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Piening S, van Balkom IDC, Stapert AF, Henning D, Greaves-Lord K, Davids LRCD, Castelein S, Groen Y. Perspectives on Autism Spectrum Disorder Diagnosis, Symptoms, Treatment and Gender Roles: A Qualitative Study of Similarities and Differences between Sexes. Int J Environ Res Public Health 2023; 20:7183. [PMID: 38131734 PMCID: PMC10742825 DOI: 10.3390/ijerph20247183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/23/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
This study aims to compare the experiences of women and men of different age groups with regard to their first autism spectrum disorder (ASD) diagnosis, symptoms, treatment, and gender roles to inform our understanding in clinical practice of differences as well as similarities. Semi-structured interviews were conducted amongst 22 women (n = 12) and men (n = 10) in three adult age groups regarding their diagnostic process, symptoms, treatment, and gender roles. Participants also filled out questionnaires on gender traits, social support, coping, and quality of life. Framework analysis guidelines were followed to identify subthemes within the three pre-defined key themes of the semi-structured interviews, and quantitative analyses were performed on the questionnaire results. Women often had caregiver roles and were more focused on social and family-oriented life aspects than men. Family and societal expectations may have been different for women from an early age onward and were considered burdensome by some, but not all. Views on ASD diagnosis, symptoms, and treatment were largely individually determined. The questionnaire results mostly showed no significant sex differences. Perceived gender roles differed between participants. In diagnosis and treatment, awareness of general gender differences and gender roles is important, but inter-individual differences and similar experiences in men should not be overlooked.
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Affiliation(s)
- Sigrid Piening
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute, 9700 AB Groningen, The Netherlands (A.F.S.); (K.G.-L.)
| | - Ingrid D. C. van Balkom
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute, 9700 AB Groningen, The Netherlands (A.F.S.); (K.G.-L.)
| | - Anne Fleur Stapert
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute, 9700 AB Groningen, The Netherlands (A.F.S.); (K.G.-L.)
| | - Daria Henning
- Outpatient Clinic for the Elderly, Lentis Psychiatric Institute, 9725 AG Groningen, The Netherlands
| | - Kirstin Greaves-Lord
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute, 9700 AB Groningen, The Netherlands (A.F.S.); (K.G.-L.)
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, 9712 TS Groningen, The Netherlands
| | | | - Stynke Castelein
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, 9712 TS Groningen, The Netherlands
- Lentis Research, Lentis Psychiatric Institute, 9725 AG Groningen, The Netherlands
| | - Yvonne Groen
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
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Groen Y, Ebert WM, Dittner FM, Stapert AF, Henning D, Greaves-Lord K, Davids RCD(L, Castelein S, Baron Cohen S, Allison C, Van Balkom IDC, Piening S. Measuring the Autistic Women's Experience (AWE). Int J Environ Res Public Health 2023; 20:7148. [PMID: 38131700 PMCID: PMC10742621 DOI: 10.3390/ijerph20247148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
We developed a Dutch questionnaire called the Autistic Women's Experience (AWE) and compared its psychometric properties to the Autism Spectrum Quotient (AQ). Whilst attenuated gender differences on the AQ have been widely replicated, this instrument may not fully capture the unique experience of autistic women. The AWE was co-developed with autistic women to include items that reflect autistic women's experience. We investigated the AWE (49 items) and compared it with the AQ (50 items) in Dutch autistic individuals (N = 153, n = 85 women) and in the general population (N = 489, n = 246 women) aged 16+. Both the AQ and AWE had excellent internal consistency and were highly and equally predictive of autism in both women and men. Whilst there was a gender difference on the AQ among non-autistic people (men > women), there was no gender difference among autistic people, confirming all earlier studies. No gender differences were detected on the AWE overall scale, yet subtle gender differences were observed on the subscales. We conclude that the AQ is valid for both genders, but the AWE provides an additional useful perspective on the characteristics of autistic women. The AWE needs further validation in independent samples using techniques that allow for testing gender biases, as well as a confirmatory factor analysis in a larger sample.
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Affiliation(s)
- Yvonne Groen
- Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - W. Miro Ebert
- Institute for Sport Sciences, University of Regensburg, D-93053 Regensburg, Germany
| | - Francien M. Dittner
- Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Anne Fleur Stapert
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute, 9728 JR Groningen, The Netherlands; (A.F.S.); (I.D.C.V.B.); (S.P.)
| | - Daria Henning
- Lentis Psychiatric Institute, Outpatient Clinic for the Elderly, 9725 AG Groningen, The Netherlands;
| | - Kirstin Greaves-Lord
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute, 9728 JR Groningen, The Netherlands; (A.F.S.); (I.D.C.V.B.); (S.P.)
- Clinical Psychology and Experimental Psychopathology, University of Groningen, 9712 TS Groningen, The Netherlands
| | | | - Stynke Castelein
- Clinical Psychology and Experimental Psychopathology, University of Groningen, 9712 TS Groningen, The Netherlands
- Lentis Research, Lentis Psychiatric Institute, 9725 AG Groningen, The Netherlands
| | - Simon Baron Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge CB2 8AH, UK
| | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge CB2 8AH, UK
| | - Ingrid D. C. Van Balkom
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute, 9728 JR Groningen, The Netherlands; (A.F.S.); (I.D.C.V.B.); (S.P.)
| | - Sigrid Piening
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute, 9728 JR Groningen, The Netherlands; (A.F.S.); (I.D.C.V.B.); (S.P.)
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Oshima F, Mandy W, Seto M, Hongo M, Tsuchiyagaito A, Hirano Y, Sutoh C, Guan S, Nitta Y, Ozawa Y, Kawasaki Y, Ohtani T, Masuya J, Takahashi N, Sato N, Nakamura S, Nakagawa A, Shimizu E. Cognitive behavior therapy for autistic adolescents, awareness and care for my autistic traits program: a multicenter randomized controlled trial. BMC Psychiatry 2023; 23:661. [PMID: 37679711 PMCID: PMC10485995 DOI: 10.1186/s12888-023-05075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 08/02/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Autistic people demonstrate focused interests, sensitivity to sensory stimulation, and, compared with the general population, differences in social communication and interaction. We examined whether a combination of the Awareness and Care for My Autistic Traits (ACAT) program and treatment-as-usual is more effective than only treatment-as-usual in increasing the understanding of autistic attributes, reducing treatment stigma, and improving mental health and social adaptation among autistic adolescents and their parents/guardians. METHODS Forty-nine adolescents and their parents/guardians were randomly assigned to either a combination of ACAT and treatment-as-usual or only treatment-as-usual. The combined group received six weekly 100-minute ACAT sessions, while the treatment-as-usual group received no additional intervention. The primary outcome was the change in understanding of autistic attributes (Autism Knowledge Quiz-Child), administered from pre- to post-intervention. The secondary outcomes included the change in Autism Knowledge Quiz-Parent, reduced treatment stigma, and improved mental health and social adaptation among autistic adolescents and their parents/guardians. A primary outcome measure scale was scored by assessors who were blind to the group assignment. RESULTS The combined group (both autistic adolescents and their parents/guardians) showed an increase in Autism Knowledge Quiz scores compared to those in the treatment-as-usual group. Autistic adolescents in the combined group also demonstrated a decrease in treatment-related stigma and an improvement in general mental health compared to those in the treatment-as-usual group, while there were no group differences in the change in social adaptation. For parents/guardians, there were no group differences in the change in treatment-related stigma, general mental health, adaptive skills, or attitudes toward their children. CONCLUSIONS The ACAT program could be an effective treatment modality to increase the understanding of autistic attributes among both autistic adolescents and their parents/guardians. The ACAT program positively affects self-understanding, reduces treatment stigma, and stabilizes behavioral issues for autistic adolescents as a part of mental health measures, but it does not effectively reduce treatment barriers or improve mental health for parents/guardians. Further research should consider whether additional support for parents/guardians could be beneficial. TRIAL REGISTRATION The study was registered in UMIN (UMIN000029851, 06/01/2018).
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Affiliation(s)
- Fumiyo Oshima
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan.
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan.
| | - William Mandy
- Research Department of Clinical, Educational & Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK
| | - Mikuko Seto
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Minako Hongo
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan
| | - Aki Tsuchiyagaito
- Laureate Instituto for Brain Research, 6655 S Yale Ave, Tulsa, OK, 74136, USA
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan
| | - Chihiro Sutoh
- Department of Cognitive Behavioral Physiology, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Siqing Guan
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Yusuke Nitta
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Yoshihito Ozawa
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Toshiyuki Ohtani
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan
- Safety and Health Organization, Chiba University, Chiba, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University Ibaraki, Medical Center, 3-20-1 3-20-1 Chuo, Ami-machi, Inashiki-gun, Ibaraki, 300-0395, Japan
| | - Noriko Takahashi
- Fukushima University Child Mental Health-Care Center, 1 Kanayagawa, Fukushima, 960-1296, Japan
| | - Noriyuki Sato
- Fukushima University Child Mental Health-Care Center, 1 Kanayagawa, Fukushima, 960-1296, Japan
| | - Shizuka Nakamura
- Fukushima University Child Mental Health-Care Center, 1 Kanayagawa, Fukushima, 960-1296, Japan
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan
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Hogendoorn E, Hartman CA, Burke SM, van Dijk MWG, Rosmalen JGM. Longitudinal relations between autistic-like features and functional somatic symptoms in adolescence. Autism 2023; 27:1690-1701. [PMID: 36588286 PMCID: PMC10375000 DOI: 10.1177/13623613221143874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract Autistic-like features and functional somatic symptoms (FSS) frequently co-occur. It remains unknown how autistic-like features and FSS affect each other and develop throughout adolescence. This study examined reciprocal relations between autistic-like features and FSS in adolescence. Participants were 2772 adolescents (52.5% male) from the Tracking Adolescents’ Individual Lives Survey population and clinical cohort. Data from four waves were included, covering the ages between 11 and 19 years. Autistic-like features were measured using the Children’s Social Behavior Questionnaire. FSS were assessed using the Youth Self Report and Adult Self Report, respectively. Using the random intercept cross-lagged panel model, a stable positive, moderately strong between-persons association was found between autistic-like features and FSS. No within-persons reciprocal effects from wave to wave were observed. Secondary analyses revealed a consistent relation with FSS for three different domains of autistic-like features (social and communication behaviors, repetitive behaviors, and self-regulatory behaviors), and highly similar interrelations in a subsample of adolescents with a clinical autism spectrum disorder diagnosis. In conclusion, the co-occurrence between autistic-like features and FSS is stable throughout adolescence. Clinicians working with adolescents with autistic-like features should be alert to the presence FSS, and vice versa.
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Carbone A, Dell'Aquila A. The Diagnosis of "Pervasive Developmental Disorder Not Otherwise Specified": A Systematic Literature Review. Children (Basel) 2023; 10:children10050844. [PMID: 37238392 DOI: 10.3390/children10050844] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
(1) Background: The study deepens the diagnosis of "pervasive developmental disorder not otherwise specified" (PDD-NOS), a subthreshold diagnosis introduced in DSM-IV and then absorbed into the broader spectrum disorder of autism in DSM 5. The presence of people still attributed with a diagnosis of PDD-NOS can cause confusion in the understanding of this disorder, which is no longer present in the current diagnostic system. This review aims to gain a deeper understanding of the characteristics and boundaries of diagnosis, its use within the scientific community, and the long-term stability of that diagnosis. (2) Methods: The Prisma method was used to carry out the literature review; the scientific papers were selected using scientific search engines, including SCOPUS, PUBMED, and PsychINFO. Twenty-three articles were finally selected, and a meticulous reading was carried out in relation to the research questions. (3) Results: Four cross-cutting categories were identified: (1) diagnosis; (2) differential diagnosis; (3) prognosis; and (4) comorbidity. (4) Conclusions: Limits have emerged regarding the consistency, sensitivity, and the stability of PDD-NOS. The inclusion of this diagnosis within the broader autism spectrum disorder category coined in DSM-5 appears applicable.
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Affiliation(s)
- Agostino Carbone
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Asia Dell'Aquila
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Roma, Italy
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Dekker LP, van der Vegt EJM, Louwerse A, Visser K, van der Ende J, Maras A, Verhulst FC, Greaves-Lord K. Complementing or Congruent? Desired Characteristics in a Friend and Romantic Partner in Autistic versus Typically Developing Male Adolescents. Arch Sex Behav 2023; 52:1153-1167. [PMID: 36241943 PMCID: PMC10102130 DOI: 10.1007/s10508-022-02444-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 05/11/2023]
Abstract
Ideal friend and romantic partner characteristics related to self-perceived characteristics have been investigated in typically developing (TD) individuals, but not in individuals with autism spectrum disorder (ASD). Considering the autistic symptoms and challenges, investigating these concepts in autistic individuals is relevant. Given the lack of consensus, identity-first ("autistic person") and person-first ("person with autism") language are mixed throughout, to cover all preferences. This study explored (1) the association between self-perceived characteristics and desires in a friend/romantic partner, as well as (2) compare two groups (ASD and TD) in their desires for a friend/romantic partner. Two matched groups (ASD and TD) of 38 male adolescents (age 14-19 years) reported on the desire for nine characteristics (i.e., funny, popular, nice, cool, smart, trustworthy, good looking, similar interests, and being rich) in a friend/partner, and to what extent they felt they themselves possessed seven characteristics (i.e., funny, popular, nice, cool, smart, trustworthy, and good looking). Results showed both groups sought a friend and partner similar to themselves on intrinsic characteristics (e.g., trustworthiness), but less similar on extrinsic and social status characteristics (e.g., being less cool and popular). Particularly intrinsic characteristics, more than extrinsic and social status characteristics, were valued in both partners and friends, regardless of group. No significant differences were found between groups concerning to what extent characteristics were desired. Overall, adolescents with ASD desire similar characteristics as TD adolescents in their potential romantic partners and friends. There is some indication that the match between self-perception and desired characteristics is different.
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Affiliation(s)
- Linda P Dekker
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, Room T13-24, 3000 DR, Rotterdam, The Netherlands.
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands.
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands.
| | | | - Anneke Louwerse
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
| | - Kirsten Visser
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
- Youz Child and Adolescent Psychiatry, Team Sarr Autism Expertise Centre, Rotterdam, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Athanasios Maras
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
- Autism Team Northern-Netherlands of Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, The Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
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Horwitz E, Vos M, De Bildt A, Greaves-Lord K, Rommelse N, Schoevers R, Hartman C. Sex differences in the course of autistic and co-occurring psychopathological symptoms in adolescents with and without autism spectrum disorder. Autism 2023:13623613221146477. [PMID: 36680498 PMCID: PMC10375001 DOI: 10.1177/13623613221146477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
LAY ABSTRACT There is an ongoing debate as to whether autism spectrum disorder (ASD) is expressed differently in women than men. Studies on sex differences in autistic symptoms and symptoms of other psychiatric problems present in individuals with autism generally do not include a general population comparison group, making it unclear whether differences are specific to autism or merely reflecting development in the general population. In this study, we compared sex differences in the course of autistic and at the same time present symptoms of other psychiatric problems in adolescents with milder forms of ASD to those in a group of the general population with an equal intelligence quotient (IQ) and socioeconomic status. Data of five assessment moments from ages 11 to 22 years were analyzed using a statistic procedure that allowed us to determine which factors affect the course of symptoms over time. We found that in adolescence, sex differences in the course of psychopathological symptoms specific for autism are confined to the repetitive stereotyped domains. Males had higher scores on the sensory/stereotypic and resistance to change domains, the latter difference disappeared during the course of adolescence due to an increase of these problems in autistic females. Other sex differences, among which an increase over time in mood and anxiety problems in females was the most outstanding, were also observed in females without autism. These sex-specific differences have relevance in the clinical care of autistic men and women, although they are subtle compared to differences between individuals with and without autism.
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Affiliation(s)
| | - Melissa Vos
- University Medical Center Groningen, The Netherlands
| | | | - Kirstin Greaves-Lord
- Erasmus Medical Center Rotterdam, The Netherlands.,Sophia Children's Hospital, The Netherlands
| | - Nanda Rommelse
- Karakter Child and Adolescent Psychiatry University Centre, The Netherlands
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Ghanouni P, Eves L. Resilience among Parents and Children with Autism Spectrum Disorder. Ment Illn 2023; 2023:1-10. [DOI: 10.1155/2023/2925530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Resilience plays a pivotal role to offset stress among families of children with autism spectrum disorder (ASD). Although the majority of previous studies investigated resilience in parents, it is unclear what factors contribute to resilience in children. Thus, we aimed to explore resilience experienced by parents of children with ASD and how it affects children’s resilience. We invited 50 parents of a child with ASD, 13 years old or younger, across various Canadian provinces in an online survey. Parental resilience was positively associated with household income and negatively associated with parental stress. Resilience in children with ASD was positively associated with their social participation at home and community. Findings indicate a relationship between resilience in children with ASD and their participation, suggesting new ways to increase resilience in children with ASD by enhancing their participation.
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Zhang M, Hu X, Jiao J, Yuan D, Li S, Luo T, Wang M, Situ M, Sun X, Huang Y. Brain white matter microstructure abnormalities in children with optimal outcome from autism: a four-year follow-up study. Sci Rep 2022; 12:20151. [PMID: 36418886 PMCID: PMC9684497 DOI: 10.1038/s41598-022-21085-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 09/22/2022] [Indexed: 11/24/2022] Open
Abstract
Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder, with only a small proportion of people obtaining optimal outcomes. We do not know if children with ASD exhibit abnormalities in the white matter (WM) microstructure or if this pattern would predict ASD prognosis in a longitudinal study. 182 children with ASD were recruited for MRI and clinical assessment; 111 completed a four-year follow-up visit (30 with optimal outcomes, ASD-; 81 with persistent diagnosis, ASD+). Additionally, 72 typically developing controls (TDC) were recruited. The microstructural integrity of WM fiber tracts was revealed using tract-based spatial statistics (TBSS) and probabilistic tractography analyses. We examined the neuroimaging abnormality associated with ASD and its relationship to ASD with optimal outcome. The ASD+ and TDC groups were propensity score matched to the ASD- group in terms of age, gender, and IQ. TBSS indicated that children with ASD exhibited abnormalities in the superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF), and extending to the anterior thalamic radiation (ATR) and cingulum; whereas the ASD+ group showed more severe abnormalities than the ASD- group. Probabilistic tractography analysis revealed that ASD+ group exhibited lower Fractional Anisotropy (FA) of the left superior thalamic radiation (STR L) than ASD- group, and that FA value of the STR L was a significant predictor of optimal outcome (EX(B), 6.25; 95% CI 2.50-15.63; p < 0.001). Children with ASD showed significant variations in SLF_L and STR_L, and STR_L was a predictor of 'ASD with optimal outcome'. Our findings may aid in comprehension of the mechanisms of 'ASD with optimal outcome'.
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Affiliation(s)
- Manxue Zhang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412461.40000 0004 9334 6536The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao Hu
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022West China Second Hospital of Sichuan University, Chengdu, China
| | - Jian Jiao
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Danfeng Yuan
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Sixun Li
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Tingting Luo
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Meiwen Wang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Mingjing Situ
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xueli Sun
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yi Huang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
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10
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Liu F, Scheeren AM, Grove R, Hoekstra RA, Wang K, Guo D, Wang C, Begeer S. Exploring Cultural Differences in Autistic Traits: A Factor Analytic Study of Children with Autism in China and the Netherlands. J Autism Dev Disord 2021; 52:4750-4762. [PMID: 34741233 DOI: 10.1007/s10803-021-05342-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2021] [Indexed: 10/19/2022]
Abstract
Autism spectrum disorders are diagnosed globally, but recognition, interpretation and reporting may vary across cultures. To compare autism across cultures it is important to investigate whether the tools used are conceptually equivalent across cultures. This study evaluated the factor structure of the parent-reported Autism Spectrum Quotient Short Form in autistic children from China (n = 327; 3 to 17 years) and the Netherlands (n = 694; 6 to 16 years). Confirmatory factor analysis did not support the two-factor hierarchical model previously identified. Exploratory factor analysis indicated culturally variant factor structures between China and the Netherlands, which may hamper cross-cultural comparisons. Several items loaded onto different factors in the two samples, indicating substantial variation in parent-reported autistic traits between China and the Netherlands.
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Affiliation(s)
- Fangyuan Liu
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anke M Scheeren
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rachel Grove
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Rosa A Hoekstra
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ke Wang
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, 38 Tongyan Road, Tianjin, China
| | - Dehua Guo
- Department of Special Education, Guangxi College for Preschool Education, Nanjing, China
| | - Chongying Wang
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, 38 Tongyan Road, Tianjin, China.
| | - Sander Begeer
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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11
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Rosello R, Martinez-Raga J, Mira A, Girela B, Cortese S. Developmental outcomes in adolescence of children with autism spectrum disorder without intellectual disability: A systematic review of prospective studies. Neurosci Biobehav Rev 2021; 126:590-603. [PMID: 33872683 DOI: 10.1016/j.neubiorev.2021.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/23/2021] [Accepted: 04/10/2021] [Indexed: 11/30/2022]
Abstract
Individuals with Autism Spectrum Disorder (ASD) without intellectual disability (ID) represent approximately two-thirds of the ASD population. Here we focused on prospective research assessing different areas of functioning of children with ASD, without ID, until adolescence. Based on a pre-registered protocol (PROSPERO CRD42020189029), a systematic review of prospective studies (published between 01.01.2010 and 01.01.2020) was conducted. Twenty-eight studies met eligibility criteria. Findings indicated that ASD diagnosis and the Intelligence Quotient were highly stable over time across studies. Executive Functioning, Theory of Mind and Central Coherence processes tended to improve, although deficits remained when compared to typically developed controls. Adaptive difficulties and psychiatric comorbidity were relatively stable over time. We discuss potential implications of the findings for clinicians and educators and suggest recommendations for future research.
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Affiliation(s)
- Rocio Rosello
- Division of Psychiatry, Imperial College London, UK.
| | - Jose Martinez-Raga
- Psychiatry Department, University Hospital Doctor Peset of Valencia & University of Valencia, Spain
| | - Alvaro Mira
- Division of Developmental and Educational Psychology, University of Valencia, Spain
| | | | - Samuele Cortese
- Centre for Innovation in Mental Health (CIMH), School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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12
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Dekker LP, Visser K, van der Vegt EJM, Maras A, van der Ende J, Tick NT, Verhulst FC, Greaves-Lord K. Insight into Informant Discrepancies Regarding Psychosexual Functioning of Adolescents with and without Autism Spectrum Disorder. J Res Adolesc 2020; 30:487-501. [PMID: 31802571 DOI: 10.1111/jora.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The private nature of psychosexual functioning leads adolescents and their parents to have different perspectives, which highlights studying parent-child informant discrepancies in this domain. We investigated informant discrepancy in psychosexual functioning, using the self-report and parent report versions of the Teen Transition Inventory (TTI), of adolescents with autism spectrum disorder (ASD; 136 parent-child dyads) compared to adolescents from the general population (GP; 70 parent-child dyads). Significantly larger informant discrepancies exist in ASD dyads than GP dyads in most domains of psychosexual functioning, except for Body image, Sexual behavior, and Confidence in the future. It is important to use and pay attention to both informants, as discrepancies are relevant for both research and clinical practice regarding psychosexual functioning.
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Affiliation(s)
| | - Kirsten Visser
- Erasmus MC-Sophia
- Yulius, Organization for Mental Health
- Youz Child & Adolescent Psychiatry, Team Sarr Autism Expertise Centre
| | | | | | | | - Nouchka T Tick
- Yulius, Organization for Mental Health
- University Utrecht
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13
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Horwitz EH, Schoevers RA, Greaves-Lord K, de Bildt A, Hartman CA. Adult Manifestation of Milder Forms of Autism Spectrum Disorder; Autistic and Non-autistic Psychopathology. J Autism Dev Disord 2020; 50:2973-2986. [PMID: 32052317 PMCID: PMC7374470 DOI: 10.1007/s10803-020-04403-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We compared the presence of autistic and comorbid psychopathology and functional impairments in young adults who received a clinical diagnosis of Pervasive Developmental Disorders Not Otherwise Specified or Asperger’s Disorder during childhood to that of a referred comparison group. While the Autism Spectrum Disorder group on average scored higher on a dimensional ASD self- and other-report measure than clinical controls, the majority did not exceed the ASD cutoff according to the Autism Diagnostic Observation Schedule. Part of the individuals with an ASD diagnosis in their youth no longer show behaviors that underscribe a clinical ASD diagnosis in adulthood, but have subtle difficulties in social functioning and a vulnerability for a range of other psychiatric disorders.
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Affiliation(s)
- E H Horwitz
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. .,GGZ Friesland, Leeuwarden, The Netherlands.
| | - R A Schoevers
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | | | - A de Bildt
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - C A Hartman
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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14
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Scheeren AM, Koot HM, Begeer S. Stability and change in social interaction style of children with autism spectrum disorder: A 4-year follow-up study. Autism Res 2020; 13:74-81. [PMID: 31472004 PMCID: PMC6973179 DOI: 10.1002/aur.2201] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 08/14/2019] [Indexed: 11/12/2022]
Abstract
Children with autism spectrum disorder (ASD) show atypical social behavior but vary in their social interaction style (SIS), ranging from social aloofness to awkward social approaches. In a 4-year follow-up study, we examined longitudinal stability and change of SIS in children and adolescents with ASD and a normal intellectual ability (n = 55; mean age Time 1: 13 years; mean age Time 2: 17 years). Children's SIS was assessed with a parent questionnaire, the Wing Subtypes Questionnaire. As expected, most participants (69%) showed SIS stability across the 4-year interval. Some participants (18%) shifted to a more typical or more active (but odd) SIS, while others (13%) shifted to a less typical or less active (but odd) SIS. A decrease in ASD symptoms predicted a shift toward a more typical or active SIS, but children's age and receptive verbal ability did not. SISs may be a meaningful way to create ASD subgroups and thus offer a promising research venue to further disentangle the heterogeneous autism spectrum. Autism Res 2020, 13: 74-81. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: People with autism spectrum disorder (ASD) demonstrate different social interaction styles (SIS), ranging from social aloofness to awkward social approaches. We examined if and how SIS changes across a 4-year period in 55 children and adolescents with ASD (mean age Time 1 = 13 years; mean age Time 2 = 17 years). Most children (69%) showed the same SIS at both time points, indicating that SIS might be a relatively stable trait across adolescence.
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Affiliation(s)
- Anke M. Scheeren
- Department of Clinical, Neuro & Developmental Psychology and EMGO Institute for Health and Care ResearchVrije UniversiteitAmsterdamThe Netherlands
| | - Hans M. Koot
- Department of Clinical, Neuro & Developmental Psychology and EMGO Institute for Health and Care ResearchVrije UniversiteitAmsterdamThe Netherlands
| | - Sander Begeer
- Department of Clinical, Neuro & Developmental Psychology and EMGO Institute for Health and Care ResearchVrije UniversiteitAmsterdamThe Netherlands
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15
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Camodeca A. Description of Criterion Validity of the Autism Spectrum Rating Scales 6-18 Parent Report: Initial Exploration in a Large Community Sample. Child Psychiatry Hum Dev 2019; 50:987-1001. [PMID: 31152377 DOI: 10.1007/s10578-019-00899-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Research regarding psychometric properties of autism spectrum disorder questionnaires is lacking. This study explored the criterion validity of the ASRS 6-18 parent report (ASRS-6-18-P) in a large, well-characterized, real-world clinical sample of 422 children ([Formula: see text] autism [AUT] n = 139; non-autism [NOT] n = 283) evaluated with the Autism Diagnostic Observation Schedule-2, a gold-standard measure. Significant mean differences were observed for DSM-5, social, and unusual behaviors. Total, DSM-5, social, and unusual behaviors demonstrated significant correlations with ADOS-2 comparison scores (modules 1-3), but not with module 4 (raw) scores. DSM-5 and Unusual Behaviors demonstrated significant but poor AUCs (0.60). Findings with/without covariates (IQ/age) were overall similar. Sensitivity and specificity could not be optimized. The suggested cutpoint (T-score = 60) demonstrated unacceptably high false positive rates (> 76.33%). While findings suggest limited diagnostic utility of the ASRS-6-18-P, the sample's complex psychiatric presentation and measurement error inherent in cutoff score application should be considered when generalizing results. Further research is recommended.
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16
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de Jong RK, Snoek H, Staal WG, Klip H. The effect of patients' feedback on treatment outcome in a child and adolescent psychiatric sample: a randomized controlled trial. Eur Child Adolesc Psychiatry 2019; 28:819-34. [PMID: 30390148 DOI: 10.1007/s00787-018-1247-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 10/26/2018] [Indexed: 11/01/2022]
Abstract
The systematic use of feedback from patients on treatment progress and treatment satisfaction is a promising method to increase treatment effectiveness. The extent to which this also applies to the treatment of children with severe psychiatric problems is not clear. We conducted a Randomized Controlled Trial (RCT) to study the effect of adding Feedback Informed Treatment (FIT) to care as usual in a child psychiatric sample. Quality of Life (QoL) was used as the primary outcome measure and symptom severity as the second. Fifty-one therapists from eight Autism Care Teams in a multi-center facility for Child and Adolescent Psychiatry (Karakter) participated and were cluster randomized to the FIT condition (n = 4 teams) or the Care as Usual (CAU) condition (n = 4 teams). Children aged 6-18 years, mainly with an Autism Spectrum Disorder (ASD) and treated in one of the Autism Care Teams were allocated to the FIT condition (n = 86) or the CAU condition (n = 80). Results indicated that adding FIT leads to an increased QoL [F (2,165) = 3.16, p = 0.045]. No additional effects were observed for symptom severity decrease [F (2,158) = 0.19, p = 0.825]. No interaction with time was found for QoL nor symptom severity. Adding FIT in a child psychiatric setting may increase QoL, but does not appear to decrease symptom severity as compared with CAU. It is suggested that FIT positively changes parents' expectations. Results should be replicated in other child psychiatric samples and with an extended theoretical model.
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17
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Righi G, Benevides J, Mazefsky C, Siegel M, Sheinkopf SJ, Morrow EM. Predictors of Inpatient Psychiatric Hospitalization for Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2018; 48:3647-3657. [PMID: 28536960 DOI: 10.1007/s10803-017-3154-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Autism Spectrum Disorder (ASD) is associated with significant healthcare expenditures and a greater utilization of psychiatric health services. High utilization may not be evenly distributed across individuals with ASD. The objective of this study was to identify individual and family characteristics that increase the risk of psychiatric hospitalization. Naturalistic study of two age- and gender-matched ASD cohorts, inpatients enrolled in the Autism Inpatient Collection (AIC) and outpatients enrolled in the Rhode Island Consortium of Autism Research and Treatment (RI-CART), revealed a number of factors associated with hospitalization. Multiple logistic regression analyses revealed that adaptive functioning, ASD symptom severity, primary caregiver's marital status, the presence of mood disorders, and the presence of sleep problems independently increased the risk of psychiatric hospitalization.
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Affiliation(s)
- Giulia Righi
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA. .,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Dr, Providence, RI, 02906, USA. .,Division of Biology and Medicine, Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute (HCHII), Brown University, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA.
| | - Jill Benevides
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA
| | - Carla Mazefsky
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Matthew Siegel
- Maine Medical Center Research Institute, Spring Harbor Hospital, Tufts University School of Medicine, 123 Andover Road, Westbrook, ME, 04092, USA
| | - Stephen J Sheinkopf
- Women and Infant's Hospital, 101 Dudley street, Providence, RI, 02905, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Dr, Providence, RI, 02906, USA.,Division of Biology and Medicine, Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute (HCHII), Brown University, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA.,Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute, Alpert Medical School of Brown University, 101 Dudley street, Providence, RI, 02905, USA
| | - Eric M Morrow
- Emma Pendleton Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Dr, Providence, RI, 02906, USA.,Division of Biology and Medicine, Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute (HCHII), Brown University, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA
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18
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Abstract
This study examined growth trajectories of teacher-reported adaptive behavior in a diverse sample of adolescents with autism spectrum disorder. The participants were 244 adolescents between the ages of 14 and 21 years who were assessed at up to four time points across two and a half years of high school. Demographic variables (age, sex, race, maternal education), phenotypic characteristics (intelligence quotient, autism severity) and school factors (location of the school, school quality) were collected. Growth mixture modeling was used to identify distinct classes of growth trajectories in communication, daily living skills, and socialization domains of adaptive behavior. Two distinct classes were identified for each domain. The first class had moderately low adaptive behavior scores and demonstrated growth of adaptive behavior over time and the second class had low adaptive behavior scores and did not demonstrate change over time. Adolescents within the moderately low adaptive behavior classes were younger at enrollment in the study, had higher IQs, and lower autism symptom severity. Logistic regressions were performed, and aspects of school quality predicted the likelihood of being in the moderately low classes above and beyond autism symptoms.
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19
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Abstract
Autism spectrum disorder (ASD) characteristics seem to abate over time, but whether this protracts until late adulthood is largely unknown. We cross-sectionally investigated self- and other-reported ASD characteristics of adults with (ASD: Nmax-self = 237, Nmax-other = 130) and without ASD (COM: Nmax-self = 198, Nmax-other = 148) aged 19-79 years. Within the ASD group, self-reported ASD characteristics, and sensory sensitivities were highest in middle adulthood, while age was not associated to empathy. Sex differences were also found. However, age-and sex-related differences were not revealed by others and self- and other-report were poorly concordant. These results show that ASD characteristics in adulthood are differently perceived across age, sex, and informants and suggest that it is important to repeatedly assess self-reported ASD characteristics during adulthood.
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Affiliation(s)
- Anne G Lever
- Department of Psychology, Dutch Autism and ADHD Research Center, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS, Amsterdam, The Netherlands
- Department of Psychiatry, VU Medical Center, Amsterdam, The Netherlands
- Dimence, Deventer, The Netherlands
| | - Hilde M Geurts
- Department of Psychology, Dutch Autism and ADHD Research Center, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS, Amsterdam, The Netherlands.
- Dr. Leo Kannerhuis, Research Development & Innovation, Doorwerth, The Netherlands.
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20
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Duvekot J, van der Ende J, Verhulst FC, Greaves-Lord K. Examining bidirectional effects between the autism spectrum disorder (ASD) core symptom domains and anxiety in children with ASD. J Child Psychol Psychiatry 2018; 59:277-284. [PMID: 29076153 DOI: 10.1111/jcpp.12829] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Although a bidirectional relationship between autism spectrum disorder (ASD) and anxiety symptoms is assumed, few studies have investigated this. Moreover, little is known about potential differential relationships of the two core symptom domains of ASD - social communication impairment and restricted, repetitive behavior - with anxiety over time. METHOD Participants were 130 children with an ASD (M age 6.7 years, 81.5% boys) of whom 79 participated in a follow-up assessment 2 years later. We used cross-lagged models to test whether social communication impairment and restricted, repetitive behavior at T0 predicted anxiety at T2 and vice versa. RESULTS Crossed-lagged models showed that anxiety symptoms predicted social communication impairment over time (β = .22, p = .008), but not vice versa (β = -.07, p = .49). There were no significant paths from anxiety symptoms to later restricted, repetitive behavior (β = .11, p = .34) or vice versa (β = -.11, p = .27). CONCLUSIONS Our results do not support a bidirectional relationship between the ASD core symptom domains and anxiety, but suggest that higher levels of anxiety symptoms increase the risk of more social communication impairment over time in children with ASD. This underlines the importance of treating anxiety symptoms to improve both social and emotional functioning.
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Affiliation(s)
- Jorieke Duvekot
- Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Jan van der Ende
- Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Kirstin Greaves-Lord
- Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.,Yulius Mental Health, Dordrecht, The Netherlands
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21
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Black KR, Stevenson RA, Segers M, Ncube BL, Sun SZ, Philipp-Muller A, Bebko JM, Barense MD, Ferber S. Linking Anxiety and Insistence on Sameness in Autistic Children: The Role of Sensory Hypersensitivity. J Autism Dev Disord 2018; 47:2459-2470. [PMID: 28540453 DOI: 10.1007/s10803-017-3161-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sensory hypersensitivity and insistence on sameness (I/S) are common, co-occurring features of autism, yet the relationship between them is poorly understood. This study assessed the impact of sensory hypersensitivity on the clinical symptoms of specific phobia, separation anxiety, social anxiety and I/S for autistic and typically developing (TD) children. Parents of 79 children completed questionnaires on their child's difficulties related to sensory processing, I/S, and anxiety. Results demonstrated that sensory hypersensitivity mediated 67% of the relationship between symptoms of specific phobia and I/S and 57% of the relationship between separation anxiety and I/S. No relationship was observed between sensory hypersensitivity and social anxiety. These mediation effects of sensory hypersensitivity were found only in autistic children, not in TD children.
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Affiliation(s)
- Karen R Black
- Department of Psychology, University of Toronto, Toronto, ON, Canada.,Department of Psychology, York University, Toronto, ON, Canada
| | - Ryan A Stevenson
- Department of Psychology, Western University, London, ON, Canada. .,Brain and Mind Institute, Western University, London, ON, Canada. .,Neuroscience Program, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. .,Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. .,Westminster Hall, University of Western Ontario, 361 Windermere Road, London, ON, N6G 2K3, Canada.
| | - Magali Segers
- Department of Psychology, York University, Toronto, ON, Canada
| | - Busiswe L Ncube
- Department of Psychology, York University, Toronto, ON, Canada
| | - Sol Z Sun
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | | | - James M Bebko
- Department of Psychology, York University, Toronto, ON, Canada
| | - Morgan D Barense
- Department of Psychology, University of Toronto, Toronto, ON, Canada.,Rotman Research Institute at Baycrest, Toronto, ON, Canada
| | - Susanne Ferber
- Department of Psychology, University of Toronto, Toronto, ON, Canada.,Rotman Research Institute at Baycrest, Toronto, ON, Canada
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22
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Andersen CH, Thomsen PH, Nohr EA, Lemcke S. Maternal body mass index before pregnancy as a risk factor for ADHD and autism in children. Eur Child Adolesc Psychiatry 2018; 27:139-148. [PMID: 28712019 DOI: 10.1007/s00787-017-1027-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 07/10/2017] [Indexed: 12/15/2022]
Abstract
The risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) may be influenced by environmental factors such as maternal obesity before pregnancy. Previous studies investigating those associations have found divergent results. We aim to investigate in a large birth cohort this association further in children with ADHD, ASD and comorbid ADHD and ASD. Our study population consisted of 81,892 mother-child pairs participating in the Danish National Birth Cohort (DNBC). Information about pre-pregnancy weight and height was collected in week 16 of pregnancy; the analysis was divided into groups based on BMI. Children with a clinical diagnosis of ADHD and/or ASD were identified in the Danish health registries at an average age of 13.3 years. Hazard ratios (HRs) were estimated using time-to-event analysis. Compared to normal weight mothers, the risk of having a child with ADHD was significantly increased if the mother was overweight (HR = 1.28 [95% CI 1.15;1.48]), obese (HR = 1.47 [95% CI 1.26;1.71]) or severely obese (HR = 1.95 [95% CI 1.58;2.40]). The same pattern was seen for the combined ADHD and ASD group. Regarding ASD, an increased risk was observed in underweight (HR = 1.30 [95% CI 1.01;1.69]) and obese (HR = 1.39 [95% CI 1.11;1.75]) mothers. Subgroup analysis revealed that the association in the ADHD group could mostly be attributable to the hyperactive group. Maternal obesity before pregnancy is a risk factor for ADHD in children. Maternal obesity as well as underweight may also be associated with an increased risk for ASD.
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Affiliation(s)
| | - Per Hove Thomsen
- Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark
| | - Ellen Aagaard Nohr
- Research Unit for Gynaecology and Obstetrics, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sanne Lemcke
- Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.
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23
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Dekker LP, van der Vegt EJM, van der Ende J, Tick N, Louwerse A, Maras A, Verhulst FC, Greaves-Lord K. Psychosexual Functioning of Cognitively-able Adolescents with Autism Spectrum Disorder Compared to Typically Developing Peers: The Development and Testing of the Teen Transition Inventory- a Self- and Parent Report Questionnaire on Psychosexual Functioning. J Autism Dev Disord 2017; 47:1716-1738. [PMID: 28299510 PMCID: PMC5432605 DOI: 10.1007/s10803-017-3071-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To gain further insight into psychosexual functioning, including behaviors, intrapersonal and interpersonal aspects, in adolescents with Autism Spectrum Disorder (ASD), comprehensive, multi-informant measures are needed. This study describes (1) the development of a new measure of psychosexual functioning in both parent- and self-reports (Teen Transition Inventory; TTI) covering all three domains of psychosexual functioning (i.e. psychosexual socialization, psychosexual selfhood, and sexual/intimate behavior). And (2) the initial testing of this instrument, comparing adolescents with ASD (n = 79 parent-report; n = 58 self-report) to Typically Developing (TD) adolescents (n = 131 parent-report; n = 91 self-report) while taking into account gender as a covariate. Results from both informants indicate more difficulties regarding psychosexual socialization and psychosexual selfhood in the ASD group. With regard to sexual/intimate behavior, only parents reported significantly more problems in adolescents with ASD.
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Affiliation(s)
- Linda P Dekker
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands. .,Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands.
| | - Esther J M van der Vegt
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands.,Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands
| | - Nouchka Tick
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands.,Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands
| | - Anneke Louwerse
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands.,Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands
| | - Athanasios Maras
- Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/psychology, Erasmus MC-Sophia, Wytemaweg 8, Room KP 2881, 3015 CN, Rotterdam, The Netherlands.,Yulius Academy & Yulius Autism, Yulius, Mental Health Organisation, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands
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Lukito S, Jones CRG, Pickles A, Baird G, Happé F, Charman T, Simonoff E. Specificity of executive function and theory of mind performance in relation to attention-deficit/hyperactivity symptoms in autism spectrum disorders. Mol Autism 2017; 8:60. [PMID: 29152165 PMCID: PMC5680830 DOI: 10.1186/s13229-017-0177-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 10/31/2017] [Indexed: 01/17/2023] Open
Abstract
Background Individuals with autism spectrum disorder (ASD) frequently demonstrate symptoms of attention-deficit/hyperactivity disorder (ADHD). Previous findings in children with ASD have suggested that these symptoms are associated with an impairment in executive function (EF) abilities. However, studies rarely considered this association within a single framework that controls for other related factors such as Theory of Mind (ToM) abilities and ASD symptoms. Methods We used structural equation modeling to explore the relations among EF, ToM, and symptoms of ASD and ADHD, using data from a population-based sample of 100 adolescents with ASD and full-scale IQ ≥ 50 (the Special Needs and Autism Project (SNAP) cohort). The study used a multi-measure and multi-informant approach, where performance of inhibition, planning, switching, and working memory tasks indexed EF and performance on tasks involving mentalizing indexed ToM. Measures of ASD and ADHD symptoms included parent and teacher reports and direct observation of the children. Shared source of symptom reporting was accounted for with a parental rating latent factor indexed by symptom measures reported by parents. Results Impairments in EF abilities were specifically associated with ADHD symptoms while impaired ToM was specifically associated with ASD symptoms, when accounting for the associations of each cognitive domain with the other factors. ASD and ADHD symptom latent factors were also correlated, but this association became nonsignificant once the shared source of reporting from parents was accounted for and within a model that also controlled for the correlated pathway between EF and ToM factors. The specific relations between the cognitive domains and behavioral symptoms remained even after controlling for IQ. Conclusions In this ASD sample, symptoms of ADHD and ASD are underpinned by separate cognitive domains. The association between EF and ToM impairments is a likely partial explanation for the co-occurrence of ADHD symptoms in ASD, but the role of shared reporting effects is also important and supports the inclusion of independent informants and objective measures in future research.
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Affiliation(s)
- Steve Lukito
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Andrew Pickles
- Department of Biostatistics and Biomedical Research Centre for Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gillian Baird
- Guy's and St Thomas' NHS Foundation Trust, King's Health Partners, London, UK
| | - Francesca Happé
- Institute of Psychiatry, Social, Genetic and Developmental Psychiatry (SGDP) Centre, Psychology and Neuroscience, King's College London, London, UK
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Bieleninik Ł, Posserud MB, Geretsegger M, Thompson G, Elefant C, Gold C. Tracing the temporal stability of autism spectrum diagnosis and severity as measured by the Autism Diagnostic Observation Schedule: A systematic review and meta-analysis. PLoS One 2017; 12:e0183160. [PMID: 28934215 PMCID: PMC5608197 DOI: 10.1371/journal.pone.0183160] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 07/31/2017] [Indexed: 12/27/2022] Open
Abstract
Background Exploring ways to improve the trajectory and symptoms of autism spectrum disorder is prevalent in research, but less is known about the natural prognosis of autism spectrum disorder and course of symptoms. The objective of this study was to examine the temporal stability of autism spectrum disorder and autism diagnosis, and the longitudinal trajectories of autism core symptom severity. We furthermore sought to identify possible predictors for change. Methods We searched PubMed, PsycInfo, EMBASE, Web of Science, Cochrane Library up to October 2015 for prospective cohort studies addressing the autism spectrum disorder/autism diagnostic stability, and prospective studies of intervention effects. We included people of all ages with autism spectrum disorder/autism or at risk of having autism spectrum disorder, who were diagnosed and followed up for at least 12 months using the Autism Diagnostic Observation Schedule (ADOS). Both continuous ADOS scores and dichotomous diagnostic categories were pooled in random-effects meta-analysis and meta-regression. Results Of 1443 abstracts screened, 44 were eligible of which 40 studies contained appropriate data for meta-analysis. A total of 5771 participants from 7 months of age to 16.5 years were included. Our analyses showed no change in ADOS scores across time as measured by Calibrated Severity Scores (mean difference [MD] = 0.05, 95% CI -0.26 to 0.36). We observed a minor but statistically significant change in ADOS total raw scores (MD = -1.51, 95% CI -2.70 to -0.32). There was no improvement in restricted and repetitive behaviours (standardised MD [SMD] = -0.04, 95% CI -0.19 to 0.11), but a minor improvement in social affect over time (SMD = -0.31, 95% CI -0.50 to -0.12). No changes were observed for meeting the autism spectrum disorder criteria over time (risk difference [RD] = -0.01, 95% CI -0.03 to 0.01), but a significant change for meeting autism criteria over time (RD = -0.18, 95% CI -0.29 to -0.07). On average, there was a high heterogeneity between studies (I2 range: 65.3% to 93.1%). Discussion While 18% of participants shifted from autism to autism spectrum disorder diagnosis, the overall autism spectrum disorder prevalence was unchanged. Overall autism core symptoms were remarkably stable over time across childhood indicating that intervention studies should focus on other areas, such as quality of life and adaptive functioning. However, due to high heterogeneity between studies and a number of limitations in the studies, the results need to be interpreted with caution.
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Affiliation(s)
- Łucja Bieleninik
- GAMUT–The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
| | - Maj-Britt Posserud
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Monika Geretsegger
- GAMUT–The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
| | - Grace Thompson
- Melbourne Conservatorium of Music, the University of Melbourne, Melbourne, Australia
| | - Cochavit Elefant
- School for Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Christian Gold
- GAMUT–The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
- * E-mail:
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26
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Verheij C, Louwerse A, van der Ende J, Eussen ML, Van Gool AR, Verheij F, Verhulst FC, Greaves-Lord K. The Stability of Comorbid Psychiatric Disorders: A 7 Year Follow Up of Children with Pervasive Developmental Disorder-Not Otherwise Specified. J Autism Dev Disord 2015; 45:3939-48. [PMID: 26456972 DOI: 10.1007/s10803-015-2592-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The current study was a 7-year follow-up of 74 6–12 year old children with Pervasive Developmental Disorder-Not Otherwise Specified. We examined the rates and 7 year stability of comorbid psychiatric diagnoses as ascertained with the Diagnostic Interview Schedule for Children: Parent version at ages 6–12 and again at ages 12–20. Also, we examined childhood factors that predicted the stability of comorbid psychiatric disorders. The rate of comorbid psychiatric disorders dropped significantly from childhood (81 %) to adolescence (61 %). Higher levels of parent reported stereotyped behaviors and reduced social interest in childhood significantly predicted the stability of psychiatric comorbidity. Re-evaluation of psychiatric comorbidity should be considered in clinical practice, since several individuals shifted in comorbid diagnoses.
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