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Cárcel-López MD, Ferrando-Prieto M. Differences and Relationships Between Sensory Profile and Repetitive Behavior in Autism. CHILDREN (BASEL, SWITZERLAND) 2025; 12:504. [PMID: 40310120 PMCID: PMC12025408 DOI: 10.3390/children12040504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Revised: 04/04/2025] [Accepted: 04/08/2025] [Indexed: 05/02/2025]
Abstract
Repetitive behaviors are actions that are performed consistently and repeatedly, often without an obvious functional purpose. These types of behaviors are common and diverse in individuals with Autism Spectrum Disorder (ASD) and can influence daily life, making social integration difficult for individuals who experience them and thus becoming a source of distress. Research show that, in most individuals with ASD, sensory processing tends to be affected. It has been suggested that, in children with ASD, sensory processing disorders can cause them to experience their environment in an exaggerated or diminished way, and this affects their behavior. Repetitive behaviors may emerge as a way to regulate the level of stimulation and achieve a state of sensory balance. Objectives: The aim of this investigation is to study differences and relationships between the sensory profile and repetitive behavior in autism. Methods: A total of 48 students, aged 4 to 26 years (M = 14.39; SD = 7.24), participated. The Bodfish Repetitive Behavior Scale and Sensory Profile 2 by Dunn were used as instruments of measure. Results: Results show that the student groups differ only in some variables, with Level 3 students being the most affected. In this sense, Level 3 students present with higher self-injury, greater tactile and movement processing difficulties, and higher registration (passive response and a high threshold of perception). Hyper-reactivity shows a weak prediction power over insistence of sameness, while hypo-reactivity showed none. Conclusions: Correlations between repetitive behavior and sensory processing were weak and of low magnitude, which contradicts the previous literature.
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Affiliation(s)
- María-Dolores Cárcel-López
- Department of Didactics and School Organization, University of Murcia, 30100 Murcia, Spain
- AUFREN (Autism Friendly Environment Center), 30107 Murcia, Spain
| | - Mercedes Ferrando-Prieto
- Department of Developmental and Educational Psychology, University of Murcia, 30100 Murcia, Spain;
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2
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Lin Y, Mason D, Hirsch C, Happé F. Intolerance of Uncertainty and Anxiety (but not Alexithymia) Mediate the Association Between Autistic Traits and Quality of Life. J Autism Dev Disord 2025; 55:1389-1401. [PMID: 38446267 PMCID: PMC11933226 DOI: 10.1007/s10803-024-06310-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
Previous research has indicated that autistic individuals report lower quality of life (QoL) than non-autistic people. It is unclear whether it is the autism traits themselves or co-occurring thinking styles or mental health difficulties that most impair QoL. This study tested a hypothesised model to explore how 'intolerance of uncertainty' (IU), alexithymia (difficulty in identifying and describing own emotions), and anxiety play into the association between autistic traits and QoL. Online survey data were analysed from 116 autistic and 51 non-autistic adults who completed six standardised questionnaires measuring autistic traits, alexithymia, IU, anxiety and QoL (physical health, psychological health, social relations, and environment domains). The autistic group reported higher scores for alexithymia, IU and anxiety, and lower scores for QoL across domains, compared to the non-autistic group. Across the entire sample, autistic traits, alexithymia, IU and anxiety were positively correlated with one another, and negatively related to the four domains of QoL. Finally, IU and anxiety partially serially mediated the pathways from autistic traits to physical health and environment domains of QoL, and fully mediated the pathways from autistic traits to psychological health and social relations domains of QoL, across the full sample. The lower QoL experienced by autistic people may be explained in part by the mediating effect of both IU and anxiety (but not alexithymia). This study highlights the need for evidence-based interventions to address both IU and anxiety to improve QoL for autistic people/those with high levels of autistic traits.
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Affiliation(s)
- Yeju Lin
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
| | - David Mason
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Colette Hirsch
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Francesca Happé
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
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3
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Poulsen R, Tan DW, Sowman PF, McAlpine D, Pellicano E. Auditory environments influence the link between Autistic traits and quality of life. Sci Rep 2025; 15:10612. [PMID: 40148426 PMCID: PMC11950209 DOI: 10.1038/s41598-025-94585-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Accepted: 03/13/2025] [Indexed: 03/29/2025] Open
Abstract
Autistic people often report a heightened sensitivity to sound. Yet, research into Autistic people's auditory environments and their impacts on quality of life is limited. We conducted an online survey to understand how auditory environments influence the relationships between Autistic traits and impacts on quality of life (iQoL) due to sound sensitivity. We also sought to determine strategies that Autistic people use to navigate auditory sensitivities in daily life.296 Autistic adults (58.4% women, 15.9% men, 24.3% non-binary +) aged 18-71 years completed the survey comprising a questionnaire with bespoke items measuring auditory experiences in different environments (e.g., noisy vs. quiet) and measures of Autistic traits and iQoL. Our path analyses revealed a significant indirect effect of aversive auditory environments on the relationships between all domains of Autistic traits and iQoL. Notably, the association between non-verbal social communication trait and iQoL was fully mediated by all forms of auditory environments. Additionally, most (n = 217, 73.5%) Autistic participants reported using earplugs and headphones to manage their sound environments in everyday life. Our study demonstrates that many aspects of auditory environments-beyond noise alone-can negatively impact Autistic people's QoL. Addressing barriers created by auditory environments through accommodations should improve QoL for Autistic people.
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Affiliation(s)
- R Poulsen
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University, 16 University Avenue, Macquarie Park, NSW, 2109, Australia.
| | - D W Tan
- Macquarie School of Education, Macquarie University, Macquarie Park, Australia
- Health & Wellbeing Research Centre, Lifespan, Macquarie University, Macquarie Park, Australia
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - P F Sowman
- School of Clinical Sciences, Auckland University of Technology, Auckland, Aotearoa, New Zealand
- School of Psychological Sciences, Macquarie University, Macquarie Park, Australia
| | - D McAlpine
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University, 16 University Avenue, Macquarie Park, NSW, 2109, Australia
| | - E Pellicano
- Macquarie School of Education, Macquarie University, Macquarie Park, Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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4
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Moore HL, Freeston M, Rodgers J, Cassidy S. A Measurement Invariance Analysis of the Anxiety Scale for Autism-Adults in a Sample of Autistic and Non-Autistic Men and Women. J Autism Dev Disord 2025; 55:981-996. [PMID: 38740697 PMCID: PMC11828802 DOI: 10.1007/s10803-024-06260-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 05/16/2024]
Abstract
The Anxiety Scale for Autism-Adults (ASA-A) captures the autistic anxiety experience, but we do not know whether it is structurally equivalent for men and women, or non-autistic people. Measurement invariance analysis considered gender and diagnostic status (342 cis-gender autistic men (N = 105) and women (N = 237), 316 cis-gender non-autistic men (N = 104) and women (N = 212)). Strict invariance was achieved between autistic men and women and between non-autistic men and women, but the ASA-A structure is quantitatively different in autistic compared to non-autistic adults. Therefore, this tool cannot be used to directly compare anxiety between these groups. Autistic women scored significantly higher on the ASA-A than autistic men and Uncertainty was the highest scoring factor for autistic participants. Future research should include alternative gender identities.
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Affiliation(s)
- Heather L Moore
- School of Psychology, Dame Margaret Barbour Building, Wallace Street, Newcastle upon Tyne, NE2 4DR, UK.
| | - Mark Freeston
- School of Psychology, Dame Margaret Barbour Building, Wallace Street, Newcastle upon Tyne, NE2 4DR, UK
| | - Jacqui Rodgers
- Population Health Sciences Institute, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Level 3, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
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5
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Yu MHM, Cao Y, Fung SSY, Kwan GSY, Tse ZCK, Shum DHK. Intolerance of uncertainty, aging, and anxiety and mental health concerns: A scoping review and meta-analysis. J Anxiety Disord 2025; 110:102975. [PMID: 39842138 DOI: 10.1016/j.janxdis.2025.102975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 01/08/2025] [Accepted: 01/14/2025] [Indexed: 01/24/2025]
Abstract
Although intolerance of uncertainty (IU) is associated with negative outcomes, studies focusing on older adults are still emerging. Specifically, the relationship between IU and psychological health in this population remains unclear. Moreover, no review has focused on understanding the unique contributions of IU and aging to anxiety and mental health in older adults. This scoping review and meta-analysis addressed this gap and provided a comprehensive understanding of the relationship between IU, aging, and mental health. Among 45 studies reviewed, 37 were included in the meta-analysis using mixed effect analysis to examine the relationship between IU and age across adulthood. The remaining eight studies, along with seven selected from the meta-analysis, were included in the scoping review to evaluate the relationship between IU, anxiety, and mental health. Among these, 12 studies focused on late adulthood, two on overall adulthood, and one included both late and overall adulthood. Results of the meta-analysis revealed an overall significant age difference in IU throughout adulthood. Moreover, results of the scoping review indicated a direct correlation between IU and anxiety, and other psychological issues in elderly. These findings provide insights for future research and interventions aimed at reducing IU and improving mental health among older adults.
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Affiliation(s)
- Mandy H M Yu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Yuan Cao
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong.
| | - Sylvia S Y Fung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Gerald S Y Kwan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
| | - Zita C K Tse
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - David H K Shum
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Keshavarz S, Esmaeilpour K. Relationship between social anxiety and separation anxiety symptoms with insistence on sameness with the mediating role of sensory hypersensitivity. BMC Psychol 2025; 13:62. [PMID: 39838432 PMCID: PMC11752653 DOI: 10.1186/s40359-025-02369-w] [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] [Received: 07/16/2024] [Accepted: 01/08/2025] [Indexed: 01/23/2025] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is characterized by impairments in social communication and interaction, restricted and repetitive patterns of behavior, and sensory processing abnormalities. These core features are often accompanied by comorbid anxiety disorders. However, the sequence and mechanisms of these associations warrant further investigation. Therefore, the aim of this study was to examine the relationship of social anxiety and separation anxiety on insistence on sameness, mediated by sensory hypersensitivity. METHODS This was a cross-sectional study based on caregiver reports of 247 children, aged 7 ̶ 11 years. The parents completed the Autism Quotient-Children's Version (AQ-C), the Repetitive Behavior Questionnaire-2 (RBQ-2), the Sensory Profile 2 (SP2), and the Spence Children's Anxiety Scale-Parent Version (SCAS-P). RESULTS The path analysis revealed a significant indirect effect of social anxiety and separation anxiety on insistence on sameness via sensory hypersensitivity (p ≤ 0.05). However, neither social anxiety nor separation anxiety had a significant direct effect on insistence on sameness (p = 0.108 and p = 0.342, respectively). CONCLUSIONS Based on the results, the mediated association of sensory hypersensitivity with the relationship between social anxiety, separation anxiety, and insistence on sameness was observed. The article discusses the theoretical explanations and implications of the results, as well as various manifestations of anxiety symptoms in children with ASD.
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Affiliation(s)
- Shima Keshavarz
- Master's Degree in Child and Adolescent Clinical Psychology, Faculty of Psychology and Educational Sciences, University of Tabriz, Tabriz, Iran
| | - Khalil Esmaeilpour
- Faculty of psychology and educational sciences, University of Tabriz, Tabriz, Iran.
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7
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Poulsen R, Williams Z, Dwyer P, Pellicano E, Sowman PF, McAlpine D. How auditory processing influences the autistic profile: A review. Autism Res 2024; 17:2452-2470. [PMID: 39552096 PMCID: PMC11638897 DOI: 10.1002/aur.3259] [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: 11/22/2023] [Accepted: 10/23/2024] [Indexed: 11/19/2024]
Abstract
We need to combine sensory data from various sources to make sense of the world around us. This sensory data helps us understand our surroundings, influencing our experiences and interactions within our everyday environments. Recent interest in sensory-focused approaches to supporting autistic people has fixed on auditory processing-the sense of hearing and the act of listening-and its crucial role in language, communications, and social domains, as well as non-social autism-specific attributes, to understand better how sensory processing might differ in autistic people. In this narrative review, we synthesize published research into auditory processing in autistic people and the relationship between auditory processing and autistic attributes in a contextually novel way. The purpose is to understand the relationship between these domains more fully, drawing on evidence gleaned from experiential perspectives through to neurological investigations. We also examine the relationship between auditory processing and diagnosable auditory conditions, such as hyperacusis, misophonia, phonophobia, and intolerance to loud sounds, as well as its relation to sleep, anxiety, and sensory overload. Through reviewing experiential, behavioral and neurological literature, we demonstrate that auditory processes interact with and shape the broader autistic profile-something not previously considered. Through a better understanding of the potential impact of auditory experiences, our review aims to inform future research on investigating the relationship between auditory processing and autistic traits through quantitative measures or using qualitative experiential inquiry to examine this relationship more holistically.
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Affiliation(s)
- R. Poulsen
- Department of Linguistics, Faculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Z. Williams
- Medical Scientist Training Program, Vanderbilt University School of MedicineVanderbilt University School of MedicineNashvilleTennesseeUSA
- Department of Hearing and Speech SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Brain InstituteVanderbilt UniversityNashvilleTennesseeUSA
- Frist Center for Autism and InnovationVanderbilt University School of EngineeringNashvilleTennesseeUSA
| | - P. Dwyer
- Center for the Mind and BrainDepartment of PsychologyMIND InstituteUniversity of CaliforniaDavisCaliforniaUSA
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
| | - E. Pellicano
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - P. F. Sowman
- School of Psychological SciencesMacquarie UniversitySydneyNew South WalesAustralia
- School of Clinical SciencesAuckland University of TechnologyAucklandNew Zealand
| | - D. McAlpine
- Department of Linguistics, Faculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNew South WalesAustralia
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8
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Nwaordu G, Charlton RA. Repetitive Behaviours in Autistic and Non-Autistic Adults: Associations with Sensory Sensitivity and Impact on Self-Efficacy. J Autism Dev Disord 2024; 54:4081-4090. [PMID: 37751091 PMCID: PMC11461748 DOI: 10.1007/s10803-023-06133-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Restricted and repetitive behaviours are a core feature of autism diagnoses but have not been widely studied in adulthood. This study examined the rates of and associations between repetitive behaviours and sensory sensitivity in autistic and non-autistic adults; and whether repetitive behaviours described as "stimming" impacted coping with difficulties (self-efficacy). METHODS Diagnosed autistic (n = 182), undiagnosed autistic (n = 163) and non-autistic (n = 146) adults completed online measures of repetitive behaviours, sensory sensitivity, and self-efficacy for when able and not able to stim. RESULTS Repetitive behaviours and sensory sensitivity correlated significantly in each group, although ratings were higher in autistic compared to non-autistic groups. When people were able to stim, no differences between the groups were observed on self-efficacy ratings. However when unable to stim, autistic people reported lower self-efficacy than non-autistic people. CONCLUSIONS Results suggest that repetitive behaviours are significantly associate with sensory sensitivities. Rather than repetitive behaviours being viewed as negative, stimming was associated with increased self-efficacy. Results suggest that stimming may have beneficial effects. Further work is needed to better understand how repetitive behaviours and stimming manifest in adulthood, how they change over time and their effects for autistic adults.
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Affiliation(s)
- Gabrielle Nwaordu
- Department of Psychology, Goldsmiths University of London, New Cross, London, SE14 6NW, UK.
| | - Rebecca A Charlton
- Department of Psychology, Goldsmiths University of London, New Cross, London, SE14 6NW, UK
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Rodgers J, Brice S, Welsh P, Ingham B, Wilson C, Evans G, Steele K, Cropper E, Le Couteur A, Freeston M, Parr JR. A Pilot Randomised Control Trial Exploring the Feasibility and Acceptability of Delivering a Personalised Modular Psychological Intervention for Anxiety Experienced by Autistic Adults: Personalised Anxiety Treatment-Autism (PAT-A). J Autism Dev Disord 2024; 54:4045-4060. [PMID: 37728782 PMCID: PMC11461680 DOI: 10.1007/s10803-023-06112-5] [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: 08/15/2023] [Indexed: 09/21/2023]
Abstract
Anxiety is commonly experienced by autistic people and impacts on quality of life and social participation. New anxiety interventions are required to effectively meet the needs of autistic people. Personalised Anxiety Treatment-Autism (PAT-A©) is a bespoke, modular approach to treating anxiety in up to 12 sessions. This study explored the feasibility and acceptability of delivering PAT-A© in the UK National Health Service (NHS). A single-blind randomised controlled trial design. Thirty-four autistic adults were recruited via clinical services and randomised to receive either PAT-A© or enhanced treatment as usual (CCSP). Outcome assessments relating to anxiety, quality of life and related constructs were completed at baseline, immediately post intervention; and at 3 and 12 months. Seventy-one percent of the PAT-A© group and 65% of the CCSP met diagnostic threshold for at least three anxiety disorders. Retention was good across both groups, with 82% (N = 14/17) completing the full course of PAT-A© and 71% (N = 12/17) attending both psychoeducational sessions in CCSP. 94% in PAT-A© and 82% in CCSP completed some follow up assessment 3 months post-intervention. Thematic analysis of interview data revealed that many participants valued the personalised approach, developed transferable skills and experienced positive changes to their anxiety. Participants were willing to be recruited and randomised, PAT-A© was feasible to deliver in the NHS and the trial methods and materials were acceptable. Our findings indicate that a fully powered clinical and cost-effectiveness trial of PAT-A© is warranted.
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Affiliation(s)
- Jacqui Rodgers
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
| | - Samuel Brice
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Patrick Welsh
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Barry Ingham
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Colin Wilson
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Gemma Evans
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Katie Steele
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Emily Cropper
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Ann Le Couteur
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Mark Freeston
- School of Psychology, Newcastle University, Newcastle Upon Tyne, UK
| | - Jeremy R Parr
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle Upon Tyne, UK
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
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Recio P, Pozo P, García-López C, Sarriá E. Autistic Sensory Traits and Psychological Distress: Mediating Role of Worry and Intolerance of Uncertainty. Brain Sci 2024; 14:1088. [PMID: 39595851 PMCID: PMC11591926 DOI: 10.3390/brainsci14111088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 10/24/2024] [Accepted: 10/24/2024] [Indexed: 11/28/2024] Open
Abstract
BACKGROUND/OBJECTIVES Autistic adults exhibit core and comorbid features that can have an impact on their daily functioning and lead to considerable psychological distress. Significant and consistent associations have been identified between autism characteristics-restricted repetitive behaviors and sensory features-and high levels of stress and anxiety. For a better understanding of the issue, it is necessary to consider the cognitive aspects that can help explain variations in stress and anxiety levels among adults with autism. We therefore aimed to model the contributions of worry and intolerance of uncertainty on the relationship between autism characteristics (sensory sensitivities and repetitive behaviors) and psychological distress (stress and anxiety). METHODS The sample comprised 144 autistic individuals with a mean age of 35.15 (SD = 11.44). They participated in the study by completing an online questionnaire to assess the study variables. Most of the participants reported being diagnosed with Asperger syndrome (63.6%) or Level 1 autism spectrum disorder (27.1%). RESULTS The model fit index values tested through path analysis indicated a good fit (χ2 = 5.65; p = 0.13 ns; CFI = 0.993; NFI = 0.985; RMSEA = 0.079; SRMR = 0.025) and identified worry and intolerance of uncertainty as significant mediating variables within a comprehensive explanatory model. CONCLUSIONS These findings highlight the importance of worry and intolerance of uncertainty as specific targets in interventions aimed at improving stress and anxiety problems in autistic adults.
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Affiliation(s)
- Patricia Recio
- Department of Methodology of Behavioral Sciences, Faculty of Psychology, National University for Distance Education (UNED), 28040 Madrid, Spain; (P.R.); (P.P.)
- IMIENS: Joint Research Institute UNED-Health Institute Carlos III, 28029 Madrid, Spain;
| | - Pilar Pozo
- Department of Methodology of Behavioral Sciences, Faculty of Psychology, National University for Distance Education (UNED), 28040 Madrid, Spain; (P.R.); (P.P.)
- IMIENS: Joint Research Institute UNED-Health Institute Carlos III, 28029 Madrid, Spain;
| | - Cristina García-López
- IMIENS: Joint Research Institute UNED-Health Institute Carlos III, 28029 Madrid, Spain;
- Learning Disabilities Unit (UTAE), Neuropediatrics Department, Hospital Sant Joan de Déu, 08950 Barcelona, Spain
- Psychology Department, Faculty of Health Sciences, University Abat Oliba CEU, 08022 Barcelona, Spain
| | - Encarnación Sarriá
- Department of Methodology of Behavioral Sciences, Faculty of Psychology, National University for Distance Education (UNED), 28040 Madrid, Spain; (P.R.); (P.P.)
- IMIENS: Joint Research Institute UNED-Health Institute Carlos III, 28029 Madrid, Spain;
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Graham J, Rodgers J, Cassidy S. Why Are Autistic People More Likely to Experience Suicidal Thoughts? Applying the Integrated Motivational-Volitional Model with Autistic Adults. AUTISM IN ADULTHOOD 2024; 6:272-283. [PMID: 39371353 PMCID: PMC11447394 DOI: 10.1089/aut.2023.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2024]
Abstract
Background Autistic people are at considerably greater risk of suicidality than non-autistic people, and the reasons behind this are not fully understood. Current suicide theories may be useful to help further our understanding of the mechanisms behind autistic suicidality. We aimed to test the key predictors of suicidal ideation-defeat and entrapment-as described in the integrated motivational-volitional (IMV) model of suicide behavior, in an autistic group. We also looked to extend the IMV model by including autism-related constructs of camouflaging and intolerance of uncertainty (IU). Methods We recruited 374 autistic adults from the community (female 42.5%; 18-63 years of age), who completed a cross-sectional online survey between August 2020 and January 2021. We collected data on lifetime suicidality, depression symptoms, defeat, entrapment, camouflaging, and IU. Results We found that entrapment significantly mediated the relationship between defeat and suicidal ideation. Camouflaging and IU were not found to moderate this pathway but were found to be significantly associated with suicidal ideation. Conclusions We found that entrapment mediates the relationship between defeat and suicidality in autistic adults. This is consistent with the predictions in the motivational phase of the IMV model of suicidal behavior, suggesting that this model is useful for understanding autistic suicidality. We did not find evidence that camouflaging and IU act as moderators within the mediated model. Nevertheless, there is some evidence that camouflaging and IU are worthwhile constructs to be aware of for future work researching autistic suicidality.
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Affiliation(s)
- Jessica Graham
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jacqui Rodgers
- Newcastle University, Newcastle upon Tyne, United Kingdom
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Moore HL, Cassidy S, Rodgers J. Exploring the mediating effect of camouflaging and the moderating effect of autistic identity on the relationship between autistic traits and mental wellbeing. Autism Res 2024; 17:1391-1406. [PMID: 38108621 DOI: 10.1002/aur.3073] [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] [Received: 05/04/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
Mental health difficulties are prevalent among autistic adults. Camouflaging (behaving differently to fit in) may be a mechanism by which autistic traits and mental health difficulties relate to each other, but little research has considered the role of different facets of camouflaging. Additionally, autistic identity might buffer against camouflaging and mental health difficulties. This research aims to explore the mediating effects of camouflaging behaviours on the relationship between autistic traits and both positive and negative mental wellbeing, as well as how autistic identity might moderate the relationship between autistic traits and camouflaging, and also mental health. Data were available for 627 autistic adults, recruited through volunteer databases and social media. Participants completed measures of autistic traits, anxiety, depression, positive wellbeing, camouflaging behaviours (compensating for difficulties, masking, and assimilating/putting on an act) and autistic identity. Mediation and moderated mediation models were tested, applying 95% bootstrapped CIs (10,000 resamples) and including age, gender and diagnosis as covariates. There were no significant direct effects between autistic traits and mental wellbeing. Assimilation was a significant mediator of all mental wellbeing measures, and compensation was a significant mediator of positive wellbeing only. Autistic identity was not a significant moderator. Assimilation and compensation should be considered when offering psychological interventions to support mental wellbeing of autistic people. Additional research into external drivers of camouflaging (e.g. stigma) and mechanisms by which camouflaging impacts mental wellbeing, such as autonomy, authenticity, skill mastery and community, may identify other areas of support. Concurrently, societal change is necessary to reduce the need to camouflage.
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Affiliation(s)
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, University Park, Nottingham, UK
| | - Jacqui Rodgers
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
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Jones CRG, Livingston LA, Fretwell C, Uljarević M, Carrington SJ, Shah P, Leekam SR. Measuring self and informant perspectives of Restricted and Repetitive Behaviours (RRBs): psychometric evaluation of the Repetitive Behaviours Questionnaire-3 (RBQ-3) in adult clinical practice and research settgs. Mol Autism 2024; 15:24. [PMID: 38845057 PMCID: PMC11157832 DOI: 10.1186/s13229-024-00603-7] [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: 11/01/2023] [Accepted: 05/11/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Brief questionnaires that comprehensively capture key restricted and repetitive behaviours (RRBs) across different informants have potential to support autism diagnostic services. We tested the psychometric properties of the 20-item Repetitive Behaviours Questionnaire-3 (RBQ-3), a questionnaire that includes self-report and informant-report versions enabling use across the lifespan. METHOD In Study 1, adults referred to a specialised adult autism diagnostic service (N = 110) completed the RBQ-3 self-report version, and a relative or long-term friend completed the RBQ-3 informant-report version. Clinicians completed the abbreviated version of the Diagnostic Interview for Social and Communication Disorders (DISCO-Abbreviated) with the same adults as part of the diagnostic process. For half of the assessments, clinicians were blind to the RBQ-3 ratings. We tested internal consistency, cross-informant reliability and convergent validity of the RBQ-3. In Study 2, a follow-up online study with autistic (N = 151) and non-autistic (N = 151) adults, we further tested internal consistency of the RBQ-3 self-report version. We also tested group differences and response patterns in this sample. RESULTS Study 1 showed good to excellent internal consistency for both self- and informant-report versions of the RBQ-3 (total score, α = 0.90, ω = 0.90, subscales, α = 0.76-0.89, ω = 0.77-0.88). Study 1 also showed cross-informant reliability as the RBQ-3 self-report scores significantly correlated with RBQ-3 informant-report scores for the total score (rs = 0.71) and subscales (rs= 0.69-0.72). Convergent validity was found for both self and informant versions of the RBQ-3, which significantly correlated with DISCO-Abbreviated RRB domain scores (rs = 0.45-0.54). Moreover, the RBQ-3 scores showed significantly weaker association with DISCO -Abbreviated scores for the Social Communication domain, demonstrating divergent validity. Importantly, these patterns of validity were found even when clinicians were blind to RBQ-3 items. In Study 2, for both autistic and non-autistic groups, internal consistency was found for the total score (α = 0.82-0.89, ω = 0.81-0.81) and for subscales (α = 0.68-0.85, ω = 0.69-0.85). A group difference was found between groups. LIMITATIONS Due to the characteristics and scope of the specialist autism diagnostic service, further testing is needed to include representative samples of age (including children) and intellectual ability, and those with a non-autistic diagnostic outcome. CONCLUSIONS The RBQ-3 is a questionnaire of RRBs that can be used across the lifespan. The current study tested its psychometric properties with autistic adults without intellectual disability and supported its utility for both clinical diagnostic and research settings.
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Affiliation(s)
- Catherine R G Jones
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, UK.
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK.
| | - Lucy A Livingston
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, UK
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christine Fretwell
- Integrated Autism Service, Aneurin Bevan University Health Board, Pontypool, Wales, UK
| | - Mirko Uljarević
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, US
| | - Sarah J Carrington
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Punit Shah
- Department of Psychology, University of Bath, Bath, UK
| | - Susan R Leekam
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, UK
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, 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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15
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Josyfon E, Spain D, Blackmore C, Murphy D, Oakley B. Alexithymia in Adult Autism Clinic Service-Users: Relationships with Sensory Processing Differences and Mental Health. Healthcare (Basel) 2023; 11:3114. [PMID: 38132004 PMCID: PMC10742835 DOI: 10.3390/healthcare11243114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Mental health difficulties commonly co-occur with autism, especially in autistic people accessing clinic services, impacting substantially on quality-of-life. Alexithymia (difficulty describing/identifying feelings) and sensory processing differences are prevalent traits in autism that have been associated with depression/anxiety in autistic community samples. However, it is important to better understand interrelationships between these traits in clinical populations to improve identification of service-user needs. In this study, 190 autistic adults (65.3% male), seen in a tertiary autism clinic, completed self-report measures of alexithymia (20-item Toronto Alexithymia Scale), sensory processing differences (Adolescent/Adult Sensory Profile) and depression/anxiety (Hospital Anxiety and Depression Scale). Multiple linear regression models and mediation analyses were used to examine associations between alexithymia, sensory processing differences, and depression/anxiety severity. Across the sample, 66.3% of individuals (N = 126) were classified as alexithymic (score ≥ 61). Total alexithymia and difficulty describing/identifying feelings were significantly associated with depression severity (β = 0.30-0.38, highest p < 0.002), and difficulty identifying feelings was significantly associated with anxiety severity (β = 0.36, p < 0.001). Sensory processing differences were also significantly associated with depression severity (β = 0.29, p = 0.002) and anxiety severity across all models (β = 0.34-0.48, highest p < 0.001) Finally, difficulty describing/identifying feelings partially mediated the relationships between sensory processing differences and both depression/anxiety severity. Overall, these results highlight that interventions adapted for and targeting emotional awareness and sensory-related uncertainty may improve mental health outcomes in autistic service-users.
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Affiliation(s)
- Emily Josyfon
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Debbie Spain
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Charlotte Blackmore
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
- Sackler Institute for Translational Neurodevelopment, King’s College London, De Crespigny Park, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust (SLaM), London SE5 8AZ, UK
| | - Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
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16
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Connolly SE, Constable HL, Mullally SL. School distress and the school attendance crisis: a story dominated by neurodivergence and unmet need. Front Psychiatry 2023; 14:1237052. [PMID: 37810599 PMCID: PMC10556686 DOI: 10.3389/fpsyt.2023.1237052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023] Open
Abstract
Background The Covid-19 pandemic has brought into sharp focus a school attendance crisis in many countries, although this likely pre-dates the pandemic. Children and young people (CYP) struggling to attend school often display extreme emotional distress before/during/after school. We term this School Distress. Here we sought to elucidate the characteristics of the CYP struggling to attend school in the United Kingdom. Methods Using a case-control, concurrent embedded mixed-method research design, 947 parents of CYP with experience of School Distress completed a bespoke online questionnaire (February/March 2022), alongside an age-matched control group (n = 149) and a smaller group of parents who electively home-educate (n = 25). Results In 94.3% of cases, school attendance problems were underpinned by significant emotional distress, with often harrowing accounts of this distress provided by parents. While the mean age of the CYP in this sample was 11.6 years (StDev 3.1 years), their School Distress was evident to parents from a much younger age (7.9 years). Notably, 92.1% of CYP currently experiencing School Distress were described as neurodivergent (ND) and 83.4% as autistic. The Odds Ratio of autistic CYP experiencing School Distress was 46.61 [95% CI (24.67, 88.07)]. Autistic CYP displayed School Distress at a significantly earlier age, and it was significantly more enduring. Multi-modal sensory processing difficulties and ADHD (among other neurodivergent conditions) were also commonly associated with School Distress; with School Distress CYP having an average of 3.62 NDs (StDev 2.68). In addition, clinically significant anxiety symptomology (92.5%) and elevated demand avoidance were also pervasive. Mental health difficulties in the absence of a neurodivergent profile were, however, relatively rare (6.17%). Concerningly, despite the striking levels of emotional distress and disability reported by parents, parents also reported a dearth of meaningful support for their CYP at school. Conclusion While not a story of exclusivity relating solely to autism, School Distress is a story dominated by complex neurodivergence and a seemingly systemic failure to meet the needs of these CYP. Given the disproportionate number of disabled CYP impacted, we ask whether the United Kingdom is upholding its responsibility to ensure the "right to an education" for all CYP (Human Rights Act 1998).
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Affiliation(s)
- Sophie E. Connolly
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Hannah L. Constable
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sinéad L. Mullally
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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17
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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: 8] [Impact Index Per Article: 4.0] [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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18
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Evers K, Gijbels E, Maljaars J, Rumball F, Spain D, Happé F, Noens I. Mental health of autistic adults during the COVID-19 pandemic: The impact of perceived stress, intolerance of uncertainty, and coping style. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:832-847. [PMID: 36263743 PMCID: PMC9582738 DOI: 10.1177/13623613221119749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
LAY ABSTRACT More and more research shows us that autistic individuals are at risk of experiencing mental health problems in response to the COVID-19 pandemic. However, little is known about why this is the case. At two timepoints during the pandemic, we asked 149 autistic and 147 non-autistic adults about feelings of anxiety, depression, and stress, and about characteristics that may explain why some (autistic) people have a larger chance of developing anxiety and depression during this pandemic. In our study, autistic adults experienced more anxiety and depression than non-autistic adults. Across autistic and non-autistic individuals, the people who experienced more stress at timepoint 1 experienced more anxiety and depression 4 months later. This was especially the case for those individuals who use maladaptive coping styles, such as denial or venting, and for those who have difficulties dealing with uncertain situations. Our findings show the burden of the COVID-19 pandemic on the mental health of autistic adults. Interventions to support autistic adults during and after the pandemic are needed, and they may want to focus on the negative impact of stress and teach autistic (and non-autistic) adults more adaptive ways to cope with stressful circumstances.
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Affiliation(s)
- Kris Evers
- KU Leuven, Belgium
- UPC Z.org KU Leuven, Belgium
| | | | | | - Freya Rumball
- King’s College London, UK
- Oxleas NHS Foundation Trust, UK
| | | | | | - Ilse Noens
- KU Leuven, Belgium
- UPC Z.org KU Leuven, Belgium
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19
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The relationship between communication skills, sensory difficulties, and anxiety in children with autism spectrum disorder. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00236-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Despite the high prevalence of communicational differences, anxiety, and sensory processing difficulties in children with autism spectrum disorder (ASD), little is known about the nature of their experiences. Thus, the present study aimed to explore the correlation between communication skills, sensory difficulties, and anxiety in children with ASD. Fifty-three children with ASD (Mage = 8.51, SD = 2.51; males = 42) were recruited. The Persian version of the Short Sensory Profile (SSP), the Children’s Communication Checklist (CCC), and the Spence Children’s Anxiety Scale (SCAS) was used to assess the variables.
Results
The overall sensory score of children with ASD was significantly and positively correlated with most of the communication skills (P < 0.05). The overall sensory score of children with ASD was significantly and negatively correlated with all anxiety subsets of these children (P < 0.05). The social relationships score of children with ASD had a significant and negative correlation with all subsets of anxiety and a significant and positive correlation with all sensory subsets (P < 0.05). The total score of communication was significantly and negatively related to all subsets of anxiety except separation anxiety (P < 0.05).
Conclusions
Sensory processing difficulties in ASD children appear to be significantly associated with communication skills and anxiety acts as a mediator between the two.
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Soker-Elimaliah S, Lehrfield A, Scarano SR, Wagner JB. Associations between the pupil light reflex and the broader autism phenotype in children and adults. Front Hum Neurosci 2022; 16:1052604. [PMID: 36895201 PMCID: PMC9990758 DOI: 10.3389/fnhum.2022.1052604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/16/2022] [Indexed: 02/25/2023] Open
Abstract
The pupil light reflex (PLR), a marker of neuronal response to light, is a well-studied index of autonomic functioning. Studies have found that autistic children and adults have slower and weaker PLR responses compared to non-autistic peers, suggesting lower autonomic control. Altered autonomic control has also been associated with increased sensory difficulties in autistic children. With autistic traits varying in the general population, recent studies have begun to examine similar questions in non-autistic individuals. The current study looked at the PLR in relation to individual differences in autistic traits in non-autistic children and adults, asking how differences in the PLR could lead to variation in autistic traits, and how this might change across development. Children and adults completed a PLR task as a measure of sensitivity to light and autonomic response. Results showed that, in adults, increased levels of restricted and repetitive behaviors (RRB) were associated with a weaker and slower PLR. However, in children, PLR responses were not associated with autistic traits. Differences in PLR were also found across age groups, with adults showing smaller baseline pupil diameter and stronger PLR constriction as compared with children. The current study expanded on past work to examine the PLR and autistic traits in non-autistic children and adults, and the relevance of these findings to sensory processing difficulties is discussed. Future studies should continue to examine the neural pathways that might underlie the links between sensory processing and challenging behaviors.
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Affiliation(s)
- Sapir Soker-Elimaliah
- Department of Psychology, College of Staten Island, City University of New York, New York, NY, United States.,Department of Psychology, The Graduate Center, City University of New York, New York, NY, United States.,Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Aviva Lehrfield
- Albert Einstein College of Medicine, The Bronx, NY, United States
| | - Samuel R Scarano
- Department of Psychology, College of Staten Island, City University of New York, New York, NY, United States
| | - Jennifer B Wagner
- Department of Psychology, College of Staten Island, City University of New York, New York, NY, United States.,Department of Psychology, The Graduate Center, City University of New York, New York, NY, United States
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