Health-related risky behaviors and their risk factors in adolescents with high-functioning autism

Abstract

BACKGROUND Health-related risky behaviors generally refer to behaviors that have a negative impact on health and quality of life. Health-related risky behaviors in adolescents with high-functioning autism (HFA) have not been well understood so far. Adolescents with HFA may have more health-related risky behaviors than neurotypical adolescents. AIM To investigate health-related risky behaviors and their risk factors with HFA. METHODS This is an observational study. Our study enrolled 110 adolescents aged 12-19-years-old meeting Diagnostic and Statistical Manual of Mental Disorders 4 th edition criteria for HFA. They were recruited from Peking University Sixth Hospital. There were also 110 age, sex and nationality matched controls enrolled who came from a public school in Beijing, China. Both groups completed the Adolescents Health-related Risky Behavior Inventory. Nonparametric tests were carried out for comparison of the Adolescents Health-related Risky Behavior Inventory scores between the two groups. Expression recognition, the Inventory of Subjective Life Quality for Child and Adolescent, Chinese Wechsler Intelligence Scale for Children, Wechsler Intelligence Scale for Adult-Chinese Revised, Theory of Mind test and Autism Spectrum Screening Questionnaire were assessed in the autism group to explore factors associated with health-related risky behaviors. Multivariate regression analysis was conducted to explore the risk factors of health-related risky behaviors in the HFA group. RESULTS The results showed that the total score of the Adolescents Health-related Risky Behavior Inventory and scores of “aggression and violence,” “suicide and self-injury,” “health compromising behavior” and “unprotected sex” subscales in the HFA group were significantly higher than those in the control group (Z range -4.197 to -2.213, P < 0.05). Among the associated factors, poor emotional experience (B = -0.268, P < 0.001), depression (B = -0.321, P < 0.001), low score of intelligence (B = -0.032, P = 0.042), low score of Theory of Mind test (B = -1.321, P = 0.003) and poor adaptation to school life (B = -0.152, P = 0.006) were risk factors. These risky behaviors may promote the occurrence of health-related risky behaviors in adolescents with HFA. CONCLUSION This study showed that adolescents with HFA were more likely to be involved in health-related risky behaviors. Different health-related risky behaviors have different reasons.

Age differences and brain maturation provide insight into heterogeneous results in autism spectrum disorder

“…Having an ASD appears to increase a number of adolescent risks and stressors that an individual experiences, undermining development into adulthood ( Carter et al, 1998 ; Kanne et al, 2011 ; Bal et al, 2015 ). Adolescents with ASD are at a higher risk for problems with social health (fewer, less intimate friends; Orsmond et al, 2013 ; Magiati et al, 2014 ) and mental health (anxiety, depression, schizophrenia, substance use; Taurines et al, 2012 ; Lever and Geurts, 2016 ; Park et al, 2018 ; Hossain et al, 2020 ; Schwartzman and Corbett, 2020 ; Oakley et al, 2021 ; Sun et al, 2021 ), compared to TD adolescents. These heightened risks are often specific to adolescence, and may make adolescence particularly difficult to navigate for those with ASD.…”

“…These heightened risks are often specific to adolescence, and may make adolescence particularly difficult to navigate for those with ASD. Adolescents with ASD are also more likely than TD adolescents to experience stressors, such as bullying ( Maïano et al, 2016 ), social isolation ( Orsmond and Kuo, 2011 ; Orsmond et al, 2013 ), and health-related risky behaviors ( Sun et al, 2021 ), including suicide attempts ( Zahid and Upthegrove, 2017 ; Kirby et al, 2019 ; Hirvikoski et al, 2020 ). These stressors disrupt mental health and brain maturation in TD samples ( Page and Coutellier, 2018 ; Shaw et al, 2020 ).…”