Abstract
BackgroundThis study aims to compare the effects of neurofeedback training on male and female adolescents with autism spectrum disorder (ASD). Furthermore, it examines sex differences regarding improvements in co-occurring psychopathological symptoms, cognitive flexibility and emotion recognition abilities. The study might provide first hints whether there is an influence of sex on treatment outcomes.MethodsSix female and six male adolescents with ASD were matched according to age, IQ and symptom severity. All participants received 24 sessions of electroencephalography-based neurofeedback training. Before and after the intervention, psychological data for measuring co-occurring psychopathological symptoms as well as behavioral data for measuring cognitive flexibility and emotion recognition abilities were recorded.ResultsCaregivers rated statistically significant higher psychopathological problems in female than in male adolescents with ASD at baseline. Apart from that, no statistically significant sex-related differences were revealed in this sample; however, male adolescents tended to report greater improvements of externalizing, internalizing and total symptoms, whereas females experienced smaller improvements of externalizing and total problems, but no improvements of internalizing problems. Regarding caregivers’ assessments, more improvement of total problems was reported for females. For males, only improvements of internalizing and total problems were described.ConclusionThis study reveals preliminary results that sex-related differences might play a role when evaluating treatment outcomes after neurofeedback training regarding comorbid psychopathological symptoms. Adolescents’ self-report and parental assessments, especially concerning psychopathological symptoms, should be combined and considered in future studies to help prevent sex bias in adolescents with ASD.
Highlights
Autism spectrum disorder (ASD) is generally described as a neurodevelopmental disorder characterized by impairments in reciprocal social interaction, a deficit in social communication, repetitive and restrictive behavior [1]
The present study investigated sex differences regarding the effects of an intense neurofeedback training on emotion recognition abilities, cognitive flexibility and co-occurring psychopathological symptoms in male and female adolescents with ASD
The current study highlights the importance of measuring baseline data and treatment outcome on different levels, when aiming to investigate sex differences
Summary
Autism spectrum disorder (ASD) is generally described as a neurodevelopmental disorder characterized by impairments in reciprocal social interaction, a deficit in social communication, repetitive and restrictive behavior [1]. In females ASD is often unrecognized, undiagnosed or misdiagnosed due to a different phenotype presentation in females and a lack of sexspecific elements in diagnostic procedures [2]. This fact can lead to a shortage of interventions targeting the impairments of females with ASD. There are different theses that defend the hypothesis of a rarer occurrence of ASD in females. One is the female protective effect, which states that women require a higher genetic and/or environmental risk
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