Levels of anxiety and sources of stress in adults with autism.
TL;DR: Stress was found to correlate with high anxiety levels for the autism group, particularly the ability to cope with change, anticipation, sensory stimuli and unpleasant events, which has important implications for clinicians in terms of both assessment and treatment.
Abstract: Clinical reports suggest that anxiety is a pertinent issue for adults with autism. We compared 34 adults with autism with 20 adults with intellectual disabilities, utilizing informant-based measures of anxiety and stress. Groups were matched by age, gender and intellectual ability. Adults with autism were almost three times more anxious than the comparison group and gained significantly higher scores on the anxiety subscales of panic and agoraphobia, separation anxiety, obsessive-compulsive disorder and generalized anxiety disorder. In terms of sources of stress, significant differences between the two groups were also found, and stress was found to correlate with high anxiety levels for the autism group, particularly the ability to cope with change, anticipation, sensory stimuli and unpleasant events. That is, the more anxious the individual with autism, the less likely they were able to cope with these demands. This has important implications for clinicians in terms of both assessment and treatment.
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TL;DR: The results indicate that stress experience early in pregnancy may contribute to male neurodevelopmental disorders through impacts on placental function and fetal development.
Abstract: Prenatal stress is associated with an increased vulnerability to neurodevelopmental disorders, including autism and schizophrenia. To determine the critical time window when fetal antecedents may induce a disease predisposition, we examined behavioral responses in offspring exposed to stress during early, mid, and late gestation. We found that male offspring exposed to stress early in gestation displayed maladaptive behavioral stress responsivity, anhedonia, and an increased sensitivity to selective serotonin reuptake inhibitor treatment. Long-term alterations in central corticotropin-releasing factor (CRF) and glucocorticoid receptor (GR) expression, as well as increased hypothalamic–pituitary–adrenal (HPA) axis responsivity, were present in these mice and likely contributed to an elevated stress sensitivity. Changes in CRF and GR gene methylation correlated with altered gene expression, providing important evidence of epigenetic programming during early prenatal stress. In addition, we found the core mechanism underlying male vulnerability may involve sex-specific placenta responsivity, where stress early in pregnancy significantly increased expression of PPARα (peroxisome proliferator-activated receptor α), IGFBP-1 (insulin-like growth factor binding protein 1), HIF3α (hypoxia-inducible factor 3a), and GLUT4 (glucose transporter 4) in male placentas but not females. Examination of placental epigenetic machinery revealed basal sex differences, providing further evidence that sex-specific programming begins very early in pregnancy, and may contribute to the timing and vulnerability of the developing fetus to maternal perturbations. Overall, these results indicate that stress experience early in pregnancy may contribute to male neurodevelopmental disorders through impacts on placental function and fetal development.
933 citations
Cites background from "Levels of anxiety and sources of st..."
...Stress experience during gestation is associated with an increased incidence of numerous neuropsychiatric disorders, including depression, anxiety, schizophrenia, and autism (Koenig et al., 2002; Nestler et al., 2002; Gillott and Standen, 2007; Walker et al., 2008)....
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TL;DR: Nearly all medical conditions were significantly more common in adults with autism, including immune conditions, gastrointestinal and sleep disorders, seizure, obesity, dyslipidemia, hypertension, and diabetes.
Abstract: Compared to the general pediatric population, children with autism have higher rates of co-occurring medical and psychiatric illnesses, yet very little is known about the general health status of adults with autism. The objective of this study was to describe the frequency of psychiatric and medical conditions among a large, diverse, insured population of adults with autism in the United States. Participants were adult members of Kaiser Permanente Northern California enrolled from 2008 to 2012. Autism spectrum disorder cases (N = 1507) were adults with autism spectrum disorder diagnoses (International Classification of Diseases-9-Clinical Modification codes 299.0, 299.8, 299.9) recorded in medical records on at least two separate occasions. Controls (N = 15,070) were adults without any autism spectrum disorder diagnoses sampled at a 10:1 ratio and frequency matched to cases on sex and age. Adults with autism had significantly increased rates of all major psychiatric disorders including depression, anxiety...
683 citations
Cites result from "Levels of anxiety and sources of st..."
...…consistent with previous studies which typically included fewer than 200 cases and focused on young adults (Buck et al., 2014; Eaves and Ho, 2008; Gillott and Standen, 2007; Hofvander et al., 2009; Joshi et al., 2013; Kanne et al., 2009; Lugnegard et al., 2011; Morgan et al., 2002; Russell et…...
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...Our findings of high prevalence of psychiatric disorders, including depression, anxiety, psychoses, OCD, bipolar disorder, and attention deficit disorder, are consistent with previous studies which typically included fewer than 200 cases and focused on young adults (Buck et al., 2014; Eaves and Ho, 2008; Gillott and Standen, 2007; Hofvander et al., 2009; Joshi et al., 2013; Kanne et al., 2009; Lugnegard et al., 2011; Morgan et al., 2002; Russell et al., 2005; Sterling et al., 2008; Vannucchi et al., 2014)....
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Dissertation•
01 Jan 1999
TL;DR: High-functioning children with autism were compared with two control groups on measures of anxiety and social worries and high anxiety subscale scores for the autism group were separation anxiety and obsessive-compulsive disorder.
Abstract: High-functioning children with autism were compared with two control groups on measures of anxiety and social worries. Comparison control groups consisted of children with specific language impairment (SLI) and normally developing children. Each group consisted of 15 children between the ages of 8 and 12 years and were matched for age and gender. Children with autism were found to be most anxious on both measures. High anxiety subscale scores for the autism group were separation anxiety and obsessive-compulsive disorder. These findings are discussed within the context of theories of autism and anxiety in the general population of children. Suggestions for future research are made.
545 citations
TL;DR: A critical review of the current empirical studies that have addressed prognosis in this population in terms of diagnostic severity, cognitive functioning, language, academic performance and social outcomes is presented in this paper.
361 citations
TL;DR: In this paper, the authors consider the nosology and pathogenesis of anxiety disorders in youth with autism and suggest that anxiety may play at least three roles: (a) a downstream consequence of ASD symptoms (e.g., via stress generation through social rejection); (b) a moderator of ASD symptom severity, such that certain core autism symptoms like social skill deficits and repetitive behaviors may be exacerbated by anxiety; and (c) as a proxy of core ASD symptoms.
Abstract: [Clin Psychol Sci Prac 17: 281–292, 2010]
This article considers the nosology and pathogenesis of anxiety disorders in youth with autism. The comparability of anxiety in the autism spectrum disorder (ASD) population in relation to the typically developing population has been suggested by some recent findings, but conceptual and empirical ambiguities remain. It is suggested that anxiety may play at least three roles: (a) a downstream consequence of ASD symptoms (e.g., via stress generation through social rejection); (b) a moderator of ASD symptom severity, such that certain core autism symptoms like social skill deficits and repetitive behaviors may be exacerbated by anxiety; and (c) as a proxy of core ASD symptoms. Suggestions for clarifying the nature and function of anxiety in autism are made.
360 citations
References
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Journal Article•
8,054 citations
07 Feb 2014
6,430 citations
TL;DR: A new model of metarepresentational development is used to predict a cognitive deficit which could explain a crucial component of the social impairment in childhood autism.
6,017 citations
01 Jan 1985
TL;DR: In this paper, a new model of metarepresentational development was used to predict a cognitive deficit in children with autism, which could explain a crucial component of the social impairment in childhood autism.
Abstract: Abstract We use a new model of metarepresentational development to predict a cognitive deficit which could explain a crucial component of the social impairment in childhood autism. One of the manifestations of a basic metarepresentational capacity is a ‘theory of mind’. We have reason to believe that autistic children lack such a ‘theory’. If this were so, then they would be unable to impute beliefs to others and to predict their behaviour. This hypothesis was tested using Wimmer and Perner's puppet play paradigm. Normal children and those with Down's syndrome were used as controls for a group of autistic children. Even though the mental age of the autistic children was higher than that of the controls, they alone failed to impute beliefs to others. Thus the dysfunction we have postulated and demonstrated is independent of mental retardation and specific to autism.
6,007 citations
Journal Article•
2,459 citations