Autism-spectrum quotient Japanese version measures mental health problems other than autistic traits

Mapping the link between socio-economic factors, autistic traits and mental health across different settings

LAY ABSTRACT

Autistic individuals are more likely than non-autistic individuals to experience a mental health condition in their lifetime, and this includes externalising and internalising symptoms. We know very little about how different environments and family conditions impact these symptoms for autistic individuals. Improving our understanding of these relationships is important so that we can identify individuals who may be in greater need of support. In this article, we seek to improve our understanding of how environmental and family conditions impact externalising and internalising symptoms in autistic and non-autistic people. To do this, we conducted analyses with two cohorts in very different settings - in Europe and South Africa - to ensure our findings are globally representative. We used advanced statistical methods to establish environmental and family conditions that were similar to each other, and which could be combined into specific 'factors'. We found that four similar 'factors' could be identified in the two cohorts. These were distinguished by personal characteristics and environmental conditions of individuals, and were named Person Characteristics, Family System, Parental and Material Resources. Interestingly, just 'Family System' was associated with internalising and externalising symptoms, and this was the same in both cohorts. We also found that having high traits of autism impacted this relationship between Family System and mental health conditions with opposite directions in the two settings. These results show that characteristics in the Family System are associated with internalising and externalising symptoms, and autistic persons are particularly impacted, reinforcing the notion that family stressors are important to consider when implementing policy and practice related to improving the mental health of autistic people.

After one year in university; a robust decrease in autistic traits reporting among autistic students

Background

Previous research on autistic students enrolled in university support programs has reported moderate improvement in anxiety/depression or adaptive behavior. However, alterations in autistic traits have not been examined.

Methods

This longitudinal study evaluated changes in university students' autistic trait and state/trait anxiety levels. Participants were 24 neurotypically developed (ND) students with high levels of social anxiety symptoms (High SA), 30 ND students with low levels of SA symptoms (Low SA), and 41 autistic students (the primary focus of this study) residing with an ND peer student mentor as part of participating in the university's integration support program. Autism spectrum quotient [AQ and State Trait Anxiety Inventory STAI] data were collected during the first semester of two consecutive academic years (T1, T2), as well as baseline (T1) levels of social anxiety, depression, and obsessive-compulsive symptoms.

Results

Significant interaction between group and time was observed, denoting a sharp decrease (2.9 SD) from T1 to T2 in the overall autistic trait level among the autistic group (AQ "attention switching" subscale demonstrating the most robust decrease), and a moderate decrease (0.5 SD) among the high SA group. Only for the autistic students were more compulsive symptoms at T1 associated with a lesser decrease in AQ scores (T1-T2), which in turn was negatively correlated with their T1 year-end grade point average.

Conclusion

The findings suggest that attending post-secondary education (while partaking in a support/transition program) is followed by a profound change of the individual's subjective experience of autism, characterized by a sharp decline in the level of autistic traits, particularly attention switching. This change is independent of alterations in well-being indices, such as anxiety, that are known to characterize students attending university.

Risk of postpartum depression and very early child mistreatment among mothers reporting higher autistic traits: Evidence from the Japan Environment and Children's Study

BACKGROUND

Little is known about how mothers who report higher autistic traits face new parenthood. This study examined the association between antenatal non-clinical autistic traits and the risks of both postpartum depression (PPD) and child mistreatment at one-month postpartum and if these associations were mediated by preexisting social support.

METHODS

Participants included 73,532 singleton mothers without histories of psychiatric conditions from the Japan Environment and Children's Study, a nationwide birth cohort. Autistic traits were measured during the second/third trimesters using the short-version of the Autism Quotient-Japanese version. Participants were classified into three groups (i.e., typical-range, moderate-range, and high-range). PPD was measured using the Japanese version of the Edinburgh Postnatal Depression Scale, while participants self-reported experiences of child mistreatment (i.e., hit or shake the child); both assessments were conducted at one-month postpartum. Individual social support was reported during pregnancy. Data analyses were conducted through Poisson regressions.

RESULTS

A total of 7,147 (9.7%) participants reported PPD, while 12,994 (17.7%) reported child mistreatment at one-month postpartum. Autistic traits were associated with increased PPD risk (adjusted-relative risk [aRR] =1.74, 95%CI=1.64-1.84 for moderate-range; aRR=2.33, 2.13-2.55 for high-range) and child mistreatment (aRR=1.19, 1.13-1.24 for moderate-range; aRR=1.39, 1.28-1.50 for high-range) independently of confounders. Social support mediated 26-31% of these associations for moderate/high-range groups (both risks).

LIMITATIONS

Self-reported measurements were used.

CONCLUSIONS

Mothers who reported moderate-to-high autistic traits in the general population were vulnerable to PPD and newborn mistreatment at one-month postpartum, which was partially explained by the lack of social support during pregnancy.

Suicidality in Adults with Autism Spectrum Disorder: The Role of Depressive Symptomatology, Alexithymia, and Antidepressants

People with autism spectrum disorder (ASD) have an increased risk of suicidality. However, the risk factors remain under-investigated. This study explored factors that increase suicidality risk in ASD. Through an online survey, 150 adults with ASD were compared to 189 control adults. Autistic traits, depressive symptomatology, alexithymia, and antidepressant intake were assessed on their contribution predicting suicidality. Among people with ASD, 63% scored above the cutoff for high suicidality risk. Increased autistic traits, depressive symptomatology, and antidepressant intake significantly predicted suicidality. Furthermore, among those with high levels of autistic traits, the risk of suicidality was increased if they also had high levels of alexithymia. These results highlight the importance of considering depression, antidepressants, and alexithymia to prevent suicidality in ASD.

Autism spectrum conditions in hikikomori: A pilot case-control study

AIM

Hikikomori, a form of pathological social withdrawal, has been suggested to have comorbidity with autism spectrum disorder (ASD). This study aimed to clarify how characteristics of hikikomori are associated with ASD, including undiagnosed autism spectrum conditions (ASC), in clinical settings.

METHODS

A total of 416 clinical patients were recruited through the Mood Disorder/Hikikomori Clinic at Kyushu University Hospital. A total of 103 hikikomori cases and 221 clinical controls without hikikomori conditions were extracted using a semi-structured interview, and completed a series of self-rated scales, including the Japanese version of the Autism-Spectrum Quotient (AQ-J).

RESULTS

Compared to non-hikikomori controls, hikikomori cases were more likely to have higher autistic tendency based on the AQ-J. The cases showed more severe subjective depressive symptoms based on the self-rated Beck Depression Inventory II, whereas no significant difference was found on interview-based severity evaluation using the Hamilton Depression Rating Scale. Comparison within hikikomori cases based on the AQ-J cut-off score revealed that hikikomori cases with high ASC were significantly more likely to have higher traits of modern-type depression, smaller social networks, and less social support.

CONCLUSION

The present data suggest that hikikomori sufferers are more likely to have autistic tendency, and that hikikomori sufferers with high ASC may have much more difficulty in social communication and social interaction. In addition, those with high ASC may also have lower self-esteem and higher complaint tendencies as aspects of modern-type depression traits, which may relate to the occurrence of hikikomori. Thus, evaluating autistic tendencies is important for appropriate interventions in hikikomori. Further investigations should be conducted to validate our pilot findings using structured diagnostic systems of ASD.

Measuring Autism Traits in the Adult General Population with the Brief Autism-Spectrum Quotient, AQ-10: Findings from the Stockholm Public Health Cohort

BACKGROUND

The autism-spectrum quotient scale was developed to study autism as a spectrum. Few studies have examined the psychometric properties of the 10 item AQ (AQ-10). We examine the AQ-10 measurement ability and convergent validity in a population health survey (n = 44,722).

METHODS

The item severity and item discrimination was assessed using item response theory. Convergent validity was assessed by regressing on ADHD, psychological distress (PD) and having an education in the sciences.

RESULTS

Whilst unidimensional, the AQ-10 had some poorly fitting items. Item discrimination ranged from very low to very high. The scale correlated as hypothesised with the regress expected when factoring in ADHD, PD and possessing an eduction in the sciences.

CONCLUSION

The AQ-10 has adequate validity in the present sample and may be used in s as a measure of autistic traits. In Conclusion, The AQ-10 has adequate validity to be used in health surveys as a measure of autistic traits, although some items may perform poorly.

Whether the Autism Spectrum Quotient consists of two different subgroups? Cluster analysis of the Autism Spectrum Quotient in general population

The purpose of this study was to investigate whether the individuals in the general population with high scores on the Autism Spectrum Quotient constituted a single homogeneous group or not. A cohort of university students (n = 4901) was investigated by cluster analysis based on the original five subscales of the Autism Spectrum Quotient. Based on the results of the analysis, the students could be divided into six clusters: the first with low scores on all the five subscales, the second with high scores on only the ‘attention to detail’ subscale, the third and fourth with intermediate scores on all the subscales, the fifth with high scores on four of the five subscales but low scores on the ‘attention to detail’ subscale and the sixth with high scores on all the five subscales. The students with high total Autism Spectrum Quotient scores (n = 166) were divided into two groups: one with high scores on four subscales but low scores on the ‘attention to detail’ subscale and the other with high scores on all the five subscales. The results of this study suggested that individuals from the general population with high Autism Spectrum Quotient scores may consist of two qualitatively different groups.

Distinctive Rorschach profiles of young adults with schizophrenia and autism spectrum disorder

OBJECTIVE

The differential diagnosis of schizophrenia (SZ) versus autism spectrum disorder (ASD) can be clinically challenging because accumulating evidence suggests both clinical and biological overlaps between them. The aim of this study was to compare Rorschach profiles between young adults with SZ and those with ASD.

METHODS

We evaluated quantitative tendencies on the Rorschach test among 20 patients diagnosed with SZ and 20 diagnosed with ASD. Both groups were matched for age, sex, and intelligence quotient.

RESULTS

We found significant differences in six response variables on the Rorschach comprehensive system. Those with SZ had significantly higher scores on D score, adjusted D score (Adj D), developmental quality code reflecting ordinary response (DQo), and form quality minus (FQ -) than those with ASD. In contrast, those with SZ had significantly lower scores on the active and developmental quality code reflecting synthesized response (DQ+) subscales than those with ASD.

CONCLUSION

The present findings reveal that individuals with SZ might have more stress tolerance, stronger perception distortions, and simpler and poorer recognition than those with ASD. We suggest that the Rorschach test might be a useful tool for differentiating between SZ and ASD.

Genetic and environmental influences underlying the relationship between autistic traits and temperament and character dimensions in adulthood

BACKGROUND

In recent years, several twin studies adopted a dimensional approach to Autism Spectrum Disorders (ASD) and estimated the contribution of genetic and environmental influences to variation in autistic traits. However, no study was performed on adults over 18 years of age and all but two studies were based on parent or teacher ratings. Also, the genetic and environmental contributions to the interplay between autistic traits and adult personality dimensions have not been investigated.

METHODS

A sample of 266 complete twin pairs (30% males, mean age 40 ± 12 years) drawn from the population-based Italian Twin Register was administered the Autism-Spectrum Quotient, Temperament and Character Inventory (TCI-125), and General Health Questionnaire (GHQ-12). Genetic structural equation modelling was performed with the Mx program. Estimates were adjusted for gender, age, and GHQ-12 score.

RESULTS

Genetic factors accounted for 44% and 20%-49% of individual differences in autistic traits and TCI dimensions, respectively. Unshared environmental factors explained the remaining proportion of variance. Consistently with the notion of a personality profile in ASD characterised by obsessive temperament, autistic traits showed significant phenotypic correlations with several TCI dimensions (positive: HA; negative: NS, RD, SD, C). Genetic and unshared environmental correlations between AQ and these TCI dimensions were significant. The degree of genetic overlap was generally greater than the degree of environmental overlap.

CONCLUSIONS

Despite some limitations, this study suggests that genetic factors contribute substantially to individual differences in autistic traits in adults, with unshared environmental influences also playing an important role. It also suggests that autistic traits and the majority of temperament and character dimensions share common genetic and environmental aetiological factors.

The Autism-Spectrum Quotient in university students: pattern of changes in its scores and associated factors

INTRODUCTION

Support to university students with autism spectrum disorders (ASD) is becoming increasingly important. To determine the validity of the Autism-Spectrum Quotient (AQ) for ASD screening of university students, we conducted longitudinal measurements of the AQ in a large sample of university students and investigated the possibility of changes in the AQ and associated factors.

METHODS

The AQ, University Personality Inventory (UPI), and the willingness of the students to be interviewed were determined at admission in students from four departments of Kochi University; the AQ was determined again in the second year. Changes in the AQ and associated factors were analyzed statistically.

RESULTS

The number of valid responses in the initial survey was 3427 (87.2%). The AQ was significantly higher in the group with high UPI scores (F = 156.08, P < 0.001). Of the 486 students interviewed at admission, 22 had suspected ASD. The sensitivity/specificity of the AQ for ASD was 81.8%/92.0%. A total of 319 (11.0%) students responded to the second-year survey, which revealed significant decrease of the AQ in the group with high AQ values at admission.

DISCUSSION

The AQ measured at admission was correlated with the UPI score, regardless of the sex or department; in the second survey, the scores decreased significantly in those with high AQ values at admission, suggesting that an unstable mental state can produce a temporary increase of the AQ scores.

Association of autism tendency and hemodynamic changes in the prefrontal cortex during facial expression stimuli measured by multi-channel near-infrared spectroscopy

AIM

The aim of this study is to examine the hemodynamic changes induced by the cognitive process of facial expression by using multi-channel near-infrared spectroscopy in healthy subjects with varying degrees of autism tendency.

METHODS

Subjects were 38 volunteers, 20 men and 18 women. Autism tendency was measured by the Autism Spectrum Quotient. The hemodynamic changes in the prefrontal cortex were measured by 24-channel near-infrared spectroscopy system, while subjects were asked to judge their own emotional response to standardized pictures of eight kinds of facial expressions on a computer screen.

RESULTS

There were significant negative correlations between Autism Spectrum Quotient scores and accuracy of fearful expression recognition as well as increases in the concentration of oxygenated hemoglobin in response to four kinds of emotional faces (fear, contempt, sadness and disgust).

CONCLUSION

Our findings suggest that the greater tendency to autism that subjects have, the more difficulty they have in recognizing a fearful expression and the less hemodynamic change in the prefrontal cortex they show in response to negative facial expressions.

The French version of the autism-spectrum quotient in adolescents: a cross-cultural validation study

We assessed the accuracy of the French version of the Autism Spectrum Quotient (AQ) in adolescents with Asperger syndrome (AS) and high-functioning autism (HFA) compared to healthy controls and adolescents with psychiatric disorders (PDs). Three groups of adolescents, aged 11-18, were assessed: 116 with AS/HFA (93 with IQ ≥ 85 and 20 with 70 ≤ IQ < 85), 39 with other PDs, and 199 healthy controls. The AS/HFA group scored significantly higher than the healthy control and PD groups. A cut-off score of 26 was used to differentiate the autism group from healthy controls with 0.89 sensitivity and 0.98 specificity. Scores did not vary by age or sex.

Association between autistic traits and social anxiety among Japanese university students

Background: Symptom overlap between autism spectrum disorders (ASD) and social anxiety disorder has been reported. However, few reports exist on the associations between autistic traits and social anxiety in young adults.

Methods: Autistic traits and social anxiety were assessed using the Autism-Spectrum Quotient (AQ) and the Liebowitz Social Anxiety Scale (LSAS), respectively. The survey was performed as part of the student health check-up at admission to our school, Kochi University. The relationship between the AO and LSAS scores were analyzed.

Results: In all, 1479 students (77.2%) completed both the questionnaires. The overall AQ score was significantly related to the score on the Japanese version of the LSAS (LSAS-J) (Spearman’s correlation coefficient; 0.46, p<0.001). The group of students with AQ≥33 had significantly higher total and subscale scores on the LSAS-J as compared to the group with AQ<33, while the group with LSAS-J≥44 showed significantly higher scores on all the subscales of the AQ, except “Attention to detail,” as compared to the group with LSAS-J<44.

Conclusions: The results suggest that both students diagnosed as having ASD and those with autistic traits may experience anxiety symptoms. The score for “Attention to detail” on the AQ, which was not related to the presence of social anxiety, may be useful in discriminating between autistic traits and social anxiety.

Do patients with hoarding disorder have autistic traits?

BACKGROUND

Hoarding symptoms have been described in individuals with autism spectrum disorders (ASD). Furthermore, individuals with hoarding disorder (HD) may display some ASD-like features. In order to further refine the diagnostic boundaries of HD, we examined the presence of autistic traits and theory of mind deficits in individuals with HD and of hoarding behavior in patients with ASD.

METHODS

Two hundred and twenty-one participants in five groups (HD, ASD, obsessive-compulsive disorder (OCD), anxiety disorders (AD), and healthy controls (HC)) were administered measures of autistic traits (Autism-Spectrum Quotient), theory of mind (eyes test-revised), and hoarding severity (saving inventory-revised; SI-R (add acronym)).

RESULTS

Hoarders displayed more autistic traits compared to healthy individuals but not to psychiatric controls. Participants with ASD had significantly higher scores on the SI-R than both psychiatric (OCD or AD) and HC groups, indicating more severe hoarding behavior, but had lower scores than participants with HD. The presence of autistic traits in individuals with HD was related to the presence of comorbid OCD, but the presence of hoarding symptoms in individuals with ASD was unrelated to comorbid OCD.

CONCLUSIONS

We conclude that individuals with HD do not display more autistic traits than psychiatric controls, thus supporting its status as an independent diagnostic entity. More research is needed to further understand the phenomenology and clinical relevance of hoarding symptoms in ASD.

Impaired ability to organize information in individuals with autism spectrum disorders and their siblings

Despite rigorous research on disturbances of executive function and social cognition in autism spectrum disorders (ASD), little information has been available concerning higher cognitive functions, such as the ability to focus and associate relevant features to form categories, or 'organizing of information'. The purpose of this study was to investigate this issue by using the Wisconsin Card Sorting Test (WCST) and the Verbal Learning Task (VLT). Cognitive assessments were conducted in 22 individuals with ASD, 14 non-affected siblings, and 15 age-matched control subjects. Overall, individuals with ASD performed significantly worse on the WCST and VLT compared to their siblings and normal control subjects. Although siblings performed generally well on both tasks, they exhibited similar degree of perseverative responses in the WCST compared to the probands. A linear increase of the memory organization score in the VLT was also absent in siblings as well as the ASD group. These results suggest an impaired ability to organize information is one of the cognitive endophenotypes for ASD.

Autistic traits predict performance on the block design

The Autism-Spectrum Quotient (AQ) has been developed to measure the degree to which an adult with normal intelligence has autistic traits. Although use of the AQ has resulted in a number of important findings, few studies have assessed whether scores predict cognitive aspects of ASD. This study assessed whether AQ scores predicted performance on an adapted block design. The test was adapted with a 'whole' and a 'segmented' task. High AQ scorers performed better than low scorers on the 'whole' task in the block design but performed equivalently on the 'segmented' task, as would be predicted in the autism spectrum. These findings add to the evidence showing construct validity for the AQ.