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Gulsrud A, Lin CE, Park MN, Hellemann G, McCracken J. Self-injurious behaviours in children and adults with autism spectrum disorder (ASD). J Intellect Disabil Res 2018; 62:1030-1042. [PMID: 29696700 DOI: 10.1111/jir.12490] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 02/22/2018] [Accepted: 03/30/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Self-injurious behaviours (SIB) are concerning, maladaptive behaviours that commonly occur in people with neurodevelopmental conditions and delays but seem to be particularly prevalent in children and adults with autism spectrum disorder (ASD). There has been increasing research examining the risk markers associated with the presence of SIB in people with ASD. Some of the factors associated with SIB have included cognitive abilities, adaptive functioning deficits and behaviour regulation impairments (e.g. impulsivity and repetitive behaviours). However, many of the findings in the literature are mixed and only explain a small proportion of the variance contributing to SIB. Limitations in the previous literature have centred on lack of availability of large and diverse samples, restricted age ranges and constraints of measurement. METHOD This study characterises a clinic-referred sample of children and adults currently presenting with and without SIB using a range of standardised and parent-report measures. The sample includes 144 individuals with ASD between the ages of 2.5 and 60.1 years. RESULTS After adjusting for multiple tests, none of the variables maintained statistical significance between the group of individuals with and without SIB, but medium to large effect sizes were noted. These variables include parent-reported early motor and toileting delays and perinatal risk, and current cognitive and social impairment. The remaining variables, including current autism severity levels, early ASD symptomatology, impulsivity, executive functioning impairments, adaptive functioning, mood and anxiety, did not differ between those with and without current engagement in SIB. CONCLUSIONS Utilising a diverse clinic-referred sample and standardised diagnostic tools, this study explored retrospective and current correlate risk markers of SIB in individuals with ASD. In addition to impairments in current functioning, specific early developmental delays and perinatal risk factors were preliminarily associated with the presence of SIB in individuals with ASD. Together these findings suggest that a set of specific characteristics may be related to both early risk and concurrent manifestation of SIB. Identifying this set of characteristics in early development may lead to faster identification and better intervention services, but future work utilising longitudinal design and multivariate analysis is warranted.
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Affiliation(s)
- A Gulsrud
- Child and Adolescent Psychiatry Division, University of California at Los Angeles (UCLA) Geffen Medical School, Los Angeles, CA, USA
| | - C E Lin
- Division of Child and Adolescent Psychiatry, University of California, San Francisco (UCSF) Weill Institute for Neurosciences, San Francisco, CA, USA
| | - M N Park
- Division of Child and Adolescent Psychiatry, University of California, San Francisco (UCSF) Weill Institute for Neurosciences, San Francisco, CA, USA
| | - G Hellemann
- Child and Adolescent Psychiatry Division, University of California at Los Angeles (UCLA) Geffen Medical School, Los Angeles, CA, USA
| | - J McCracken
- Child and Adolescent Psychiatry Division, University of California at Los Angeles (UCLA) Geffen Medical School, Los Angeles, CA, USA
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Mucci A, Galderisi S, Green MF, Nuechterlein K, Rucci P, Gibertoni D, Rossi A, Rocca P, Bertolino A, Bucci P, Hellemann G, Spisto M, Palumbo D, Aguglia E, Amodeo G, Amore M, Bellomo A, Brugnoli R, Carpiniello B, Dell'Osso L, Di Fabio F, di Giannantonio M, Di Lorenzo G, Marchesi C, Monteleone P, Montemagni C, Oldani L, Romano R, Roncone R, Stratta P, Tenconi E, Vita A, Zeppegno P, Maj M. Familial aggregation of MATRICS Consensus Cognitive Battery scores in a large sample of outpatients with schizophrenia and their unaffected relatives. Psychol Med 2018; 48:1359-1366. [PMID: 29017620 DOI: 10.1017/s0033291717002902] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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] [Indexed: 11/06/2022]
Abstract
BACKGROUND The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative-control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands' scores. METHODS Multivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands' MCCB scores predicted REL neurocognitive performance. RESULTS SCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning. CONCLUSIONS In a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.
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Affiliation(s)
- A Mucci
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - S Galderisi
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - M F Green
- Department of Psychiatry and Biobehavioral Sciences,Semel Institute for Neuroscience and Human Behavior,University of California Los Angeles,Los Angeles,CA,USA
| | - K Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences,Semel Institute for Neuroscience and Human Behavior,University of California Los Angeles,Los Angeles,CA,USA
| | - P Rucci
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - D Gibertoni
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - A Rossi
- Department of Biotechnological and Applied Clinical Sciences,Section of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - P Rocca
- Department of Neuroscience,Section of Psychiatry,University of Turin,Turin,Italy
| | - A Bertolino
- Department of Neurological and Psychiatric Sciences,University of Bari,Bari,Italy
| | - P Bucci
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - G Hellemann
- Department of Psychiatry and Biobehavioral Sciences,Semel Institute for Neuroscience and Human Behavior,University of California Los Angeles,Los Angeles,CA,USA
| | - M Spisto
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - D Palumbo
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
| | - E Aguglia
- Department of Clinical and Molecular Biomedicine,Psychiatry Unit,University of Catania,Catania,Italy
| | - G Amodeo
- Department of Molecular Medicine and Clinical Department of Mental Health,University of Siena,Siena,Italy
| | - M Amore
- Department of Neurosciences,Rehabilitation,Ophthalmology,Genetics and Maternal and Child Health,Section of Psychiatry,University of Genoa,Genoa,Italy
| | - A Bellomo
- Department of Medical Sciences,Psychiatry Unit,University of Foggia,Foggia,Italy
| | - R Brugnoli
- Department of Neurosciences,Mental Health and Sensory Organs,S. Andrea Hospital,Sapienza University of Rome,Rome,Italy
| | - B Carpiniello
- Department of Public Health,Clinical and Molecular Medicine,Section of Psychiatry,University of Cagliari,Cagliari,Italy
| | - L Dell'Osso
- Department of Clinical and Experimental Medicine,Section of Psychiatry,University of Pisa,Pisa,Italy
| | - F Di Fabio
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - M di Giannantonio
- Department of Neuroscience and Imaging,Chair of Psychiatry,G. d'Annunzio University,Chieti,Italy
| | - G Di Lorenzo
- Department of Systems Medicine,Chair of Psychiatry,Tor Vergata University of Rome,Rome,Italy
| | - C Marchesi
- Department of Neuroscience,Psychiatry Unit,University of Parma,Parma,Italy
| | - P Monteleone
- Department of Medicine and Surgery,Chair of Psychiatry,University of Salerno,Salerno,Italy
| | - C Montemagni
- Department of Neuroscience,Section of Psychiatry,University of Turin,Turin,Italy
| | - L Oldani
- Department of Psychiatry,University of Milan,Milan,Italy
| | - R Romano
- Department of Neurological and Psychiatric Sciences,University of Bari,Bari,Italy
| | - R Roncone
- Department of Life,Health and Environmental Sciences,Unit of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - P Stratta
- Department of Biotechnological and Applied Clinical Sciences,Section of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - E Tenconi
- Psychiatric Clinic,Department of Neurosciences,University of Padua,Padua,Italy
| | - A Vita
- Department of Mental Health,Psychiatric Unit,School of Medicine,University of Brescia,Spedali Civili Hospital,Brescia,Italy
| | - P Zeppegno
- Department of Translational Medicine,Psychiatric Unit,University of Eastern Piedmont,Novara,Italy
| | - M Maj
- Department of Psychiatry,Campania University "Luigi Vanvitelli",Naples,Italy
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