Spectrum Conditions Research Articles

Dialectical behaviour therapy outcomes for adolescents with autism spectrum conditions compared to those without: findings from a seven-year service evaluation

PurposeAutism spectrum conditions (ASC) and borderline personality disorder (BPD) have overlapping symptom profiles. Dialectical behaviour therapy (DBT) is an established treatment for self-harm and BPD, but little research has investigated the outcomes of DBT for ASC populations. This exploratory service evaluation aims to investigate the outcomes of a comprehensive DBT programme for adolescents with a diagnosis of emerging BPD and a co-occurring ASC diagnosis as compared to those without an ASC diagnosis.Design/methodology/approachDifferences from the start to end of treatment in the frequency of self-harming behaviours, BPD symptoms, emotion dysregulation, depression, anxiety, the number of A&E attendances and inpatient bed days, education and work status, and treatment non-completion rates were analysed for those with an ASC diagnosis, and compared between those with an ASC diagnosis and those without.FindingsSignificant medium to large reductions in self-harming behaviours, BPD symptoms, emotion dysregulation and inpatient bed days were found for those with an ASC diagnosis by the end of treatment. There were no significant differences between those with an ASC and those without in any outcome or in non-completion rates. These findings indicate that DBT may be a useful treatment model for those with an ASC diagnosis, though all results are preliminary and require replication.Originality/valueTo the best of the authors’ knowledge, this is the first study to report the outcomes of a comprehensive DBT programme for adolescents with an ASC diagnosis, and to compare the changes in outcomes between those with a diagnosis and those without.

Immunomodulatory options for neurodevelopmental spectrum conditions: are we there yet?

About 3-7% of the worldwide population is diagnosed with a neurodevelopmental condition, including autism and attention-deficit hyperactivity disorder. Nonetheless, the aetiology of these conditions is unclear and support options are limited or not effective for all those diagnosed. Cumulating evidence, however, supports a role of the immune system in neurodevelopment, and immune dysregulations have been implicated in neurodevelopmental atypicalities. This knowledge offers tremendous opportunities, especially the possibility to adopt immunomodulatory compounds, which are already available and safe to use, for the management of neurodevelopmental difficulties. This perspective discusses the potential of immune-based interventions in neurodevelopmental care. Here, the application of existing immunomodulatory compounds to symptom management is justified by findings of immune dysregulations across neurodevelopmental conditions and preliminary, encouraging immune-based clinical trials. Still, key considerations are presented, specifically the necessity of immune biomarkers to ensure the right support option for the right (subgroup of) individuals within the neurodevelopmental spectrum.

Emotional Face Processing in Autism Spectrum Condition: A Study of Attentional Orienting and Inhibitory Control.

A core feature of Autistic Spectrum Condition (ASC) is the presence of difficulties in social interactions. This can be explained by an atypical attentional processing of social information: individuals with ASC may show problems with orienting attention to socially relevant stimuli and/or inhibiting their attentional responses to irrelevant ones. To shed light on this issue, we examined attentional orienting and inhibitory control to emotional stimuli (angry, happy, and neutral faces).An antisaccade task (with both prosaccade and antisacade blocks) was applied to a final sample of 29 children with ASC and 27 children with typical development (TD).Whereas children with ASC committed more antisaccade errors when seeing angry faces than happy or neutral ones, TD children committed more antisaccade errors when encountering happy faces than neutral faces. Furthermore, latencies in the prosaccade and antisaccade blocks were longer in children with ASC and they were associated with the severity of ASC symptoms. Thus, children with ASC showed an impaired inhibitory control when angry faces were presented.This bias to negative high-arousal information is congruent with affective information-processing theories on ASC, suggesting that threatening stimuli induce an overwhelming response in ASC. Therapeutic strategies where train the shift attention to emotional stimuli (i.e. faces) may improve ASC symptomatology and their socials functioning.

A novel image database for social concepts reveals preference biases in autistic spectrum in adults and children.

Human beings display the extraordinary ability of grasping and communicating abstract concepts. Yet, no standardized instruments exist to assess this ability. Developing these tools is paramount for understanding abstract representations such as social concepts, with ramifications in educational and clinical settings. Here, we developed an image database depicting abstract social concepts varying in social desirability. We first validated the image database in a sample of neurotypical participants. Then, we applied the database to test different hypotheses regarding how social concepts are represented across samples of adults and children with autism spectrum condition (ASC). Relative to the neurotypicals, we did not observe differences related to ASC in identification performance of the social desirability of the concepts, nor differences in metacognitive ability. However, we observed a preference bias away from prosocial concepts that was linked to individual autistic traits in the neurotypicals, and higher in ASC relative to the neurotypicals both in adults and children. These results indicate that abstract representations such as social concepts are dependent on individual neurodevelopmental traits. The image database thus provides a standardized assessment tool for investigating the representation of abstract social concepts in the fields of psycholinguistics, neuropsychology, neuropsychiatry, and cognitive neuroscience, across different cultures and languages.

The relationships of autistic child characteristics, metacognitive beliefs, and autistic traits with affiliate stigma among parents of children with autism spectrum conditions: A moderated mediation study

BackgroundCaregivers of children with autism spectrum conditions (ASCs) are typically affected by autism-related stigma, which is internalized to form affiliate stigma. Limited studies have explored the factors potentially associated with affiliate stigma among parents of children with ASC. The present study examined the relationships among autistic child characteristics, parental autistic traits, parental metacognitive beliefs, and parental affiliate stigma. MethodWe recruited 134 parents of children with ASC in a cross-sectional study. We assessed autistic child characteristics, parental autistic traits, parental metacognitive beliefs, and parental affiliate stigma by using the Social Responsiveness Scale (SRS), the Autism-Spectrum Quotient (AQ), the Metacognition Questionnaire 30 (MCQ-30), and the Affiliate Stigma Scale (ASS). Path analysis was performed to examine the relationships between autistic child characteristics, parental autistic traits, parental metacognitive beliefs, and parental affiliate stigma. ResultsThere were correlations among autistic child characteristics, parental metacognitive beliefs, and parental affiliate stigma. Parental metacognitive beliefs mediated the relationship between autistic child characteristics and parental affiliate stigma, whereas parental autistic traits were not a moderating factor. ConclusionsThis study revealed the factors potentially associated with the affiliate stigma of parents of children with ASC. The findings highlight the importance of considering parental metacognitive beliefs when assessing and managing parental affiliate stigma.

Navigating adolescence: pubertal development in autism spectrum conditions and its relation to mental health.

Adolescence is a period of social, psychological, and physiological change, including the onset of puberty. Differential pubertal onset has been linked to a myriad of problems, including mental health problems. Therefore, we aim to investigate deviating pubertal development in autism, and whether this is more pronounced in girls than in boys. A total of 68 individuals (nASC = 34, nCOM (comparisons) = 34) aged 12 to 16years were administered test concerning pubertal development and mental health (i.e., sensory sensitivity, autistic traits, depression, anxiety, and externalizing problems). Frequentist and Bayesian ANOVA was used to examine deviations in pubertal development in ASC and possible sex effects. Regression analyses was used to test whether this asynchronicity was linked to mental health problems. Our (frequentist and Bayesian) analyses revealed earlier onset and slower development of pubertal development in ASC but we did not find any sex differences. Maturation disparity was linked to higher mental health problems in ASC, but not in COM. No sex differences in the relation with mental health outcomes was found. We found evidence for a slower development of "true" puberty in those with ASC compared to those without. Moreover, we show that disparities in pubertal development are related to mental health in ASC, suggesting a greater impact on mental health in autistic than in non-autistic teens. Longitudinal studies are necessary to elucidate important developmental trajectories in puberty in neurodiverse populations.

Systemic Sclerosis in Individuals With Exposure to World Trade Center Ground Zero Rescue and Recovery Efforts: A Case Series.

The World Trade Center (WTC) attack in New York resulted in a dust plume containing silica, hydrocarbons, and asbestos. Autoimmune disorders have been reported among those with WTC site exposure. The characteristics of individuals developing systemic sclerosis (SSc) have not been previously described. The purpose of this study was to describe the features of patients with SSc with WTC exposure. Data were collected from 11 patients with SSc or SSc spectrum conditions who reported exposure to the WTC site. Seven patients completed an exposure assessment. Of the 11 patients, the majority (n = 8) were female. The median (range) for age at diagnosis was 46 (36-75) years, time between exposure and first non-Raynaud phenomenon SSc symptom was 8 (1-19) years, and time between exposure and diagnosis was 11 (2-18) years. Fifty-five percent had SSc onset > 5 years from WTC exposure. Five patients had limited cutaneous SSc, 3 patients had diffuse cutaneous SSc, 1 patient with SSc features met criteria for mixed connective tissue disease (CTD), and 2 patients had undifferentiated CTD with features of SSc. Four patients had overlapping features with other CTDs. Interstitial lung disease (ILD) was present in 10 patients. Five of 11 patients had a history of tobacco use. Seven of 7 patients who completed the questionnaire reported other hazardous exposures outside of WTC. Of these, only 2 patients reported personal protective equipment use. A high frequency of ILD and overlap features were observed among patients with SSc with WTC exposure. Future studies are needed to characterize this association.

Coping strategies and stress in mothers of children with autism spectrum condition and ADHD during the COVID 19 pandemic

Coping strategies and stress in mothers of children with autism spectrum condition and ADHD during the COVID 19 pandemic

Exploring the psychopathological profile of fibromyalgia: insights from the personality assessment inventory and its association with disease impact.

Fibromyalgia (FM) is a complex rheumatic disorder characterized by chronic nociplastic pain and central sensitization. Psychopathological conditions can influence FM symptoms, which worsen their condition. However, not all patients with FM have psychopathological disorders, indicating a heterogeneous population. To investigate the psychopathological profile and personality disorders in patients with FM and its relationship impact on this disease. An observational and cross-sectional comparative study was conducted with a sample of 90 women, mean age 48.7 years (SD = 8.12), from Hospital del Mar, Barcelona. The Personality Assessment Inventory (PAI) and the Fibromyalgia Impact Questionnaire (FIQ) were used for assessment. FM patients predominantly exhibited psychopathological profiles resembling affective disorders (37.7%) and Cluster C personality disorders (58.8%). The severity of FM's impact was related to affective disorder symptoms, hypervigilance, derealization, somatization, and Cluster B personality disorder (emotional instability). Different rheumatic symptoms correlated with specific psychopathological patterns. Increased somatic symptoms on the FIQ were related to an unstable and dependent personality, while heightened emotional symptoms on the FIQ were associated with avoidance, borderline traits, and passive-aggressive reactions. Recognizing psychopathological aspects is crucial for managing FM. The PAI is a valuable tool for establishing its psychopathological multidimensional profile, which predominantly shows an affective spectrum conditions and comorbid Cluster C personality disorder, exacerbating the disease's impact.

Giftedness and atypical sexual differentiation: enhanced perceptual functioning through estrogen deficiency instead of androgen excess.

Syndromic autism spectrum conditions (ASC), such as Klinefelter syndrome, also manifest hypogonadism. Compared to the popular Extreme Male Brain theory, the Enhanced Perceptual Functioning model explains the connection between ASC, savant traits, and giftedness more seamlessly, and their co-emergence with atypical sexual differentiation. Overexcitability of primary sensory inputs generates a relative enhancement of local to global processing of stimuli, hindering the abstraction of communication signals, in contrast to the extraordinary local information processing skills in some individuals. Weaker inhibitory function through gamma-aminobutyric acid type A (GABAA) receptors and the atypicality of synapse formation lead to this difference, and the formation of unique neural circuits that process external information. Additionally, deficiency in monitoring inner sensory information leads to alexithymia (inability to distinguish one's own emotions), which can be caused by hypoactivity of estrogen and oxytocin in the interoceptive neural circuits, comprising the anterior insular and cingulate gyri. These areas are also part of the Salience Network, which switches between the Central Executive Network for external tasks and the Default Mode Network for self-referential mind wandering. Exploring the possibility that estrogen deficiency since early development interrupts GABA shift, causing sensory processing atypicality, it helps to evaluate the co-occurrence of ASC with attention deficit hyperactivity disorder, dyslexia, and schizophrenia based on phenotypic and physiological bases. It also provides clues for understanding the common underpinnings of these neurodevelopmental disorders and gifted populations.

Deep learning (DL) based improved probabilistic dense model (IPD) for autism spectrum disorders (ASD) classification analysis

Among other symptoms, people with autism spectrum disorder (ASD) suffer from communication, social interaction, and repetitive habits. Even while complete eradication is not common, early interventions may make the illness more manageable. Here, we propose a practical framework for contrasting various Machine Learning (ML) methods for diagnosing ASD at an early age. The proposed framework uses a number of Feature Scaling (FS) methodologies, such as min-max scalar, principal component analysis, and intuitive visual representation analysis, to incorporate an efficient prediction method into the overall architecture. Our recommended design, which utilizes the IPD model, suggests that the categorization of adult autism spectrum condition, as an entity, is reflected in the overall verification of the features, and varied functional qualities. To do the mathematical analysis in our IPD model, we use chi-squared and probability density functional methods. The structure's purpose is to recognize and classify patients based on their palpable traits. We can observe that the 95.9% accuracy is far greater than the Machine Learning approach in the end.

Conform or be ostracised: restricted and repetitive behaviours in non-autistic persons

Autism is a neurological disability characterised by a number of ‘deficits’ in multiple areas of functioning and everyday life. Or is it? Damian Milton’s theory of the ‘double empathy problem’ attempts to empirically posit that the socialisation and communication difficulties present in autistic people are due to bidirectional differences in ways of communication between autistic and non-autistic people. This Current Issues piece extends said theory to encompass the restricted and repetitive behaviours that are commonly observed in autistic people, arguing that such behaviours may also be present in non-autistic people, albeit in a less stereotypical, more socially acceptable way. Because autism is characterised in part by the presence of restricted and repetitive behaviours, this piece fundamentally challenges the manner in which autism spectrum conditions are diagnosed in individuals and seen far and wide, ultimately promoting the view of cognitive-behavioural difference in autistic people instead of ‘deficit’.

Investigation of the Relationship Between Orientation Discrimination Thresholds, Autistic, and Schizotypal Personality Traits

Imbalances in cortical excitation and inhibition (E-I) have been implicated in both autism spectrum conditions (ASC) and schizophrenia spectrum conditions (SSC). However, most studies investigate these clinical conditions independently, possibly due to the difficulty of obtaining comorbid clinical populations. As such, the current study investigated the relationship between performance in the orientation discrimination task “ODT” as a potential proxy for E-I balance and the autistic (as assessed by Autism Spectrum Quotient “AQ”) and schizotypal personality traits (as assessed by Schizotypal Personality Questionnaire-Brief “SPQ-BR”) in the general population. 87 healthy adult volunteers participated in the study. We found that high autistic personality traits are associated with enhanced performance in the oblique condition of ODT. In contrast, high schizotypal personality traits are associated with poor performance in the vertical condition of ODT. Such associations support the suggested disruption of cortical E-I balance in ASC and SSC.

Scene construction ability in neurotypical and autistic adults.

People with autism spectrum conditions (ASC) have difficulties imagining events, which might result from difficulty mentally generating and maintaining a coherent spatial scene. This study compared this scene construction ability between autistic (N = 55) and neurotypical (N = 63) adults. Results showed that scene construction was diminished in autistic compared to neurotypical participants, and participants with fewer autistic traits had better scene construction ability. ASC diagnosis did not influence the frequency of mentions of the self or of sensory experiences. Exploratory analysis suggests that scene construction ability is associated with the ability to understand our own and other people's mental states, and that these individual-level preferences/cognitive styles can overrule typical group-level characteristics.

What Is Applied Behavior Analysis? I know I understand nothing: Invitation to Discussion

The aim of this study in the qualitative approach is to thoroughly analyse the phenomenon of ABA and to present the perception of ABA by people working with children with ASC[1] and by me to obtain a more accurate and reliable picture of the entirety of the examined problem. I will try to explain the various meanings given to ABA and the resulting misunderstandings. This will also be an attempt to consider what professionals working with autistic children criticise or support when talking about ABA.Another goal is to organise knowledge on the subject by showing the historical background. [1] Autistic Spectrum Conditions. On the 18 June 2018, World Health Organisation released its new International Classification of Diseases (ICD-11). The ICD catalogues different pathologies and conditions to provide a common language to inform and control their development, as well as comparing and sharing data following standard criteria between hospitals, regions and countries in different time periods. ICD-11 was presented at the World Health Assembly in May 2019 for adoption by Member States, and came into effect on 1 January 2022.

Serious game the Emotion Detectives helps to improve social–emotional skills of children with neurodevelopmental disorders

AbstractChildren with neurodevelopmental disorders often have social–emotional difficulties. Serious games can be used to support their social–emotional learning. This study investigated if 6–10‐year‐old children with autism spectrum condition, attention deficit hyperactivity disorder and developmental language disorder would improve their emotion discrimination skills by playing a serious game. Intervention (n = 30) and control groups (n = 20), comprising children with neurodevelopmental disorders, and a group of typically developing (TD) age peers (n = 106), completed six emotion discrimination tasks. ABA research design was applied in this study. Prior to the game intervention, children with neurodevelopmental disorders were significantly delayed in relation to their TD age peers in all tasks. After playing the game for two months, the children in the intervention group had significantly improved their emotion discrimination skills in four tasks, whereas the control group had significantly advanced in only one task without practice. Intervention gains were maintained at the one‐month follow‐up. Parents reported that the children in the intervention group somewhat improved their emotion recognition and behavioural skills in daily life in comparison to the control group. Implications for practice are discussed. Practitioner notesWhat is already known about this topic Children with neurodevelopmental disorders often exhibit various social–emotional symptoms. Within the field of social–emotional learning, many serious games have a narrow focus on specific skills, and they often only provide possibilities for observing target behaviours, not actual skill training. There are mixed results on the efficacy of game‐based interventions targeted at improving social–emotional skills. What this paper adds The Emotion Detectives game used in this study offers a well‐designed learning environment that provides adaptive learning and feedback systems. The participating children's social–emotional skills were assessed with versatile methods and via triangulation. Intervention with the Emotion Detectives game helped to decrease some emotion and behavioural symptoms of the players. Implications for practice This study provides information about the efficacy of a web‐based game that is freely available for supporting children's social–emotional learning. Improvements in emotion discrimination and recognition, as well as behavioural skills, can be gained by playing serious games. For optimal intervention outcomes, multimodal training should be utilized in serious games targeting social–emotional learning.

The biosocial correlates and predictors of emotion dysregulation in autistic adults compared to borderline personality disorder and nonclinical controls

BackgroundEmotion dysregulation (ED) is a core symptom of borderline personality disorder (BPD), whose aetiology has been attributed to biosocial factors. In autism spectrum condition (ASC), although ED is prevalent and is associated with decreased well-being (e.g. self-harm, suicidality), it has been understudied, especially in adults. It is therefore crucial to further understand ED in autistic adults to improve its treatment. Our study investigates ED, its behavioural correlates (e.g. self-harm, suicidality) and biosocial predictors in autistic adults relative to BPD and nonclinical controls (NC).MethodsA total of 724 participants (ASC = 154; BPD = 111; NC = 459) completed 11 self-reported questionnaires assessing ED, ASC and BPD traits, co-occurring disorders, alexithymia, emotional vulnerability and invalidating experiences (e.g. bullying, autistic camouflaging). The occurrence of ED behavioural correlates (i.e. self-harm, history of suicide attempts, and psychiatric hospitalizations) was collected. In addition, between-groups analyses, linear regressions and machine learning (ML) models were used to identify ED predictors in each group.ResultsED and its behavioural correlates were higher in ASC compared to NC, but milder than in BPD. While gender did not predict ED scores, autistic women had increased risk factors to ED, including sexual abuse and camouflaging. Interestingly, BPD traits, emotional vulnerability and alexithymia strongly predicted ED scores across the groups. Using ML models, sensory sensitivity and autistic camouflaging were associated with ED in ASC, and ADHD symptoms with ED in BPD.LimitationsASC and BPD diagnoses were self-reported, which did not allow us to check their accuracy. Additionally, we did not explore the transactional and the moderating/mediating relationships between the different variables. Moreover, our research is cross-sectional and cannot draw conclusions regarding the direction and causality of relationships between ED and other clinical dimensions.ConclusionsED and its behavioural correlates are heightened in BPD compared to ASC and nonclinical controls. In the ASC group, there were no gender differences in ED, despite the heightened exposure of autistic women to ED risk factors. BPD traits, emotional vulnerability, and alexithymia are core to ED regardless of diagnosis. Although less central, sensory sensitivity and autistic camouflaging seem to be specific predictors of ED in autistic adults.

Effectiveness of a universal preschool-based program for emotional education in 3- to 5-year-old children with autism spectrum conditions.

There are numerous programs and interventions to improve social and emotional skills that expressly target children with autism spectrum conditions. However, there is less knowledge about the impact of universal (directed to all children) school programs of emotional education specifically on these children. In this context, the aim of our study was to evaluate the impact of the "1,2,3,emoció!" universal school program on them. The results show that children with autism spectrum conditions participating in the program improved their emotional competence more than the ones who did not participate. Therefore, we conclude that the "1,2,3,emoció!" universal program is effective in children with autism spectrum conditions. This promising outcome gives the opportunity to these children to benefit from group learning in an inclusive school setting, by complementing individual interventions with a universal program.

The Memory Influence on Opinion Dynamics in Coopetitive Social Networks: Analysis, Application, and Simulation

In social psychology, it is well known that the evolution of opinion dynamics in a society depends not only on the current opinions of individuals, but also on the past opinions stored in memory. However, it is still difficult to clearly characterize and analyze the memory influence on opinion dynamics in social networks, especially in coopetitive (cooperative and competitive) networks. In this paper, we propose a novel model of opinion dynamics to describe the memory influence in coopetitive networks. In this model, memory and memoryless communication rules are simultaneously proposed for the opinion update mechanism. In terms of the network topological structure and the graph spectrum, sufficient and/or necessary conditions are respectively established to ensure that the opinion is nonstationary polarization, nonstationary consensus and neutral. We employ the Kahneman's seminal experiment on choices in risky and riskless contexts to interpret the results obtained in the present paper. Simulation analysis shows that the memory capacity of the individual is inversely proportional to the speeds of the ultimate opinions formational, and the opinions reach a persistent disagreement when the individuals are very confident.

Thinking differently works: Understanding the essential elements for the success of a competitive integrated employment program developed for persons with autism spectrum conditions.

Thinking differently works: Understanding the essential elements for the success of a competitive integrated employment program developed for persons with autism spectrum conditions.