Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2021; 9(22): 6329-6342
Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6329
Health-related risky behaviors and their risk factors in adolescents with high-functioning autism
Ya-Jing Sun, Ling-Zi Xu, Zeng-Hui Ma, Yu-Lu Yang, Ting-Ni Yin, Xiao-Yun Gong, Zi-Lin Gao, Yan-Ling Liu, Jing Liu
Ya-Jing Sun, Ling-Zi Xu, Zeng-Hui Ma, Yu-Lu Yang, Ting-Ni Yin, Xiao-Yun Gong, Jing Liu, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
Zi-Lin Gao, Quanzhou Children’s and Women’s Hospital, Quanzhou 362000, Fujian Province, China
Yan-Ling Liu, Department of Mathematics, Changzhi Medical College, Changzhi 046000, Shanxi Province, China
Author contributions: Sun YJ, Xu LZ, Ma ZH, Yang YL, Yin TN, Gong XY and Gao ZL performed the study; Sun YJ and Liu YL analyzed the data; Sun YJ wrote the manuscript; Xu LZ, Ma ZH and Liu J revised the manuscript; all authors have read and approved the final manuscript.
Supported by National Key R&D Program of China, No. 2017YFC1309900; and Beijing Municipal Science & Technology Commission, No. Z171100001017088 and No. Z161100000116098.
Institutional review board statement: This study was approved by Ethics Committee of Peking University Sixth Hospital (No. 2016-11-7-1).
Informed consent statement: All study participants provided written informed consent prior to study enrollment.
Conflict-of-interest statement: All authors declare no conflicts of interest in this study.
Data sharing statement: Statistical code and data are available from the corresponding author.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Liu, MD, Chief Physician, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. 51 Huayuan North Road, Haidian District, Beijing 100191, China. ljyuch@bjmu.edu.cn
Received: May 15, 2021
Peer-review started: May 15, 2021
First decision: May 23, 2021
Revised: May 25, 2021
Accepted: June 2, 2021
Article in press: June 2, 2021
Published online: August 6, 2021
ARTICLE HIGHLIGHTS
Research background

Our study mainly explored health-related risky behaviors in adolescents with high-functioning autism (HFA) and their risk factors. Autism is a neurodevelopmental disorder with an increasing prevalence. Adolescents with HFA are in a critical period with many physical and mental changes. Except for social interaction disorder, communication barriers and stereotyped or repetitive behaviors, adolescents with HFA are more likely to be involved in health-related risky behaviors. These behaviors have not been understood so far.

Research motivation

Most of the previous researchers focused on a single risky behavior with HFA. Related risk factors of health-related risky behaviors in autistic individuals have not been fully explored. Our results may provide a better understanding of health-related risky behaviors in adolescents with HFA.

Research objectives

We aimed to explore health-related risky behaviors and their risk factors in adolescents with HFA. This study may lay a foundation for comprehensive intervention by discovering factors associated with such behaviors.

Research methods

The study was set up into autism group and control group. Both groups completed the Adolescents Health-related Risky Behavior Inventory. Expression recognition, the Inventory of Subjective Life Quality for Child and Adolescent, Chinese Wechsler Intelligence Scale for Children, Wechsler Intelligence Scale for Adult-Chinese Revised, Theory of Mind Test and Autism Spectrum Screening Questionnaire were assessed in the HFA group to explore risk factors of health-related risky behaviors in autistic adolescents.

Research results

We found that individuals with HFA had more aggression and violence, suicide or self-injury, health compromising behavior and unprotected sex than neurotypical teenagers. Uncomfortable emotional experience, depression, low intelligence quotient score, low score of theory of mind test and not adapted to school life experience were risk factors.

Research conclusions

Through this cross-sectional study, we found that adolescents with HFA have more health-related risky behaviors than neurotypical adolescents. Different health-related risky behaviors have different risk factors. We should pay attention to the emotional experience and school life experience of autistic adolescents and teach them self-protection knowledge.

Research perspectives

This information will assist in the comprehensive evaluation and lay the foundation for intervention of health-related risky behaviors in adolescents with HFA. Future study should expand the sample size and enroll more female participants. More related factors should be taken into consideration, such as health status of subjects’ parents.