autism, the focus has predominantly been on anxiety disorders and not upon general levels of anxiousness or trait anxiety. This review summarises research investigating trait anxiety in autism. Systematic searches yielded 1099 records, with 23 studies meeting inclusion criteria. Study participants were mainly males from Western countries, with no representation of older adults or individuals with intellectual disability. All articles used self-report questionnaire trait anxiety measures. Anxiety measure psychometric details were absent in most studies, with 21 using subjective measures that are not validated for use in autism. Results showed higher trait anxiety scores in autism versus control groups, and correlations between trait anxiety scores and other study outcomes.
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20
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Sternheim LC, van Passel B, Dingemans A, Cath D, Danner UN. Cognitive and Experienced Flexibility in Patients With Anorexia Nervosa and Obsessive Compulsive Disorder. Front Psychiatry 2022; 13:868921. [PMID: 35615449 PMCID: PMC9124825 DOI: 10.3389/fpsyt.2022.868921] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) share a neuropsychological profile characterized by cognitive inflexibility as evident in set-shifting problems, and by strong detail focus. Clinically, both patient groups display a strong rigidity which may be explained by these neurocognitive difficulties. Cognitive inflexibility may hinder treatment uptake and help explain suboptimal treatment outcomes in both AN and OCD. This is the first study to compare clinical AN and OCD groups andto examine similarities and differences in cognitive flexibility. Specifically, this study aims to investigate neuropsychological outcomes and self-reported difficulties in both clinical groups and a control group, and explore associations between the different flexibility outcomes and illness. METHOD Two hundred participants (61 AN, 72 OCD and 67 HC) performed neuropsychological tasks on set-shifting abilities (Trail Making Task, Stroop color-word interference, Intradimensional-Extradimensional shift task), detail focus (Group Embedded Figures Test) and self-reported set-shifting abilities and attention to detail (DFlex). RESULTS Similarities between patient groups were found in terms of reduced set-shifting ability on the Trail Making Task and detail focus. Moreover, both patient groups self-reported more set-shifting problems but a less strong detail focus than HC, which in turn were not related to neuropsychological task outcomes in either of the groups. In both patient groups longer illness duration was associated to longer reaction times in the switching tasks and for both groups symptom severity was associated to higher experienced inflexibility and attention to detail. CONCLUSION Cognitive inflexibility processes are largely similar in patients with AN and OCD. Both patient groups report inflexibility, yet this is unrelated to neuropsychological outcomes. Illness duration seems to contribute to poorer set-shifting and higher illness severity is linked to more experienced inflexibility. Findings highlight the need for entangling different domains of cognitive flexibility and detail focus and examining self-report measures for a cohesive understanding of clinically relevant flexibility weaknesses in AN and OCD.
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Affiliation(s)
| | - Boris van Passel
- Centre for Anxiety Disorders Overwaal, Institution for Integrated Mental Health Care, Pro Persona, Nijmegen, Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | | | - Danielle Cath
- Department of Specialist Training, GGz Drenthe, Groningen, Netherlands.,Department of Psychiatry, Rijksuniversiteit Groningen and University Medical Center Groningen, Groningen, Netherlands
| | - Unna Nora Danner
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands.,Altrecht Eating Disorders Rintveld, Zeist, Netherlands
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21
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Rinaldi C, Attanasio M, Valenti M, Mazza M, Keller R. Autism spectrum disorder and personality disorders: Comorbidity and differential diagnosis. World J Psychiatry 2021; 11:1366-1386. [PMID: 35070783 PMCID: PMC8717043 DOI: 10.5498/wjp.v11.i12.1366] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/26/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Differential diagnosis, comorbidities and overlaps with other psychiatric disorders are common among adults with autism spectrum disorder (ASD), but clinical assessments often omit screening for personality disorders (PD), which are especially common in individuals with high-functioning ASD where there is less need for support. AIM To summarize the research findings on PD in adults with ASD and without intellectual disability, focusing on comorbidity and differential diagnosis. METHODS PubMed searches were performed using the key words "Asperger's Syndrome", "Autism", "Personality", "Personality disorder" and "comorbidity" in order to identify relevant articles published in English. Grey literature was identified through searching Google Scholar. The literature reviews and reference sections of selected papers were also examined for additional potential studies. The search was restricted to studies published up to April 2020. This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. RESULTS The search found 22 studies carried out on ASD adults without intellectual disability that met the inclusion criteria: 16 evaluated personality profiles or PD in ASD (comorbidity), five compared ASD and PD (differential diagnosis) and one performed both tasks. There were significant differences in the methodological approaches, including the ASD diagnostic instruments and personality measures. Cluster A and cluster C PD are the most frequent co-occurring PD, but overlapping features should be considered. Data on differential diagnosis were only found with cluster A and cluster B PD. CONCLUSION ASD in high-functioning adults is associated with a distinct personality profile even if variability exists. Further studies are needed to explore the complex relationship between ASD and PD.
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Affiliation(s)
- Camilla Rinaldi
- Adult Autism Center, Department of Mental Health, ASL Città di Torino, Turin 10138, Italy
| | - Margherita Attanasio
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila 67100, Italy
- Regional Centre for Autism, Abruzzo Region Health System, L’Aquila 67100, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila 67100, Italy
- Regional Centre for Autism, Abruzzo Region Health System, L’Aquila 67100, Italy
| | - Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila 67100, Italy
- Regional Centre for Autism, Abruzzo Region Health System, L’Aquila 67100, Italy
| | - Roberto Keller
- Adult Autism Center, Department of Mental Health, ASL Città di Torino, Turin 10138, Italy
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22
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Doi S, Kobayashi Y, Takebayashi Y, Mizokawa E, Nakagawa A, Mimura M, Horikoshi M. Associations of Autism Traits With Obsessive Compulsive Symptoms and Well-Being in Patients With Obsessive Compulsive Disorder: A Cross-Sectional Study. Front Psychol 2021; 12:697717. [PMID: 34393929 PMCID: PMC8360877 DOI: 10.3389/fpsyg.2021.697717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this study is to examine the association of autism traits with long-term obsessive compulsive disorder (OCD) symptoms and well-being levels in patient with OCD. Participants comprised 18 outpatients from a tertiary hospital and 100 adults who were registered in a large Japanese internet marketing research company and met OCD criteria by the Mini-International Neuropsychiatric Interview and were between the ages of 20 and 65 years. Clinical characteristics, autism trait assessed using the Autism Spectrum Quotient (AQ), OCD symptoms assessed using Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and well-being assessed using the Flourishing Scale were assessed. Multiple regression analyses showed that a greater total score of AQ, a greater subscale score "imagination" was associated with a greater score of Y-BOCS. Greater total score of AQ, a greater subscale score "social skill," and "imagination" were associated with lower well-being score. Autism traits, especially lack of imagination, were associated with more severe OCD symptoms. Further, autism traits, especially social skill problems and lack of imagination, were associated with lower levels of well-being. Assessment of autism traits before treatment and a strategy designed for OCD patients with autism traits may be warranted.
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Affiliation(s)
- Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Yuki Kobayashi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yoshitake Takebayashi
- Department of Health Risk Communication, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | | | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Horikoshi
- National Center for Cognitive Behavioral Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
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Examining the correlation between symptoms of obsessive compulsive disorder and autism spectrum disorder in a community-based sample of adults. Psychiatry Res 2021; 299:113826. [PMID: 33677188 DOI: 10.1016/j.psychres.2021.113826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/21/2021] [Indexed: 01/07/2023]
Abstract
We examined the association between obsessive compulsive disorder (OCD) and autism spectrum disorder (ASD) symptoms among a community-based sample of adults (n = 217) that completed an OCD and ASD screening instrument. Approximately 39% of the sample that met the ASD screener cutoff criteria also met the screener cutoff criteria for OCD. The correlation between overall OCD symptoms (i.e., obsessions and compulsions) and ASD symptoms was small but statistically significant for the entire sample of participants. Similarly, obsession and compulsion subscales showed almost identical results for correlation with ASD symptoms (i.e., small but statistically significant) for the entire sample. These results suggest that levels of compulsions and obsessions are equally correlated with ASD symptoms, and neither elevated compulsions nor obsessions differentially predicted the severity of ASD symptoms in a community-based sample of adults. However, when the analysis was restricted to only the participants that met screening criteria cutoff score for ASD, statistically significant results occurred with only elevated compulsions accurately predicting severity of ASD symptoms. These results suggest that compulsive behavior appears to be a good candidate for targeting intervention resources for individuals with characteristics of ASD given the mounting data suggesting that compulsions are more common than obsessions.
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Colvert E, Simonoff E, Capp SJ, Ronald A, Bolton P, Happé F. Autism Spectrum Disorder and Mental Health Problems: Patterns of Difficulties and Longitudinal Trajectories in a Population-Based Twin Sample. J Autism Dev Disord 2021; 52:1077-1091. [PMID: 33864558 PMCID: PMC8854265 DOI: 10.1007/s10803-021-05006-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2021] [Indexed: 12/02/2022]
Abstract
There is increasing concern regarding additional psychiatric problems that co-occur with Autism Spectrum Disorder (ASD), as reflected in recent changes to diagnostic schemes. However, there remains little research with population-based samples across childhood. We report on additional problems, as measured by the Strengths and Difficulties Questionnaire, in a population-based sample of 135 twins with ASD, 55 non-ASD co-twins, and 144 comparison twins low in ASD traits. Frequencies, associated demographic factors, and changes in mental health difficulties from age 4 to 13 years are presented. Our data confirm the high rates of additional difficulties reported in previous studies, and suggest that the profile, associated risk factors and longitudinal course of additional difficulties in ASD may differ from those in typically-developing populations.
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Affiliation(s)
- Emma Colvert
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, PO80, Denmark Hill, London, SE5 8AF, UK.
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Denmark Hill, London, SE5 8AF, UK
| | - Simone J Capp
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, PO80, Denmark Hill, London, SE5 8AF, UK
| | - Angelica Ronald
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London, WC1E 7HX, UK
| | - Patrick Bolton
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Denmark Hill, London, SE5 8AF, UK
| | - Francesca Happé
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, PO80, Denmark Hill, London, SE5 8AF, UK
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25
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Frigaux A, Lighezzolo-Alnot J, Maleval JC, Evrard R. Clinique différentielle du spectre de l’autisme : l’intérêt de penser un « autisme ordinaire ». EVOLUTION PSYCHIATRIQUE 2021. [DOI: 10.1016/j.evopsy.2020.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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26
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Resilience in Autism and Intellectual Disability: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00239-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Scattoni ML, Micai M, Ciaramella A, Salvitti T, Fulceri F, Fatta LM, Poustka L, Diehm R, Iskrov G, Stefanov R, Guillon Q, Rogé B, Staines A, Sweeney MR, Boilson AM, Leósdóttir T, Saemundsen E, Moilanen I, Ebeling H, Yliherva A, Gissler M, Parviainen T, Tani P, Kawa R, Vicente A, Rasga C, Budişteanu M, Dale I, Povey C, Flores N, Jenaro C, Monroy ML, Primo PG, Charman T, Cramer S, Warberg CK, Canal-Bedia R, Posada M, Schendel D. Real-World Experiences in Autistic Adult Diagnostic Services and Post-diagnostic Support and Alignment with Services Guidelines: Results from the ASDEU Study. J Autism Dev Disord 2021; 51:4129-4146. [PMID: 33502713 PMCID: PMC8510906 DOI: 10.1007/s10803-021-04873-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 12/22/2022]
Abstract
Research providing an evidence-base for autistic adult services is sparse. The Autism Spectrum Disorders in the European Union (ASDEU) network implemented an on-line survey to determine gaps in autistic adult diagnostic evaluation and post-diagnostic support services. More than 55% in all groups experienced most of the recommended features for diagnostic evaluation for autistic adults. In contrast, < 2% of adults or carers, and < 21% of professionals experienced each of the recommended features for post-diagnostic support. In contrast to 61% of professionals, only about 30% of autistic adults and carers had knowledge of good local services models for autism diagnosis in adulthood. There are major differences between good practice guidelines for diagnostic and post-diagnostic care for autistic adults, and what is actually experienced by services users and professionals.
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Affiliation(s)
- Maria Luisa Scattoni
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy.
| | - Martina Micai
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy
| | - Antonio Ciaramella
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy
| | - Tommaso Salvitti
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy
| | - Francesca Fulceri
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy
| | - Laura Maria Fatta
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Gottingen, Germany
| | - Robert Diehm
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Georgi Iskrov
- Institute for Rare Diseases, Plovdiv, Bulgaria.,Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv Town, Bulgaria
| | - Rumen Stefanov
- Institute for Rare Diseases, Plovdiv, Bulgaria.,Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv Town, Bulgaria
| | - Quentin Guillon
- Université Toulouse Jean Jaurès, CERPPS, Toulouse, Occitanie, France
| | - Bernadette Rogé
- Université Toulouse Jean Jaurès, CERPPS, Toulouse, Occitanie, France
| | - Anthony Staines
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Republic of Ireland
| | - Mary Rose Sweeney
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Republic of Ireland
| | - Andrew Martin Boilson
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Republic of Ireland
| | - Thora Leósdóttir
- The State Diagnostic and Counselling Centre, 200, Kópavogur, Iceland
| | - Evald Saemundsen
- The State Diagnostic and Counselling Centre, 200, Kópavogur, Iceland
| | - Irma Moilanen
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,Medical Faculty, Oulu University Hospital, Oulu, Finland
| | - Hanna Ebeling
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,Medical Faculty, Oulu University Hospital, Oulu, Finland
| | - Anneli Yliherva
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,University of Oulu, Logopedic Child Language Research Center, Oulu, Finland
| | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland.,University of Turku, Research Centre for Child Psychiatry, Turku, Finland.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Tarja Parviainen
- Finnish Association for Autism and Asperger's Syndrome, Helsinki, Uusimaa, Finland
| | - Pekka Tani
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Rafal Kawa
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Astrid Vicente
- Center for Biodiversity, Functional and Integrative Genomics, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Célia Rasga
- Center for Biodiversity, Functional and Integrative Genomics, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Magdalena Budişteanu
- Victor Babeş" National Institute for Research and Development in Pathology and Biomedical Sciences, Timisoara, Romania
| | - Ian Dale
- National Autistic Society, The Centre for Autism, London, UK
| | - Carol Povey
- National Autistic Society, The Centre for Autism, London, UK
| | - Noelia Flores
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, INICO-Instituto Universitario de Integración en la Comunidad University of Salamanca, Salamanca, Spain
| | - Cristina Jenaro
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, INICO-Instituto Universitario de Integración en la Comunidad University of Salamanca, Salamanca, Spain
| | - Maria Luisa Monroy
- Departamento de Psicología Evolutiva y de la Educación, INICO-Instituto Universitario de Integración en la Comunidad University of Salamanca, Salamanca, Spain
| | - Patricia García Primo
- Instituto de Salud Carlos III, Institute of Rare Diseases Research Madrid, Madrid, Spain
| | - Tony Charman
- Institute of Psychiatry, Kings College London, London, UK
| | - Susanne Cramer
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Ricardo Canal-Bedia
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, INICO-Instituto Universitario de Integración en la Comunidad University of Salamanca, Salamanca, Spain
| | - Manuel Posada
- Instituto de Salud Carlos III, Institute of Rare Diseases Research Madrid, Madrid, Spain
| | - Diana Schendel
- Department of Public Health, Aarhus University, Aarhus, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Economics and Business, Aarhus University, National Centre for Register-Based Research, Aarhus, Denmark
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Doi H, Tsumura N, Kanai C, Masui K, Mitsuhashi R, Nagasawa T. Automatic Classification of Adult Males With and Without Autism Spectrum Disorder by Non-contact Measurement of Autonomic Nervous System Activation. Front Psychiatry 2021; 12:625978. [PMID: 34079477 PMCID: PMC8165244 DOI: 10.3389/fpsyt.2021.625978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/01/2021] [Indexed: 12/27/2022] Open
Abstract
People with autism spectrum disorder (ASD) exhibit atypicality in various domains of behavior. Previous psychophysiological studies have revealed an atypical pattern of autonomic nervous system (ANS) activation induced by psychosocial stimulation. Thus, it might be feasible to develop a novel assessment tool to evaluate the risk of ASD by measuring ANS activation in response to emotional stimulation. The present study investigated whether people with ASD could be automatically classified from neurotypical adults based solely on physiological data obtained by the recently introduced non-contact measurement of pulse wave. We video-recorded faces of adult males with and without ASD while watching emotion-inducing video clips. Features reflective of ANS activation were extracted from the temporal fluctuation of facial skin coloration and entered into a machine-learning algorithm. Though the performance was modest, the gradient boosting classifier succeeded in classifying people with and without ASD, which indicates that facial skin color fluctuation contains information useful for detecting people with ASD. Taking into consideration the fact that the current study recruited only high-functioning adults who have relatively mild symptoms and probably developed some compensatory strategies, ASD screening by non-contact measurement of pulse wave could be a promising assessment tool to evaluate ASD risk.
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Affiliation(s)
- Hirokazu Doi
- Graduate School of Engineering, School of Science and Engineering, Kokushikan University, Setagaya, Japan.,Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | | | - Chieko Kanai
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan.,Faculty of Humanities, Wayo Women's University, Chiba, Japan
| | - Kenta Masui
- Graduate School of Engineering, Chiba University, Chiba, Japan
| | | | - Takumi Nagasawa
- Graduate School of Engineering, Chiba University, Chiba, Japan
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29
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Pazuniak M, Pekrul SR. Obsessive-Compulsive Disorder in Autism Spectrum Disorder Across the Lifespan. Psychiatr Clin North Am 2020; 43:745-758. [PMID: 33127006 DOI: 10.1016/j.psc.2020.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Obsessive-compulsive disorder is a relatively common disorder seen in autism spectrum disorder across the lifespan. Many obsessive-compulsive disorder symptoms can present similarly to the core features of autism spectrum disorder and it is often difficult to differentiate between obsessive-compulsive disorder and stereotypic behaviors or restricted interests in autism spectrum disorder. However, there are differences between the 2 disorders. This article is a review of the current literature with the goal of helping the clinician to diagnose and treat obsessive-compulsive disorder in a patient with autism spectrum disorder.
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Affiliation(s)
- Markian Pazuniak
- Department of Child and Adolescent Psychiatry, University of Maryland Medical Center, 701 West Pratt Street, 2nd Floor, Baltimore, MD 21201, USA
| | - Scott R Pekrul
- Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204, USA.
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30
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Pehlivanidis A, Papanikolaou K, Mantas V, Kalantzi E, Korobili K, Xenaki LA, Vassiliou G, Papageorgiou C. Lifetime co-occurring psychiatric disorders in newly diagnosed adults with attention deficit hyperactivity disorder (ADHD) or/and autism spectrum disorder (ASD). BMC Psychiatry 2020; 20:423. [PMID: 32847520 PMCID: PMC7449076 DOI: 10.1186/s12888-020-02828-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/19/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose. METHODS The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD+ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group. RESULTS At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025). CONCLUSIONS Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.
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Affiliation(s)
- Artemios Pehlivanidis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, "Eginition" Hospital, 72-74 Vas. Sofias Ave, 11528, Athens, Greece.
| | - Katerina Papanikolaou
- Department of Child Psychiatry, National and Kapodistrian University of Athens, Medical School, “Agia Sophia” Children’s Hospital, 11527 Athens, Greece
| | - Vasilios Mantas
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Eva Kalantzi
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Kalliopi Korobili
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Lida-Alkisti Xenaki
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Georgia Vassiliou
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
| | - Charalambos Papageorgiou
- grid.5216.00000 0001 2155 08001st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, “Eginition” Hospital, 72-74 Vas. Sofias Ave, 11528 Athens, Greece
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31
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Bedford SA, Hunsche MC, Kerns CM. Co-occurrence, Assessment and Treatment of Obsessive Compulsive Disorder in Children and Adults With Autism Spectrum Disorder. Curr Psychiatry Rep 2020; 22:53. [PMID: 32803413 DOI: 10.1007/s11920-020-01176-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW This review aims to give an update on research in the past 5 years regarding the co-occurrence, assessment and treatment of obsessive compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD). RECENT FINDINGS Recent findings affirm not only a high prevalence of OCD amongst individuals with ASD (and vice versa) but also notable variability in assessment methods and results. There remain limited validated measures with which to assess OCD in those with ASD, which are often difficult to differentiate. Adapted and function-based CBT programs specifically designed for ASD demonstrate promising results, but additional randomised controlled trials are needed. Though some exciting progress has been made in the area of treatment of OCD in ASD, progress remains hampered by inconsistent measurement of OCD in ASD. Future priorities include development of brief, valid assessment tools and determining the efficacy and effectiveness of newly developed and adapted treatment programs.
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Affiliation(s)
- Saashi A Bedford
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Michelle C Hunsche
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada.
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32
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Huang Y, Arnold SR, Foley KR, Trollor JN. Diagnosis of autism in adulthood: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1311-1327. [PMID: 32106698 DOI: 10.1177/1362361320903128] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2025]
Abstract
LAY ABSTRACT More adults are getting assessed for possible autism. Here, we give an overview on what is already known about autism diagnosis in adulthood and find areas that need more research. We divided results from the studies we found into six topics of (1) rates of autism in different groups; (2) the process of getting an autism diagnosis in adulthood; (3) gender; (4) personality traits, abilities and behaviours of diagnosed adults; (5) mental and physical health conditions that occur together with autism; and (6) how adults think and feel about being assessed and diagnosed. We found that adults often have strong emotions after being diagnosed, the process of getting a diagnosis can be unclear and different for everyone, and not many support services are available for adults. More research on diagnosing adults with intellectual disability, differences between early and late-diagnosed adults, and support after diagnosis would be useful.
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Affiliation(s)
- Yunhe Huang
- University of New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Samuel Rc Arnold
- University of New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Kitty-Rose Foley
- University of New South Wales, Australia
- Southern Cross University, Australia
| | - Julian N Trollor
- University of New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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33
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Nobili A, Glazebrook C, Bouman WP, Baron-Cohen S, Arcelus J. The stability of autistic traits in transgender adults following cross-sex hormone treatment. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 21:431-439. [PMID: 34993521 PMCID: PMC8726673 DOI: 10.1080/26895269.2020.1783738] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background: Recent research has shown that a high percentage of treatment-seeking transgender adults who were assigned female at birth (AFAB) reported scores above the clinical cutoff for autistic traits. It is unclear whether those scores reflect a stable trait or may be inflated by the high levels of anxiety typically associated with transgender people attending clinical services. Aims: This longitudinal study aims to explore the impact of Cross-sex Hormone Treatment (CHT) on levels autistic traits, independent of changes in anxiety. Method: Transgender adults who were assessed at a national transgender health service in the UK, who had not previously received CHT and who had completed the AQ-Short as a measure of autistic traits pre- and one-year post-CHT were included in the study (n = 118). Anxiety was assessed at the same time points using the Hospital Anxiety and Depression Scale. Results: AQ-Short scores remained very stable over time (ICC = 0.7; CIs 0.591-0.779) but anxiety showed little consistency (ICC = 0.386; CIs 0.219 to 0.531). Repeated measures ANOVA found a main effect of assigned sex with AFAB having higher AQ-Short scores. There was no change in AQ-Short scores and no significant interaction between assigned sex and change in AQ-Short scores. Conclusion: This study confirmed that treatment seeking transgender AFAB people have higher levels of autistic traits at follow-up compared to AMAB transgender people and that these traits are stable following one year of CHT regardless of assigned sex. This may have clinical implications regarding the support that transgender people may require following medical transition.
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Affiliation(s)
- Anna Nobili
- Institute of Mental Health, Department of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Nottingham National Centre for Transgender Health, Nottingham, UK
| | - Cris Glazebrook
- Institute of Mental Health, Department of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Walter Pierre Bouman
- Institute of Mental Health, Department of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Nottingham National Centre for Transgender Health, Nottingham, UK
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Jon Arcelus
- Institute of Mental Health, Department of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
- Nottingham National Centre for Transgender Health, Nottingham, UK
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34
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Espelöer J, Hellmich M, Vogeley K, Falter-Wagner CM. Brief Report: Social Anxiety in Autism Spectrum Disorder is Based on Deficits in Social Competence. J Autism Dev Disord 2020; 51:315-322. [PMID: 32410100 PMCID: PMC7810630 DOI: 10.1007/s10803-020-04529-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study differentially examined the relation between two clinical constructs: “social anxiety” and “social competence” in autism spectrum disorder (ASD). Employing two questionnaires (SASKO; IU), individuals with ASD (n = 23) showed increased scores of SOCIAL ANXIETY (SASKO) and of INTOLERANCE OF UNCERTAINTY (IU), compared to a non-clinical comparison group (NC; n = 25). SOCIAL ANXIETY scores were equally increased for ASD and a reference population of individuals with social anxiety disorder (SAD; n = 68). However, results showed increased SOCIAL COMPETENCE DEFICITS in ASD compared to SAD and NC groups. This study allows drawing the conclusion that social anxiety symptoms in ASD can be traced back to autism-specific deficits in social skills and are therefore putatively based on different, substantially “deeper” implemented cognitive mechanisms.
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Affiliation(s)
- J Espelöer
- Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.
| | - M Hellmich
- Faculty of Medicine, Institute of Medical Statistics and Computational Biology, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
| | - K Vogeley
- Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
| | - C M Falter-Wagner
- Department of Psychiatry, Medical Faculty, LMU Munich, Nussbaumstr. 7, 80336, Munich, Germany
- Institute of Medical Psychology, Medical Faculty, LMU Munich, Goethestrasse 31, 80336, Munich, Germany
- Department of Psychology, University of Cologne, Gronewaldstraße 2, 50931, Cologne, Germany
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35
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Pazuniak M, Pekrul SR. Obsessive-Compulsive Disorder in Autism Spectrum Disorder Across the Lifespan. Child Adolesc Psychiatr Clin N Am 2020; 29:419-432. [PMID: 32169271 DOI: 10.1016/j.chc.2019.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Obsessive-compulsive disorder is a relatively common disorder seen in autism spectrum disorder across the lifespan. Many obsessive-compulsive disorder symptoms can present similarly to the core features of autism spectrum disorder and it is often difficult to differentiate between obsessive-compulsive disorder and stereotypic behaviors or restricted interests in autism spectrum disorder. However, there are differences between the 2 disorders. This article is a review of the current literature with the goal of helping the clinician to diagnose and treat obsessive-compulsive disorder in a patient with autism spectrum disorder.
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Affiliation(s)
- Markian Pazuniak
- Department of Child and Adolescent Psychiatry, University of Maryland Medical Center, 701 West Pratt Street, 2nd Floor, Baltimore, MD 21201, USA
| | - Scott R Pekrul
- Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204, USA.
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36
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Briot K, Jean F, Jouni A, Geoffray MM, Ly-Le Moal M, Umbricht D, Chatham C, Murtagh L, Delorme R, Bouvard M, Leboyer M, Amestoy A. Social Anxiety in Children and Adolescents With Autism Spectrum Disorders Contribute to Impairments in Social Communication and Social Motivation. Front Psychiatry 2020; 11:710. [PMID: 32793002 PMCID: PMC7393242 DOI: 10.3389/fpsyt.2020.00710] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/06/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Recognition of symptoms of Social anxiety (SA) may be difficult among individuals with Autism Spectrum Disorders (ASD) because of overlap between social anxiety and autistic symptomatology. The main aim of our study was thus to explore the association between symptoms of social anxiety and clinical characteristics of ASD in order to identify individuals experiencing concomitant ASD and social anxiety disorder. We also described the prevalence of SA in a sample of children and adolescents with ASD. METHOD 79 children and adolescents with ASD (with and without intellectual disability) and 28-matched control participants were recruited in two French Expert Centers for ASD, coordinated by the Fundation FondaMental. Psychiatric comorbidities, anxiety disorders and depression were screened with standard tools (Liebowitz social anxiety scale, Hamilton Depression and Anxiety Rating Scale) and correlated to autistic features and social skills assessed with the social responsiveness scale 2 (SRS-2) and the repetitive behavior scale (RBS-R). We performed bivariate analysis between the social anxiety level and the scores measured with different clinical scales. We then adjusted the observed relationships with the alterations of SRS-2 and RBS-R scores. RESULTS After adjustment, the level of social anxiety appeared as significantly associated with alterations in social reciprocity and particularly with the SRS-2 "social communication" and "social motivation" sub-scores, but not with RBS-R score. CONCLUSIONS We confirm previous reports showing that individuals with ASD are at high risk for specific anxiety disorders. In particular, high levels of impairments in social motivation and social communication (SRS-2) are indicative of comorbid disorders namely, social anxiety and ASD. Our findings clearly inform diagnostic assessment in ASD and stress the need to take comorbid anxiety disorders into consideration to improve treatment of ASD. To further clarify the impact of social anxiety on social competences and socio-adaptive handicap, longitudinal studies and cluster analysis will be needed in the future.
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Affiliation(s)
- Kellen Briot
- University of Bordeaux, Medical Sciences Department, Bordeaux, France.,Centre Hospitalier Charles-Perrens, Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Bordeaux, France
| | - François Jean
- Centre Hospitalier Dr Jean Eric Techer, Pôle de Psychiatrie de l'enfant et de l'adolescent, Calais, France
| | - Ali Jouni
- Centre Hospitalier Charles-Perrens, Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Bordeaux, France
| | - Marie-Maude Geoffray
- Department of Child and Adolescent Psychiatry, Centre Hospitalier le Vinatier, Bron, France
| | - Myriam Ly-Le Moal
- Institut Roche, Tour Horizons- Bureau 18M3, Boulogne-Billancourt, France
| | - Daniel Umbricht
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Christopher Chatham
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Lorraine Murtagh
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Richard Delorme
- Fondation FondaMental, Créteil, France.,Institut Pasteur, Human Genetics and Cognitive Functions Unit, Paris, France.,Université Paris Est Créteil, AP-HP, DMU IMPACT, Psychiatry and Addictology Department, Mondor University Hospital, Créteil, France
| | - Manuel Bouvard
- University of Bordeaux, Medical Sciences Department, Bordeaux, France.,Centre Hospitalier Charles-Perrens, Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Bordeaux, France.,Fondation FondaMental, Créteil, France.,Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA UMR 5287, Bordeaux, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France.,Université Paris Est Créteil, AP-HP, DMU IMPACT, Psychiatry and Addictology Department, Mondor University Hospital, Créteil, France.,INSERM, U955, IMRB, Laboratoire de NeuroPsychiatrie translationnelle, Créteil, France
| | - Anouck Amestoy
- University of Bordeaux, Medical Sciences Department, Bordeaux, France.,Centre Hospitalier Charles-Perrens, Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Bordeaux, France.,Fondation FondaMental, Créteil, France.,Aquitaine Institute for Cognitive and Integrative Neuroscience, INCIA UMR 5287, Bordeaux, France
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Thorkelson G, Laughlin SF, Turner KS, Ober N, Handen BL. Selective Serotonin Reuptake Inhibitor Monotherapy for Anxiety Disorders in Children and Adolescents with Autism Spectrum Disorder: A Chart Review. J Child Adolesc Psychopharmacol 2019; 29:705-711. [PMID: 31295004 DOI: 10.1089/cap.2019.0001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: Anxiety disorders are one of the most commonly co-occurring psychiatric diagnoses in youth with autism spectrum disorder (ASD), with a frequency ranging from 22% to 84%. Methods: We conducted a chart review of 29 children and adolescents with ASD who had been treated with selective serotonin reuptake inhibitor (SSRI) monotherapy for an anxiety disorder for at least 2 months. Subsequent chart reviews were conducted for the first follow-up visit within 2-6 months (M = 4.2 months) and the visit closest to 9 months posttreatment (ranging from 7 to 12 months; M = 10.5 months). The presence of adverse events (AEs) was examined, and a consensus Clinical Global Impressions Improvement (CGI-I) score was determined. Results: Fifty-five percent of patients were given a CGI-I of "improved" or "very much improved" at the 9-month follow-up. Four patients discontinued treatment owing to AEs. Other reported AEs not leading to discontinuation included vivid dreaming, increased emotional lability, and irritability. Responders included a number of patients who had failed previous SSRI trials. Conclusions: This study suggests that SSRI treatment should be considered for individuals with ASD and anxiety disorders, even if prior SSRI trials have been unsuccessful.
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Affiliation(s)
- Gregory Thorkelson
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sarah F Laughlin
- Department of Physical Medicine and Rehabilitation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kylan S Turner
- Department of Behavior Analysis, Simmons University, Boston, Massachusetts
| | - Nicole Ober
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Benjamin L Handen
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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38
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Dell'Osso L, Carpita B, Bertelloni CA, Diadema E, Barberi FM, Gesi C, Carmassi C. Subthreshold autism spectrum in bipolar disorder: Prevalence and clinical correlates. Psychiatry Res 2019; 281:112605. [PMID: 31629303 DOI: 10.1016/j.psychres.2019.112605] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/05/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND While few previous studies highlighted a higher prevalence of autistic traits among adults with Bipolar Disorder (BD), little is known about their clinical significance in this population. METHOD 143 subjects with BD were enrolled at the adult psychiatric inpatient clinic of the University of Pisa. Assessments included the SCID-5, the MOODS-SR, the AQ and the AdAS Spectrum. RESULTS 42.7% of the sample scored positively for significant levels of autistic traits. Subjects with high autistic traits showed a greater likelihood of a very early onset of BD, greater length of current in-hospital stay, significantly higher rates of anxiety disorders and lower rates of substance use disorders compared to patients with low autistic traits. They also show significantly greater depressive symptoms and suicidality across the lifetime. Suicidality was associated with the altered responsiveness to sensory input and inversely related to adherence to routine and inflexibility. CONCLUSION The study is a first exploration of the clinical significance of autistic traits among BD patients. Our results highlight the clinical significance of autistic traits in patients with BD, supporting the usefulness of a dimensional approach to the autism spectrum.
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Affiliation(s)
- Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.
| | | | - Elisa Diadema
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | | - Camilla Gesi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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Pozza A, Barcaccia B, Dèttore D. Psychometric Evaluation of the Italian Obsessive Compulsive Inventory–Child Version: Factor Structure and Predictive Validity at One-Year Follow-Up in Adolescents. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1080/07481756.2019.1594913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Barbara Barcaccia
- Sapienza University of Rome, Rome, Italy
- Associazione di Psicologia Cognitiva APC and Scuola di Psicoterapia srl SPC, Rome, Italy
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40
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Urbano MR, Teal Raffaele C, Kreiser NL, Flaherty JM, Hartmann K. Clinical considerations for the inclusion of individuals with autism spectrum disorder in clinical trials. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:295-302. [PMID: 30290207 DOI: 10.1016/j.pnpbp.2018.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/21/2018] [Accepted: 09/30/2018] [Indexed: 10/28/2022]
Abstract
Diagnoses of autism spectrum disorder (ASD) have increased considerably over the past 20 years. Because of this rise and the inherent complexity of ASD, there is a need for an increased number of scientifically valid basic and clinical research studies addressing this disorder. This manuscript serves as an introduction to the clinical presentation of ASD as well as the unique challenges and modifications required to conduct clinical research with this population. This includes detailing the current diagnostic criteria, process of receiving an ASD diagnosis, information on assessment measures, and special considerations when developing research. It is the hope that this information will provide researchers interested in conducting clinical trials with those with ASD with baseline information and considerations when developing their research topics and methodology.
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Affiliation(s)
- Maria R Urbano
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States.
| | - C Teal Raffaele
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
| | - Nicole L Kreiser
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
| | - Jennifer M Flaherty
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
| | - Kathrin Hartmann
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
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41
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Hswen Y, Gopaluni A, Brownstein JS, Hawkins JB. Using Twitter to Detect Psychological Characteristics of Self-Identified Persons With Autism Spectrum Disorder: A Feasibility Study. JMIR Mhealth Uhealth 2019; 7:e12264. [PMID: 30747718 PMCID: PMC6390184 DOI: 10.2196/12264] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/16/2018] [Accepted: 11/18/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND More than 3.5 million Americans live with autism spectrum disorder (ASD). Major challenges persist in diagnosing ASD as no medical test exists to diagnose this disorder. Digital phenotyping holds promise to guide in the clinical diagnoses and screening of ASD. OBJECTIVE This study aims to explore the feasibility of using the Web-based social media platform Twitter to detect psychological and behavioral characteristics of self-identified persons with ASD. METHODS Data from Twitter were retrieved from 152 self-identified users with ASD and 182 randomly selected control users from March 22, 2012 to July 20, 2017. We conducted a between-group comparative textual analysis of tweets about repetitive and obsessive-compulsive behavioral characteristics typically associated with ASD. In addition, common emotional characteristics of persons with ASD, such as fear, paranoia, and anxiety, were examined between groups through textual analysis. Furthermore, we compared the timing of tweets between users with ASD and control users to identify patterns in communication. RESULTS Users with ASD posted a significantly higher frequency of tweets related to the specific repetitive behavior of counting compared with control users (P<.001). The textual analysis of obsessive-compulsive behavioral characteristics, such as fixate, excessive, and concern, were significantly higher among users with ASD compared with the control group (P<.001). In addition, emotional terms related to fear, paranoia, and anxiety were tweeted at a significantly higher rate among users with ASD compared with control users (P<.001). Users with ASD posted a smaller proportion of tweets during time intervals of 00:00-05:59 (P<.001), 06:00-11:59 (P<.001), and 18:00-23.59 (P<.001), as well as a greater proportion of tweets from 12:00 to 17:59 (P<.001) compared with control users. CONCLUSIONS Social media may be a valuable resource for observing unique psychological characteristics of self-identified persons with ASD. Collecting and analyzing data from these digital platforms may afford opportunities to identify the characteristics of ASD and assist in the diagnosis or verification of ASD. This study highlights the feasibility of leveraging digital data for gaining new insights into various health conditions.
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Affiliation(s)
- Yulin Hswen
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, United States
| | - Anuraag Gopaluni
- Department of Mathematics and Statistics, Boston University, Boston, MA, United States
| | - John S Brownstein
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, United States
| | - Jared B Hawkins
- Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
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42
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Nobili A, Glazebrook C, Bouman WP, Glidden D, Baron-Cohen S, Allison C, Smith P, Arcelus J. Autistic Traits in Treatment-Seeking Transgender Adults. J Autism Dev Disord 2018; 48:3984-3994. [PMID: 29654452 PMCID: PMC6223809 DOI: 10.1007/s10803-018-3557-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The present study aimed to compare prevalence of autistic traits measured by the self-reported autism spectrum quotient-short (AQ-short) in a transgender clinical population (n = 656) matched by age and sex assigned at birth to a cisgender community sample. Results showed that transgender and cisgender people reported similar levels of possible autistic caseness. Transgender people assigned female were more likely to have clinically significant autistic traits compared to any other group. No difference was found between those assigned male. High AQ scores may not be indicative of the presence of an autism spectrum condition as the difference between groups mainly related to social behaviours; such scores may be a reflection of transgender people’s high social anxiety levels due to negative past experiences.
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Affiliation(s)
- Anna Nobili
- Nottingham National Centre for Transgender Health, Nottingham, UK
- Institute of Mental Health, University of Nottingham, Room B12, B Floor, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Cris Glazebrook
- Institute of Mental Health, University of Nottingham, Room B12, B Floor, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
| | | | - Derek Glidden
- Nottingham National Centre for Transgender Health, Nottingham, UK
- Nottingham City Asperger Service, Highbury Hospital, Nottingham, UK
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Paula Smith
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Jon Arcelus
- Nottingham National Centre for Transgender Health, Nottingham, UK
- Institute of Mental Health, University of Nottingham, Room B12, B Floor, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
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Brookman-Frazee L, Stadnick N, Chlebowski C, Baker-Ericzén M, Ganger W. Characterizing psychiatric comorbidity in children with autism spectrum disorder receiving publicly funded mental health services. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 22:938-952. [PMID: 28914082 PMCID: PMC6491206 DOI: 10.1177/1362361317712650] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Publicly funded mental health programs play a significant role in serving children with autism spectrum disorder. Understanding patterns of psychiatric comorbidity for this population within mental health settings is important to implement appropriately tailored interventions. This study (1) describes patterns of psychiatric comorbidity in children with autism spectrum disorder who present to mental health services with challenging behaviors and (2) identifies child characteristics associated with comorbid conditions. Data are drawn from baseline assessments from 201 children with autism spectrum disorder who participated in a community effectiveness trial across 29 publicly funded mental health programs. Non-autism spectrum disorder diagnoses were assessed using an adapted Mini-International Neuropsychiatric Interview, parent version. Approximately 92% of children met criteria for at least one non-autism spectrum disorder diagnosis (78% attention deficit hyperactivity disorder, 58% oppositional defiant disorder, 56% anxiety, 30% mood). Logistic regression indicated that child gender and clinical characteristics were differentially associated with meeting criteria for attention deficit hyperactivity disorder, oppositional defiant disorder, an anxiety, or a mood disorder. Exploratory analyses supported a link between challenging behaviors and mood disorder symptoms and revealed high prevalence of these symptoms in this autism spectrum disorder population. Findings provide direction for tailoring intervention to address a broad range of clinical issues for youth with autism spectrum disorder served in mental health settings.
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Affiliation(s)
- Lauren Brookman-Frazee
- University of California, San Diego, USA
- Rady Children’s Hospital, San Diego, USA
- Child and Adolescent Services Research Center, USA
| | - Nicole Stadnick
- University of California, San Diego, USA
- Child and Adolescent Services Research Center, USA
| | - Colby Chlebowski
- University of California, San Diego, USA
- Child and Adolescent Services Research Center, USA
| | - Mary Baker-Ericzén
- Rady Children’s Hospital, San Diego, USA
- Child and Adolescent Services Research Center, USA
| | - William Ganger
- Child and Adolescent Services Research Center, USA
- San Diego State University, USA
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Esler AN, Stronach ST, Jacob S. Insistence on sameness and broader autism phenotype in simplex families with autism spectrum disorder. Autism Res 2018; 11:1253-1263. [PMID: 30289619 DOI: 10.1002/aur.1975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 03/30/2018] [Accepted: 04/24/2018] [Indexed: 12/28/2022]
Abstract
Insistence on sameness (IS) in individuals with autism spectrum disorder (ASD) and their families may have utility in identifying meaningful subgroups for studying the pathophysiological and genetic pathways affected in ASD. The primary objectives of the current study were to (1) characterize features of IS in parents of children with ASD and (2) examine their relationships with child IS symptoms. Participants were 2760 families who participated in the Simons Simplex Collection. Levels of parent IS were measured using the Broader Autism Phenotype Questionnaire (BAPQ). A factor analysis generated a BAPQ-IS scale, consisting of a subset of 11 items from the original BAPQ-Rigid scale. Correlations were run to examine the relationship between parent BAP and child IS variables. Correlations were found between parent IS and measures of child IS. Although relationships between parent and child IS features were statistically significant in this large sample, effect sizes were small. Results may be reflective of sample design that only included simplex families, where ASD severity may be predominantly driven by spontaneous mutations and less by common inherited risk from parents. In addition, child and parent measures used may have differentially captured features and severity of IS. Further research is needed on how IS can be accurately measured throughout development and across individuals with ASD and their unaffected family members to facilitate future studies on IS as a possible endophenotype for ASD. Autism Res 2018, 11: 1253-1263. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Previous research has suggested that insistence on sameness (IS) may be a heritable trait in autism spectrum disorder (ASD). The study examined whether children with high levels of IS had parents with IS tendencies. A small relationship was found between parent and child measures of IS. Future research is needed on measurement of insistence on sameness across individuals with and without ASD to further examine this relationship and improve understanding of the genetics of ASD.
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Affiliation(s)
- Amy N Esler
- Department of Pediatrics, University of Minnesota-Twin Cities, Minneapolis, MN
| | - Sheri T Stronach
- Department of Speech-Language-Hearing Sciences, University of Minnesota-Twin Cities, Minneapolis, MN
| | - Suma Jacob
- Departments of Psychiatry and Pediatrics, University of Minnesota-Twin Cities, Minneapolis, MN
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Diagnostic accuracy of the ADOS and ADOS-2 in clinical practice. Eur Child Adolesc Psychiatry 2018; 27:1193-1207. [PMID: 29560529 DOI: 10.1007/s00787-018-1143-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 03/09/2018] [Indexed: 12/22/2022]
Abstract
The Autism Diagnostic Observation Schedule is a semi-structured, standardized assessment tool for individuals with suspected autism spectrum disorders (ASD) and is deemed to be part of the gold standard for diagnostic evaluation. Good diagnostic accuracy and interpersonal objectivity have been demonstrated for the ADOS in research setting. The question arises whether this is also true for daily clinical practice and whether diagnostic accuracy depends on specialized experience in the diagnostic evaluation. The present study explores the diagnostic accuracy of the original and the revised version of the ADOS for Modules 1 through 4. Thus, seven cases of ADOS executions were recorded and coded by a group of experts of specialized outpatient clinics for ASD. In an extensive consensus process, including video analysis of every minute of the ADOS executions, a "gold standard" coding for every case was defined. The videos of the ADOS administration were presented to a large group of clinicians (from daily clinical routine care) and their codings (n = 189) were obtained and analysed. Variance of coding and congruence with the expert coding were determined. High variance was found in the codings. The accuracy of the coding depends on the experience of the coder with the ADOS as well as on characteristics of the cases and the quality of the administration of the ADOS. Specialization in the diagnostic of ASD has to be claimed. Specialized outpatient clinics for ASD are required which guarantee a qualified diagnostic/differential diagnostic and case management with the aim of demand-oriented supply of individual cases.
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Hirose M, Hirano Y, Nemoto K, Sutoh C, Asano K, Miyata H, Matsumoto J, Nakazato M, Matsumoto K, Masuda Y, Iyo M, Shimizu E, Nakagawa A. Relationship between symptom dimensions and brain morphology in obsessive-compulsive disorder. Brain Imaging Behav 2018; 11:1326-1333. [PMID: 27730476 DOI: 10.1007/s11682-016-9611-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Obsessive-compulsive disorder (OCD) is known as a clinically heterogeneous disorder characterized by symptom dimensions. Although substantial numbers of neuroimaging studies have demonstrated the presence of brain abnormalities in OCD, their results are controversial. The clinical heterogeneity of OCD could be one of the reasons for this. It has been hypothesized that certain brain regions contributed to the respective obsessive-compulsive dimensions. In this study, we investigated the relationship between symptom dimensions of OCD and brain morphology using voxel-based morphometry to discover the specific regions showing alterations in the respective dimensions of obsessive-compulsive symptoms. The severities of symptom dimensions in thirty-three patients with OCD were assessed using Obsessive-Compulsive Inventory-Revised (OCI-R). Along with numerous MRI studies pointing out brain abnormalities in autistic spectrum disorder (ASD) patients, a previous study reported a positive correlation between ASD traits and regional gray matter volume in the left dorsolateral prefrontal cortex and amygdala in OCD patients. We investigated the correlation between gray and white matter volumes at the whole brain level and each symptom dimension score, treating all remaining dimension scores, age, gender, and ASD traits as confounding covariates. Our results revealed a significant negative correlation between washing symptom dimension score and gray matter volume in the right thalamus and a significant negative correlation between hoarding symptom dimension score and white matter volume in the left angular gyrus. Although our result was preliminary, our findings indicated that there were specific brain regions in gray and white matter that contributed to symptom dimensions in OCD patients.
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Affiliation(s)
- Motohisa Hirose
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. .,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan.
| | - Kiyotaka Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Chihiro Sutoh
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kenichi Asano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan
| | - Haruko Miyata
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Junko Matsumoto
- Department of Regional Disaster Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michiko Nakazato
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan
| | - Koji Matsumoto
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan.,Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan
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Murphy D, Glaser K, Hayward H, Eklund H, Cadman T, Findon J, Woodhouse E, Ashwood K, Beecham J, Bolton P, McEwen F, Wilson E, Ecker C, Wong I, Simonoff E, Russell A, McCarthy J, Chaplin E, Young S, Asherson P. Crossing the divide: a longitudinal study of effective treatments for people with autism and attention deficit hyperactivity disorder across the lifespan. PROGRAMME GRANTS FOR APPLIED RESEARCH 2018. [DOI: 10.3310/pgfar06020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BackgroundAutism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) frequently persist into adolescence and young adulthood. However, there are few clinical services that support those with these disorders through adulthood.ObjectiveOur aim was to determine if clinical services meet the needs of people with ASD and ADHD, who are ‘at transition’ from childhood to adulthood.DesignA longitudinal study of individuals with ASD and ADHD, the impact of services and treatments.MethodsOur research methods included (1) interviewing > 180 affected individuals (and their families) with a confirmed diagnosis of ASD and/or ADHD, (2) screening for ASD and ADHD in approximately 1600 patients and (3) surveying general practitioner prescribing to 5651 ASD individuals across the UK. In addition, we tested the effectiveness of (1) new ASD diagnostic interview measures in 169 twins, 145 familes and 150 non-twins, (2) a magnetic resonance imaging-based diagnostic aid in 40 ASD individuals, (3) psychological treatments in 46 ASD individuals and (4) the feasability of e-learning in 28 clinicians.SettingNHS clinical services and prisons.ParticipantsFocus – young people with ASD and ADHD as they ‘transition’ from childhood and adolescence into early adulthood.InterventionsTesting the utility of diagnostic measures and services, web-based learning interventions, pharmacological prescribing and cognitive–behavioural treatments.Main outcome measuresSymptom severity, service provision and met/unmet need.ResultsPeople with ASD and ADHD have very significant unmet needs as they transition through adolescence and young adulthood. A major contributor to this is the presence of associated mental health symptoms. However, these are mostly undiagnosed (and untreated) by clinical services. Furthermore, the largest determinant of service provision was age and not severity of symptoms. We provide new tools to help diagnose both the core disorders and their associated symptoms. We also provide proof of concept for the effectiveness of simple psychological interventions to treat obsessional symptoms, the potential to run treatment trials in prisons and training interventions.LimitationsOur findings only apply to clinical service settings.ConclusionsAs individuals ‘transition’ their contact with treatment and support services reduces significantly. Needs-led services are required, which can both identify individuals with the ‘core symptoms’ of ASD and ADHD and treat their residual symptoms and associated conditions.Future workTo test our new diagnostic measures and treatment approaches in larger controlled trials.Trial registrationCurrent Controlled Trials ISRCTN87114880.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- Declan Murphy
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Karen Glaser
- Institute of Gerontology, King’s College London, London, UK
| | - Hannah Hayward
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Hanna Eklund
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Tim Cadman
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - James Findon
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Emma Woodhouse
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - Karen Ashwood
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | | | - Patrick Bolton
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, London, UK
| | - Fiona McEwen
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, London, UK
| | - Ellie Wilson
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Christine Ecker
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Ian Wong
- Department of Pharmacology and Pharmacy, University of Hong Kong, PokFuLam, Hong Kong
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, London, UK
| | - Ailsa Russell
- Department of Psychology, University of Bath, Bath, UK
| | | | - Eddie Chaplin
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Susan Young
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Philip Asherson
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
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48
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Bittker SS, Bell KR. Acetaminophen, antibiotics, ear infection, breastfeeding, vitamin D drops, and autism: an epidemiological study. Neuropsychiatr Dis Treat 2018; 14:1399-1414. [PMID: 29910617 PMCID: PMC5987866 DOI: 10.2147/ndt.s158811] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND While many studies have examined environmental risk factors for autism spectrum disorder (ASD), much of the research focus has been on prenatal or perinatal factors. Yet, the postnatal environment may affect the risk of ASD as well. OBJECTIVE To determine whether a set of five postnatal variables are associated with ASD. These variables are: acetaminophen exposure, antibiotic exposure, incidence of ear infection, decreased duration of breastfeeding, and decreased consumption of oral vitamin D drops. MATERIALS AND METHODS An Internet-based survey was conducted. Participants were parents living in the USA with at least one biological child between 3 and 12 years of age. Potential participants were informed about the survey via postings on social media, websites, and listservs and were offered an opportunity to participate in a raffle as well. Participants were also recruited through the Interactive Autism Network. RESULTS There were 1,741 completed survey responses. After exclusions, there remained 1,001 responses associated with children with ASD (cases) and 514 responses associated with children who do not have ASD (controls). In this data set, doses of postnatal acetaminophen (adjusted odds ratio [aOR] 1.016, CI: 1.003-1.032, p=0.026), courses of postnatal antibiotics (aOR 1.103, CI: 1.046-1.168, p<0.001), incidence of postnatal ear infection (aOR 1.137, CI: 1.046-1.236, p=0.003), and decreased duration of breastfeeding (aOR 0.948, CI: 0.932-0.965, p<0.001) are all associated with ASD when adjusted for eight demographic variables. A weak association between oral vitamin D drop exposure and ASD was also found when adjusted for breastfeeding and demographics (aOR 1.025, CI: 0.995-1.056, p=0.102). CONCLUSION This study adds to evidence that postnatal acetaminophen use, postnatal antibiotic use, incidence of ear infection, and early weaning are associated with an increased risk of ASD. It also finds that postnatal oral vitamin D drops are weakly associated with ASD when adjusted for breastfeeding and demographics.
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Affiliation(s)
- Seth Scott Bittker
- Interdisciplinary Center for Innovative Theory and Empirics (INCITE), Columbia University, New York, NY, USA
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49
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Scherr JF, Hogan AL, Hatton D, Roberts JE. Stranger Fear and Early Risk for Social Anxiety in Preschoolers with Fragile X Syndrome Contrasted to Autism Spectrum Disorder. J Autism Dev Disord 2018; 47:3741-3755. [PMID: 28210826 DOI: 10.1007/s10803-017-3059-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study investigated behavioral indicators of social fear in preschool boys with fragile X syndrome (FXS) with a low degree of autism spectrum disorder (ASD) symptoms (FXS-Low; n = 29), FXS with elevated ASD symptoms (FXS-High; n = 25), idiopathic ASD (iASD; n = 11), and typical development (TD; n = 36). Gaze avoidance, escape behaviors, and facial fear during a stranger approach were coded. Boys with elevated ASD symptoms displayed more avoidant gaze, looking less at the stranger and parent than those with low ASD symptoms across etiologies. The iASD group displayed more facial fear than the other groups. Results suggest etiologically distinct behavioral patterns of social fear in preschoolers with elevated ASD symptoms.
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Affiliation(s)
- Jessica F Scherr
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite 220, Columbia, SC, 29208, USA
| | - Abigail L Hogan
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite 220, Columbia, SC, 29208, USA
| | - Deborah Hatton
- Department of Special Education, Vanderbilt University, 417D One Magnolia Circle, Nashville, TN, 37203, USA
| | - Jane E Roberts
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite 220, Columbia, SC, 29208, USA.
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50
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Autistic Traits and Symptoms of Social Anxiety are Differentially Related to Attention to Others' Eyes in Social Anxiety Disorder. J Autism Dev Disord 2018; 47:3814-3821. [PMID: 28000078 PMCID: PMC5676829 DOI: 10.1007/s10803-016-2978-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Autism spectrum disorder (ASD) and social anxiety disorder (SAD) have partly overlapping symptoms. Gaze avoidance has been linked to both SAD and ASD, but little is known about differences in social attention between the two conditions. We studied eye movements in a group of treatment-seeking adolescents with SAD (N = 25), assessing SAD and ASD dimensionally. The results indicated a double dissociation between two measures of social attention and the two symptom dimensions. Controlling for social anxiety, elevated autistic traits were associated with delayed orienting to eyes presented among distractors. In contrast, elevated social anxiety levels were associated with faster orienting away from the eyes, when controlling for autistic traits. This distinction deepens our understanding of ASD and SAD.
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