Predictive utility of autistic traits in youth with ADHD: a controlled 10-year longitudinal follow-up study

Joshi, Gagan; DiSalvo, Maura; Faraone, Stephen V.; Wozniak, Janet; Fried, Roland; Galdo, Maribel; Belser, Abigail; Hoskova, Barbora; Dallenbach, Nina T.; Leon, Melissa F. De; Biederman, Joseph

doi:10.1007/s00787-019-01384-8

Cited by 17 publications

(7 citation statements)

References 28 publications

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“…Notably, only a portion of the people who are high in autistic traits and seek a diagnostic assessment of autism eventually qualify for an autism diagnosis ( 18 ). Moreover, autistic traits may be present in neurodevelopmental conditions other than autism [e.g., ( 19 )]. The present results may be relevant to these individuals as well.…”

Section: Discussionmentioning

confidence: 99%

Autistic Traits Predict Social-Contact Uncertainty in University Students

Bertrams

Zäch

2021

Front. Psychiatry

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Social anxiety (alternatively: social-contact uncertainty) in the university context can lead to reduced health, well-being, and performance, and can even cause premature leaving of education. With the present study, we intended to supplement cross-sectional studies on students' autistic traits and social anxiety with longitudinal findings. We measured autistic traits and social-contact uncertainty of 118 university students on two occasions, roughly 1 year apart. Correlation, multiple regression, and cross-lagged analyses showed that more pronounced autistic traits predicted higher future social-contact uncertainty. Social-contact uncertainty did not predict autistic traits. We conclude that university students who are high in autistic traits tend not only to be more socially anxious at the moment but have a heightened risk of still being so in the future.

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Section: Discussionmentioning

confidence: 99%

Autistic Traits Predict Social-Contact Uncertainty in University Students

Bertrams

Zäch

2021

Front. Psychiatry

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“…Furthermore, with regard to their emotional and behavioral profile, a recent study has demonstrated that children with comorbid ASD and ADHD result with higher externalizing problems than ASD alone, and lower externalizing symptoms than children with ADHD alone ( Carta et al, 2020 ). Similarly, children with a diagnosis of ADHD who displayed higher autistic traits showed lower cognitive and social skills and the presence of autistic traits determined a more severe outcome ( Kotte et al, 2013 ; Green et al, 2016 ; Joshi et al, 2020 ; Sesso et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Autistic Traits and Empathy in Children With Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder and Co-occurring Attention Deficit Hyperactivity Disorder/Autism Spectrum Disorder

et al. 2021

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Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD) are two of the most represented neurodevelopmental conditions in childhood. The diagnostic shift introduced by the DSM-5, allowing a combined diagnosis of ADHD and ASD, poses different clinical challenges related to diagnostic overshadowing, accuracy of clinical judgment and potential delay in an ASD diagnosis in children presenting with ADHD. Here we tried to disentangle the clinical phenotype and specificity of the two co-occurring conditions in relation to autism traits and empathy, by comparing children with ASD with and without comorbid ADHD with children presenting ADHD only and children with typical development. The child versions of the Autism Quotient (C-AQ) and Empathy Quotient (C-EQ) were administered to a total sample of 198 male children between 6 and 14 years old with age appropriate language skills and normal intelligence. Univariate analysis demonstrated no significant differences in the C-AQ total and subscale scores as well as the C-EQ between children with ASD and children with ASD + ADHD, while children with ADHD alone presented an intermediate phenotype between ASD and TD. Furthermore, a receiver operating characteristic (ROC) analysis was applied to discriminate among the different phenotypes. We found that the C-AQ and C-EQ were accurate at distinguishing with satisfactory reliability between: (a) ASD vs. non- ASD (N-ASD) groups comprising both ADHD and TD children (Area Under the Curve AUC 88% for C-AQ and 81% for C-EQ); (b) ASD and TD (AUC 92% for C-AQ and 95% for C-EQ); (c) ASD and ADHD (AUC 80% for C-AQ and 68% for C-EQ). Our data confirm the reliability of the C-AQ and C-EQ as behavioral markers to differentiate ASD (regardless of comorbid ADHD) from an ADHD condition and TD. Interestingly, in our sample an ADHD condition does not increase the severity of the clinical phenotype in terms of autism traits distribution and empathy, suggesting that the psychological measures detected by the two quantitative instruments are independent of ADHD traits. This evidence will contribute to the translational efforts in developing better tailored treatments and preventive strategies.

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“…For instance, it is estimated that up to 83% of psychiatrically referred youth and adults with ASD suffer from ADHD (de Bruin et al, 2007; Frazier et al, 2011; Gjevik et al, 2011; Joshi et al, 2010, 2013; Leyfer et al, 2006; Mattila et al, 2010; Sinzig et al, 2009; Stahlberg et al, 2004; Wozniak et al, 1997). The identification and treatment of ADHD is particularly important in individuals with high-functioning ASD (HF-ASD) because ADHD is a highly treatable disorder and when treated, it can benefit the academics of individuals with HF-ASD (Joshi et al, 2020a). Yet little is known about the treatment of ADHD in relation to ASD.…”

Section: Introductionmentioning

confidence: 99%

Pharmacotherapy of attention deficit/hyperactivity disorder in individuals with autism spectrum disorder: A systematic review of the literature

et al. 2020

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Aim: To assess the empirical evidence for the treatment of attention deficit/hyperactivity disorder (ADHD) in populations with autism spectrum disorder (ASD). Methods: A systemic PubMed, PsychINFO, Embase, and Medline database search of peer-reviewed literature was conducted. Included in the review were controlled trials published in English with sample sizes ⩾10 participants examining the safety and efficacy of anti-ADHD medication in ASD populations. Data was extracted on relevant variables of study design, demographics, associated psychopathology, medication dose, efficacy, and tolerability. Results: Nine controlled trials met the inclusion and exclusion criteria: five with methylphenidate, three with atomoxetine, and one with guanfacine. Sample sizes ranged from 10 to 128 with 430 children participating across all the trials. In all the trials, treatment response was significantly superior to placebo. However, almost all trials assessed only hyperactivity, and most included only participants with intellectual disability with high levels of irritability. None of the trials distinguished agitation from hyperactivity. The response on hyperactivity for methylphenidate and atomoxetine was less than that observed in the neurotypical population; however, the response for guanfacine surpassed results observed in neurotypical populations. Treatment-emergent mood lability (i.e. mood dysregulation and mood-related adverse events) was frequently associated with methylphenidate and guanfacine treatments. Worse treatment outcomes were associated with individuals with lower intellectual capability compared with those with higher IQs. Conclusions: here is a scarcity of controlled trials examining ADHD treatments in ASD populations, particularly in intellectually capable individuals with ASD and in adults. Response to ADHD medications in ASD were adversely moderated by the presence of intellectual disability and mood lability.

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Predictive utility of autistic traits in youth with ADHD: a controlled 10-year longitudinal follow-up study

Cited by 17 publications

References 28 publications

Autistic Traits Predict Social-Contact Uncertainty in University Students

Autistic Traits Predict Social-Contact Uncertainty in University Students

Autistic Traits and Empathy in Children With Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder and Co-occurring Attention Deficit Hyperactivity Disorder/Autism Spectrum Disorder

Pharmacotherapy of attention deficit/hyperactivity disorder in individuals with autism spectrum disorder: A systematic review of the literature

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