Linking Anxiety and Insistence on Sameness in Autistic Children: The Role of Sensory Hypersensitivity

Black, Karen R.; Stevenson, Ryan A.; Segers, Magali; Ncube, Busiswe L.; Sun, Sol Z.; Philipp-Muller, Aviva; Bebko, James M.; Barense, Morgan D.; Ferber, Susanne

doi:10.1007/s10803-017-3161-x

Cited by 73 publications

(61 citation statements)

References 65 publications

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“…Sensory issues were also identified as triggers, and were again corroborated as a predictor of self-injury in our quantitative analysis. That both alexithymia and sensory disturbances are predictive of self-injury in autistic people is consistent with the prevalence of these features in other self-harming populations, and with the relationship that both alexithymia and sensory differences show with internalizing symptoms and/or mental ill-health in autism [41][42][43][44][45][46]. Alexithymia is higher than average in adolescent selfharmers and is a well-known correlate of self-injury in clinical populations [47][48][49].…”

supporting

confidence: 64%

“…Additionally, it may be that individuals who use NSSI for sensory stimulation are driven more by the correlates or comorbidities of sensory differences rather than the sensory differences per se. Such correlates, in autism, include sociocommunicative abilities, insistence on sameness, cognitive problems and inattention, adaptive behavior, and as previously mentioned, anxiety and other forms of affective difficulties [41][42][43][44][45]. Notably, impulsivity is an intrapersonal factor associated with sensation-seeking through NSSI [73] and with acquired capability for suicide [74], and has indeed been linked to self-injurious behavior [75] and to suicidal acts [25] in autistic children.…”

Section: Discussionmentioning

confidence: 92%

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Links between self-injury and suicidality in autism

et al. 2020

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Background: Autistic individuals without intellectual disability are at heightened risk of self-injury, and appear to engage in it for similar reasons as non-autistic people. A wide divergence of autistic perspectives on self-injury, including those who frame it as a helpful coping mechanism, motivate investigating the link between self-injury, suicide ideation, and attempts which has been reported in typically developing individuals. Method: One hundred three autistic participants completed the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT), the Suicide Behaviors Questionnaire (SBQ-R), and the Interpersonal Social Evaluation List (ISEL-12) across two online studies. Logistic regression was conducted to predict self-harming status via responses to questions on suicidality, and to predict whether certain self-injurious behaviors, including cutting, were especially associated with suicide ideation and attempts. Non-parametric correlation analysis examined relationships between suicide ideation/ attempts and other variables that might characterize self-harmers especially at risk of suicidality. These included perceived access to social support, purposes or reasons for self-injury, the number of different self-injurious behaviors engaged in, the duration and lifetime incidence of self-injury, and the individual's feelings about their self-injury. Results: While self-injuring status was significantly predicted by responses to a question on suicide ideation and attempts, there was no relationship between suicide ideation/attempts and a participant's personal feelings about their self-injury. The method of cutting was also predicted by suicide ideation and attempts, though other methods common in autistic people were at borderline significance. Use of self-injury for the regulation of low-energy emotional states like depression, for self-punishment or deterrence from suicide, and for sensory stimulation, was associated with suicide ideation and attempts, as was the number of self-injurious behaviors engaged in. There was no significant relationship between suicide ideation/attempts and the duration and lifetime incidence of self-injury or social support. Conclusions: These preliminary data suggest that while individuals might frame their self-injury as a positive or neutral thing, there remains a concerning relationship between self-injury and suicidality which exists regardless of individual feelings on self-injury. This is consistent with the theoretical perspective that self-injury can be a "gateway" through which individuals acquire capability for lethal suicidal behaviors. The data highlight that particular methods (cutting) and reasons for self-injury may be of significant concern, but this information, which might be of extreme value for clinicians, requires further investigation and validation.

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supporting

confidence: 64%

Section: Discussionmentioning

confidence: 92%

Links between self-injury and suicidality in autism

et al. 2020

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“…In mothers of children with ASD, intolerance for uncertainty mediated the association between anxiety and sensory sensitivity (Uljarević et al, 2016). Black et al (2017) found that sensory hyperresponsivity mediated the relationship between specific phobia and insistence on sameness in children with ASD 7 to 17 years of age.…”

Section: Mediation Modelsmentioning

confidence: 89%

“…RRBs were often proposed as a manifestation of anxiety-driven behaviors, as many authors pointed to the role in which overarousal played in these behaviors. Twelve of these studies included children with ASD, and the relationship between sensory features and RRBs remains across development in this group, including toddlers (Wiggins, Robins, Bakeman, & Adamson, 2009;Wolff et al, 2017), school aged children (Black et al, 2017;Boyd et al, 2010;Matsushima et al, 2016;Neil, Olsson, & Pellicano, 2016), and adolescents (Green, Chandler, Charman, Simonoff, & Baird, 2016). Researchers have attempted to unravel the complexities between specific RRBs, anxiety, and sensory sensitivity.…”

Section: Restricted and Repetitive Behaviorsmentioning

confidence: 99%

Sensory Processing Patterns and Internalizing Behaviors in the Pediatric and Young Adult General Population: A Scoping Review

Kotsiris¹,

Westrick²,

Little³

2020

The Open Journal of Occupational Therapy

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Background: While research has largely focused on the relationship between sensory processing patterns and internalizing behaviors (e.g., anxiety, depression) in children with autism spectrum disorder or attention deficit hyperactivity disorder, this relationship is not fully understood among the general population or across development.Method: This scoping review addressed the following research question: How are sensory processing patterns associated with internalizing behaviors (e.g., anxiety, depression) among children with various conditions as well as typically developing children from birth to 22 years of age?Results: Since 2005, n = 97 peer-reviewed articles have addressed this topic and were included in the current review. Overall, findings show a complex interplay between sensory processing patterns, internalizing behaviors, cognitive factors (intolerance of uncertainty, ritualism, cognitive rigidity), and personality characteristics.Discussion: The results of this review showed that research primarily focused on individuals with ASD, and many articles used mediation models to examine complex relationships. Implications for future research are discussed. CommentsThe authors report that they have no conflicts of interest to disclose.

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“…The emotional difficulties of children with ASD are well reported in the literature and research shows increased negative emotional reactivity and decreased emotion regulation ability in children with ASD compared to typically developing (TD) peers [Mazefsky & White, ]. These emotional difficulties in ASD can be due to factors common among people with ASD such as sensory hypersensitivity [Black et al, ], insistence on sameness [Uljarević, Richdale, Evans, Cai, & Leekam, ], and impaired predictive abilities [Sinha et al, ].…”

Section: Emotional Difficulties In Children With Asdmentioning

confidence: 99%

The role of alexithymia in parent–child interaction and in the emotional ability of children with autism spectrum disorder

2019

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Children with autism spectrum disorder (ASD) have more emotional difficulties than typically developing (TD) children. Of all the factors that impact children's emotional development, parents, and the way they interact with their children, are of crucial importance. The present study compared the amount of parent–child interactions among 35 dyads of parents and their children with ASD and 41 dyads of parents and their TD children, aged between 3 and 13 years, during a frustration‐eliciting situation. We further examined whether children's alexithymia is linked to parent–child interactions and whether parent–child interactions are linked to children's emotional difficulties. We found that parents of children with ASD interacted significantly less with their children than parents of TD children. This reduced interaction was better explained by children's alexithymia than by children's ASD diagnosis. Finally, parent–child interaction mediated the relationship between children's ASD diagnosis and children's emotion regulation ability, as well as some aspects of children's emotional reactivity but only if not accounting for children's alexithymia levels. Our results demonstrate the determinant role children's alexithymia plays on parent–child interactions and on how these interactions are linked to children's difficulties in emotion regulation and emotional reactivity. Results are discussed in light of how parent–child interactions and the emotional ability of children with ASD can be improved by targeting children's alexithymia. Autism Res 2019, 12: 458–468 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary In the present research, we found that parents of children with autism interact less with their children compared to parents of typically developing children. We also found that this decreased interaction is linked to children's difficulties to recognize, describe, and distinguish emotions, a triad of difficulties known as alexithymia. Furthermore, parents' interaction with their children explains emotional reactivity and emotion regulation problems in children with autism. However, if we take into consideration children's alexithymia, then parents' interaction with their children is not related to their children's emotional difficulties in reactivity and regulation. Therefore, to improve the interaction between parents and their children with autism, and the emotional development of these children, we recommend interventions that teach children with autism how to recognize, describe, and distinguish emotions in themselves and others.

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Linking Anxiety and Insistence on Sameness in Autistic Children: The Role of Sensory Hypersensitivity

Cited by 73 publications

References 65 publications

Links between self-injury and suicidality in autism

Links between self-injury and suicidality in autism

Sensory Processing Patterns and Internalizing Behaviors in the Pediatric and Young Adult General Population: A Scoping Review

The role of alexithymia in parent–child interaction and in the emotional ability of children with autism spectrum disorder

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