Autism diagnosis as a social process / J. HAYES in Autism, 26-2 (February 2022)  

Public ISBD [article]  inAutism > 26-2 (February 2022) . - p.488-498 Titre : Autism diagnosis as a social process Type de document : Texte imprimé et/ou numérique Auteurs : J. HAYES, Auteur ; T. FORD, Auteur ; R. MCCABE, Auteur ; G. RUSSELL, Auteur Article en page(s) : p.488-498 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  diagnosis  health services  policy  qualitative research  of interest with respect to the research, authorship and/or publication of this  article. Index. décimale : PER Périodiques Résumé : When a child or adult is referred for an autism diagnosis, clinicians from different backgrounds work together to make a diagnostic decision. A few studies have asked clinicians in interview how they feel about diagnosis and what the challenges are. We interviewed clinicians in child and adult assessment services in England, and from different professional backgrounds, about the challenges of autism diagnosis and the factors that might influence the assessment process. We found that there were a number of challenges in autism diagnosis, especially when someone coming for diagnosis was considered to be near the diagnostic threshold. Clinicians told us that making a diagnosis was like creating a 'narrative': looking at many different factors that told a story about a person, rather than just looking at the results of diagnostic tests. Clinicians do not always agree with the results of those tests and have to use their specialist clinical judgement to make decisions. Clinicians were concerned about the amount of time people have to wait for an autism assessment, and the resulting pressure on the assessment process. The findings of this work can help us to understand how diagnosis happens and consider ways in which it can be improved for adults, children and families coming for assessment, as well as clinicians. En ligne : http://dx.doi.org/10.1177/13623613211030392 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=452 [article] Autism diagnosis as a social process [Texte imprimé et/ou numérique] / J. HAYES, Auteur ; T. FORD, Auteur ; R. MCCABE, Auteur ; G. RUSSELL, Auteur . - p.488-498. Langues : Anglais (eng) in Autism > 26-2 (February 2022) . - p.488-498 Mots-clés : autism spectrum disorders  diagnosis  health services  policy  qualitative research  of interest with respect to the research, authorship and/or publication of this  article. Index. décimale : PER Périodiques Résumé : When a child or adult is referred for an autism diagnosis, clinicians from different backgrounds work together to make a diagnostic decision. A few studies have asked clinicians in interview how they feel about diagnosis and what the challenges are. We interviewed clinicians in child and adult assessment services in England, and from different professional backgrounds, about the challenges of autism diagnosis and the factors that might influence the assessment process. We found that there were a number of challenges in autism diagnosis, especially when someone coming for diagnosis was considered to be near the diagnostic threshold. Clinicians told us that making a diagnosis was like creating a 'narrative': looking at many different factors that told a story about a person, rather than just looking at the results of diagnostic tests. Clinicians do not always agree with the results of those tests and have to use their specialist clinical judgement to make decisions. Clinicians were concerned about the amount of time people have to wait for an autism assessment, and the resulting pressure on the assessment process. The findings of this work can help us to understand how diagnosis happens and consider ways in which it can be improved for adults, children and families coming for assessment, as well as clinicians. En ligne : http://dx.doi.org/10.1177/13623613211030392 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=452

Pathways between early-life adversity and adolescent self-harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children / A. E. RUSSELL in Journal of Child Psychology and Psychiatry, 60-10 (October 2019)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 60-10 (October 2019) . - p.1094-1103 Titre : Pathways between early-life adversity and adolescent self-harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children Type de document : Texte imprimé et/ou numérique Auteurs : A. E. RUSSELL, Auteur ; J. HERON, Auteur ; D. GUNNELL, Auteur ; T. FORD, Auteur ; G. HEMANI, Auteur ; C. JOINSON, Auteur ; P. MORAN, Auteur ; C. RELTON, Auteur ; M. SUDERMAN, Auteur ; B. MARS, Auteur Article en page(s) : p.1094-1103 Langues : Anglais (eng) Mots-clés : Avon Longitudinal Study of Parents and Children  C-reactive protein  Inflammation  Self-harm  adverse childhood experiences  interleukin-6  mediation  suicide Index. décimale : PER Périodiques Résumé : BACKGROUND: Adverse childhood experiences (ACEs) such as physical and emotional abuse are strongly associated with self-harm, but mechanisms underlying this relationship are unclear. Inflammation has been linked to both the experience of ACEs and self-harm or suicide in prior research. This is the first study to examine whether inflammatory markers mediate the association between exposure to ACEs and self-harm. METHODS: Participants were 4,308 young people from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based birth cohort in the United Kingdom. A structural equation modelling approach was used to fit a mediation model with the number of ACEs experienced between ages 0 and 9 years old (yo), levels of the inflammatory markers interleukin-6 and C-reactive protein measured at 9.5 yo, and self-harm reported at 16 yo. RESULTS: The mean number of ACEs young people experienced was 1.41 (SE 0.03). Higher ACE scores were associated with an increased risk of self-harm at 16 yo (direct effect relative risk (RR) per additional ACE 1.11, 95% CI 1.05, 1.18, p < 0.001). We did not find evidence of an indirect effect of ACEs on self-harm via inflammation (RR 1.00, 95% CI 1.00, 1.01, p = 0.38). CONCLUSIONS: Young people who have been exposed to ACEs are a group at high risk of self-harm. The association between ACEs and self-harm does not appear to be mediated by an inflammatory process in childhood, as indexed by peripheral levels of circulating inflammatory markers measured in childhood. Further research is needed to identify alternative psychological and biological mechanisms underlying this relationship. En ligne : http://dx.doi.org/10.1111/jcpp.13100 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=406 [article] Pathways between early-life adversity and adolescent self-harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children [Texte imprimé et/ou numérique] / A. E. RUSSELL, Auteur ; J. HERON, Auteur ; D. GUNNELL, Auteur ; T. FORD, Auteur ; G. HEMANI, Auteur ; C. JOINSON, Auteur ; P. MORAN, Auteur ; C. RELTON, Auteur ; M. SUDERMAN, Auteur ; B. MARS, Auteur . - p.1094-1103. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 60-10 (October 2019) . - p.1094-1103 Mots-clés : Avon Longitudinal Study of Parents and Children  C-reactive protein  Inflammation  Self-harm  adverse childhood experiences  interleukin-6  mediation  suicide Index. décimale : PER Périodiques Résumé : BACKGROUND: Adverse childhood experiences (ACEs) such as physical and emotional abuse are strongly associated with self-harm, but mechanisms underlying this relationship are unclear. Inflammation has been linked to both the experience of ACEs and self-harm or suicide in prior research. This is the first study to examine whether inflammatory markers mediate the association between exposure to ACEs and self-harm. METHODS: Participants were 4,308 young people from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based birth cohort in the United Kingdom. A structural equation modelling approach was used to fit a mediation model with the number of ACEs experienced between ages 0 and 9 years old (yo), levels of the inflammatory markers interleukin-6 and C-reactive protein measured at 9.5 yo, and self-harm reported at 16 yo. RESULTS: The mean number of ACEs young people experienced was 1.41 (SE 0.03). Higher ACE scores were associated with an increased risk of self-harm at 16 yo (direct effect relative risk (RR) per additional ACE 1.11, 95% CI 1.05, 1.18, p < 0.001). We did not find evidence of an indirect effect of ACEs on self-harm via inflammation (RR 1.00, 95% CI 1.00, 1.01, p = 0.38). CONCLUSIONS: Young people who have been exposed to ACEs are a group at high risk of self-harm. The association between ACEs and self-harm does not appear to be mediated by an inflammatory process in childhood, as indexed by peripheral levels of circulating inflammatory markers measured in childhood. Further research is needed to identify alternative psychological and biological mechanisms underlying this relationship. En ligne : http://dx.doi.org/10.1111/jcpp.13100 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=406

Selection bias on intellectual ability in autism research: a cross-sectional review and meta-analysis / G. RUSSELL in Molecular Autism, 10 (2019)  

Public ISBD [article]  inMolecular Autism > 10 (2019) . - 9 p. Titre : Selection bias on intellectual ability in autism research: a cross-sectional review and meta-analysis Type de document : Texte imprimé et/ou numérique Auteurs : G. RUSSELL, Auteur ; W. MANDY, Auteur ; D. ELLIOTT, Auteur ; R. WHITE, Auteur ; T. PITTWOOD, Auteur ; T. FORD, Auteur Article en page(s) : 9 p. Langues : Anglais (eng) Mots-clés : *Autism  *Autism spectrum disorder  *Intellectual disability  *Nosology  *Selection bias  interests.Springer Nature remains neutral with regard to jurisdictional claims in  published maps and institutional affiliations. Index. décimale : PER Périodiques Résumé : Background: Current global estimates suggest the proportion of the population with autism spectrum disorder (ASD) who have intellectual disability (ID) is approximately 50%. Our objective was to ascertain the existence of selection bias due to under-inclusion of populations with ID across all fields of autism research. A sub-goal was to evaluate inconsistencies in reporting of findings. Methods: This review covers all original research published in 2016 in autism-specific journals with an impact factor greater than 3. Across 301 included studies, 100,245 participants had ASD. A random effects meta-analysis was used to estimate the proportion of participants without ID. Selection bias was defined as where more than 75% of participants did not have ID. Results: Meta-analysis estimated 94% of all participants identified as being on the autism spectrum in the studies reviewed did not have ID (95% CI 0.91-0.97). Eight out of ten studies demonstrated selection bias against participants with ID. The reporting of participant characteristics was generally poor: information about participants' intellectual ability was absent in 38% of studies (n = 114). Where there was selection bias on ID, only 31% of studies mentioned lack of generalisability as a limitation. Conclusions: We found selection bias against ID throughout all fields of autism research. We recommend transparent reporting about ID and strategies for inclusion for this much marginalised group. En ligne : https://dx.doi.org/10.1186/s13229-019-0260-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=389 [article] Selection bias on intellectual ability in autism research: a cross-sectional review and meta-analysis [Texte imprimé et/ou numérique] / G. RUSSELL, Auteur ; W. MANDY, Auteur ; D. ELLIOTT, Auteur ; R. WHITE, Auteur ; T. PITTWOOD, Auteur ; T. FORD, Auteur . - 9 p. Langues : Anglais (eng) in Molecular Autism > 10 (2019) . - 9 p. Mots-clés : *Autism  *Autism spectrum disorder  *Intellectual disability  *Nosology  *Selection bias  interests.Springer Nature remains neutral with regard to jurisdictional claims in  published maps and institutional affiliations. Index. décimale : PER Périodiques Résumé : Background: Current global estimates suggest the proportion of the population with autism spectrum disorder (ASD) who have intellectual disability (ID) is approximately 50%. Our objective was to ascertain the existence of selection bias due to under-inclusion of populations with ID across all fields of autism research. A sub-goal was to evaluate inconsistencies in reporting of findings. Methods: This review covers all original research published in 2016 in autism-specific journals with an impact factor greater than 3. Across 301 included studies, 100,245 participants had ASD. A random effects meta-analysis was used to estimate the proportion of participants without ID. Selection bias was defined as where more than 75% of participants did not have ID. Results: Meta-analysis estimated 94% of all participants identified as being on the autism spectrum in the studies reviewed did not have ID (95% CI 0.91-0.97). Eight out of ten studies demonstrated selection bias against participants with ID. The reporting of participant characteristics was generally poor: information about participants' intellectual ability was absent in 38% of studies (n = 114). Where there was selection bias on ID, only 31% of studies mentioned lack of generalisability as a limitation. Conclusions: We found selection bias against ID throughout all fields of autism research. We recommend transparent reporting about ID and strategies for inclusion for this much marginalised group. En ligne : https://dx.doi.org/10.1186/s13229-019-0260-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=389

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