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Penner F, Bunderson M, Bartz C, Brooker RJ, Rutherford HJV. Emotion regulation strategies and perceived stress during pregnancy in expectant mothers and fathers. J Reprod Infant Psychol 2024; 42:410-423. [PMID: 35949103 PMCID: PMC9911557 DOI: 10.1080/02646838.2022.2110224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Stress during pregnancy can increase physical and mental health risks in parents and offspring. Emotion regulation (ER) may protect against prenatal stress; however, ER is understudied in expectant parents, particularly expectant fathers. This study aimed to evaluate associations between ER strategies (reappraisal, suppression, ratio of suppression-to-reappraisal) and perceived stress among expectant parents, and also test whether expectant mothers and fathers differed in ER strategy use and perceived stress levels. METHODS N = 83 expectant parents (62.7% mothers) in the third trimester completed measures assessing perceived stress,reappraisal, and suppression. ANCOVA, hierarchical regression, and multilevel models were used to evaluate associations between ER strategies and perceived stress, and test for sex differences. RESULTS Controlling for age and education, lower reappraisal and higher suppression were associated with higher perceived stress; in addition, higher suppression-to-reappraisal ratios were associated with greater perceived stress. Mothers and fathers did not differ in perceived stress, reappraisal, or suppression; however, suppression-to-reappraisal ratios significantly differed. CONCLUSION Increasing ER skills such as reappraisal while reducing suppression may be beneficial for decreasing stress in expectant parents. Expectant fathers report similar levels of perceived stress to mothers and would benefit from prenatal mental health screening and intervention.
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Affiliation(s)
| | - Madison Bunderson
- Yale Child Study Center, Yale University School of Medicine
- Graduate School of Education, Stanford University
| | - Cody Bartz
- Yale Child Study Center, Yale University School of Medicine
- School of Public Affairs, American University
| | - Rebecca J Brooker
- Department of Psychological and Brain Sciences, Texas A&M University
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2
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Barnes GL, Ozsivadjian A, Baird G, Absoud M, Hollocks MJ. Investigating the Effects of Transdiagnostic Processes on Anxiety and Depression Symptoms in Autistic Young People: the Mediating Role of Emotion Dysregulation. J Autism Dev Disord 2024:10.1007/s10803-024-06246-0. [PMID: 38438816 DOI: 10.1007/s10803-024-06246-0] [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: 01/12/2024] [Indexed: 03/06/2024]
Abstract
Internalising symptoms are elevated in autism compared to the general population. Few studies have investigated emotional dysregulation (ED) as a potential mediator between specific transdiagnostic processes and anxiety and depression symptoms in autistic youth. In a sample of 94 autistic young people aged 5-18 years referred to a specialist clinic for an autism evaluation, we tested the effects of ED as a mediator between cognitive inflexibility (CI), intolerance of uncertainty (IU) and alexithymia with anxiety and depression symptoms, using structural equation modelling. Effect sizes were compared to a non-autistic comparison group (n = 84). CI and alexithymia did not significantly predict depression symptoms in autistic young people, directly nor via ED. Relationships between CI/alexithymia and depression were fully mediated by ED in the non-autistic sample. There was a direct effect of CI on anxiety in the non-autistic group but not in those with a diagnosis. IU predicted depression symptoms in the autism group; and ED mediated this relationship only in those who did not receive a diagnosis. IU directly predicted anxiety in both groups and this relationship did not occur via ED. The finding of a direct pathway from IU to anxiety and depression in autistic youth is consistent with the literature. The finding that CI did not predict anxiety or depression in those with autism is novel, as was the finding that ED mediated relationships between alexithymia and anxiety/depression symptoms in both samples. The findings may have important implications for the delivery of psychological interventions for autistic youth.
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Affiliation(s)
- Georgina L Barnes
- South London & Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK
| | - Ann Ozsivadjian
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gillian Baird
- Newcomen Centre, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Michael Absoud
- Newcomen Centre, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Matthew J Hollocks
- South London & Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK.
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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Riedelbauch S, Gaigg SB, Thiel T, Roessner V, Ring M. Examining a model of anxiety in autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:565-579. [PMID: 37329157 PMCID: PMC10913331 DOI: 10.1177/13623613231177777] [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] [Indexed: 06/18/2023]
Abstract
ABSTRACT Anxiety disorders commonly occur in autism. Existing studies implicate intolerance of uncertainty, alexithymia, sensory processing differences and emotion regulation difficulties as influencing factors of anxiety in autism. To date, a few studies have considered the combination of these factors within the same sample. This study used structural equation modelling to test the prediction that intolerance of uncertainty and emotion regulation constitute more direct causes of anxiety in autism that mediate the influences of sensory processing difference and alexithymia as more sequential contributing factors. Autistic (n = 86) and non-autistic adults (n = 100) completed a battery of self-report questionnaires. Only when applied to each group separately, the broad predictions of the model were confirmed for the autistic group following data-driven additions of paths between sensory processing difference and anxiety and alexithymia implying that sensory processing difference contribute indirectly as well as directly to individual differences in anxiety. For the non-autistic group, model fit could only be achieved after removing autism-related traits and sensory processing differences as predictors of anxiety. These results suggest that aetiology and expression of anxiety in autism partially overlap with what is observed in the general population except that sensory processing differences appear to play a relatively unique role in the context of autism.
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Affiliation(s)
- Saskia Riedelbauch
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | | | - Tobias Thiel
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Melanie Ring
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
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4
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Keefer A, Singh V, Jang YS, Alon L, Surmacz M, Holingue C, Mostofsky SH, Vasa RA. Exploring the Symptom Profiles of Intolerance of Uncertainty in Autistic Children. J Autism Dev Disord 2024; 54:121-130. [PMID: 36227445 PMCID: PMC10097837 DOI: 10.1007/s10803-022-05744-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 02/06/2023]
Abstract
Intolerance of uncertainty (IU) is a multidimensional construct involving maladaptive responses to uncertainty. IU is strongly associated with autism and anxiety, yet no studies have examined its symptom profile in autistic children. This study compares IU symptom profiles in autistic and NT children and in autistic children with and without anxiety using the Intolerance of Uncertainty Scale for Children. Compared to NT peers, autistic children exhibited heightened IU symptoms in all domains, affective, behavioral, and cognitive; affective symptoms had the highest association with autism. Autistic children with anxiety also exhibited elevated IU symptoms in all domains compared to those without anxiety; behavioral IU symptoms had the highest association with anxiety. IU symptom profiles should be considered in assessment and treatment.
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Affiliation(s)
- Amy Keefer
- Kennedy Krieger Institute, Center for Autism and Related Disorders, Baltimore, MD, US.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US.
| | - Vini Singh
- Kennedy Krieger Institute, Center for Autism and Related Disorders, Baltimore, MD, US
| | - Yeon Sik Jang
- Psychology Department, Georgetown University, Washington, DC, US
| | - Leigh Alon
- Psychology Department, Georgetown University, Washington, DC, US
| | - Madison Surmacz
- Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Calliope Holingue
- Kennedy Krieger Institute, Center for Autism and Related Disorders, Baltimore, MD, US
| | - Stewart H Mostofsky
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, US
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Roma A Vasa
- Kennedy Krieger Institute, Center for Autism and Related Disorders, Baltimore, MD, US
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
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5
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Cardon G, McQuarrie M, Calton S, Gabrielsen TP. Similar overall expression, but different profiles, of autistic traits, sensory processing, and mental health between young adult males and females. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 109:102263. [PMID: 37990737 PMCID: PMC10659573 DOI: 10.1016/j.rasd.2023.102263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Recent trends suggest that autism is more common in females than traditionally held. Additionally, some argue that females express autistic traits differently than males. Dimensional views of autism could shed light on these issues, especially with regards to understudied behavioral areas, such as sensory processing. We examined autistic traits, sensory processing, anxiety, and related behaviors in a large sample of neurotypical young adult males and females (n = 1,122; 556 female; ages 19-26). Participants completed an online survey containing questionnaires related to the above. Between groups statistical analyses, as well as within groups correlations and mediation analyses containing these constructs were then computed. We also carried out a cluster analysis to establish groups with behavioral similarities and estimate within-cluster male/female ratios. Results showed modest differences in the overall expression of autistic traits and sensory processing, if any, between males and females. Conversely, more detailed examination of survey subtests and mediation analyses revealed differing profiles between these groups. Cluster analysis uncovered a group comprised of both males (69.8%) and females (30.2%) who exhibited elevated degrees of autism-related behaviors, suggesting a higher proportion of females than would be predicted by traditional ratios. Taken together, these findings suggest that males and females may not differ as much as previously thought in their general levels of autistic traits or sensory processing, but may present with distinct profiles of such behaviors. These novel results add to our understanding of autistic traits in females and have the potential to positively influence diagnostic and support practices.
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Sáez-Suanes GP, García-Villamisar D, Del Pozo Armentia A. The role of intellectual disability and emotional regulation in the autism-depression relationship. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:1960-1967. [PMID: 36967538 DOI: 10.1177/13623613231161881] [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: 09/16/2023]
Abstract
LAY ABSTRACT Many people with autism and intellectual disability have significant levels of depressive symptoms. However, this relationship is not clear. For this reason, knowing the factors that are associated with having depression in autism and intellectual disability is important. Emotion regulation is associated with depression in autism spectrum disorder and intellectual disability. After evaluating a group of people with autism and intellectual disability, we found that people with mild intellectual disability have problems regulating their emotions which lead them to develop depressive symptoms. These findings suggest that interventions designed to prevent or reduce depressive symptoms in people with autism spectrum disorder and mild intellectual disability should include among their goals emotional regulation.
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7
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Dell’Osso L, Massoni L, Battaglini S, De Felice C, Nardi B, Amatori G, Cremone IM, Carpita B. Emotional dysregulation as a part of the autism spectrum continuum: a literature review from late childhood to adulthood. Front Psychiatry 2023; 14:1234518. [PMID: 37791135 PMCID: PMC10544895 DOI: 10.3389/fpsyt.2023.1234518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
The concept of emotional dysregulation (ED) has recently gained interest in the scientific literature and is commonly defined as the inability to use the modulatory mechanisms involved in emotion regulation, resulting in a functioning meaningfully below the baseline. Even though the data available are still limited, an increasing number of studies have hypothesized a promoting role for some of the core features of autism spectrum disorder (ASD) in the development of ED, in particular being repetitive behaviors, social difficulties and alexythimia. In this framework, the purpose of this study was to review the literature that is currently available about presence and correlates of ED in young adults with autism spectrum conditions as well as to offer some insights about possible implications for illness trajectories. The data reported seems to point to a shared etiology between ED and repetitive/restricted ASD symptoms, with perseveration features serving as the foundation for the inability to control one's emotions. In this context, a neurodevelopmental basis for ED could be consistent with the transnosographic conceptualization of ASD, which hypothesizes a potential neurodevelopmental basis for several psychiatric disorders, whose autistic traits would be the phenotypical presentation.
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Affiliation(s)
| | | | | | | | | | | | | | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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8
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Akkuş Y, Menekli T. Determining the Relationship Between Intolerance of Uncertainty and Attitudes Toward Complementary and Alternative Medicine in Patients With Cancer. Holist Nurs Pract 2023; 37:277-284. [PMID: 37595120 DOI: 10.1097/hnp.0000000000000600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
Disease-related uncertainty and the factors associated with uncertainty in patients with cancer have not been adequately investigated. This study aimed to determine the relationship between intolerance of uncertainty and attitudes toward complementary and alternative medicine (CAM) in patients with cancer. This cross-sectional descriptive study included 351 patients treated in the oncology clinic of a university hospital. All participants completed the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) and the 12-item Intolerance of Uncertainty Scale (IUS-12). Most patients (84.3%) said that they had information about CAM, 39.7% reported obtaining this information from their social environment, 83.2% said that they believed that CAM methods are effective, and 76.0% reported not telling health care professionals about their CAM use. Mean IUS-12 and HCAMQ total scores were 46.53 ± 2.05 and 32.11 ± 2.32, respectively, and showed a weak negative correlation. The patients in our study showed high intolerance of uncertainty and a moderately positive attitude toward CAM, and most patients did not notify health care professionals of their CAM use. Therefore, we recommend assessing intolerance of uncertainty and CAM use in this patient group. By identifying patients experiencing uncertainty and seeking different treatment, nurses can support patients physiologically, psychologically, and socially, and can explain the effects of CAM use.
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Affiliation(s)
- Yeliz Akkuş
- Department of Nursing, Health Science Faculty, Kafkas University, Kars, Turkey (Dr Akkuş); and Department of Nursing, Health Science Faculty, Turgut Ozal University, Malatya Turkey (Dr Menekli)
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9
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Vasa RA, Kerns CM, Singh V, McDonald R, Jang YS, Keefer A. Anxiety in autistic preschool children: Phenomenology and a network analysis of correlates. Autism Res 2023; 16:1561-1572. [PMID: 37350221 DOI: 10.1002/aur.2968] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/03/2023] [Indexed: 06/24/2023]
Abstract
Anxiety disorders in autistic children are associated with significant functional impairment. Few studies have examined impairing anxiety presentations in autistic preschool children (i.e., 3-5 years old). This cross-sectional study examined the phenomenology of impairing anxiety and the strongest correlates of anxiety in 75 autistic preschool children. Parents completed a diagnostic interview that assesses two anxiety types, DSM-5 anxiety disorders and impairing distinct anxiety presentations, and measures of anxiety correlates. An exploratory network analysis examined connections between anxiety and its correlates. Forty percent of children had impairing anxiety. Specific phobia followed by 'other social fear,' a type of distinct anxiety, were the most common anxiety types. Child intolerance of uncertainty (IU) was the only correlate that was associated with anxiety in a network analysis framework. Child IU linked anxiety to two other correlates, sensory over-responsivity and somatic symptoms. Findings emphasize the need for early intervention for anxiety and further research on its correlates.
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Affiliation(s)
- Roma A Vasa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Rachel McDonald
- Department of Psychology, Montclair State University, Montclair, New Jersey, USA
| | - Yeon Sik Jang
- Department of Psychology, Georgetown University, Washington D.C, USA
| | - Amy Keefer
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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10
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Crawford H. Social Anxiety in Neurodevelopmental Disorders: The Case of Fragile X Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:302-318. [PMID: 37470255 DOI: 10.1352/1944-7558-128.4.302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 10/04/2022] [Indexed: 07/21/2023]
Abstract
Despite significant advances in understanding and treating social anxiety in the general population, progress in this area lags behind for individuals with intellectual disability. Fragile X syndrome is the most common cause of inherited intellectual disability and is associated with an elevated prevalence rate of social anxiety. The phenotype of fragile X syndrome encompasses multiple clinically significant characteristics that are posed as risk markers for social anxiety in other populations. Here, evidence is reviewed that points to physiological hyperarousal, sensory sensitivity, emotion dysregulation, cognitive inflexibility, and intolerance of uncertainty as primary candidates for underlying mechanisms of heightened social anxiety in fragile X syndrome. A multilevel model is presented that provides a framework for future research to test associations.
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11
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Godara M, Everaert J, Sanchez-Lopez A, Joormann J, De Raedt R. Interplay between uncertainty intolerance, emotion regulation, cognitive flexibility, and psychopathology during the COVID-19 pandemic: a multi-wave study. Sci Rep 2023; 13:9854. [PMID: 37330557 PMCID: PMC10276821 DOI: 10.1038/s41598-023-36211-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 05/31/2023] [Indexed: 06/19/2023] Open
Abstract
The COVID-19 pandemic has created a significant mental health burden on the global population. Studies during the pandemic have shown that risk factors such as intolerance of uncertainty and maladaptive emotion regulation are associated with increased psychopathology. Meanwhile, protective factors such as cognitive control and cognitive flexibility have been shown to protect mental health during the pandemic. However, the potential pathways through which these risk and protective factors function to impact mental health during the pandemic remain unclear. In the present multi-wave study, 304 individuals (18 years or older, 191 Males), residing in the USA during data collection, completed weekly online assessments of validated questionnaires across a period of five weeks (27th March 2020-1st May 2020). Mediation analyses revealed that longitudinal changes in emotion regulation difficulties mediated the effect of increases in intolerance of uncertainty on increases in stress, depression, and anxiety during the COVID-19 pandemic. Further, individual differences in cognitive control and flexibility moderated the relationship between intolerance of uncertainty and emotion regulation difficulties. While intolerance of uncertainty and emotion regulation difficulties emerged as risk factors for mental health, cognitive control and flexibility seems to protect against the negative effects of the pandemic and promote stress resilience. Interventions aimed at enhancing cognitive control and flexibility might promote the protection of mental health in similar global crises in the future.
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Affiliation(s)
- Malvika Godara
- Department of Experimental, Clinical & Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium.
- Social Neuroscience Lab, Max Planck Society, Berlin, Germany.
| | - Jonas Everaert
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium
| | - Alvaro Sanchez-Lopez
- Department of Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, USA
| | - Rudi De Raedt
- Department of Experimental, Clinical & Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
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12
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Burnley A, St Clair M, Bedford R, Wren Y, Dack C. Understanding the prevalence and manifestation of anxiety and other socio-emotional and behavioural difficulties in children with Developmental Language Disorder. J Neurodev Disord 2023; 15:17. [PMID: 37322422 PMCID: PMC10268478 DOI: 10.1186/s11689-023-09486-w] [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: 01/16/2023] [Accepted: 05/30/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND It is well-documented that children with Developmental Language Disorder (DLD) have a higher likelihood of experiencing anxiety, as well as other socio-emotional and behavioural (SEB) difficulties. Despite this, there is little consensus as to how these difficulties manifest. This study aims to understand the prevalence of broader SEB difficulties and anxiety, informing intervention development by understanding the relationships between them. METHODS A mixed-methods, case-control study was conducted. First, an online survey was completed by 107 parents of either children with DLD ("DLD sample"; n = 57) or typically developing children ("typical sample"; n = 50), aged 6-12 years old. Binary SEB statements informed by previous qualitative work (e.g. "my child requires routine/sameness"; "my child has frequent tantrums") provided an insight into the prevalence of SEB difficulties in both DLD and typical samples. Validated measures of anxiety, emotion regulation, intolerance of uncertainty, insistence on sameness, family stress and coping mechanisms were also collected. Correlation and mediation analyses were run using these validated measures to understand the manifestation of anxiety in children with DLD in more detail. Qualitative interviews were then carried out with a select panel of survey respondents (n = 4). RESULTS The DLD sample scored significantly higher on all binary SEB statements than the typical sample: experiencing anxiety (80.7%, p < .05), requiring routine and sameness (75.4%, p < .001) and emotional dysregulation (75.4%; p < .001) were the most common difficulties reported for children with DLD. Using the validated scales, family stress and coping mechanisms were found to only correlate with the manifestation of anxiety in the typical group, not the DLD group. "Intolerance of uncertainty" and "insistence on sameness" were found to fully mediate the relationship between DLD diagnosis and symptoms of anxiety. Parent's interviews provided contextual support for the analysis, as well as highlighting sensory sensitivities as a focus for future research. CONCLUSIONS Parents of children with DLD appear to cope well with their children's complex SEB needs. Intervention focussing on intolerance of uncertainty may help the management of difficulties with anxiety. Behaviours such as insistence on sameness should be investigated further, as potential indicators for anxiety amongst children with DLD.
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Affiliation(s)
- Annabel Burnley
- Department of Psychology, University of Bath, Bath, Somerset County UK
| | - Michelle St Clair
- Department of Psychology, University of Bath, Bath, Somerset County UK
| | - Rachael Bedford
- Department of Psychology, University of Bath, Bath, Somerset County UK
| | - Yvonne Wren
- Bristol Dental School, University of Bristol, Bristol, Bristol County UK
| | - Charlotte Dack
- Department of Psychology, University of Bath, Bath, Somerset County UK
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13
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Muniandy M, Richdale AL, Arnold SRC, Trollor JN, Lawson LP. Brief Report: Longitudinal Role of Coping Strategies on Mental Health Outcomes in Autistic Youth and Adults. J Autism Dev Disord 2023:10.1007/s10803-023-05953-4. [PMID: 37017862 DOI: 10.1007/s10803-023-05953-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 04/06/2023]
Abstract
The stress literature suggests that coping strategies are implicated in mental health outcomes. However, the longitudinal relationship between coping strategies and mental health in the autistic adult population has not yet been examined. This 2-year longitudinal study examined the predictive role of both baseline and change in coping strategy use over time (i.e., an increase or decrease) on anxiety, depression, and well-being after 2-years in 87 autistic adults aged 16 to 80 years. Controlling for baseline mental health, both baseline and increase in disengagement coping strategies (e.g., denial, self-blame) predicted higher anxiety and depression, and lower well-being, while an increase in engagement coping strategies (e.g., problem solving, acceptance) predicted higher well-being. These findings extend the current coping literature in autistic adults, offering insight into mental health support and intervention options.
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Affiliation(s)
- Melanie Muniandy
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
| | - Samuel R C Arnold
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, 34 Botany St, Sydney, NSW, 2052, Australia
| | - Julian N Trollor
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, 34 Botany St, Sydney, NSW, 2052, Australia
| | - Lauren P Lawson
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
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14
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Qiu H, Lu H, Pei J, Zhang Y, Ma Y, Xing C, Wang X, Zhu X. Effects of chronic stress on smartphone addiction: A moderated mediation model. Front Public Health 2023; 11:1048210. [PMID: 36741954 PMCID: PMC9895953 DOI: 10.3389/fpubh.2023.1048210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
Introduction Based on the compensatory Internet use theory and diathesis-stress model, the present study explores the effects of chronic stress on smartphone addiction (SPA). As intolerance of uncertainty and emotion-related variables are important factors that affect addictive behavior, we explore the mediating role of intolerance of uncertainty and the moderating role of emotion differentiation. Methods We conducted a questionnaire survey of 286 participants (13.64% female; M age = 22.88; SD = 3.77; range = 17-39) on chronic stress, SPA, intolerance of uncertainty, and emotion differentiation. SPSS 28.0 was used to analyze the descriptive statistics and correlations and test the moderated mediation model. Results We find that (1) intolerance of uncertainty, SPA, and chronic stress are positively correlated with each other. Positive emotion differentiation is positively correlated with intolerance of uncertainty and negative emotion differentiation. (2) Intolerance of uncertainty plays a mediating role in chronic stress and SPA. (3) Positive emotion differentiation significantly moderates the relationship between chronic stress and SPA. Under the condition of low positive emotion differentiation, chronic stress is more effective in predicting SPA. Discussion These findings may contribute to intervention and prevention programs for SPA. Thus, the intervention and prevention of SPA can start from two directions-reduce the intolerance of uncertainty and enhance the ability to experience positive emotion differentiation.
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Affiliation(s)
- Huake Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Hongliang Lu
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Jiawei Pei
- Outpatient Department, 969 Hospital of PLA, Hohhot, China
| | - Yajuan Zhang
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Yongjie Ma
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Chen Xing
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Xinlu Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi'An, China,*Correspondence: Xia Zhu ✉
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15
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Sáez-Suanes GP, García-Villamisar D, Pozo Armentia AD. Does the gender matter?: Anxiety symptoms and emotion dysregulation in adults with autism and intellectual disabilities. Autism Res 2023; 16:113-121. [PMID: 36271821 PMCID: PMC10092007 DOI: 10.1002/aur.2839] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/12/2022] [Indexed: 01/14/2023]
Abstract
Research shows high rates of anxious symptoms in people autistic spectrum disorder (ASD). Finding factors related to the development of anxiety in ASD is necessary. Emotion regulation (ER) is associated with anxiety in ASD. Moreover, some studies find higher rates of anxiety in women with ASD. A total of 121 adults (M = 35.46 years, SD = 9.46) with ASD and intellectual disabilities were evaluated to verify moderating role of gender and mediating role of ER. A moderated mediation analysis supported the moderated role of gender in the relationship mediated by emotional dysregulation between ASD and anxiety. These findings suggest that interventions designed to prevent or reduce anxiety symptoms in women with ASD should include among their goals emotional regulation. LAY SUMMARY: If we want to reduce or prevent anxiety symptoms in women with ASD we must work on emotional regulation.
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Affiliation(s)
- Gema P Sáez-Suanes
- Department of Developmental and Educational Psychology, Faculty of Teacher Training and Education, Universidad Autónoma de Madrid, Madrid, Spain
| | - Domingo García-Villamisar
- Departmental Unit of Personality, Assessment and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Araceli Del Pozo Armentia
- Departmental Unit of Personality, Assessment and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
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16
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Preliminary efficacy of cognitive-behavioral therapy on emotion regulation in adults with autism spectrum disorder: A pilot randomized waitlist-controlled study. PLoS One 2022; 17:e0277398. [PMID: 36417403 PMCID: PMC9683545 DOI: 10.1371/journal.pone.0277398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/11/2022] [Indexed: 11/26/2022] Open
Abstract
Previous studies have demonstrated the clinical utility of cognitive-behavioral therapy in improving emotion regulation in children on the autism spectrum. However, no studies have elucidated the clinical utility of cognitive-behavioral therapy in improving emotion regulation in autistic adults. The aim of the present pilot study was to explore the preliminary clinical utility of a group-based cognitive-behavioral therapy program designed to address emotion regulation skills in autistic adults. We conducted a clinical trial based on a previously reported protocol; 31 participants were randomly allocated to the intervention group and 29 to the waitlist control group. The intervention group underwent an 8-week program of cognitive-behavioral therapy sessions. Two participants from the intervention group withdrew from the study, leaving 29 participants (93.5%) in the group. Compared with the waitlist group, the cognitive-behavioral therapy group exhibited significantly greater pre-to-post (Week 0-8) intervention score improvements on the attitude scale of the autism spectrum disorder knowledge and attitude quiz (t = 2.21, p = 0.03, d = 0.59) and the difficulty describing feelings scale of the 20-item Toronto Alexithymia Scale (t = -2.07, p = 0.04, d = -0.57) in addition to pre-to-follow-up (Week 0-16) score improvements on the emotion-oriented scale of the Coping Inventory for Stressful Situations (t = -2.14, p = 0.04, d = -0.59). Our study thus provides preliminary evidence of the efficacy of the group-based cognitive-behavioral therapy program on emotion regulation in autistic adults, thereby supporting further evaluation of the effectiveness of the cognitive-behavioral therapy program in the context of a larger randomized clinical trial. However, the modest and inconsistent effects underscore the importance of continued efforts to improve the cognitive-behavioral therapy program beyond current standards.
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17
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Conner CM, Kim PS, White SW, Mazefsky CA. The role of emotion dysregulation and intolerance of uncertainty in autism: Transdiagnostic factors influencing co-occurring conditions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 130:104332. [PMID: 36116227 DOI: 10.1016/j.ridd.2022.104332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 07/11/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Individuals with autism spectrum disorders (ASD) are more likely to have co-occurring psychiatric conditions such as depression and anxiety. Transdiagnostic constructs such as intolerance of uncertainty (IU) and emotion dysregulation (ED) have both been shown to be individually associated with depression and anxiety in those with ASD. AIMS The current study examined the relationship between IU and ED, depression, and anxiety in an ED treatment-seeking sample and examined whether ED acts as a mediator between IU-depression and IU-anxiety. METHODS AND PROCEDURES We examined baseline scores for 78 adolescents and young adults (12-21 years old) who were participating in an ED treatment. We assessed for correlations between IU, Reactivity and Dysphoria, anxiety, and depression symptoms, and then conducted mediation analyses to determine whether Reactivity and Dysphoria functioned as a mediator in IU- anxiety and IU- depression relationships. OUTCOMES AND RESULTS Concordant with prior research, ED, IU, anxiety, and depression scores were correlated. Both Reactivity and Dysphoria were found to mediate both IU-depression and IU-anxiety. CONCLUSIONS AND IMPLICATIONS Findings suggest that ED contributes to how IU affects psychopathology. Furthermore, both IU and ED may be pertinent treatment targets for individuals with depression or anxiety and ASD.
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Affiliation(s)
- Caitlin M Conner
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Paul S Kim
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Carla A Mazefsky
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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18
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Muniandy M, Richdale AL, Lawson LP. Coping-resilience profiles and experiences of stress in autistic adults. Autism Res 2022; 15:2149-2166. [PMID: 36114687 PMCID: PMC9826183 DOI: 10.1002/aur.2817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/01/2022] [Indexed: 01/11/2023]
Abstract
Emerging studies allude to high stress in autistic adults. Considering the detrimental impact of stress on health outcomes, examining individual resources which may influence the extent to which stress is experienced (e.g., coping and resilience) is vital. Using a person-focused approach, this study aimed to identify coping-resilience profiles, and examine their relations to general perceived stress and daily hassles in a sample of autistic adults (N = 86; aged 19-74 years). Cluster analysis identified four coping-resilience profiles (i.e., high cope/ low resilience, low cope/ high resilience, engage cope/ high resilience, and disengage cope/ low resilience). The high cope/ low resilience and disengage cope/ low resilience groups had significantly higher general perceived stress than the remaining groups. No significant group differences were noted in relation to daily hassles. Jointly addressing coping and resilience may be beneficial on the perceived stress experienced in autistic adults. The use of coping-resilience profiles may also allow for the personalization of stress management and support options in the autistic adult population.
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Affiliation(s)
- Melanie Muniandy
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityBundooraVictoriaAustralia,Cooperative Research Centre for Living with Autism (Autism CRC), The University of QueenslandBrisbaneAustralia
| | - Amanda L. Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityBundooraVictoriaAustralia,Cooperative Research Centre for Living with Autism (Autism CRC), The University of QueenslandBrisbaneAustralia
| | - Lauren P. Lawson
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityBundooraVictoriaAustralia,Cooperative Research Centre for Living with Autism (Autism CRC), The University of QueenslandBrisbaneAustralia
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19
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Carmassi C, Conti L, Gravina D, Nardi B, Dell'Osso L. Emotional dysregulation as trans-nosographic psychopathological dimension in adulthood: A systematic review. Front Psychiatry 2022; 13:900277. [PMID: 36104987 PMCID: PMC9464828 DOI: 10.3389/fpsyt.2022.900277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Emotional dysregulation (ED) is characterized by inappropriate emotional reactions related to environmental or cognitive stimuli. In most recent years, increasing interest has been devoted to its definition and detection across mental disorders for its detrimental role progressively highlighted in both neurodevelopment and adult mental disorders, with implications on the severity of clinical manifestations. The aim of this systematic review was to evaluate and gather the scientific evidence about ED in adult psychiatric population to elucidate the concept of ED as trans-nosographic entity. Methods The electronics databases PubMed, Scopus and Web of Science was reviewed to identify studies in accordance with the PRISMA guidelines; at the end of the selection process a total of 29 studies (N = 709; N = 658; N = 1,425) was included. All studies included assessed the presence of ED symptoms, by means of a validate scale in adult (>18 years of age), in clinically diagnosed patients as well as healthy control participants. Results Our results suggest ED as a trans-diagnostic factor across multiple mental disorders, such as bipolar disorder, attention deficit hyperactivity disorder, autism spectrum disorder, personality disorders; a better definition of this concept could be helpful to interpret and clarify many clinical cases and improve their diagnostic and therapeutic management.
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Affiliation(s)
| | - Lorenzo Conti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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20
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Radoeva PD, Ballinger K, Ho T, Webb SJ, Stobbe GA. Brief Report: Risk and Protective Factors Associated with Depressive Symptoms among Autistic Adults. J Autism Dev Disord 2022; 52:2819-2824. [PMID: 34189682 PMCID: PMC10027384 DOI: 10.1007/s10803-021-05085-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 11/28/2022]
Abstract
Autistic individuals are at risk for developing depression though the risk and protective factors for co-occurring depression in autistic individuals are not yet fully characterized. In this retrospective medical chart review study, we explored factors associated with self-reported depressive symptoms (Patient Health Questionnaire-9) in autistic adults (N = 58). For autistic adults, engagement in one or more activities (recreational, educational and/or vocational) was associated with less severe depressive symptoms (Mann-Whitney U test, p = 0.006); and reported family history of depression/anxiety was associated with increased likelihood of suicidal ideation (Chi-square test, p = 0.027). Promotion of community-based activities and family support systems may be an integral part of creating effective treatment plans for depressive symptoms in autistic adults.
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Affiliation(s)
- Petya D Radoeva
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Emma Pendleton Bradley Hospital, East Providence, RI, USA.
| | - Kristen Ballinger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Theodore Ho
- Seattle Children's Autism Center, Seattle, WA, USA
| | - Sara J Webb
- Seattle Children's Autism Center, Seattle, WA, USA
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, USA
| | - Gary A Stobbe
- Seattle Children's Autism Center, Seattle, WA, USA
- Adult Autism Clinic, University of Washington, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
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21
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Regulating Together: Emotion Dysregulation Group Treatment for ASD Youth and Their Caregivers. J Autism Dev Disord 2022; 53:1942-1962. [PMID: 35141815 PMCID: PMC10126211 DOI: 10.1007/s10803-022-05461-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2022] [Indexed: 12/13/2022]
Abstract
Individuals with autism spectrum disorder (ASD) experience behavioral and emotional symptoms hypothesized to arise from emotion dysregulation (ED), difficulty modulating emotional experience, expression, and intensity in an acceptable and contextually appropriate manner. We developed Regulating Together (RT)-an intensive-outpatient, caregiver-assisted group program to meet the ASD + ED intervention critical need. A within-subjects trial was conducted (5-week-control lead-in period, 5-week-treatment, and 5-and 10-weeks-post-treatment follow-ups). Forty-four youth with ASD + ED (25 8-12, 19 13-18 yr-olds, 88% male, mean FSIQ of 96) participated. Improvements were found in reactivity, emotion regulation knowledge, and flexibility post-treatment and 10-weeks post-treatment. A reduction in inpatient hospitalization rates by 16% from the 12 months pre-RT to 12 months post-RT was observed. RT shows promise to reduce ED in ASD.
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22
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Mutluer T, Aslan Genç H, Özcan Morey A, Yapici Eser H, Ertinmaz B, Can M, Munir K. Population-Based Psychiatric Comorbidity in Children and Adolescents With Autism Spectrum Disorder: A Meta-Analysis. Front Psychiatry 2022; 13:856208. [PMID: 35693977 PMCID: PMC9186340 DOI: 10.3389/fpsyt.2022.856208] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/29/2022] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED Psychiatric comorbidity in autism spectrum disorder (ASD) is a subject of critical scientific importance, affecting the quality of life, prognosis, and functional outcomes. The prevalence of psychiatric disorders vary considerably according to variables such as index subject characteristics, study setting, sampling frame, diagnostic methods used, as well as country of geographic origin. To date, most studies comprise clinical or treatment referral samples in tertiary care or subjects enrolled in clinical trials and genetic cohort collections. Such samples carry the potential for overestimation of both the frequency and severity of psychiatric comorbidity. A systematic literature search was performed using PubMed and Web of Science databases restricted to population-based study publications in the English between May 1, 2015, and May 31, 2020. A comprehensive keyword list was generated to investigate co-occurrence of psychiatric disorders in children and adolescents with ASD. A wide range of DSM-5 based disorders such as anxiety, mood, ADHD, intellectual disability/intellectual developmental disorder, eating/feeding, gender dysphoria and sleep-wake disorders were assessed. Initial search revealed a total of 1674 articles after removal of duplicates. Two independent researchers conducted a parallel-blinded screening process to identify the eligible studies based on titles and abstracts; 39 studies were analyzed in the current review. The main findings show prevalence estimates of 22.9% (95% CI: 17.7- 29.2) for intellectual disability; 26.2% (22-31) for attention-deficit hyperactivity disorder; 11.1% (8.6-14.1) for anxiety disorders; 19.7% (11.9-30.7) for sleep disorders; 7% (5.2- 9.3) for disruptive disorders; 2% (1.3- 3.1) for bipolar disorders; 2.7% (1.8- 4.2) for depression; 1.8% (0.4-8.7) for obsessive-compulsive disorder; and 0.6% (0.3-1.1) for psychosis. Psychiatric comorbidity in population-based studies is lower than in clinical and referred samples. However, our results also indicate that the frequency of psychiatric comorbidity in children and adolescents with ASD in the population context is considerable, without the influence of referral bias implicit in clinical and treatment samples. There is a need for better targeted diagnostic tools to detect psychiatric comorbidity in children and youth in future population-based studies, as an essential component in providing care as well as new insights into the nature and mechanisms of its underlying associations. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021234464].
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Affiliation(s)
- Tuba Mutluer
- Department of Psychiatry, School of Medicine, Koç University, Istanbul, Turkey.,Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | - Herdem Aslan Genç
- Division of Child and Adolescent Psychiatry, Koç University Hospital, Istanbul, Turkey
| | - Aslihan Özcan Morey
- Division of Child and Adolescent Psychiatry, Koç University Hospital, Istanbul, Turkey
| | - Hale Yapici Eser
- Department of Psychiatry, School of Medicine, Koç University, Istanbul, Turkey.,Research Center for Translational Medicine (KUTTAM), Koç University, Istanbul, Turkey
| | | | - Merve Can
- Department of Child and Adolescent Psychiatry, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Mental Health and Nervous Disorders, Istanbul, Turkey
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
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23
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Yao R, Wu W. Mental Disorders Associated with COVID-19 Related Unemployment. APPLIED RESEARCH IN QUALITY OF LIFE 2022; 17:949-970. [PMID: 33968280 PMCID: PMC8096626 DOI: 10.1007/s11482-021-09950-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/12/2021] [Indexed: 05/13/2023]
Abstract
In response to the COVID-19 pandemic, restrictions on economic activities have resulted in a sharp rise of unemployment. The purpose of this research is to explore mental disorders associated with COVID-19 related unemployment using a large, nationally representative dataset, the 2020 COVID-19 Household Pulse Survey. ANOVA with post hoc tests (Tukey HSD) are utilized to reveal the mean difference of mental disorders between various employment status, as well as between reasons of unemployment. Binary logit model is used to investigate the potential effect of different reasons of unemployment on mental disorders. Individuals who were not working during the pandemic due to involuntary reasons had higher probabilities of mental disorders than those who were working and those who voluntarily separated from work. Among respondents who were not working due to COVID-19 related reasons, respondents whose employer went out of business were the most likely to experience mental disorders. Household job uncertainty in the next four weeks positively contributed to mental disorders. Government should consider measures to contain the spread of virous while keeping as many people employed as possible. Government should also consider providing adequate financial and counseling assistance to individuals who are in the greatest need for such support.
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Affiliation(s)
- Rui Yao
- Department of Personal Financial Planning, University of Missouri, 239B Stanley Hall, Columbia, MO 65211 USA
| | - Weipeng Wu
- Department of Personal Financial Planning, University of Missouri, 240A Stanley Hall, Columbia, MO 65211 USA
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24
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Jean FA, Jouni A, Bouvard MP, Camelot G, Beggiato A, Scheid I, Gaman A, Bouquet C, Ly-Le Moal M, Houenou J, Delorme R, Leboyer M, Amestoy A. Overlap of anxiety, depression, irritability and aggressiveness in autism spectrum disorder: an exploratory study using cluster analysis. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-08-2020-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to explore the overlap between symptoms of depression, anxiety, irritability and aggressiveness in autism spectrum disorder (ASD), to measure specific and idiosyncratic emotional responses.
Design/methodology/approach
A total of 42 high functioning adolescents and adults, between 12 and 39 years old, meeting the diagnostic and statistical manual of mental disorders – 5 criteria for ASD were selected from the InFoR Autism cohort. Data were analyzed in an exploratory way using Hill and Smith and K-medoids cluster analysis.
Findings
The authors found an aggregation of anxiety, depression, aggressive behaviors and irritability. Cluster analysis was maximized for two groups with 17 and 25 participants, respectively. The first group was characterized by high levels of symptoms of irritability, aggressiveness, hyperactivity and intermediate levels of anxiety and depression. In the first group, participants had significantly higher levels of autistic symptoms considering the social responsiveness scale and repetitive behavior scale-revised scales (relatives’ reports) suggesting that a particular group of subjects with a high level of ASD specific symptoms may express anxiety and depression in a specific way based on externalizing behaviors in addition to the common mood and anxiety symptoms.
Research limitations/implications
Improved understanding of the aggregation of externalized symptoms with symptoms of anxiety and mood disorders in ASD should lead to a better understanding of the underlying mechanisms related to emotion dysregulation in ASD.
Practical implications
Improved knowledge of the symptoms could lead to enhanced detection of psychiatric comorbidities in ASD.
Originality/value
The study was based on a transdiagnostic approach of psychiatric symptoms in individuals with ASD. Aggregation and clustering analysis was used to explore naive patterns of these psychiatric symptoms.
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25
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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 2021; 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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorder shares many symptoms with other mental health disorders, and comorbid disorders such as mood and anxiety disorders are common, making the diagnostic process challenging. We aimed to explore the diagnostic accuracy of two standard autism spectrum disorder diagnostic instruments and to identify those behavioral items that best differentiate between autism spectrum disorder and mood and anxiety disorder in a naturalistic sample of patients utilizing autism spectrum disorder specialist services. The study included data of 847 participants (5–65 years of age, n = 586 with autism spectrum disorder, n = 261 with mood and anxiety disorder) all evaluated with the Autism Diagnostic Observation Schedule in the context of the diagnostic process. Data of the Autism Diagnostic Interview–Revised were available for 428 participants (5–51 years of age, n = 367 with autism spectrum disorder, n = 61 with mood and anxiety disorder). By means of binominal logistic regressions and an ensemble feature selection, we identified a subset of items that best differentiated between autism spectrum disorder and mood and anxiety disorder. Overall, the results indicate that a combination of communicational deficits and unusual and/or inappropriate social overtures differentiates autism spectrum disorder and mood and anxiety disorder. Aspects of social cognition are also relevant. Limitations of the current study and implications for research and practice are discussed.
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26
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Huang Y, Arnold SRC, Foley KR, Trollor JN. Choose your Own Adventure: Pathways to Adulthood Autism Diagnosis in Australia. J Autism Dev Disord 2021; 52:2984-2996. [PMID: 34241747 DOI: 10.1007/s10803-021-05169-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2021] [Indexed: 02/02/2023]
Abstract
Pathways to diagnosis in adulthood are poorly understood. Even less is known about undiagnosed adults who believe they may be autistic. This mixed-methods online survey examined adults' journeys from initial concern to receiving the diagnosis. Quantitative findings showed the diagnostic process to be highly heterogeneous. Qualitative analysis identified desires for explanation and support as motives for seeking diagnosis. Cost and fear of not being taken seriously were major barriers, echoed by qualitative responses that described the process as confusing, expensive and time-consuming. While most participants were satisfied with the diagnosis, their emotional reactions were complex. Findings support the need for thoroughly implementing national guidelines, and for improved knowledge and communication in mainstream clinicians encountering clients with possible autism characteristics.
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Affiliation(s)
- Yunhe Huang
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, NSW, 2052, Australia
- The Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
| | - Samuel R C Arnold
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, NSW, 2052, Australia.
- The Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia.
| | - Kitty-Rose Foley
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, NSW, 2052, Australia
- School of Health and Human Sciences, Southern Cross University, Gold Coast, QLD, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, NSW, 2052, Australia
- The Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
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27
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Yan Y, Zhang J, Dong S. Influence of Childhood Family Routines on Adult Depression: A Cross Sectional Study. Front Psychol 2021; 12:654433. [PMID: 34290646 PMCID: PMC8288247 DOI: 10.3389/fpsyg.2021.654433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/28/2021] [Indexed: 12/02/2022] Open
Abstract
In order to explore the influence of childhood family routines on adult depression and the mediating role of tolerance of uncertainty and rumination, the current study tested 818 participants by adopting four questionnaires. The results of structural equation modeling revealed that (1) family routines had a negative effect on depression among Chinese college students; (2) family routines were found to have a positive effect on tolerance of uncertainty, and tolerance of uncertainty was a bridge linking family routines and depression; (3) family routines had a significant effect on depression through rumination; (4) the relationship between family routines and depression was partially mediated by the chain of tolerance of uncertainty and rumination. The result reveals not only the fact that childhood family routines have significant influence on college students' depression but also the mechanism of childhood family routines that affect college students' depression. The limitations and implications of our study were also discussed.
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Affiliation(s)
- Yuzhi Yan
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Junyi Zhang
- Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Shenghong Dong
- School of Psychology, Jiangxi Normal University, Nanchang, China
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28
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Lei J, Russell A. Understanding the role of self-determination in shaping university experiences for autistic and typically developing students in the United Kingdom. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1262-1278. [PMID: 33535817 PMCID: PMC8264627 DOI: 10.1177/1362361320984897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
LAY ABSTRACT Prior research suggests that autistic students in higher education might struggle with developing autonomy, competence and establish relatedness due to their executive functioning and social communication difficulties. We interviewed 18 autistic and 18 typically developing students to explore how students perceived themselves to be in control of their university experience. Both groups provided anecdotal examples that supported similar perceptions of self-determination in shaping the academic, daily living and socialisation aspects of university life. Autistic students reflected on their cognitive strengths such as attention to detail, persistence and ability to tailor their academic studies towards their interest. Varying degrees of sociability were noted, with some autistic students preferring to focus their self-determination efforts on academic success, while others treasured the novel social experiences including peer support and friendship at university. Compared to greater flexibility endorsed by typically developing students, autistic students perceived establishing a routine at university to be a necessity and were self-determined in maintaining stability amid a sea of change. Recognising strengths and self-determination efforts in autistic students can help stakeholders support their personal development towards independent living and self-sufficiency in adulthood and to successfully transition into, through and out of university.
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Affiliation(s)
- Jiedi Lei
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, UK
- King’s College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London, UK
| | - Ailsa Russell
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, UK
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Underlying Thinking Pattern Profiles Predict Parent-Reported Distress Responses in Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:2112-2131. [PMID: 34052971 DOI: 10.1007/s10803-021-05092-8] [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: 05/14/2021] [Indexed: 10/20/2022]
Abstract
Appreciating autistic neurodiversity is important when supporting autistic people who experience distress. Specifically, use of a profiling model can reveal less visible autistic differences, including strengths and abilities. Binary logistic regressions showed that the likelihood of extreme distress responses could be interpreted based on parent-reported autistic thinking pattern profiles for 140 young people. Perspective-taking (specifically empathy), extreme demand avoidance, and over-sensory sensitivity each contributed to the combined regression models. From the clinical perspective of autism as a multi-dimensional and inter-connected construct, there may be implications for planning support and building positive self-understanding. Individually tailored adjustments and support strategies may be identified more easily after delineating variables found across four core aspects: sensory coherence, flexible thinking, perspective-taking, and regulation.
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30
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Clark M, Adams D. Parent perspectives of what helps and hinders their child on the autism spectrum to manage their anxiety. CLIN PSYCHOL-UK 2021. [DOI: 10.1111/cp.12223] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Megan Clark
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Queensland, Australia,
- Griffith Institute for Educational Research, Griffith University, Brisbane, Queensland, Australia,
| | - Dawn Adams
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Queensland, Australia,
- Griffith Institute for Educational Research, Griffith University, Brisbane, Queensland, Australia,
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31
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Rumball F, Antal K, Happé F, Grey N. Co-occurring mental health symptoms and cognitive processes in trauma-exposed ASD adults. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 110:103836. [PMID: 33453693 DOI: 10.1016/j.ridd.2020.103836] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/24/2020] [Accepted: 12/12/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Mental health problems are common amongst adults with an Autism Spectrum Disorder (ASD). Stressful and traumatic life events can trigger or exacerbate symptoms of anxiety, depression and PTSD. In the general population, transdiagnostic processes such as suppression and perseverative thinking are associated with responses to trauma and mental health symptoms. AIMS This study explored the relationships between thought suppression, perseverative thinking and symptoms of depression, anxiety and PTSD in ASD adults who reported exposure to a range of DSM-5 and non-DSM-5 traumatic events. METHODS 59 ASD adults completed a series of online self-report questionnaires measuring trauma, transdiagnostic cognitive processes, and mental health symptoms. RESULTS Probable PTSD rarely occurred in isolation and was associated with depression and anxiety symptoms in trauma-exposed ASD adults. All cognitive processes and mental health symptoms were positively associated with one another, regardless of whether the trauma met DSM-5 PTSD Criterion A. When accounting for both cognitive processes, only thought suppression significantly predicted PTSD and anxiety symptoms, while only perseverative thinking significantly predicted depression symptoms. CONCLUSIONS AND IMPLICATIONS These preliminary results suggest that different cognitive processes more strongly affect anxiety/PTSD versus depression symptom severity in trauma-exposed ASD adults, although co-occurring symptoms are common. Implications for assessment, treatment and future research are discussed.
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Affiliation(s)
- Freya Rumball
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience - PO80, De Crespigny Park, Denmark Hill, London, SE5 8AF, United Kingdom.
| | - Kinga Antal
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience - PO80, De Crespigny Park, Denmark Hill, London, SE5 8AF, United Kingdom
| | - Francesca Happé
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience - PO80, De Crespigny Park, Denmark Hill, London, SE5 8AF, United Kingdom
| | - Nick Grey
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience - PO80, De Crespigny Park, Denmark Hill, London, SE5 8AF, United Kingdom; Sussex Partnership NHS Foundation Trust, United Kingdom
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32
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Steele M, Uljarević M, Rached G, Frazier TW, Phillips JM, Libove RA, Busch RM, Klaas P, Martinez-Agosto JA, Srivastava S, Eng C, Sahin M, Hardan AY. Psychiatric Characteristics Across Individuals With PTEN Mutations. Front Psychiatry 2021; 12:672070. [PMID: 34489750 PMCID: PMC8418135 DOI: 10.3389/fpsyt.2021.672070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/27/2021] [Indexed: 11/13/2022] Open
Abstract
Germline heterozygous PTEN mutations have been associated with high prevalence of autism spectrum disorder (ASD) and elevated rates and severity of broadly defined behavioral problems. However, limited progress has been made toward understanding whether PTEN mutation is associated with specific psychiatric co-morbidity profiles when compared to idiopathic ASD. The current study aimed to utilize a cross-measure approach to compare concurrent psychiatric characteristics across children and adolescents with PTEN mutation with (PTEN-ASD; n = 38) and without ASD (PTEN-No ASD; n = 23), and ASD with macrocephaly but no PTEN mutation (macro-ASD; n = 25) using the Child Behavior Checklist (CBCL) and the Aberrant Behavior Checklist (ABC). There were significant group effects for the CBCL Internalizing and Externalizing broad symptom score, the majority of specific CBCL syndrome scores, and all ABC subscale scores. Post-hoc comparisons revealed greater behavioral symptoms in the ASD groups (PTEN-ASD and macro-ASD) compared to the PTEN-no ASD group on nearly all subtest scores examined. There were no statistically significant differences between the PTEN-ASD and macro-ASD groups; however, there was a trend for the macro-ASD group showing higher levels of aggressive behaviors. Our findings provide evidence of specific behavior profiles across PTEN-No ASD, PTEN-ASD, and macro-ASD groups and highlight the importance of early identification of behavioral vulnerabilities in individuals with PTEN mutations in order to provide access to appropriate evidence-based interventions.
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Affiliation(s)
- Morgan Steele
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Mirko Uljarević
- The School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.,La Trobe University, Melbourne, VIC, Australia
| | - Gaëlle Rached
- Saint Joseph University, Faculty of Medicine, Beirut, Lebanon
| | - Thomas W Frazier
- Autism Speaks, New York, NY, United States.,Department of Psychology, John Carroll University, University Heights, OH, United States
| | - Jennifer M Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Robin A Libove
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Robyn M Busch
- Genomic Medicine Institute, Cleveland, OH, United States.,Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Patricia Klaas
- Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Julian A Martinez-Agosto
- Departments of Human Genetics, Pediatrics and Psychiatry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Siddharth Srivastava
- Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Charis Eng
- Genomic Medicine Institute, Cleveland, OH, United States.,Department of Genetics and Genome Sciences, Case Western University School of Medicine, Cleveland, OH, United States
| | - Mustafa Sahin
- Department of Neurology, Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
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33
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Pickard H, Hirsch C, Simonoff E, Happé F. Exploring the cognitive, emotional and sensory correlates of social anxiety in autistic and neurotypical adolescents. J Child Psychol Psychiatry 2020; 61:1317-1327. [PMID: 32115711 PMCID: PMC7116440 DOI: 10.1111/jcpp.13214] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Social anxiety is common in autistic adolescents. While emerging evidence indicates the importance of several mechanisms (including intolerance of uncertainty (IU), alexithymia and sensory processing) for maintaining anxiety, limited research has explored how these factors are associated with social anxiety in autistic adolescents. METHODS We investigated whether IU, emotional and sensory processing are related to social anxiety in autistic and neurotypical adolescents, gathering experimental and questionnaire data from 61 autistic and 62 neurotypical 11- to 17-year-olds recruited to have similarly high levels of anxiety. RESULTS In autistic and neurotypical adolescents matched for social anxiety, similar significant associations were observed between social anxiety and IU, alexithymia, maladaptive emotion regulation, sensory hypersensitivity and interoceptive sensibility. Taking a dimensional approach, we found that child- and parent-reported IU, alexithymia and sensory hypersensitivity mediated the relationship between autistic traits and social anxiety symptoms in the combined group of adolescents. CONCLUSIONS Our findings indicate that similar correlates of social anxiety are evident in autistic and neurotypical youths experiencing social anxiety and further our understanding of mechanisms that may contribute towards social anxiety in both groups.
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Affiliation(s)
- H Pickard
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - C Hirsch
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - E Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - F Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
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Abstract
This study examined age trends in anxious and depressive symptoms, from older adolescence to old age, and explored the association between anxious and depressive symptoms with gender, ASD severity, and socio-economic factors. Two hundred and fifty-five individuals with ASD (151 males, Mage = 33.52 years, SDage = 14.98) took part. More than one-third of participants reported clinically significant anxiety (38.4%) or depression (38%). A slight trend for an increase in the severity of both anxiety and depression from adolescence to middle adulthood, and then a slight decline in older adulthood was found. Female gender and higher ASD severity predicted more anxiety and depression symptoms. Our findings emphasise the need to provide timely assessment and treatment of anxiety and depression in ASD.
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35
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Sáez-Suanes GP, García-Villamisar D, Del Pozo Armentia A, Dattilo J. Emotional dysregulation and uncertainty intolerance as transdiagnostic mediators of anxiety in adults with autism spectrum disorders and intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 106:103784. [PMID: 33022552 DOI: 10.1016/j.ridd.2020.103784] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND There is extensive documentation supporting the comorbidity of anxiety and autistic spectrum disorder (ASD). Transdiagnostic factors such as executive functions, emotion regulation, and uncertainty intolerance are associated with anxiety in ASD. AIM The primary aim of this paper is to study anxiety symptoms in adults with ASD and ID and their relationship with transdiagnostic variables. METHOD 121 adults (M = 35.46 years, SD = 9.46) with ASD and intellectual disabilities (ID) were evaluated to determine the predictive and mediating role of executive functioning, emotional regulation and intolerance to uncertainty. RESULTS Hierarchical linear regression showed uncertainty intolerance was a predictor of anxiety. A multiple mediation analysis supported the mediating role of uncertainty intolerance and emotional regulation between ASD and anxiety. CONCLUSIONS AND IMPLICATIONS These findings suggest that interventions designed to reduce anxiety symptoms in people with ASD and ID should include among their goals emotional regulation and especially intolerance of uncertainty.
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Affiliation(s)
- Gema P Sáez-Suanes
- Departmental Unit of Personality, Assessment and Clinical Psychology, Complutense University of Madrid, Rector Royo Villanova, s/n, 28040, Madrid, Spain.
| | - Domingo García-Villamisar
- Departmental Unit of Personality, Assessment and Clinical Psychology, Complutense University of Madrid, Rector Royo Villanova, s/n, 28040, Madrid, Spain
| | - Araceli Del Pozo Armentia
- Departmental Unit of Personality, Assessment and Clinical Psychology, Complutense University of Madrid, Rector Royo Villanova, s/n, 28040, Madrid, Spain
| | - John Dattilo
- Dept. of Recreation, Park and Tourism Management, Penn State University, State College, PA, United States
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36
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Egan V, Bull E, Trundle G. Individual differences, ADHD, adult pathological demand avoidance, and delinquency. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 105:103733. [PMID: 32682221 DOI: 10.1016/j.ridd.2020.103733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 04/01/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Pathological Demand Avoidance (PDA) is a developmental disorder involving challenging behaviour clinically linked to Autism Spectrum Disorder (ASD). Many of the problematic features of PDA are often seen in persons with attention deficit hyperactivity disorder and impulsivity. ADHD and impulsivity are also common in the backgrounds of offenders. AIMS Method and procedure: We examined if self-reported ASD, ADHD, impulsivity, and general personality traits such as low conscientiousness and low emotional stability predicted self-reported PDA scores, and which constructs contributed to the prediction of delinquency, recruiting 132 participants (mean age 34.6 years, SD = 10.9, range 18-68), of whom 126 cases had complete data. OUTCOMES AND RESULTS Many of these constructs, but particularly ADHD (r = 0.71, p < 0.001) were significant correlates of PDA, the correlation between ASD and PDA was small, and did not predict PDA. Multiple regression indicated that a combination of higher attention deficit, antagonism, and lower emotional stability predicted 65 % of an individual's PDA score, but that their PDA score did not contribute to the prediction of delinquency. CONCLUSIONS AND IMPLICATIONS This research indicates that, for community adult populations, self-reported individual differences in ADHD, emotional instability, and antagonism appear to better predict PDA than ASD. The association PDA has with delinquency may reflect these constructs, which are also correlates of offending.
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Affiliation(s)
- Vincent Egan
- Centre for Forensic and Family Psychology, University of Nottingham, Yang Fujia Building, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK.
| | - Elinor Bull
- Centre for Forensic and Family Psychology, University of Nottingham, Yang Fujia Building, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK.
| | - Grace Trundle
- Centre for Forensic and Family Psychology, University of Nottingham, Yang Fujia Building, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK.
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37
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Jenkinson R, Milne E, Thompson A. The relationship between intolerance of uncertainty and anxiety in autism: A systematic literature review and meta-analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1933-1944. [PMID: 32564625 PMCID: PMC7539603 DOI: 10.1177/1362361320932437] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
LAY ABSTRACT People who find it especially hard to cope with the unexpected or unknown are said to have an intolerance of uncertainty. Autistic individuals often report a preference for certainty and experience levels of anxiety that can interfere with their daily life. Understanding more about the link between the intolerance of uncertainty and anxiety in autistic people might lead to better treatments for anxiety being developed. Therefore, this work aimed to review previous research in order to explore this link. Twelve studies were found and their results were compared and contrasted. The autistic people who participated in the studies completed questionnaires that suggested a large number of them experienced very high levels of anxiety and intolerance of uncertainty. Of 10 studies that used relevant statistics, nine found a statistically significant link between anxiety and the intolerance of uncertainty. In general, the strength of the link was about the same as previous research found in people who did not have a diagnosis of autism. This might mean that interventions that aim to help people who are intolerant of uncertainty could be effective for autistic individuals.
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38
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England-Mason G. Emotion Regulation as a Transdiagnostic Feature in Children with Neurodevelopmental Disorders. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020. [DOI: 10.1007/s40474-020-00200-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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39
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Faghani N, Akbari M, Hasani J, Marino C. An emotional and cognitive model of problematic Internet use among college students: The full mediating role of cognitive factors. Addict Behav 2020; 105:106252. [PMID: 32062334 DOI: 10.1016/j.addbeh.2019.106252] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 02/07/2023]
Abstract
Numerous researches have shown that the problematic Internet use (PIU) is significantly associated with a variety of psychological problems among young people. However, limited research has focused on the psychological mechanism underlying PIU. The purpose of this study was to investigate the relationship between several emotional and cognitive factors in predicting PIU in a sole model. In this model, difficulties in emotion regulation was the independent variable, three cognitive variables (i.e. experiential avoidance, desire thinking, and intolerance of uncertainty) were the mediators, and PIU was the dependent variable. Participants were 300 college students from four universities in Tehran (60% females; Mean age = 20.27). Results of the Structural Equation Modeling analysis revealed a full mediation role of experiential avoidance and desire thinking in the relationship between difficulties in emotion regulation and PIU (R2 = 57%). Based on these findings a special attention to cognitive factors is suggested in the treatment of PIU.
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Abstract
Individuals with autism spectrum disorder (ASD) tend to experience difficulties with emotion regulation (ER). Treatments designed to address ER difficulties in individuals with ASD are emerging. The authors review cognitive-behavioral therapy (CBT) and mindfulness-based treatments that have focused on ER difficulties in youth and young adults with ASD. In general, these treatments addressing ER skills have included awareness of emotions/psychoeducation about emotions, frustration tolerance, and ER skills, as well as practice and use of these skills during group therapy that sometimes includes caregivers. The results from these interventions are encouraging for individuals with high-functioning ASD because ER skills tend to improve following treatment. The inclusion of ER in other ASD treatments is discussed.
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Affiliation(s)
| | | | - Judy Reaven
- Departments of Pediatrics and Psychiatry at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado
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41
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Hwang YI(J, Arnold S, Srasuebkul P, Trollor J. Understanding anxiety in adults on the autism spectrum: An investigation of its relationship with intolerance of uncertainty, sensory sensitivities and repetitive behaviours. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:411-422. [DOI: 10.1177/1362361319868907] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Anxiety is present in high rates in both children and adults on the autism spectrum. An increasing number of studies have highlighted the potentially important role that intolerance of uncertainty may have in anxiety for those on the spectrum, as well as their interrelationships with sensory sensitivities and repetitive behaviours. In response to a lack of studies involving adults, this study examined self-report survey data regarding intolerance of uncertainty, sensory sensitivities, repetitive behaviours and anxiety in a sample of 176 adults on the autism spectrum (mean age = 42). Intolerance of uncertainty and anxiety were both found to be elevated relative to non-autistic adults ( N = 116) and significant, positive correlations were found between intolerance of uncertainty, anxiety, repetitive behaviours and sensory sensitivities in those on the spectrum. Intolerance of uncertainty was found to be a significant mediator between sensory sensitivities and anxiety, as well as between anxiety and insistence on sameness behaviours. These results were not sensitive to age. Intolerance of uncertainty is an important factor to be considered in the conceptualisation and management of elevated rates of anxiety for adults on the autism spectrum.
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Affiliation(s)
- Ye In (Jane) Hwang
- UNSW Sydney, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Samuel Arnold
- UNSW Sydney, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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Griffiths S, Allison C, Kenny R, Holt R, Smith P, Baron-Cohen S. The Vulnerability Experiences Quotient (VEQ): A Study of Vulnerability, Mental Health and Life Satisfaction in Autistic Adults. Autism Res 2019; 12:1516-1528. [PMID: 31274233 PMCID: PMC6851759 DOI: 10.1002/aur.2162] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/03/2019] [Accepted: 05/27/2019] [Indexed: 01/07/2023]
Abstract
Co‐morbid mental health conditions such as anxiety and depression are extremely common in autistic adults. Vulnerability to negative life experiences such as victimisation and unemployment may be partially responsible for the development of these conditions. Here we measure the frequency of negative life experiences in autistic adults and explore how these are associated with current anxiety and depression symptoms and life satisfaction. We developed the Vulnerability Experiences Quotient (VEQ) through stakeholder consultation. The VEQ includes 60 items across 10 domains. Autistic adults with a clinical diagnosis and non‐autistic controls completed the VEQ, screening measures for anxiety and depression, and a life‐satisfaction scale in an online survey. Likelihood of experiencing each VEQ event was compared between groups, using binary logistic regression. Mediation analysis was used to test whether total VEQ score mediated the relationship between autism and (1) depression (2) anxiety and (3) life satisfaction. Autistic adults (N = 426) reported higher rates of the majority of events in the VEQ than non‐autistic adults (N = 268). They also reported more anxiety and depression symptoms and lower life satisfaction. Group differences in anxiety, depression and life satisfaction were partially mediated by VEQ total score. This study highlights several important understudied areas of vulnerability for autistic adults, including domestic abuse, contact with social services (as parents) and financial exploitation and hardship. Improved support, advice and advocacy services are needed to reduce the vulnerability of autistic adults to negative life experiences, which may in turn improve mental health and life satisfaction in this population. Autism Res 2019, 12: 1516–1528. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. Lay Summary This study investigated whether autistic adults are more vulnerable to certain negative life experiences, and whether these experiences are related to anxiety, depression and life satisfaction. We found that autistic adults are more vulnerable to many different negative life events, including employment difficulties, financial hardship and domestic abuse. Negative life experiences partially explained the higher rates of anxiety and depression symptoms and lower life satisfaction in autistic adults compared to non‐autistic adults. Improved support services are required to reduce the vulnerability of autistic adults. Reducing vulnerability may improve mental health and increase life satisfaction in this population.
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Affiliation(s)
- Sarah Griffiths
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Rebecca Kenny
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Rosemary Holt
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Paula Smith
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,CLASS Clinic, Cambridgeshire and Peterborough Mental Health NHS Foundation Trust (CPFT), Cambridge, United Kingdom
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Brief Report: Psychometric Properties of the Patient Health Questionaire-9 (PHQ-9) in Autistic Adults. J Autism Dev Disord 2019; 50:2217-2225. [DOI: 10.1007/s10803-019-03947-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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44
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Cai RY, Richdale AL, Uljarević M, Dissanayake C, Samson AC. Emotion regulation in autism spectrum disorder: Where we are and where we need to go. Autism Res 2018; 11:962-978. [PMID: 29979494 DOI: 10.1002/aur.1968] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 03/04/2018] [Accepted: 04/20/2018] [Indexed: 12/11/2022]
Abstract
Emotion dysregulation is a common issue experienced by individuals with autism spectrum disorder (ASD) and has been associated with a wide range of negative mental and physical health outcomes. This commentary highlights the role emotion dysregulation plays in ASD by first considering the literature on emotion regulation (ER) in the general population and then summarizing the ER research in ASD. Based on the evaluation of previous research findings, we conclude that individuals with ASD have more ER difficulties and consistently self-report or demonstrate a less adaptive pattern of ER strategy use. In addition, the higher prevalence of internalizing and externalizing issues seen in ASD are associated with the greater habitual use of some ER strategies and less habitual use of others. Conceptual and methodological limitations are discussed, including the use of coping measures and single-method approaches, and ASD gender distribution. We propose a set of new directions for investigating ER in ASD, incorporating knowledge from other literatures on the role of flexibility in healthy adaptation, overlaps between flexibility and executive function deficits, the adaptive value of up-regulation of positive emotions, and the importance of emotional self-awareness. Increasing our capacity for identifying the mechanisms underlying co-morbid affective disorders can ultimately inform the design of effective interventions to maximize the wellbeing of individuals with ASD. Autism Res 2018, 11: 962-978. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY Research has shown that people diagnosed with autism tend to have difficulties with regulating their own emotions. This commentary article summarizes the main information from emotion regulation research conducted both in autism and in other populations. We make suggestions on how we can improve emotion regulation research in autism, with the ultimate goal being to use the learning gained from research to design effective interventions that can improve the wellbeing of people with autism.
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Affiliation(s)
- Ru Ying Cai
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, Victoria, 3086, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, Victoria, 3086, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Mirko Uljarević
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, Victoria, 3086, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, Victoria, 3086, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Level 3 Foxtail Building, Long Pocket, The University of Queensland, Brisbane, Queensland, 4072, Australia
| | - Andrea C Samson
- Swiss Center for Affective Sciences, University of Geneva, Campus Biotech, Chemin des Mines 9, Geneva, 1202, Switzerland.,Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, 401 Quarry Road, Stanford, CA, 94305.,Swiss Distance Learning University, Brig, Switzerland, Überlandstrasse 12, Brig, 3900, Switzerland
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45
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Fenning RM, Baker JK, Moffitt J. Intrinsic and Extrinsic Predictors of Emotion Regulation in Children with Autism Spectrum Disorder. J Autism Dev Disord 2018; 48:3858-3870. [PMID: 29926292 DOI: 10.1007/s10803-018-3647-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Difficulties regulating emotion have been linked to comorbid psychopathology in children with autism spectrum disorder (ASD), but little empirical work has examined predictors of dysregulation in this population. Forty-six families of children with ASD participated in a laboratory visit that included direct measurement of children's IQ, ASD symptoms, and psychophysiological reactivity. Child emotion regulation was observed during independent and co-regulatory tasks, and parental scaffolding was rated in the dyadic context. ASD symptom severity emerged as the strongest predictor of child emotion dysregulation across contexts. Child age and parental scaffolding also uniquely predicted child dysregulation in the dyadic task. Implications for conceptualizing intrinsic and extrinsic influences on emergent emotion regulation in children with ASD are discussed, as are applications to intervention.
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Affiliation(s)
- Rachel M Fenning
- Department of Child and Adolescent Studies, Center for Autism, California State University, Fullerton, 800 N. State College Blvd. EC-560, Fullerton, CA, 92831, USA.
| | - Jason K Baker
- Department of Child and Adolescent Studies, Center for Autism, California State University, Fullerton, 800 N. State College Blvd. EC-560, Fullerton, CA, 92831, USA
| | - Jacquelyn Moffitt
- Department of Child and Adolescent Studies, Center for Autism, California State University, Fullerton, 800 N. State College Blvd. EC-560, Fullerton, CA, 92831, USA
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46
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Green J, Absoud M, Grahame V, Malik O, Simonoff E, Le Couteur A, Baird G. Pathological Demand Avoidance: symptoms but not a syndrome. THE LANCET. CHILD & ADOLESCENT HEALTH 2018; 2:455-464. [PMID: 30169286 DOI: 10.1016/s2352-4642(18)30044-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 02/02/2023]
Abstract
Pathological (or extreme) demand avoidance is a term sometimes applied to complex behaviours in children within-or beyond-autism spectrum disorder. The use of pathological demand avoidance as a diagnosis has, at times, led to altered referral practice and misunderstandings between professionals and the families of patients. In our Viewpoint, we reviewed the current literature and conclude that the evidence does not support the validity of pathological demand avoidance as an independent syndrome. Nevertheless, the use of the term highlights an important known range of co-occurring difficulties for many children with autism spectrum disorder that can substantially affect families. We explore how these difficulties can best be understood through understanding of social, sensory, and cognitive sensitivities in autism spectrum disorder, identification of frequently occurring comorbid conditions, and assessment of how these problems interact within the child's social environment. Such understanding should then inform individualised management strategies for children and families, and in social settings, such as education. It is crucial that a shared understanding is achieved between professionals and families in this area.
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Affiliation(s)
- Jonathan Green
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust, and Manchester Academic Health Sciences Centre, Manchester, UK.
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK; King's Health Partners Academic Health Science Centre, London, UK; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Osman Malik
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK; King's Health Partners Academic Health Science Centre, London, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Ann Le Couteur
- Newcastle University, Newcastle upon Tyne, UK; Northumberland Tyne and Wear NHS Trust, Newcastle upon Tyne, UK
| | - Gillian Baird
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK; King's Health Partners Academic Health Science Centre, London, UK
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47
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Cai RY, Richdale AL, Dissanayake C, Trollor J, Uljarević M. Emotion regulation in autism: Reappraisal and suppression interactions. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:737-749. [PMID: 29792076 DOI: 10.1177/1362361318774558] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Emotion regulation has been proposed to be a transdiagnostic factor in the development and maintenance of psychopathology in the general population, yet the nature of the relationships between emotion regulation strategy use and psychological well-being has not been comprehensively explored in individuals with autism spectrum disorder (ASD). The aim of this study was to assess how the individual differences in self-reported emotion regulation strategy use relate to levels of both positive and negative psychological well-being. In total, 56 individuals with ASD aged 14-24 years (Mage = 18.15; SDage = 2.30) completed Emotion Regulation Questionnaire, Diagnostic and Statistical Manual of Mental Disorders-5 Generalized Anxiety Disorder Dimensional Scale, Patient Health Questionnaire-9, Warwick-Edinburgh Mental Well-being Scale and Autism-Spectrum Quotient - Short. Individuals were grouped into four clusters based on their Emotion Regulation Questionnaire subscale scores. Individuals in the high suppression and low reappraisal group expressed higher depressive symptoms and lower positive well-being when compared with the low suppression and high reappraisal group. Interestingly, individuals who self-reported using both high suppression and reappraisal expressed relatively high positive well-being and low depression symptoms. We suggest that the maladaptive effect of habitual suppression usage may be buffered by the habitual use of reappraisal, and this interaction between adaptive and maladaptive emotion regulation strategy use has clinical implications.
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Affiliation(s)
- Ru Ying Cai
- 1 The Olga Tennison Autism Research Centre, La Trobe University, Australia.,2 Cooperative Research Centre for Living with Autism, Australia
| | - Amanda L Richdale
- 1 The Olga Tennison Autism Research Centre, La Trobe University, Australia.,2 Cooperative Research Centre for Living with Autism, Australia
| | - Cheryl Dissanayake
- 1 The Olga Tennison Autism Research Centre, La Trobe University, Australia.,2 Cooperative Research Centre for Living with Autism, Australia
| | - Julian Trollor
- 2 Cooperative Research Centre for Living with Autism, Australia.,3 UNSW Sydney, Australia
| | - Mirko Uljarević
- 1 The Olga Tennison Autism Research Centre, La Trobe University, Australia.,2 Cooperative Research Centre for Living with Autism, Australia.,4 Stanford Autism Center, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, USA
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48
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High Risk for Severe Emotional Dysregulation in Psychiatrically Referred Youth with Autism Spectrum Disorder: A Controlled Study. J Autism Dev Disord 2018; 48:3101-3115. [DOI: 10.1007/s10803-018-3542-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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49
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Abstract
Individuals with autism spectrum disorder (ASD) are at increased risk for experiencing one or more co-occurring psychiatric conditions. When present, these conditions are associated with additional impairment and distress. It is therefore crucial that clinicians and researchers adequately understand and address these challenges. However, due to symptom overlap, diagnostic overshadowing, and ambiguous symptom presentation in ASD, the assessment of co-occurring conditions in ASD is complex and challenging. Likewise, individual difference factors, such as age, intellectual functioning, and gender, may influence the presentation of co-occurring symptoms. Relatedly, a transdiagnostic framework may offer utility in assessing and treating co-occurring conditions. However, with the exception of anxiety disorders, treatment research for co-occurring psychiatric conditions in ASD is relatively limited. Therefore, the present paper aims to summarize and review available research on the most common co-occurring psychiatric disorders in ASD, with a focus on estimated population-based prevalence rates, diagnostic challenges, the influence of individual differences, and assessment guidelines. The utility of a transdiagnostic framework for conceptualizing co-occurring disorders in ASD is discussed, and the state of treatment research for co-occurring disorders is summarized. This study concludes with a summary of the extant literature, as well as recommendations for future research.
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Affiliation(s)
- Tamara E Rosen
- a Stony Brook University , Department of Psychology , Stony Brook , NY , USA
| | - Carla A Mazefsky
- b University of Pittsburgh School of Medicine , Department of Psychiatry , Pittsburgh , PA , USA
| | - Roma A Vasa
- c Kennedy Krieger Institute, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Matthew D Lerner
- a Stony Brook University , Department of Psychology , Stony Brook , NY , USA
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50
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Su X, Cai RY, Uljarević M. Predictors of Mental Health in Chinese Parents of Children with Autism Spectrum Disorder (ASD). J Autism Dev Disord 2017; 48:1159-1168. [DOI: 10.1007/s10803-017-3364-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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