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Płatos M, Wojaczek K, Laugeson EA. Fostering Friendship and Dating Skills Among Adults on the Autism Spectrum: A Randomized Controlled Trial of the Polish Version of the PEERS® for Young Adults Curriculum. J Autism Dev Disord 2024; 54:2224-2239. [PMID: 37043040 PMCID: PMC10090714 DOI: 10.1007/s10803-023-05921-y] [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: 02/03/2023] [Indexed: 04/13/2023]
Abstract
PEERS® for Young Adults is an evidence-based program aimed at teaching social skills needed to establish and maintain close relationships, including friendship and romantic relationships. The study investigated the effects of the Polish adaptation of the curriculum on the social functioning of adults on the autism spectrum. Fifteen young adults (aged 18-32, M = 23.5) were randomly allocated to an immediate or delayed (control) treatment condition. By self and parent report, individuals who participated in the PEERS® program showed significant improvements in social skills, social cognition, and social knowledge, but limited gains in social engagement. The effects were maintained over six months after the treatment. The intervention was well-accepted and deemed feasible by young adults, their parents, and peers involved in the program.
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Affiliation(s)
- Mateusz Płatos
- Faculty of Psychology, University of Warsaw, Stawki 5/7, Warsaw, 00-183, Poland.
- Association for Social Innovation "Mary and Max", Marszałkowska 84/92/201, Warsaw, 00-514, Poland.
| | - Kinga Wojaczek
- Association for Social Innovation "Mary and Max", Marszałkowska 84/92/201, Warsaw, 00-514, Poland
| | - Elizabeth A Laugeson
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
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2
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Gernert CC, Falter-Wagner CM, Noreika V, Jachs B, Jassim N, Gibbs K, Streicher J, Betts H, Bekinschtein TA. Stress in autism (STREAM): A study protocol on the role of circadian activity, sleep quality and sensory reactivity. PLoS One 2024; 19:e0303209. [PMID: 38768146 PMCID: PMC11104633 DOI: 10.1371/journal.pone.0303209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 04/21/2024] [Indexed: 05/22/2024] Open
Abstract
Mental health issues are markedly increased in individuals with autism, making it the number one research priority by stakeholders. There is a crucial need to use personalized approaches to understand the underpinnings of mental illness in autism and consequently, to address individual needs. Based on the risk factors identified in typical mental research, we propose the following themes central to mental health issues in autism: sleep difficulties and stress. Indeed, the prevalence of manifold circadian disruptions and sleep difficulties in autism, alongside stress related to sensory overload, forms an integral part of autistic symptomatology. This proof-of-concept study protocol outlines an innovative, individualised approach towards investigating the interrelationships between stress indices, sleep and circadian activation patterns, and sensory sensitivity in autism. Embracing an individualized methodology, we aim to collect 14 days of data per participant from 20 individuals with autism diagnoses and 20 without. Participants' sleep will be monitored using wearable EEG headbands and a sleep diary. Diurnal tracking of heart rate and electrodermal activity through wearables will serve as proxies of stress. Those objective data will be synchronized with subjective experience traces collected throughout the day using the Temporal Experience Tracing (TET) method. TET facilitates the quantification of relevant aspects of individual experience states, such as stress or sensory sensitivities, by providing a continuous multidimensional description of subjective experiences. Capturing the dynamics of subjective experiences phase-locked to neural and physiological proxies both between and within individuals, this approach has the potential to contribute to our understanding of critical issues in autism, including sleep problems, sensory reactivity and stress. The planned strives to provide a pathway towards developing a more nuanced and individualized approach to addressing mental health in autism.
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Affiliation(s)
- Clara C. Gernert
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | | | - Valdas Noreika
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, United Kingdom
| | - Barbara Jachs
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Nazia Jassim
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Prediction and Learning Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | | | - Joaquim Streicher
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Hannah Betts
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Tristan A. Bekinschtein
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
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Dehghankar L, Valinezhad S, Amerzadeh M, Zarabadi Poor F, Hosseinkhani Z, Motalebi SA. Relationship between perceived social support and disability with the mediating role of perceived stress among older adults. BMC Geriatr 2024; 24:276. [PMID: 38509480 PMCID: PMC10956299 DOI: 10.1186/s12877-024-04871-z] [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: 07/26/2023] [Accepted: 03/04/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Social support is essential for individuals to cope with difficult circumstances. Older adults with disabilities face significant challenges in engaging with everyday activities. The current study examines the mediating role of perceived stress in the association between perceived social support and disability among Iranian community-dwelling older adults. METHODS In this descriptive and cross-sectional study, 300 older adults were selected using cluster sampling from January to June 2022. The data were collected using the Multidimensional Scale of Perceived Social Support (MSPSS), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2), and the Cohen Perceived Stress Scale-14 (PSS-14). The collected data was analyzed using structural equation modeling (SEM) in Mplus. RESULTS The mean age of older adults was 68.71 ± 6.13 years, ranging from 60 to 85 years old. The results of this study revealed a significant relationship between perceived social support and disability (β=-0.20, SE = 0.06, p < 0.001) and perceived stress and disability (β = 0.50, SE = 0.05, p < 0.001). The results also confirmed the mediating role of perceived stress in the relationship between perceived social support and disability (β=-0.17, SE = 0.03, p < 0.001). CONCLUSION The results indicated that increasing social support could reduce disability by decreasing perceived stress. These results have important implications for policymakers and healthcare professionals in promoting healthy aging.
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Affiliation(s)
- Leila Dehghankar
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saman Valinezhad
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Farnoosh Zarabadi Poor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zahra Hosseinkhani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Seyedeh Ameneh Motalebi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
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Agius H, Luoto AK, Backman A, Eriksdotter C, Jayaram-Lindström N, Bölte S, Hirvikoski T. Mindfulness-based stress reduction for autistic adults: A feasibility study in an outpatient context. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:403-414. [PMID: 37190953 PMCID: PMC10851647 DOI: 10.1177/13623613231172809] [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] [Indexed: 05/17/2023]
Abstract
LAY ABSTRACT Autistic adults report high stress levels and difficulties dealing with everyday stressors. Mindfulness-based stress reduction groups aim to help regulate stress responses. We asked 50 autistic adults, without intellectual disability, to participate in a study of mindfulness-based stress reduction. The group program was made accessible through clear group leader communication and good program predictability, as well as reduced exposure to disturbing sensory stimuli. The mindfulness and yoga based exercises from the original mindfulness-based stress reduction program were included. The participants were positive and would even recommend an autistic friend to participate in a mindfulness-based stress reduction group. They reported that mindfulness-based stress reduction could lower symptoms of stress and improved stress coping. We still need to investigate these effects further in larger studies. The findings of this work show that mindfulness-based stress reduction groups can be adapted for autistic adults and that the participants overall were positive to the intervention and the group format.
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Affiliation(s)
- Hanna Agius
- Karolinska Institutet, Stockholm Health Care Services, Sweden
- Stockholm Health Care Services, Sweden
| | | | - Anna Backman
- Karolinska Institutet, Stockholm Health Care Services, Sweden
- Stockholm Health Care Services, Sweden
| | | | | | - Sven Bölte
- Karolinska Institutet, Stockholm Health Care Services, Sweden
- Stockholm Health Care Services, Sweden
- Curtin University, Australia
| | - Tatja Hirvikoski
- Karolinska Institutet, Stockholm Health Care Services, Sweden
- Stockholm Health Care Services, Sweden
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Ran Q, Tu L, Wu Y, Zhang S, Zhang E, Li H, Su Y, Xiang M. Formal social support and quality of life of caregivers with autistic children: a large-scale nationwide survey in China. Front Public Health 2023; 11:1282778. [PMID: 38179564 PMCID: PMC10766108 DOI: 10.3389/fpubh.2023.1282778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/14/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Caregivers of children with autism spectrum disorder (ASD) were reported poor quality of life (QOL). Formal social support might improve the QOL of caregivers, however, limited research to date has focused on this association in China and formal social support for this group is conspicuously lacking. The study was aim to understand the QOL in male and female caregivers with ASD children in China and to explore the relationship between QOL and formal social support for caregivers with children with ASD through a large-scale nationwide survey. Methods An online questionnaire was used to conduct a cross-sectional study with a sample of 6,120 caregivers of children with ASD. Relationship between Quality of Life and several potential predictors is measured and analyzed. Quality of life were measured by Medical Study Short-Form Health Survey version 2 (Chinese version). Multivariate logistic regression analysis was used to analyze the factors affecting caregivers' QOL. Results The results revealed that the QOL of caregivers of autistic children in China was poor especially male caregivers. Social support was a positive predictor. More importantly, formal social support from rehabilitation institutions can improve caregivers' physical QOL. Caregivers' satisfaction with the rehabilitation institutions affecting their physical and mental QOL. Conclusion The formal social support provided by rehabilitation institutions plays a positive role in improving the quality of life of caregivers.
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Affiliation(s)
- Qingqing Ran
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Liangzhi Tu
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yinghui Wu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | | | - Erliang Zhang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Huilun Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Ya Su
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Mi Xiang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
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Bateman KJ, Wilson SE, Ingvarsson E, Doucette J, Therrien W, Nevill R, Mazurek M. Snack Talk: Effects of a Naturalistic Visual Communication Support on Increasing Conversation Engagement for Adults with Disabilities. Behav Anal Pract 2023; 16:1085-1099. [PMID: 38076735 PMCID: PMC10700260 DOI: 10.1007/s40617-023-00775-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2023] [Indexed: 02/08/2023] Open
Abstract
Adults with intellectual and developmental disabilities frequently experience poor life outcomes, with individuals reporting lower levels of social support, relationships, gainful employment, and satisfaction in their quality of life. To ameliorate these outcomes, social skills and social communication interventions aligned with the needs of adults are warranted. This study examined the efficacy of Snack Talk, a supplemental naturalistic visual communication support, with five adults with intellectual and developmental disabilities. Snack Talk was implemented during the midday mealtime, with the goal of increasing conversation engagement. A withdrawal design across participants was used. Results demonstrated increases in conversation engagement and showed meaningful gains for participants in the intervention and postintervention phase compared to baseline.
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Affiliation(s)
- Katherine J. Bateman
- The Haring Center for Inclusive Education, College of Education, University of Washington, Box 357925, 1981 NE Columbia Road, Seattle, WA 98195 USA
| | | | | | | | - William Therrien
- Curriculum, Instruction and Special Education; School of Education and Human Development, University of Virginia, Charlottesville, VA USA
| | - Rose Nevill
- Curriculum, Instruction and Special Education; School of Education and Human Development, University of Virginia, Charlottesville, VA USA
| | - Micah Mazurek
- Curriculum, Instruction and Special Education; School of Education and Human Development, University of Virginia, Charlottesville, VA USA
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Duncan A, Meinzen-Derr J, Ruble L, Fassler C, Stark LJ. A Randomized Clinical Trial Targeting Daily Living Skills in Autistic Adolescents Without an Intellectual Disability Before the Transition to Adulthood. J Dev Behav Pediatr 2023; 44:e590-e596. [PMID: 37862694 PMCID: PMC10843140 DOI: 10.1097/dbp.0000000000001222] [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: 02/03/2023] [Accepted: 08/07/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVES In the United States, more than 75,000 autistic adolescents graduate from high school each year, and many lack the skills to successfully transition to college, work, and independent living. Daily living skills (DLS) in autistic adolescents without an intellectual disability (ID) fall 6 to 8 years behind peers. Better DLS are linked to more positive adult outcomes for autistic individuals. Surviving and Thriving in the Real World (STRW) is the only known evidence-based intervention that targets age-appropriate DLS in autistic adolescents without ID. The study objective was to evaluate STRW's efficacy compared with an active comparator (Program for the Evaluation and Enrichment of Relational Skills [PEERS]). METHOD Autistic adolescents in their last 2 years of high school were randomized to STRW or PEERS. Outcome measures were the Vineland Adaptive Behavior Scales, Third Edition (VABS-3), DLS domain and subdomains (Personal, Domestic, Community), and DLS Goal Attainment Scaling (DLS-GAS) areas (Morning Routine, Cooking, Laundry, Money). RESULTS Adolescents were randomly assigned to STRW (n = 34) or PEERS (n = 30). Owing to COVID-19, 28.1% received in-person intervention and 71.9% received telehealth intervention. STRW youth made significant gains on the VABS-3 DLS domain ( p = 0.01) and Domestic subdomain ( p = 0.005) and DLS-GAS Total, Laundry, and Money areas (all p 's < 0.05) compared with PEERS. CONCLUSION STRW shows promise for acquiring age-appropriate DLS compared with PEERS. Adolescents in STRW progressed toward achieving DLS in the average range and closing the gap between chronological age and DLS. By improving DLS, STRW may facilitate more successful adult outcomes.
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Affiliation(s)
- Amie Duncan
- Division of Behavioral Medicine and Clinical Psychology
| | - Jareen Meinzen-Derr
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Lisa Ruble
- Teacher's College, Ball State University, Muncie, IN
| | | | - Lori J Stark
- Division of Behavioral Medicine and Clinical Psychology
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French B, Daley D, Groom M, Cassidy S. Risks Associated With Undiagnosed ADHD and/or Autism: A Mixed-Method Systematic Review. J Atten Disord 2023; 27:1393-1410. [PMID: 37341291 PMCID: PMC10498662 DOI: 10.1177/10870547231176862] [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] [Indexed: 06/22/2023]
Abstract
BACKGROUND The two most prevalent neurodevelopmental disorders-Attention Deficit Hyperactivity Disorder (ADHD) and Autism (ASD)-(ASD/ADHD) strongly impact individuals' functions. This is worsened when individuals are undiagnosed and risks such as increased imprisonments, depression or drug misuse are often observed. This systematic review synthesizes the risks associated with late/undiagnosed ASD/ADHD. METHODS Four databases were searched (Medline, Scopus, PsychInfor, and Embase). Published studies exploring the impact of undiagnosed ASD/ADHD were included. Exclusion criteria included, lack of diagnosis status, studies not solely on ASD or ADHD, gray literature and studies not in English. The findings were summarize through a narrative synthesis. RESULTS Seventeen studies were identified, 14 on ADHD and three on ASD. The narrative synthesis identified three main themes: (1) Health, (2) Offending behavior, and (3) Day-to-day impact. The risks highlighted a significant impact on mental wellbeing and social interactions, higher risks of substance abuse, accidents and offending behavior as well as lower levels of income and education. DISCUSSION The findings suggest that undiagnosed ASD/ADHD is linked to many risks and negative outcomes affecting individuals, their families, and the wider society. The restricted number of studies on ASD are a limitation to the generalization of these findings Implications for research and practice are discussed, highlighting the importance of screening and acknowledging the possibility of ASD/ADHD in many settings such as psychiatric and forensic.
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Capp SJ, Agnew-Blais J, Lau-Zhu A, Colvert E, Tye C, Aydin Ü, Lautarescu A, Ellis C, Saunders T, O'Brien L, Ronald A, Happé F, McLoughlin G. Is quality of life related to high autistic traits, high ADHD traits and their Interaction? Evidence from a Young-Adult Community-Based twin sample. J Autism Dev Disord 2023; 53:3493-3508. [PMID: 35802291 PMCID: PMC10465683 DOI: 10.1007/s10803-022-05640-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] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
This study explored whether high autistic traits, high attention deficit hyperactivity disorder (ADHD) traits and their interaction were associated with quality of life (QoL) in a sample of 556 of young-adult twins (Mean age 22 years 5 months, 52% Female). Four participant groups were created: high autistic traits, high ADHD traits, high autistic/ADHD traits, and low ADHD/autistic traits. High autistic traits were associated with lower QoL across domains (physical, psychological, social, and environmental). High ADHD traits associated with lower physical, psychological, and environmental QoL. The interaction of autistic and ADHD traits was not significant in any domain. While mental health difficulties were associated with lower QoL, after accounting for mental health, most relationships between autistic traits, ADHD traits and QoL remained.
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Affiliation(s)
- Simone J Capp
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Medical Sciences Division, Oxford Institute for Clinical Psychology Training and Research, University of Oxford, Oxford, UK.
| | - Jessica Agnew-Blais
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, School of School of Biological and Chemical Sciences, Queen Mary University London, London, UK
| | - Alex Lau-Zhu
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emma Colvert
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Charlotte Tye
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ümit Aydin
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alexandra Lautarescu
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Claire Ellis
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tyler Saunders
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- University of Edinburgh, Edinburgh, UK
| | - Lucy O'Brien
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, University of London, Birkbeck, London, UK
| | - Francesca Happé
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gráinne McLoughlin
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Ramos-Vera C, Calle D, Collacso Fiesta H, Lamilla LL, Serpa-Barrientos A, Saintila J. Psychometric Properties of the Peruvian Version of the MOS Scale for Social Support in Cancer Patients and Convergent Network with Quality of Life. Patient Prefer Adherence 2023; 17:1999-2011. [PMID: 37601089 PMCID: PMC10438453 DOI: 10.2147/ppa.s409802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/30/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction One of the key psychosocial factors that impact mental and emotional health is social support. While much research has been conducted on the role of social support in the lives of cancer patients, there is a lack of studies that consider populations who need specific tools to assess this concept. Purpose The aim of this study was to evaluate the psychometric properties of the MOS Social Support Scale (1991) in 499 Peruvian cancer patients between the ages of 18 and 87 (M= 46.30, SD = 15.747). Methods In this study, three models of the MOS were analyzed based on 19-item versions (four factor, second order and bifactor model). Results The results showed a better psychometric fit in the 19-item bifactor model with optimal fit indices through the structural equation method (SB-χ2/df = 1.94, CFI = 0.966, TLI= 0.955, SRMR = 0.038 and RMSEA = 0.058). Additionally, there was evidence of configural, metric and scalar invariance with this instrument according to the gender of the surveyed cancer patients. Convergent validity using a network analysis approach revealed positive associations between social support dimensions and quality of life. Conclusion Emotional support and positive interactions dimensions were found to be important interconnections in the overall network, as indicated by their greater centralities. Therefore, this instrument could be suggested as a reliable way to evaluate cancer patients and their perceived support.
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Affiliation(s)
- Cristian Ramos-Vera
- Research Area, Faculty of Health Sciences, Universidad César Vallejo, Lima, Perú
| | - Dennis Calle
- Research Area, Faculty of Health Sciences, Universidad César Vallejo, Lima, Perú
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11
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Andersen PN, Orm S, Fossum IN, Øie MG, Skogli EW. Adolescence internalizing problems as a mediator between autism diagnosis in childhood and quality of life in emerging adults with and without autism: a 10-year longitudinal study. BMC Psychiatry 2023; 23:149. [PMID: 36894901 PMCID: PMC9996871 DOI: 10.1186/s12888-023-04635-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Individuals with autism tend to have a reduced quality of life across their lifespan. This reduced quality of life may be a result of autism traits, mental distress, and poor person/environment fit. In this longitudinal study, we looked at the role of adolescence internalizing and externalizing problems in mediating the relationship between having an autism diagnosis from childhood and perceived quality of life as emerging adults. METHODS A total of 66 participants in a group of emerging adults with autism (mean age 22.2 years), and without autism (mean age 20.9 years) were assessed in three assessment waves (T1 at 12 years, T2 at 14 years, and T3 at 22 years of age). Parents filled out the Child Behavior Checklist at T2 and participants filled out the Perceived Quality of Life Questionnaire at T3. Total and indirect effects were tested in serial mediation analysis. RESULTS The results showed that internalizing problems fully mediated the association between childhood autism diagnosis and the quality of life in emerging adulthood, while externalizing problems did not. CONCLUSION Our findings suggest that attention to adolescent internalizing problems is important to improve the later quality of life for emerging adults with autism.
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Affiliation(s)
- Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Holsetgata, Norway.
| | - Stian Orm
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingrid Nesdal Fossum
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway.,Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Erik Winther Skogli
- Department of Psychology, Inland Norway University of Applied Sciences, Holsetgata, Norway.,Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
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12
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Bishop L, Charlton RA, McLean KJ, McQuaid GA, Lee NR, Wallace GL. Cardiovascular disease risk factors in autistic adults: The impact of sleep quality and antipsychotic medication use. Autism Res 2023; 16:569-579. [PMID: 36490360 PMCID: PMC10023317 DOI: 10.1002/aur.2872] [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: 05/02/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
Approximately 40% of American adults are affected by cardiovascular disease (CVD) risk factors (e.g., high blood pressure, high cholesterol, diabetes, and overweight or obesity), and risk among autistic adults may be even higher. Mechanisms underlying the high prevalence of CVD risk factors in autistic people may include known correlates of CVD risk factors in other groups, including high levels of perceived stress, poor sleep quality, and antipsychotic medication use. A sample of 545 autistic adults without intellectual disability aged 18+ were recruited through the Simons Foundation Powering Autism Research, Research Match. Multiple linear regression models examined the association between key independent variables (self-reported perceived stress, sleep quality, and antipsychotic medication use) and CVD risk factors, controlling for demographic variables (age, sex assigned at birth, race, low-income status, autistic traits). Overall, 73.2% of autistic adults in our sample had an overweight/obesity classification, 45.3% had high cholesterol, 39.4% had high blood pressure, and 10.3% had diabetes. Older age, male sex assigned at birth, and poorer sleep quality were associated with a higher number of CVD risk factors. Using antipsychotic medications was associated with an increased likelihood of having diabetes. Poorer sleep quality was associated with an increased likelihood of having an overweight/obesity classification. Self-reported CVD risk factors are highly prevalent among autistic adults. Both improving sleep quality and closely monitoring CVD risk factors among autistic adults who use antipsychotic medications have the potential to reduce risk for CVD.
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13
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“I Always Knew I Was Different”: Experiences of Receiving a Diagnosis of Autistic Spectrum Disorder in Adulthood—a Meta-Ethnographic Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2023. [DOI: 10.1007/s40489-023-00356-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
AbstractA broadening of diagnostic criteria and increased awareness of autism has led to a large number of individuals whose difficulties remained undetected until adulthood. This systematic review aimed to synthesise empirical evidence of the experience of individuals who received their diagnosis of autism in adulthood. Eight studies met the inclusion criteria. A meta-ethnographic approach was used to synthesise the findings. Analysis revealed two meta-themes: feeling “like an alien” and the “not guilty” verdict, each with three associated subthemes. The findings indicate the need for timely diagnosis and provision of post-diagnostic support to alleviate the mental health implications of not having a framework to understand one’s experiences and to support the process of adjustment to the diagnosis.
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14
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Krantz M, Dalmacy D, Bishop L, Hyer JM, Hand BN. Mortality rate and age of death among Medicare-enrolled autistic older adults. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 100:102077. [PMID: 36685335 PMCID: PMC9851177 DOI: 10.1016/j.rasd.2022.102077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Background An emerging body of evidence suggests that autistic people are at greater risk for mortality than non-autistic people. Yet, relatively little is known about mortality rates among autistic people during older adulthood (i.e., age 65 or older). Methods We examined 5-year mortality among a national US sample of Medicare-enrolled autistic (n=3,308) and non-autistic (n=33,080) adults aged 65 or older. Results Autistic older adults had 2.87 times greater rate of mortality (95% CI=2.61-3.07) than non-autistic older adults. Among decedents (39.6% of autistic and 15.1% of non-autistic older adults), the median age of death was 72 years (IQR=69-78) for autistic and 75 years (IQR=70-83) for non-autistic older adults. Among autistic older adults, those with intellectual disability had 1.57 times greater rate of mortality (95% CI=1.41-1.76) than those without, and males had 1.27 times greater rate of mortality (95% CI=1.12-1.43) than females. Conclusions Many trends regarding mortality observed in younger samples of autistic people were also observed in our study. However, we found only a three-year difference in median age at death between autistic and non-autistic decedents, which is a much smaller disparity than reported in some other studies. This potentially suggests that when autistic people live to the age of 65, they may live to a more similar age as non-autistic peers.
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15
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Maljaars J, Gijbels E, Evers K, Spain D, Rumball F, Happé F, Noens I. Impact of the COVID-19 Pandemic on Daily Life: Diverse Experiences for Autistic Adults. J Autism Dev Disord 2023; 53:319-331. [PMID: 35076831 PMCID: PMC8788399 DOI: 10.1007/s10803-022-05437-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 02/03/2023]
Abstract
Using a mixed methods design, this study aimed to examine the impact of the COVID-19 pandemic on autistic and non-autistic adults. We conducted an online survey with 196 autistic and 228 non-autistic adults from Belgium, the Netherlands and the United Kingdom focusing on their experiences during the first period of the pandemic. Our results indicate rather diverse experiences within the group of autistic participants across all domains of life. In comparison with non-autistic adults, autistic adults reported less negative impact on their social life and more negative impact on health and support services. In the autism group, stress was mainly related to changing and unclear measures. A wide range of coping strategies were described as helpful in reducing stress during the pandemic.
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Affiliation(s)
- Jarymke Maljaars
- Parenting and Special Education Research Unit, KU Leuven, L. Vanderkelenstraat, 32 box 3765, 3000 Leuven, Belgium ,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium ,Child and Adolescent Psychiatry, UPC Z.org KU Leuven, Leuven, Belgium
| | - Eef Gijbels
- Parenting and Special Education Research Unit, KU Leuven, L. Vanderkelenstraat, 32 box 3765, 3000 Leuven, Belgium
| | - Kris Evers
- Parenting and Special Education Research Unit, KU Leuven, L. Vanderkelenstraat, 32 box 3765, 3000 Leuven, Belgium ,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium ,Child and Adolescent Psychiatry, UPC Z.org KU Leuven, Leuven, Belgium
| | - Debbie Spain
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Freya Rumball
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,Adult Autism Assessment Service, Oxleas NHS Foundation Trust, Bexley, UK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ilse Noens
- Parenting and Special Education Research Unit, KU Leuven, L. Vanderkelenstraat, 32 box 3765, 3000 Leuven, Belgium ,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
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16
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Charlton RA, McQuaid GA, Wallace GL. Social support and links to quality of life among middle-aged and older autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:92-104. [PMID: 35362329 PMCID: PMC9806477 DOI: 10.1177/13623613221081917] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
LAY ABSTRACT Social support can take many forms, such as practical help, time spent socially with others, or the satisfaction with personal relationships. Social support is known to affect quality of life (QoL) in both non-autistic older and autistic young adults. QoL reflects how satisfied an individual is with their life either overall or in a certain area. We know little about middle-aged and older autistic adults' experiences of social support or QoL. In this study, 388 adults aged 40-83 years old, completed online questionnaires asking about background such as age and sex, depression and anxiety symptoms, QoL (physical, psychological, social, environmental, and autism-specific), and different types of social support. Even after taking into account background, depression, and anxiety, social support was important for individuals' QoL. To our knowledge this is the first paper to examine the relationship between social support and QoL in middle-aged and older autistic adults. Improving social support may have a significant impact on the QoL of older autistic adults. Future studies should examine whether age-related changes in social support (size, content, and arrangement of social networks) that are common in non-autistic aging, also occur among older autistic adults.
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Affiliation(s)
- Rebecca A Charlton
- Goldsmiths, University of London,
UK,Rebecca A Charlton, Department of
Psychology, Goldsmiths University of London, New Cross, London SE14 6NW, UK.
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17
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The relationship between fear of COVID-19 and depression, anxiety and stress in persons with disabilities: A cross-sectional study. Arch Psychiatr Nurs 2023; 43:15-21. [PMID: 37032008 PMCID: PMC9810547 DOI: 10.1016/j.apnu.2022.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/28/2022] [Accepted: 12/27/2022] [Indexed: 01/05/2023]
Abstract
AIM This study aimed to determine the relationship between the fear of COVID-19 and the depression, anxiety and stress in persons with disabilities. METHODS In this cross-sectional study, the data were collected using an online survey from 178 persons with disabilities using the Personal Information Form, Depression Anxiety Stress Scales-21 (DASS-21) and the Fear of COVID-19 Scale (FCV-19S). RESULTS The mean age of the participants was 34.08 ± 11.8 years. The disability types that participants had were related to vision (47.2 %), hearing (25.8 %), mobility (24.7 %), cognitive (8.4 %), and chronic disease (10.1 %). It has been determined that 73.6 % of the participants stated that their access to healthcare services was restricted due to the COVID-19 pandemic. The mean DASS-21 was 10.24 ± 8.25 and the mean FCV-19S was 17.71 ± 5.05. A positive correlation was found between DASS-21 and FCV-19S. CONCLUSION The pandemic has created a need to provide appropriate interventions to improve the psychosocial health of persons with disabilities.
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18
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Schuchard J, Kaplan-Kahn EA, Carle AC, Holmes LG, Law K, Miller JS, Parish-Morris J, Forrest CB. Using percentiles in the interpretation of Patient-Reported Outcomes Measurement Information System scores: Guidelines for autism. Autism Res 2022; 15:2336-2345. [PMID: 36259546 DOI: 10.1002/aur.2833] [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: 05/22/2022] [Accepted: 10/04/2022] [Indexed: 12/15/2022]
Abstract
The objectives of this study were to (1) demonstrate the application of percentiles to advance the interpretation of patient-reported outcomes and (2) establish autism-specific percentiles for four Patient-Reported Outcomes Measurement Information System (PROMIS) measures. PROMIS measures were completed by parents of autistic children and adolescents ages 5-17 years as part of two studies (n = 939 parents in the first study and n = 406 parents in the second study). Data from the first study were used to develop autism-specific percentiles for PROMIS parent-proxy sleep disturbance, sleep-related impairment, fatigue, and anxiety. Previously established United States general population percentiles were applied to interpret PROMIS scores in both studies. Results of logistic regression models showed that parent-reported material hardship was associated with scoring in the moderate-severe range (defined as ≥75th percentile in the general population) on all four PROMIS measures (odds ratios 1.7-2.2). In the second study, the percentage of children with severe scores (defined as ≥95th percentile in the general population) was 30% for anxiety, 25% for sleep disturbance, and 17% for sleep-related impairment, indicating a high burden of these problems among autistic children. Few children had scores at or above the autism-specific 95th percentile on these measures (3%-4%), indicating that their scores were similar to other autistic children. The general population and condition-specific percentiles provide two complementary reference points to aid interpretation of PROMIS scores, including corresponding severity categories that are comparable across different PROMIS measures.
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Affiliation(s)
- Julia Schuchard
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Elizabeth A Kaplan-Kahn
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Adam C Carle
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio, USA
| | | | - Kiely Law
- Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Judith S Miller
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Julia Parish-Morris
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christopher B Forrest
- Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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19
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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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20
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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 2022; 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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Autistic individuals are at particular risk of experiencing mental health
problems during the COVID-19 pandemic, yet little is known about personal
characteristics that may underlie this vulnerability. This longitudinal
questionnaire study with 149 autistic and 147 non-autistic adults investigated
the association between perceived stress and anxiety and depressive symptoms,
measured 4 months later. In addition, the moderating impact of intolerance of
uncertainty and coping styles on this association was examined. Confirming
previous studies, autistic adults reported poorer mental health than
non-autistic individuals. Results demonstrated similar moderation models across
individuals with versus without autism. Perceived stress at timepoint 1 was
associated with anxiety and depression at timepoint 2. Across both participant
groups, individuals with maladaptive coping strategies and higher levels of
intolerance of uncertainty at timepoint 1 showed more internalizing symptoms at
timepoint 2. The findings demonstrate the burden of the pandemic on the mental
health of autistic adults, especially on those with high levels of perceived
stress, maladaptive coping strategies, or intolerance of uncertainty.
Interventions to support autistic adults during and after the pandemic might
involve providing psychoeducation about the impact of stress, coping, and
intolerance of uncertainty on internalizing symptoms, and teaching more adaptive
ways to cope with difficult 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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21
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Cheak-Zamora N, Odunleye O. Stress and Coping in Autistic Young Adults. AUTISM IN ADULTHOOD 2022; 4:193-202. [PMID: 36606158 PMCID: PMC9645673 DOI: 10.1089/aut.2021.0043] [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: 01/07/2023]
Abstract
Introduction Half a million autistic youth will enter adulthood over the next decade. Support services to help youth successfully transition into adulthood are limited and not tailored to the autistic youth and young adult's needs. This study utilized qualitative methods to understand how autistic young adults experience and cope with stress during the transition to adulthood. Methods The study recruited 15 autistic young adults aged 18-25 years. Each participant completed a short demographic survey and individual interview. Interviews were conducted online via Google Docs or in-person based on the participants' preference. Three researchers organized and coded the data using a thematic approach. Results Based on our analysis, three themes emerged. Within the first theme, young adults in this study described experiencing a great deal of stress and provided examples of how it manifested in physical and emotional ways. In the second theme, youth described that the causes of this stress stemmed from general problems handling new or multiple responsibilities and specific problems in school, work, financial responsibilities, and social relationships. Finally, young adults described using various coping mechanisms including relaxation techniques, use of technology, and friends and family social support. Conclusions The study findings can help service providers and family members find new ways to help autistic young adults manage their stress. This study provides a unique understanding of stress and coping from the autistic individuals' point of view. Stress is most often derived from managing new responsibilities in general and school, work, money, and relationships in particular. Tailored support services that follow the individual from adolescence through adulthood are needed to manage these stressors. Researchers and service providers can utilize these recommendations for future program development. Furthermore, the method used in this study can be replicated to facilitate autistic individual input on future program development.
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Affiliation(s)
- Nancy Cheak-Zamora
- Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, Missouri, USA
| | - Olakunle Odunleye
- Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, Missouri, USA
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22
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Zhang H, Morris ME, Nurius PS, Mack K, Brown J, Kuehn KS, Sefidgar YS, Xu X, Riskin EA, Dey AK, Mankoff J. Impact of Online Learning in the Context of COVID-19 on Undergraduates with Disabilities and Mental Health Concerns. ACM TRANSACTIONS ON ACCESSIBLE COMPUTING 2022. [DOI: 10.1145/3538514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The COVID-19 pandemic upended college education and the experiences of students due to the rapid and uneven shift to online learning. This study examined the experiences of students with disabilities with online learning, with a consideration of surrounding stressors such as financial pressures. In a mixed method approach, we compared 28 undergraduate students with disabilities (including mental health concerns) to their peers during 2020, to assess differences and similarities in their educational concerns, stress levels and COVID-19 related adversities. We found that students with disabilities entered the Spring quarter of 2020 with significantly higher concerns about classes going online, and reported more recent negative life events than other students. These differences between the two groups diminished three months later with the exception of recent negative life events. For a fuller understanding of students’ experiences, we conducted qualitative analysis of open ended interviews. We examined both positive and negative experiences with online learning among students with disabilities and mental health concerns. We describe how online learning enabled greater access–e.g., reducing the need for travel to campus–alongside ways in which online learning impeded academic engagement–e.g., reducing interpersonal interaction. We highlight a need for learning systems to meet the diverse and dynamic needs of students with disabilities.
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23
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McQuaid GA, Weiss CH, Said AJ, Pelphrey KA, Lee NR, Wallace GL. Increased perceived stress is negatively associated with activities of daily living and subjective quality of life in younger, middle, and older autistic adults. Autism Res 2022; 15:1535-1549. [PMID: 35790082 PMCID: PMC9545671 DOI: 10.1002/aur.2779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022]
Abstract
Few studies have examined self‐reported perceived stress in autistic adults. Existing studies have included relatively small, predominantly male samples and have not included older autistic adults. Using a large autistic sample (N = 713), enriched for individuals designated female at birth (59.3%), and spanning younger, middle, and older adulthood, we examined perceived stress and its associations with independence in activities of daily living and subjective quality of life (QoL). Perceived stress for autistic adults designated male or female at birth was compared to their same birth‐sex counterparts in a general population sample. In addition, within the autistic sample, effects of sex designated at birth, age, and their interaction were examined. Regression modeling examined associations between perceived stress and independence in activities of daily living and domains of subjective QoL in autistic adults, after controlling for age, sex designated at birth, and household income. Autistic adults reported significantly greater perceived stress than a general population comparison sample. Relative to autistic adults designated male at birth, those designated female at birth demonstrated significantly elevated perceived stress. Perceived stress contributed significantly to all regression models, with greater perceived stress associated with less independence in activities of daily living, and poorer subjective QoL across all domains—Physical, Psychological, Social, Environment, and Autism‐related QoL. Findings are contextualized within the literature documenting that autistic individuals experience elevated underemployment and unemployment, heightened rates of adverse life events, and increased exposure to minority stress.
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Affiliation(s)
- Goldie A. McQuaid
- Department of Psychology George Mason University Fairfax Virginia USA
| | - Colin H. Weiss
- Department of Psychology George Mason University Fairfax Virginia USA
| | - Alex Job Said
- Department of Speech, Language, and Hearing Sciences The George Washington University Washington District of Columbia USA
| | - Kevin A. Pelphrey
- Department of Neurology University of Virginia School of Medicine Charlottesville Virginia USA
| | - Nancy Raitano Lee
- Department of Psychological and Brain Sciences Drexel University Philadelphia Pennsylvania USA
| | - Gregory L. Wallace
- Department of Speech, Language, and Hearing Sciences The George Washington University Washington District of Columbia USA
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24
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Pearson A, Rees J, Forster S. "This Was Just How This Friendship Worked": Experiences of Interpersonal Victimization Among Autistic Adults. AUTISM IN ADULTHOOD 2022; 4:141-150. [PMID: 36605970 PMCID: PMC9645672 DOI: 10.1089/aut.2021.0035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background The victimization of autistic people by familiar others (interpersonal victimization) is an understudied phenomenon despite suggestions that prevalence rates may be disproportionately high. We know very little about the way autistic people perceive these experiences, and how to support them. The aim of the current study was to explore experiences of interpersonal victimization among autistic adults from their own perspective. Methods We recruited 43 autistic adults to take part in a qualitative online study, and asked about their experiences of being victimized or taken advantage of by people they know in the past. We analyzed their comments at the semantic level using inductive thematic analysis, from a critical realist perspective. Results We identified two key themes in the data. The first theme, "cycles of victimization" highlighted the occurrence of polyvictimization in the sample. The second ("perceptions of victimization") focused on how these experiences were related to difficulties with trust (of both self and others), the recognition of victimization, and heightened compliance. The participants expressed difficulty with saying no to people, and found it difficult to identify when someone had negative or manipulative intentions. Conclusions Our findings suggest that autistic adults experience victimization from a range of close others, and may find it difficult to recognize when someone is acting in an abusive manner. Many participants had experienced heightened compliance in response to unreasonable requests from others, however, reasons for this were varied (e.g., fear and desire to avoid confrontation) and require further investigation. These findings have implications for developing supports that enable autistic adults to recognize their own boundaries and advocate for themselves, in addition to helping them to recognize what a healthy relationship looks like.
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Affiliation(s)
- Amy Pearson
- Faculty of Health and Wellbeing, School of Psychology, University of Sunderland, Sunderland, United Kingdom.,Address correspondence to: Amy Pearson, PhD, Faculty of Health Sciences and Wellbeing, School of Psychology, University of Sunderland, Helen McArdle House, City Campus, Sunderland SR1 3SD, United Kingdom
| | - Jon Rees
- Faculty of Health and Wellbeing, School of Psychology, University of Sunderland, Sunderland, United Kingdom
| | - Samantha Forster
- School of Social Sciences, University of Sunderland, United Kingdom
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25
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White SW, Smith I, Brewe AM. Brief Report: The Influence of Autism Severity and Depression on Self-Determination Among Young Adults with Autism Spectrum Disorder. J Autism Dev Disord 2022; 52:2825-2830. [PMID: 34185238 PMCID: PMC11034765 DOI: 10.1007/s10803-021-05145-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 10/21/2022]
Abstract
Self-determination (SD) is linked to autonomy and better adult outcomes. Adults with autism spectrum disorder (ASD) are often less independent than cognitively matched peers. Given the frequency with which depression co-occurs in ASD and the established association between depression and SD, we sought to evaluate the influence of both ASD severity and depression on SD among cognitively able emerging adults with ASD. Emerging adults (n = 59) with ASD completed measures of SD, ASD severity, and depression. Both ASD severity and depression were moderately correlated with SD (r = - 0.473; - 0.423, respectively) and with each other (r = 0.625). After controlling for ASD severity, depression did not significantly predict SD. Strengthening SD should be considered in programming to promote independence.
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Affiliation(s)
- Susan W White
- Center for Youth Development and Intervention, The University of Alabama, 200 Hackberry Lane, Suite 101, Tuscaloosa, AL, 35487, USA.
| | - Isaac Smith
- Department of Psychiatry, University of Connecticut School of Medicine, 65 Kane St., Room 2032, West Hartford, Hartford, CT, 06119, USA
| | - Alexis M Brewe
- Center for Youth Development and Intervention, The University of Alabama, 200 Hackberry Lane, Suite 101, Tuscaloosa, AL, 35487, USA
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26
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Lifshitz H, Gur A, Shnitzer-Meirovitz S, Eden S. The contribution of distress factors and Coping Resources to the motivation to use ICT among adults with intellectual disability during COVID-19. EDUCATION AND INFORMATION TECHNOLOGIES 2022; 27:10327-10347. [PMID: 35464110 PMCID: PMC9013739 DOI: 10.1007/s10639-022-11042-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
The current study focused on people with intellectual disability (ID), who have unique disadvantages that place them at greater risk for negative outcomes due to COVID-19. The study goals are three-fold: (a) To examine whether differences in distress factors (loneliness and stress) would be found between adults with ID who used the Zoom application, and those who did not use Zoom during the pandemic; (b) To examine whether differences in psychological and coping resources (psychological capital), and practical-technological resources (attitudes and motivation to use information communication technology) would be found between the groups; (c) To examine the contribution of background variables (gender, type of residence, Zoom use), distress factors and psychological and practical technological coping resources on the motivation to use technology. The sample included 35 adults with ID (MCA = 40.06, SD = 11.02). Of these, 57% learned to use the Zoom application during the COVID-19 pandemic (N = 20), and 47% did not (N = 15). Participants answered seven questionnaires examining distress factors and psychological and technological resources. Both groups exhibited distress factors. However, the Zoom users demonstrated higher scores in hope and motivation to use technology. Regression analysis indicated that the resilience and attitudes toward technology among the Zoom users contributed to the explained variance of motivation to use technology. In light of the higher coping resources among Zoom users, we may carefully say that using Zoom might increase the independence of individuals with ID in learning, develop their communications possibilities, and help them to cope better in distress situations.
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Affiliation(s)
- Hefziba Lifshitz
- The Faculty of Education, Bar-Ilan University, Ramat Gan, Israel
| | - Ayelet Gur
- Social Work Department, Faculty of Social Sciences & Humanities, Tel-Hai College, Qiryat Shemona, Israel
| | | | - Sigal Eden
- The Faculty of Education, Bar-Ilan University, Ramat Gan, Israel
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Skoglund C, Leknes S, Heilig M. The partial µ-opioid agonist buprenorphine in autism spectrum disorder: a case report. J Med Case Rep 2022; 16:152. [PMID: 35422015 PMCID: PMC9011926 DOI: 10.1186/s13256-022-03384-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 03/11/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There are currently no approved medications for impaired social cognition and function, core symptoms of autism spectrum disorder. We describe marked improvement of these symptoms with long-term low-dose administration of the partial µ-opioid agonist buprenorphine. We discuss these observations in the context of a role for endogenous opioid systems in social attachment, and theories integrating those findings mechanistically with autism spectrum disorder.
Case presentation
M, a 43-year-old Caucasian male, is medically healthy. Despite social difficulties since childhood, he completed high school with better-than-average grades, but failed university education. A psychiatric evaluation in his twenties diagnosed attention deficit hyperactivity disorder but also noted symptoms of coexisting autism spectrum disorder. M accidentally came across buprenorphine in his late twenties and experienced progressively improved social functioning on a low daily dosage (0.5–1.0 mg/day), an effect maintained for 15 years. He lived independently and maintained a part-time occupation. After abrupt discontinuation of treatment, his autistic symptoms returned, and function deteriorated. Following evaluation by our team, buprenorphine was resumed, with gradual return to prior level of functioning. An attempt to formally evaluate M both on and off medication was agreed with him and approved by the Swedish Ethics Authority, but medication had to be resumed when the patient worsened following discontinuation.
Conclusions
According to the µ-opioid receptor balance model, both excessive and deficient μ-receptor activity may negatively influence social behavior, and accordingly both opioid agonist and opioid antagonist treatment may be able to improve social functioning, depending on an individual’s opioid tone before treatment. Our case report is consistent with these hypotheses, and given the extensive unmet medical needs in individuals with autism spectrum disorders, randomized controlled trial appears warranted.
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Feng Y, Zhou X, Qin X, Cai G, Lin Y, Pang Y, Chen B, Deng T, Zhang L. Parental self-efficacy and family quality of life in parents of children with autism spectrum disorder in China: The possible mediating role of social support. J Pediatr Nurs 2022; 63:159-167. [PMID: 34782156 DOI: 10.1016/j.pedn.2021.10.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study explored the related factors of FQOL in parents of children with ASD and examined whether social support mediates the relationship between parental self-efficacy and FQOL in parents of children with ASD. DESIGN AND METHODS Using a cross-sectional design, a total of 260 parents of children with ASD were recruited from September 2019 to November 2020. They completed the Beach Center Family Quality of Life Scale, the Parenting Sense of Competence Scale, and the Social Support Rating Scale. RESULTS Parental self-efficacy and social support explained approximately 49.5% of the variance in FQOL. After controlling for the confounding influence of parents' education level, parental self-efficacy had a direct effect on FQOL (β = 0.292, SE = 0.108, P < 0.01) and an indirect effect on FQOL (β = 0.165, SE = 0.069, P < 0.01). Effects were mediated through social support, with partial mediating effects accounting for 36.11% of the total effect. CONCLUSIONS Both parental self-efficacy and social support are critical to promoting FQOL, and a partial mediating effect of social support was established. PRACTICAL IMPLICATIONS Interventions for families with children with ASD should focus on enhancing parental self-efficacy, followed by a perceived social support and FQOL prompt.
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Affiliation(s)
- Yongshen Feng
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Xuezhen Zhou
- Nursing department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiuqun Qin
- Pediatric Department, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
| | - Guiyi Cai
- Pediatric Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yeqing Lin
- Research Management Department, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China.
| | - Yongli Pang
- Nursing Department, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Biyuan Chen
- Pediatric Department, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou.
| | - Tao Deng
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Lifeng Zhang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China.
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van den Heuvel RM, Wensing M, Geurts HM, Teunisse JP. The Social Support Network of Adults with an Autism Spectrum Condition: An Exploration Using the Network in Action-Questionnaire. J Autism Dev Disord 2022; 53:1974-1988. [PMID: 35182260 PMCID: PMC10123042 DOI: 10.1007/s10803-022-05467-5] [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: 01/27/2022] [Indexed: 10/19/2022]
Abstract
Actively involving the network during treatment, as recommended in Autism Spectrum Condition (ASC) guidelines, can be facilitated with the Network in Action-Questionnaire (NiA-Q), which identifies the current and potential sources of social support. The aims of this study were to (1) examine the factor structure of the NiA-Q and (2) to explore the self- and proxy-report on the social network. Before the start of treatment in a mental health institution, 193 adults with an ASC diagnosis and 84 proxies completed the NiA-Q. Factor analysis showed two factors: positive social support and interpersonal distress. Self- and proxy-report on the NiA-Q did not differ for most variables, except for social network wishes. The NiA-Q provides a basis for network involvement and strengthening.
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Affiliation(s)
- Rinske M van den Heuvel
- Leo Kannerhuis, Youz (Parnassia Group), Stationsweg 49, 6861 EE, Oosterbeek, The Netherlands. .,HAN University of Applied Sciences, Nijmegen, The Netherlands. .,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.
| | - Michel Wensing
- General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Hilde M Geurts
- Leo Kannerhuis, Youz (Parnassia Group), Stationsweg 49, 6861 EE, Oosterbeek, The Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan-Pieter Teunisse
- Leo Kannerhuis, Youz (Parnassia Group), Stationsweg 49, 6861 EE, Oosterbeek, The Netherlands.,HAN University of Applied Sciences, Nijmegen, The Netherlands
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Coping, social support, and family quality of life for caregivers of individuals with autism: Meta-analytic structural equation modeling. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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31
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Feng Y, Zhou X, Liu Q, Deng T, Qin X, Chen B, Zhang L. Symptom severity and posttraumatic growth in parents of children with autism spectrum disorder: The moderating role of social support. Autism Res 2022; 15:602-613. [PMID: 35048558 DOI: 10.1002/aur.2673] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 12/20/2021] [Accepted: 01/07/2022] [Indexed: 11/07/2022]
Abstract
Parents of children with autism spectrum disorder (ASD) experience posttraumatic growth (PTG). No study has investigated the moderating effect of social support and family function between symptom severity and PTG. The study aims to examine whether social support and family function moderate the relationship between symptom severity and PTG among parents of children with ASD. Using a cross-sectional design, a total of 385 parents of children with ASD were recruited from September 2019 to November 2020 by convenience sampling. Participants completed the Posttraumatic Growth Inventory, Social Support Rating Scale, Autism Behavior Checklist, and Family Apgar Index. Both social support (r = 0.354, p < 0.01) and family function (r = 0.379, p < 0.05) were significantly related to PTG. Although symptom severity was not significantly related to PTG (p > 0.05), social support moderated the correlation between symptom severity and PTG [β(SE) = -0.134 (0.719), p < 0.01, 95% CI = (-3.552, -0.723)]; the positive association was stronger for low social support [β(SE) = 0.145 (0.054), t = 2.675, p < 0.01, 95% CI = (0.038, 0.252)], while the negative association was weaker for high social support [β(SE) = -0.121 (0.051), t = -2.378, p < 0.05, 95% CI = (-0.221, -0.021)]. Family function did not moderate the relationship (p > 0.05). Higher social support appears to buffer the detrimental effect of symptom severity on PTG, and social support seems to be an important factor when delivering interventions aimed at decreasing symptom severity and improving positive growth. LAY SUMMARY: Both social support and family function were positively associated with PTG. Providing sufficient perceived social support and enhancing family function promoted parents' positive psychological experience. Higher social support seemed to buffer the detrimental effect of symptom severity on PTG, and it could be an important intervention target for improving the psychological growth of parents of children with ASD.
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Affiliation(s)
- Yongshen Feng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Xuezhen Zhou
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qian Liu
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Tao Deng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Xiuqun Qin
- The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Biyuan Chen
- The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lifeng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Tsermentseli S. Self-esteem moderates the impact of perceived social support on the life satisfaction of adults with autism spectrum disorder. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415221147430. [PMID: 36619310 PMCID: PMC9813977 DOI: 10.1177/23969415221147430] [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] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND AIMS Although social resources and self-esteem are well-known predictors of subjective well-being in the general population, the relations among these factors have not yet been investigated in autism spectrum disorder (ASD). The present preliminary study sought to compare the levels of life satisfaction, self-esteem and perceived social support between adults with ASD and typically developing volunteers (TYP). It also examined whether self-esteem would moderate the effect of perceived social support on life satisfaction in adults with ASD. METHODS Fifty-seven adults with ASD without intellectual disability and 60 age-matched TYP in the United Kingdom (UK) completed self-reported measures of perceived social support, global self-esteem, and life satisfaction. RESULTS Results indicated that adults with ASD reported significantly lower levels of life satisfaction and self-esteem (but not social support) than TYP. Hierarchical regressions revealed that both social support and self-esteem were significant predictors of life satisfaction in adults with ASD. Self-esteem buffered the effect of perceived social support on life satisfaction. CONCLUSIONS This study corroborated a growing body of evidence that suggests that adults with ASD report lower levels of self-esteem and life satisfaction than TYP. In addition, it reported for the first time that global self-esteem influences the association between social support and life satisfaction in adults with ASD. IMPLICATIONS The present findings suggest that interventions aimed at enhancing self-esteem and cultivating social relationships could be important areas for intervention to improve the well-being of adults with ASD.
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Affiliation(s)
- Stella Tsermentseli
- Stella Tsermentseli, Department of Primary Education, University of Thessaly, Argonafton & Filellinon, Volos 38221, Greece.
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Nisticò V, Gambini O, Pizzi L, Faggioli R, Priori A, Demartini B. A paradoxical psychological impact of COVID-19 among a sample of Italian adults with High Functioning Autism Spectrum Disorder. J Clin Neurosci 2021; 95:27-30. [PMID: 34929647 PMCID: PMC8627848 DOI: 10.1016/j.jocn.2021.11.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 10/06/2021] [Accepted: 11/21/2021] [Indexed: 12/26/2022]
Abstract
Background Since February 2020, many governments of the world ordered strict social distancing rules to try to contain the COVID-19 pandemic, with a reported consequent increase in levels of stress, anxiety and depression in the general population. Aim of this study was to assess the prevalence of the aforementioned psychiatric symptoms across a sample of individuals with High Functioning Autism Spectrum Disorders (HF-ASDs) with respect to a group of neurotypical adults (NA), during the first two months of COVID-19 pandemic in Italy. Method 45 adults with HF-ASDs and 45NA completed a structured online questionnaire, including; the Depression, Anxiety and Stress Scale – 21 items (DASS-21); the Impact of Event Scale-Revised (IES-R); the Perceived Stress Scale (PSS). We also explored some specific aspects of participants’ psychological well-being through an ad-hoc questionnaire. Results Subjects with HF-ASDs scored significantly higher than NA at the DASS-21, the IES-R Total Score and the PSS; NA reported a higher perceived change of their lifestyle during the lockdown than individuals with HF-ASDs, and subjects with HF-ASDs reported to feel more comfortable and less tired during the lockdown period, in relation to the social distancing measures adopted by Italian authorities. Conclusions Adults with HF-ASDs presented higher rates of depression, anxiety, stress and PTSD-related symptoms than NA during the first two months of COVID-19 pandemic. However, they also reported to feel subjectively more comfortable and less tired during the lockdown than before, in relation to the social distancing measures.
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Affiliation(s)
- Veronica Nisticò
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy; "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, Milano, Italy
| | - Orsola Gambini
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy; "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, Milano, Italy; Unità di Psichiatria II, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Ludovica Pizzi
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - Raffaella Faggioli
- Unità di Psichiatria II, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Alberto Priori
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy; "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, Milano, Italy; III Clinica Neurologica, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Benedetta Demartini
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy; "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, Milano, Italy; Unità di Psichiatria II, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy.
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Abstract
Over the past four decades there have been significant advances in our understanding of autism, yet services for autistic adults continue to lag far behind those for children, and prospects for employment and independent living remain poor. Adult outcomes also vary widely and while cognitive and language abilities are important prognostic indicators, the influence of social, emotional, familial and many other factors remains uncertain. For this special issue marking the 40th anniversary of DSM-III, the present paper describes the changing perspectives of autism in adulthood that have occurred over this period, explores individual and wider environmental factors related to outcome, and suggests ways in which services need to be changed to improve the future for adults living with autism.
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Affiliation(s)
- Patricia Howlin
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
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35
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Stress Impact of COVID-19 Sports Restrictions on Disabled Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212040. [PMID: 34831791 PMCID: PMC8619846 DOI: 10.3390/ijerph182212040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022]
Abstract
The stress impact of COVID-19 restrictions has put the adapted sports community at an unprecedented level of emergency. The self-report Event Scale—Revised (IES-R) questionnaire was administered to assess the level of psychological distress and emotive reactions such as intrusion (INT), avoidance (AV) and hyperarousal (HYP) following training and competitions suspension within a sample of Italian disabled athletes. A total of 146 self-selected volunteers were included in this study: 73 disabled athletes (aged 42.11 ± 13.70) and 73 athletes (aged 40.23 ± 13.73) who served as the control group. Only 8.22% of the disabled participants vs. 30.14% of athletes were affected by subjective distress. MANOVA showed significant differences in IES-R subjective distress for age, where the emerging adults had a higher level of stress than adults (p = 0.031), and for the type of sport, where the individual sports group showed higher scores than the team sports group (p = 0.049). Regarding the IES-R subscales, significant differences were found in INT and AV for age, where the emerging adults showed higher scores than adults (p = 0.018 and p = 0.046, respectively). Significant differences were found in HYP for type of sport, where the individual sports group showed higher scores than the team sports group (p = 0.014). The results confirmed a lower distress level of disabled athletes to adverse events than that expressed by athletes. Both sports engagement and the experience of living with impairment, overcoming structural barriers, could act as a buffer effect against stress due to COVID-19 restrictions.
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Braden BB, Pagni BA, Monahan L, Walsh MJM, Dixon MV, Delaney S, Ballard L, Ware JE. Quality of life in adults with autism spectrum disorder: influence of age, sex, and a controlled, randomized mindfulness-based stress reduction pilot intervention. Qual Life Res 2021; 31:1427-1440. [PMID: 34655389 DOI: 10.1007/s11136-021-03013-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Adults with autism spectrum disorder (ASD) consistently report worse functional health and well-being, compared to neurotypical (NT) peers. In a series of studies, we aimed to elucidated the effects of sex, age, and their interaction on health-related quality of life (HRQoL) and evaluated the effectiveness of mindfulness-based stress reduction (MBSR) for improving health-, disability-, and autism-related QoL, with possible sex and age outcome moderators, in adults with ASD. METHODS Study 1 used the 36-Item Short Form Survey to compare mental and physical HRQoL composite scores in adults with ASD (n = 67) and matched NT adults (n = 66). Study 2 was a randomized pilot evaluation of the effect of MBSR, compared to an active control intervention with social support and relaxation education (support/education; n = 56), on the World Health Organization QoL BREF, Disability, and Autism-Specific scales in adults with ASD. RESULTS In Study 1, we replicated findings that mental HRQoL is worse in both men and women with ASD, compared to NT counterparts, but physical HRQoL is only worse in women with ASD. We present novel findings that older age is associated with better mental HRQoL in women with ASD only. In Study 2, MBSR improved disability-related QoL in adults with ASD over and above the support/education intervention, but both interventions improved mental HRQoL. Lastly, both interventions were more effective for HRQoL improvements in women with ASD. CONCLUSION Findings encourage precision medicine approaches tailored to age and sex groups for best HRQoL outcomes in adults with ASD. ClinicalTrials.gov Identifier: NCT04017793.
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Affiliation(s)
- B Blair Braden
- College of Health Solutions, Arizona State University, Tempe, AZ, USA.
| | - Broc A Pagni
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Leanna Monahan
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Melissa J M Walsh
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Maria V Dixon
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Shanna Delaney
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Lisa Ballard
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - John E Ware
- College of Health Solutions, Arizona State University, Tempe, AZ, USA.,Department of Medicine, Tufts Medical Center, Boston, MA, USA
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Fisher MH, Sung C, Kammes RR, Okyere C, Park J. Social support as a mediator of stress and life satisfaction for people with intellectual or developmental disabilities during the COVID-19 pandemic. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:243-251. [PMID: 34633129 PMCID: PMC8646736 DOI: 10.1111/jar.12943] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/04/2021] [Accepted: 09/16/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION This study examined factors that predict stress level and life satisfaction among adults with intellectual or developmental disabilities during the COVID-19 pandemic and the role of social support. METHOD From a larger study about the experiences during the pandemic of 2028 individuals with and without disabilities, 181 adults with intellectual or developmental disabilities (or proxy) responded. RESULTS Most respondents with intellectual or developmental disabilities (92.8%) reported negative impacts from the pandemic, with 55.2% of the 96 employed pre-pandemic reporting impacted employment, including job loss. The negative impact of the pandemic was a significant predictor of stress level; social support was related to reduced stress. Stress level and the negative impact of the pandemic were inversely related to life satisfaction; social support was positively related to life satisfaction. Social support partially mediated the association between stress level and life satisfaction. DISCUSSION Comprehensive services and social support systems are needed to combat the impact of the pandemic.
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Affiliation(s)
- Marisa H Fisher
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA.,Center for Research on Autism, Intellectual, and Neurodevelopmental Disabilities, Michigan State University, East Lansing, Michigan, USA
| | - Connie Sung
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA.,Center for Research on Autism, Intellectual, and Neurodevelopmental Disabilities, Michigan State University, East Lansing, Michigan, USA
| | - Rebecca R Kammes
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA.,Center for Research on Autism, Intellectual, and Neurodevelopmental Disabilities, Michigan State University, East Lansing, Michigan, USA
| | - Christiana Okyere
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA.,Center for Research on Autism, Intellectual, and Neurodevelopmental Disabilities, Michigan State University, East Lansing, Michigan, USA
| | - Jiyoon Park
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA.,Center for Research on Autism, Intellectual, and Neurodevelopmental Disabilities, Michigan State University, East Lansing, Michigan, USA.,Department of Special Education, Changwon National University, Changwon, South Korea
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McLean KJ, Eack SM, Bishop L. The Impact of Sleep Quality on Quality of Life for Autistic Adults. RESEARCH IN AUTISM SPECTRUM DISORDERS 2021; 88:101849. [PMID: 34539812 PMCID: PMC8442542 DOI: 10.1016/j.rasd.2021.101849] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Although research demonstrates that autistic children are at risk of poor sleep quality, very little is known about sleep quality and its impact on quality of life in autistic adults. We investigated the relationships between sleep quality, perceived stress, and quality of life for autistic adults. METHOD Data were prospectively collected from both autistic adults (N=40) and non-autistic adults (N=24). Sleep Quality was measured using the Pittsburgh Sleep Quality Index, Perceived Stress was measured using the Perceived Stress Scale, and Quality of Life was measured using the Brief Version of the World Health Organization Quality of Life Scale. We ran OLS regression models to examine the association between study group, perceived stress, sleep quality, and quality of life. We tested for main effects of study group (i.e., autistic or non-autistic), sleep quality, and perceived stress, adjusting for demographic characteristics. Then, we tested the interaction between study group and sleep quality. Finally, we tested a three-way interaction between group, sleep quality, and perceived stress. RESULTS Autistic adults reported worse sleep quality compared to non-autistic adults. Poorer sleep quality was significantly associated with lower quality of life for all participants in the study. Findings from the three-way interaction indicated that higher perceived stress further exacerbated the relationship between poorer sleep quality and lower quality of life for autistic adults. CONCLUSIONS These findings suggest that interventions that target both sleep quality and stress could effectively improve quality of life for autistic adults.
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Affiliation(s)
- Kiley J. McLean
- School of Social Work, University of Wisconsin-Madison
- Waisman Center
| | - Shaun M. Eack
- School of Social Work, University of Pittsburgh
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Lauren Bishop
- School of Social Work, University of Wisconsin-Madison
- Waisman Center
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A Systematic Review of Self-Reported Stress Questionnaires in People on the Autism Spectrum. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021; 10:295-318. [PMID: 34603935 PMCID: PMC8475841 DOI: 10.1007/s40489-021-00293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/08/2021] [Indexed: 10/26/2022]
Abstract
Background The goal of this systematic review was to provide an overview of self-report measures of stress in populations on the autism spectrum. In addition, information regarding psychometric properties was discussed as well. Methods Four databases were systematically searched following the PRISMA guidelines and using strict eligibility criteria. Risk of bias assessment was performed using the COSMIN checklist. Results Eight questionnaires were previously used in populations on the autism spectrum, reported over 31 studies. Discussion Future research should focus more on examining psychometric properties of these self-report measures in this population as current evidence is scarce. In addition, it is important to consider which concept of stress one aims to measure as not all questionnaires cover the same aspects of stress. Supplementary Information The online version contains supplementary material available at 10.1007/s40489-021-00293-4.
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The effects of Animal Assisted Therapy on autonomic and endocrine activity in adults with autism spectrum disorder: A randomized controlled trial. Gen Hosp Psychiatry 2021; 72:36-44. [PMID: 34237553 DOI: 10.1016/j.genhosppsych.2021.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Stress and its sequelae are very common in adults with autism spectrum disorder (ASD) without an intellectual disability (ID). Animal-assisted therapy (AAT) has shown physiological stress-reductive effects in children with ASD. The aim of the current study was to examine the acute psychophysiological response to an AAT session, and to examine the longer-term stress-physiological effects of the intervention, up until 10 weeks post-treatment, in comparison to waiting-list controls. METHOD A randomized controlled trial with pre-intervention (T0), post-intervention (T1: 10 weeks) and follow-up (T2: 20 weeks) measurements of neuroendocrine and cardiovascular measures, was conducted in 53 adults with ASD (N = 27 in intervention arm; N = 26 in control arm). Within the intervention group, stress-physiological data were collected during the 5th therapy session (acute effects). Data were analyzed with mixed models for outcome measures cortisol, alpha-amylase, heart rate variability and sympathetic activity. RESULTS The AAT interventional session was significantly associated with reduced cortisol levels (β = -0.41, p = .010), while parasympathetic and sympathetic cardiovascular activity remained unaltered. No significant changes were found for stress-physiological measures at post-treatment time points. CONCLUSIONS Acute stress reduction, reflected in significant reduction in cortisol levels, was found during an AAT session in adults with ASD, without ID. More research is needed to explore to what extent the specific factors of AAT have contributed to the decrease in cortisol and whether stress reduction is possible for the longer-term.
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Moseley RL, Turner-Cobb JM, Spahr CM, Shields GS, Slavich GM. Lifetime and perceived stress, social support, loneliness, and health in autistic adults. Health Psychol 2021; 40:556-568. [PMID: 34618502 PMCID: PMC8513810 DOI: 10.1037/hea0001108] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Although the health consequences of life stress exposure in the general population are well known, how different stressors occurring over the lifetime cause morbidity and mortality in autism is unclear, as are the factors that moderate and mediate these associations. The few studies that have compared autistic and nonautistic individuals have used instruments that yield few stress exposure indices and assess stressors occurring over short time periods. METHOD To address these issues, we used the Stress and Adversity Inventory to assess lifetime stressor exposure and perceived stressor severity in 127 autistic and 104 nonautistic adults. Moderated mediation analysis examined associations between stressor exposure and physical and mental ill-health with respect to the hypothesized mediating role of stressor perception, and moderation effects of loneliness and social support. RESULTS Autistic adults experienced more lifetime stressors and generally perceived stressors as being more severe. Greater perceived stressor severity was related to poorer physical and mental health and to greater loneliness and lower social support for both groups. An additional post hoc analysis of the association between diagnostic status and mental ill-health revealed that loneliness mediated the relation between being autistic and having poorer mental health. CONCLUSION Autistic individuals experienced more lifetime stressors, and their impact on physical and mental health was mediated by perceived stressor severity. Moreover, loneliness and low social support were associated with greater negative impact of lifetime stress exposure on mental health. Interventions that reduce cognitive-perceptual stress appraisals, and that target loneliness and social support, may help reduce risk for stress-related disease in autistic individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - Chandler M. Spahr
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Grant S. Shields
- Department of Psychological Science, University of Arkansas, Arkansas, USA
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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Benevides TW, Shore SM, Palmer K, Duncan P, Plank A, Andresen ML, Caplan R, Cook B, Gassner D, Hector BL, Morgan L, Nebeker L, Purkis Y, Rankowski B, Wittig K, Coughlin SS. Listening to the autistic voice: Mental health priorities to guide research and practice in autism from a stakeholder-driven project. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 24:822-833. [PMID: 32429818 PMCID: PMC7787673 DOI: 10.1177/1362361320908410] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
LAY ABSTRACT Autistic adults commonly experience mental health conditions. However, research rarely involves autistic adults in deciding priorities for research on mental healthcare approaches that might work for them. The purpose of this article is to describe a stakeholder-driven project that involved autistic adults in co-leading and designing research about priorities to address mental health needs. Through a large online survey, two large meetings, and three face-to-face focus group discussions involving over 350 stakeholders, we identified five priorities for mental health research desired by autistic adults. These priorities and preferred outcomes should be used to guide research and practice for autistic adults.
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Muniandy M, Richdale AL, Arnold SRC, Trollor JN, Lawson LP. Inter-relationships between trait resilience, coping strategies, and mental health outcomes in autistic adults. Autism Res 2021; 14:2156-2168. [PMID: 34184818 DOI: 10.1002/aur.2564] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/29/2021] [Accepted: 06/15/2021] [Indexed: 01/14/2023]
Abstract
Resilience has been depicted as a key characteristic in the promotion of mental health in the face of stress and adversity. Despite high levels of stress encountered in the autistic population, resilience studies remain scarce. Using data from an Australian longitudinal adult study, this study explored the inter-relationships between trait resilience, coping, and mental health in a sample of autistic adults (N = 78). In particular, we examined the relationship between resilience and use of coping strategies, and the potential mediating role of coping strategies in the relationship between resilience and mental health outcomes. Our findings suggested that increased use of engagement coping (e.g., problem-solving, positive appraisal) and decreased use of disengagement coping (e.g., self-blame, being in denial) strategies were associated with higher levels of resilience. Further, mediation analysis results suggest that disengagement coping mediated the associations between resilience and all three mental health outcomes (i.e., depression, anxiety, and well-being), while engagement coping strategies mediated the relationship between resilience and well-being only. Our results illustrate that coping strategies may be an important mechanism in explaining the resilience-mental health relationship in autistic adults, highlighting the importance of considering stress-related constructs together (i.e., trait resilience and coping) when addressing support and intervention options for mental health difficulties in the autistic adult population. LAY SUMMARY: This research explored how resilience and coping strategies influence the mental health and well-being of autistic adults. We found that resilient autistic adults used more engagement coping strategies, less disengagement coping strategies, and reported better mental health and well-being. Considering stress-related factors together (i.e., resilience and coping) offers a novel perspective to mental health difficulties in autistic adults and may be a vital step in the development of support options in this population.
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Affiliation(s)
- Melanie Muniandy
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Brisbane, Queensland, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Brisbane, Queensland, Australia
| | - Samuel R C Arnold
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Brisbane, Queensland, Australia.,Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, New South Wales, Australia
| | - Julian N Trollor
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Brisbane, Queensland, Australia.,Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, New South Wales, Australia
| | - Lauren P Lawson
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Brisbane, Queensland, Australia
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44
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Abstract
Individuals with autism experience substantially higher rates of mood problems compared to the general population, which contribute to reduced quality of life and increased mortality through suicide. Here, we reviewed evidence for the clinical presentation, aetiology and therapeutic approaches for mood problems in autism. We identified a lack of validated tools for accurately identifying mood problems in individuals with autism, who may present with 'atypical' features (e.g. severe irritability). Risk factors for mood problems in autism appear to be largely overlapping with those identified in the general population, including shared genetic, environmental, cognitive, physiological/neurobiological mechanisms. However, these mechanisms are exacerbated directly/indirectly by lived experiences of autism, including increased vulnerability for chronic stress - often related to social-communication difficulties(/bullying) and sensory sensitivities. Lastly, current therapeutic approaches are based on recommendations for primary mood disorders, with little reference to the neurobiological/cognitive differences associated with autism. Thus, we recommend: 1) the development and validation of (objective) tools to identify mood problems in autism and measure therapeutic efficacy; 2) an interactive approach to investigating aetiologies in large-scale longitudinal studies, integrating different levels of analysis (e.g. cognitive, neurobiological) and lived experience; 3) testing potential treatments through high-quality (e.g. sufficiently powered, blinded) clinical trials, specifically for individuals with autism.
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Affiliation(s)
- Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, UK
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, UK
| | - Declan G Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, UK.,South London and Maudsley NHS Foundation Trust (SLaM), London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, UK
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45
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Sáez-Suanes GP, Álvarez-Couto M. Factors Associated with Quality of Life in Adults with Autism Spectrum Disorder: A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00254-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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46
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Lam GYH, Sabnis S, Migueliz Valcarlos M, Wolgemuth JR. A Critical Review of Academic Literature Constructing Well-Being in Autistic Adults. AUTISM IN ADULTHOOD 2021; 3:61-71. [PMID: 36601269 PMCID: PMC8992886 DOI: 10.1089/aut.2020.0053] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The emergence of critical autism studies has fueled efforts to interrogate how autistic people are studied and described in academic literature. While there is a call for research that promotes better well-being for autistic people, little attention has been paid to the concept of well-being itself. Just as the medical model limits critical understandings of autism in the academic literature, so too may psychological accounts of well-being limit, rather than expand, possibilities of living a good life for autistic people. The purpose of this critical review was to identify and critique how well-being in autistic adults is constructed in research. Based on a systematic search of peer-reviewed empirical research published from 2013 to 2020, we identified 63 articles that involved direct data collection with autistic adults and focused on well-being constructs such as quality of life, life satisfaction, and happiness. We examined the articles using the techniques of critical discourse analysis to discern assumptions underlying constructions of autistic well-being, with special attention to the axiological and teleological contributions of autistic perspectives in the research and writing processes. We identified several approaches through which the literature constructed autistic well-being: (1) well-being as an objective uncontested variable, (2) well-being as personal and not fixed, (3) well-being that warrants a specific measure for the autistic population, and (4) well-being as a situated account that privileges and centers autistic people's perspectives. We subject these accounts to critical analysis, pointing to how they limit and open life possibilities for autistic people. We recommend that researchers and practitioners critically reflect on how they engage autistic adults and use their input to create works that support well-being in ways that are meaningful and ethical to autistic adults, as well as do justice to changing broader narratives of autism in research and society. Lay summary Why was this study done?: More autistic people and researchers have advocated to study autism in critical and positive ways. While it is important to promote better well-being for autistic people, little is known about what well-being actually means to them.What was the purpose of this study?: The purpose of our critical review was to identify how the concept of well-being in autistic people is understood and described in academic literature. We also critiqued how well-being research considers the input and perspectives of autistic adults.What did we do?: We systematically searched for research articles published between 2013 and 2020. We identified 63 articles that involved direct data collection with autistic adults and focused on well-being and related concepts such as quality of life, life satisfaction, and happiness. We analyzed the articles by focusing on how they used language to describe well-being in autistic adults and how they valued the data collected from these adults.What did we find?: We identified several ways that article authors described their understanding of autistic well-being: (1) well-being as an objective and uncontested object, (2) well-being is personal and can vary in nature, (3) well-being warrants a measure that considers opinions of autistic people, and (4) well-being as very specific to autistic people's subjective perspectives. We critically analyzed how these different understandings limit or open life possibilities for autistic people's well-being.How will this work help autistic people?: We recommend that researchers critically reflect on how they engage autistic adults and use their input in research. Promoting well-being needs to be meaningful and ethical to autistic adults. Research also needs to advocate for social justice to challenge how the majority in society understands or misunderstands autistic people.
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Affiliation(s)
- Gary Yu Hin Lam
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.,Address correspondence to: Gary Yu Hin Lam, PhD, Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Room 304, Ho Tim Building, Shatin, New Territories, Hong Kong
| | - Sujay Sabnis
- Department of Educational Psychology, College of Education, Health, and Society, Miami University, Oxford, Ohio, USA
| | - Maria Migueliz Valcarlos
- Department of Educational Psychology, College of Education, Health, and Society, University of South Florida, Tampa, Florida, USA
| | - Jennifer R. Wolgemuth
- Department of Educational Psychology, College of Education, Health, and Society, University of South Florida, Tampa, Florida, USA
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Zhao M, Fu W, Ai J. The Mediating Role of Social Support in the Relationship Between Parenting Stress and Resilience Among Chinese Parents of Children with Disability. J Autism Dev Disord 2021; 51:3412-3422. [PMID: 33386552 DOI: 10.1007/s10803-020-04806-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2020] [Indexed: 10/22/2022]
Abstract
Few studies have examined the relationships among parents' resilience, parenting stress, and social support. This study surveyed 486 parents of children with disability in China to understand the role of social support between parenting stress and parents' resilience. The results indicated that the resilience of Chinese parents of children with disabilities was at a high level. Additionally, parenting stress, social support and resilience were significantly associated, and the mediating effect of social support between parenting stress and parents' resilience were proved by mediation analyses. The findings suggested that reducing parental stress and improving social support may predict (or be associated with) improved parent resilience. The authors discussed the implications for the improvement the resilience of Chinese parents of children with disabilities.
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Affiliation(s)
- Meiju Zhao
- Faculty of Children Development and Education, China Women's University, Beijing, 100000, China
| | - Wangqian Fu
- China Institute of Education and Social Development, Beijing Normal University, Beijing, 100875, China.
| | - Jun Ai
- Juniper Gardens Children's Project, University of Kansas, 444 Minnesota Avenue, Suite 300, Kansas City, KS, 66101-2914, USA
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Brief report: Changes in quality of life and social functioning during vocational program - a pilot study of autistic adults. J Autism Dev Disord 2021; 51:3774-3781. [PMID: 33387243 DOI: 10.1007/s10803-020-04821-9] [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: 11/26/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Quality of life (QoL), social-emotional and occupational functioning are often diminished in young autistic adults. Measuring these constructs as vocational training outcomes may inform future programming and relevancy of measures. METHODS This pilot study analyzed changes in social-emotional functioning and QoL during the involvement at a vocational program for autistic adults using the WHOQOL-BREF, a modified version of the Birchwood- Social Functioning Scale (SFS-m) and a piloted measure. Participants completed these self-reported questionnaires upon admission and at 3 months. RESULTS Significant change was found on the SFS-m and two WHOQOL-BREF domains: psychological and environmental. CONCLUSIONS This pilot study suggests that autistic adults, similar in characterization, can self-report using these QoL and social measures; further, these measures are sensitive to certain changes over time in such group programs.
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Social Capital in Old People Living with HIV Is Associated with Quality of Life: A Cross-Sectional Study in China. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7294574. [PMID: 33313316 PMCID: PMC7721488 DOI: 10.1155/2020/7294574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/22/2020] [Accepted: 11/18/2020] [Indexed: 11/25/2022]
Abstract
Objective Old people living with HIV (PLWH) are experiencing a lower quality of life (QoL) than their younger counterparts and have received insufficient attention in China. Given that social capital has been proven to be effective in improving QoL in other countries, we aimed to examine the association between social capital and QoL among old PLWH in China. Methods The data presented in this study was based on the baseline sample of an ongoing observational prospective cohort study, which was carried out from November 2018 to February 2019. Participants were old PLWH aged ≥50 in Sichuan, China, and were recruited by stratified multistage cluster sampling from 30 communities/towns. A total of 529 eligible participants finished the face-to-face investigation to measure their social capital (i.e., individual and family- (IF-) based social capital and community and society- (CS-) based social capital) and QoL. The QoL's dimensions of physical health summary (PCS) and mental health summary (MCS) were taken as dependent variables. Stepwise linear regression models were used to examine the association between social capital and QoL. Results After considering all significant covariates, the PCS was nonsignificantly correlated with IF-based social capital (β = −0.08, 95% CI [-0.28-0.11]) and CS-based social capital (β = 0.28, 95% CI [-0.03-0.59]), and MCS was significantly correlated with IF-based social capital (β = 0.77, 95% CI [0.54-0.99], p < 0.001) and CS-based social capital (β = 0.40, 95% CI [0.08-0.72], p < 0.05). Conclusion Targeted interventions related to building up social capital should be applied to improve the QoL of old PLWH. Providing extra relief funds and allowances might be helpful to improve PCS; improving community networking and engagement and improving family care might be helpful to improve MCS among this vulnerable population.
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50
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Oakley BF, Tillmann J, Ahmad J, Crawley D, San José Cáceres A, Holt R, Charman T, Banaschewski T, Buitelaar J, Simonoff E, Murphy D, Loth E. How do core autism traits and associated symptoms relate to quality of life? Findings from the Longitudinal European Autism Project. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 25:389-404. [PMID: 33023296 PMCID: PMC7874383 DOI: 10.1177/1362361320959959] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Previous studies have reported reduced quality of life in autism. Improving quality of life for autistic people is, therefore, a key priority for clinical research and practice. However, the relative impact of core autism traits (e.g. social-communication difficulties), as compared to associated mental health symptoms (e.g. anxiety, depression) on quality of life remains poorly understood. This is despite at least 20%–50% of autistic individuals experiencing associated anxiety and/or depression symptoms. Hence, we measured subjective quality of life in 573 six to thirty-year-olds (autism spectrum disorder N = 344), using two widely validated questionnaires. Adults self-reported on the World Health Organization Quality of Life–Brief instrument. Parents of children/adolescents completed the Child Health and Illness Profile. We assessed individual variability across both measures and modelled associations between quality of life, core autism traits, anxiety, and depression symptoms. Across both age groups and quality of life measures, autistic individuals scored lower than comparison individuals, on average, particularly for physical health in adults (d = −1.24, 95% confidence interval: [−1.56, −0.93]) and school achievement for children/adolescents (d = −1.06, 95% confidence interval: [−1.29, −0.84]). However, a notable proportion of autistic individuals (36%–71% across quality of life domains) did not have reduced quality of life. Across ages and quality of life measures, severity of associated symptoms was significantly related to reduced quality of life on several domains, after accounting for core autism traits. Most notably, depression symptoms were related to reduced physical/psychological well-being in both adults (β ⩾ −0.34) and children/adolescents (β = −0.29, 95% confidence interval: [−0.36, −0.14]). For children/adolescents, anxiety symptoms (β ⩾ −0.28) and core social-communication difficulties (β ⩾ −0.22) were also related to subjective quality of life outcomes. Overall, findings indicate that not all autistic individuals experience reduced subjective quality of life. Variability in quality of life is significantly influenced by associated symptoms, across developmental stage. This may provide a tractable target for mental health services to improve quality of life for autistic individuals over the lifespan.
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Affiliation(s)
| | | | - Jumana Ahmad
- King's College London, UK.,University of Greenwich, UK
| | | | | | | | - Tony Charman
- King's College London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), UK
| | | | - Jan Buitelaar
- Radboud University Nijmegen Medical Center, The Netherlands.,Karakter Child and Adolescent Psychiatry University Center, The Netherlands
| | - Emily Simonoff
- King's College London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), UK
| | - Declan Murphy
- King's College London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), UK
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