Co-occurring psychiatric conditions in autism spectrum disorder

Rosen, Tamara; Mazefsky, Carla; Vasa, Roma A.; Lerner, Matthew D.

doi:10.1080/09540261.2018.1450229

Cited by 207 publications

(162 citation statements)

References 149 publications

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“…Numerous studies have found that youth with ASD are vulnerable to a wide range of psychiatric symptoms [e.g., Lecavalier et al, 2019;Rosen et al, 2018] and disorders [Simonoff et al, 2008]. Our findings suggest that elevations in psychiatric symptom cooccurrence [e.g., among individuals with ASD compared with non-ASD individuals might result from differences in core transdiagnostic factors between these groups.…”

Section: Discussionmentioning

confidence: 63%

A transdiagnostic model of psychiatric symptom co‐occurrence and autism spectrum disorder

et al. 2019

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Understanding whether the co‐occurrence of psychiatric symptoms within autism spectrum disorder (ASD) are specific to the ASD diagnosis or reflect similar higher‐order patterns observed in both ASD and non‐ASD samples, or a confluence of the two, is of critical importance. If similar, it would suggest that comorbid psychiatric conditions among individuals with ASD are not symptoms of specific, non‐ASD psychiatric disorders per se, but reflect a general liability to psychopathology associated with ASD. To this end, the current study examined whether the higher‐order structure of co‐occurring psychiatric symptoms was the same within ASD and non‐ASD youth. Parents of clinic‐referred youth with (n = 280) and without (n = 943) ASD completed a DSM‐IV‐referenced psychiatric symptom rating scale. A confirmatory factor analytic framework was used to examine four levels of measurement invariance across groups to determine the extent to which transdiagnostic factors were comparable. Transdiagnostic factors were characterized by symptoms of the same disorders (configural invariance) and the same factor loadings across groups (metric invariance). Furthermore, both groups evidenced equivalent numbers of symptoms of most psychiatric conditions with the notable exceptions of attention deficit hyperactivity disorder (ADHD) and social anxiety (partial strong invariance), which were higher in the ASD sample. It was concluded that disparities in the co‐occurrence of psychiatric symptoms between youth with and without ASD may be largely reflective of transdiagnostic factor level differences associated with ASD and not indicative of the ASD diagnosis per se. However, for ADHD and social anxiety, there appears to be some specific associations with the ASD diagnosis. Autism Res 2020, 13: 579–590. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Few transdiagnostic dimensions relate common mental disorder diagnoses with one another. These dimensions explain psychiatric comorbidity (i.e., the finding that many persons possess several disorder diagnoses simultaneously). However, it is unclear if these dimensions differ among children with autism spectrum disorder (ASD), compared with their non‐ASD counterparts. The results of this study demonstrate that underlying transdiagnostic dimensions are similar in both ASD and non‐ASD children. However, there appear to be ASD‐specific differences when it comes to social anxiety and attention deficit hyperactivity disorder.

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Section: Discussionmentioning

confidence: 63%

A transdiagnostic model of psychiatric symptom co‐occurrence and autism spectrum disorder

et al. 2019

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“…See Table for descriptive statistics and statistical tests of group differences. It is widely recognized that internalizing and externalizing symptoms are elevated in youth samples with ASD (Rosen, Mazefsky, Vasa, & Lerner, ). Indeed, the proportions of children with autism reaching criteria for anxiety (~40%) and ADHD symptoms (~30%) align with data from a recent study of children with autism utilizing the CBCL (Havdahl, Tetzchner, Huerta, Lord, & Bishop, ).…”

Section: Methodsmentioning

confidence: 99%

Atypicalities in sleep and semantic consolidation in autism

Fletcher

Knowland

Walker

et al. 2019

Developmental Science

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Sleep is known to support the neocortical consolidation of declarative memory, including the acquisition of new language. Autism spectrum disorder (ASD) is often characterized by both sleep and language learning difficulties, but few studies have explored a potential connection between the two. Here, 54 children with and without ASD (matched on age, nonverbal ability and vocabulary) were taught nine rare animal names (e.g., pipa). Memory was assessed via definitions, naming and speeded semantic decision tasks immediately after learning (pre‐sleep), the next day (post‐sleep, with a night of polysomnography between pre‐ and post‐sleep tests) and roughly 1 month later (follow‐up). Both groups showed comparable performance at pre‐test and similar levels of overnight change on all tasks; but at follow‐up children with ASD showed significantly greater forgetting of the unique features of the new animals (e.g., pipa is a flat frog). Children with ASD had significantly lower central non‐rapid eye movement (NREM) sigma power. Associations between spindle properties and overnight changes in speeded semantic decisions differed by group. For the TD group, spindle duration predicted overnight changes in responses to novel animals but not familiar animals, reinforcing a role for sleep in the stabilization of new semantic knowledge. For the ASD group, sigma power and spindle duration were associated with improvements in responses to novel and particularly familiar animals, perhaps reflecting more general sleep‐associated improvements in task performance. Plausibly, microstructural sleep atypicalities in children with ASD and differences in how information is prioritized for consolidation may lead to cumulative consolidation difficulties, compromising the quality of newly formed semantic representations in long‐term memory.

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“…Many studies have reported high rates of co‐occurring EBP and psychiatric disorders in children with ASD [Anderson, Maye, & Lord, ; Chandler et al, ; Gotham, Brunwasser, & Lord, ; Kanne, Abbacchi, & Constantino, ; Lecavalier, ; Leyfer et al, ; Rosen, Mazefsky, Vasa, & Lerner, ; Simonoff et al, ]. Only a handful of studies, however, have explored how EBP vary in children with different language abilities.…”

Section: Introductionmentioning

confidence: 99%

Differences in profiles of emotional behavioral problems across instruments in verbal versus minimally verbal children with autism spectrum disorder

Fok

Bal

2019

Autism Research

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There has been increasing attention to the assessment of minimally verbal (MV) children with autism spectrum disorder (ASD). Previous research has begun to examine the relationship between verbal abilities and emotional and behavioral problems (EBP). The current study compared parent-reported EBP in children of differing language levels on two instruments commonly used in ASD research and clinical practice, the Child Behavior Checklist (CBCL) and Aberrant Behavior Checklist (ABC). The study consisted of 1,937 6-18 years old children with ASD from the Simons Simplex Collection. Children were divided into three language groups, by ADOS module (Module 1 = MV, 2 = phrase speech (PS), and 3 = verbally fluent (VF)) and then compared on CBCL and ABC subscales. The ABC and CBCL showed different patterns of elevations across the language groups. MV children were reported to have more impairment than VF children on the ABC irritability, lethargy, and hyperactivity scales. Children with less language (MV and PS) exhibited less impairment on the CBCL internalizing domain than VF children, but did not differ on the externalizing domain. Post hoc comparisons showed that internalizing differences were driven by fewer children with less language exhibiting clinically elevated anxious/depressed scores compared to VF children. The present study underscores the significance of considering language when assessing EBP. Results have implications for the psychiatric screening of children with ASD, particularly those with language impairments. Researchers should exercise caution when applying EBP instruments designed for use with different populations and purposes to broad samples of children.Lay Summary: Some emotional and behavioral problem (EBP) scales include items that may be inappropriate for children with ASD and limited language. The present study found that there was a tendency for children with language impairment to have lower internalizing scores on the Child Behavior Checklist, but higher scores lethargy and irritability scores on the Aberrant Behavior Checklist, relative to verbally fluent children. This suggests that each of these instruments may underestimate EBPs in certain subsets of children.

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Co-occurring psychiatric conditions in autism spectrum disorder

Cited by 207 publications

References 149 publications

A transdiagnostic model of psychiatric symptom co‐occurrence and autism spectrum disorder

A transdiagnostic model of psychiatric symptom co‐occurrence and autism spectrum disorder

Atypicalities in sleep and semantic consolidation in autism

Differences in profiles of emotional behavioral problems across instruments in verbal versus minimally verbal children with autism spectrum disorder

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