Autistic traits and ARFID-associated eating behaviors in preschoolers: Mediating effects of sensory processing patterns

OBJECTIVE

This study aimed to examine the association between autistic traits and Avoidant Restrictive Food Intake Disorder (ARFID)-associated eating behaviors in preschool-age children and investigated whether this association was mediated by sensory processing patterns.

METHOD

A cross-sectional, parent-reported study was conducted between July 2022 and March 2023 among 503 preschoolers aged 4-6 years in China. Parents provided assessments of their children's autistic traits using the Social Responsiveness Scale, sensory processing patterns using the Short Sensory Profile 2, and ARFID-associated eating behaviors using the Nine Items ARFID Screen. The mediation model based on ordinary least squares regression was employed to test the mediating effects of sensory processing patterns between autistic traits and ARFID-associated eating behaviors.

RESULTS

The results indicated significant associations among autistic traits, ARFID-associated eating behaviors, and sensory processing patterns. Moreover, mediation analyses revealed that sensory processing patterns played a partial mediating role in the relationship between autistic traits and ARFID-associated eating behaviors. Specifically, autistic traits were observed to weaken ARFID-associated eating behaviors, particularly picky eating and poor appetite, through Registration, while simultaneously fostering them through Sensitivity and Avoiding.

DISCUSSION

Our study is limited to some extent by the inability to draw longitudinal conclusions from cross-sectional data. Nevertheless, it underscores the significance of early identification and intervention for food avoidance/restriction behaviors due to sensory processing abnormalities in children with heightened autistic traits. This proactive approach may contribute to mitigating ARFID-associated eating behaviors that might drive clinical symptoms of ARFID.

Contextual Intervention Adapted for Autism Spectrum Disorder: An RCT of a Parenting Program with Parents of Children Diagnosed with Autism Spectrum Disorder (ASD)

OBJECTIVES

We investigated the effects of a manualized Contextual Intervention adapted for Autism Spectrum Disorders (CI-ASD), and essential elements of the intervention in promoting children's participation and mothers' parenting self-efficacy.

MATERIALS & METHODS

In this randomized controlled trial, conducted in Tehran, Iran in 2017, participants (36 parents of children with ASD) were randomly assigned to wait-list control or intervention groups. The intervention comprised contextually reflective occupational therapy combines 3 elements: sensory processing patterns, coaching, and social support. We provided the program to promote child's participation and parent's efficiency. During phase 1, the participants in the intervention group received CI-ASD as long as Treatment As Usual (TAU) and during phase 2 they received TAU only. We completed the outcome measures at three-time points (pre-intervention, post-intervention, and follow-up). We conducted semi-structured interviews post-intervention to explore acceptability of intervention and participants' experiences of CI-ASD.

RESULTS

CI-ASD can produce meaningful effects in eliminating sensory issues, promoting child participation and parenting efficiency in ASD families, compared to TAU. Parents reported high levels of acceptance and also confirmed the family's achievements.

CONCLUSION

These gains suggest CI-ASD as an effective intervention for children who have ASD and their families, but further studies are needed to declare and generalize the findings over time. Estimated effect sizes were in the large and medium ranges and favored the intervention group.

Sensory profiles in unipolar and bipolar affective disorders: Possible predictors of response to antidepressant medications? A prospective follow-up study

INTRODUCTION

Sensory processing patterns have been proposed as a stable dimension able to characterize individuals with major affective disorders, but to what extent specific impairments in sensory processing may be involved in the pathophysiology of these conditions is poorly understood. We aimed to explore which sensory profiles may better respond to psychoactive medications, with particular regard to antidepressants, according to depression, alexithymia, and hopelessness levels.

METHODS

A total of 402 outpatients who received maintenance treatment and were in stable psychopathological conditions were recruited and completed the Adolescent/Adult Sensory Profile (AASP), Toronto Alexithymia Scale (TAS-20), second version of the Beck Depression Inventory (BDI-II), and Beck Hopelessness Scale (BHS) according to a longitudinal prospective study design including three time points of measurements.

RESULTS

Subjects with abnormally reduced sensory seeking, hypersensitivity, enhanced sensory avoidance, and lower ability to register information better responded to antidepressant medications according to their reduced depression levels. Similarly, participants with lower registration better responded to antidepressants as reported by lower hopelessness levels. Regression analyses revealed that the use of antidepressants was the first variable able to predict depression, hopelessness, and alexithymia levels at baseline, and after three and six months of treatment, respectively, but the pattern of sensory sensitivity contribute to the prediction of depression and hopelessness. This pattern together with low registration predicted changes in alexithymia levels.

LIMITATIONS

The study was limited by the modest sample size at the follow-up assessment points.

DISCUSSION

Exploring sensory processing patterns may provide intriguing insights into specific illness characteristics and treatment response.

Sensory profiles as potential mediators of the association between hypomania and hopelessness in 488 major affective outpatients

INTRODUCTION

Extreme sensory processing patterns may contribute to the pathophysiology of major affective disorders. We aimed to examine whether significant correlations exist between sensory profiles, hypomania, self-reported depression, and hopelessness and whether sensory profiles may be potential mediators of the association between hypomania and depression/hopelessness.

METHODS

The sample consisted of 488 euthymic affective disorder patients of which 283 diagnosed with unipolar and 162 with bipolar disorder with an age ranging from 18 to 65 years (mean = 47.82 ± 11.67).

RESULTS

Lower registration of sensory input and sensory sensitivity significantly correlated with elevated self-reported depression, hopelessness, and irritable/risk-taking hypomania while sensation seeking and avoiding significantly correlated with elevated depression and hopelessness but not with irritable/risk-taking hypomania. Moreover, individuals with lower ability to register sensory input and higher hypomania showed higher self-reported depression than those with good registration of sensory information. According to SEM analyses, there was both a direct/indirect effect of irritable/risk-taking on depression-hopelessness with the mediation model explaining 48% of the variance in depression-hopelessness.

LIMITATIONS

The relatively small sample size and the cross-sectional nature of the study design do not allow the generalization of the main findings.

CONCLUSION

Low registration was associated with enhanced depressed mood and hopelessness while sensory seeking may be considered a resilient factor.

Extreme sensory processing patterns show a complex association with depression, and impulsivity, alexithymia, and hopelessness

INTRODUCTION

The involvement of extreme sensory processing patterns, impulsivity, alexithymia, and hopelessness was hypothesized to contribute to the complex pathophysiology of major depression and bipolar disorder. However, the nature of the relation between these variables has not been thoroughly investigated.

AIMS

This study aimed to explore the association between extreme sensory processing patterns, impulsivity, alexithymia, depression, and hopelessness.

METHODS

We recruited 281 euthymic participants (mean age=47.4±12.1) of which 62.3% with unipolar major depression and 37.7% with bipolar disorder. All participants completed the Adolescent/Adult Sensory Profile (AASP), Toronto Alexithymia Scale (TAS-20), second version of the Beck Depression Inventory (BDI-II), Barratt Impulsivity Scale (BIS), and Beck Hopelessness Scale (BHS).

RESULTS

Lower registration of sensory input showed a significant correlation with depression, impulsivity, attentional/motor impulsivity, and alexithymia. It was significantly more frequent among participants with elevated hopelessness, and accounted for 22% of the variance in depression severity, 15% in greater impulsivity, 36% in alexithymia, and 3% in hopelessness. Elevated sensory seeking correlated with enhanced motor impulsivity and decreased non-planning impulsivity. Higher sensory sensitivity and sensory avoiding correlated with depression, impulsivity, and alexithymia.

LIMITATIONS

The study was limited by the relatively small sample size and cross-sectional nature of the study. Furthermore, only self-report measures that may be potentially biased by social desirability were used.

CONCLUSION

Extreme sensory processing patterns, impulsivity, alexithymia, depression, and hopelessness may show a characteristic pattern in patients with major affective disorders. The careful assessment of sensory profiles may help in developing targeted interventions and improve functional/adaptive strategies.