Pubmed du 03/07/22
1. Bhat A. Why add motor to the definition of ASD: A response to Bishop et al.’s critique of Bhat (2021). Autism Res;2022 (Jul 2)
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2. Bishop SL, Wickstrom J, Thurm A. Insufficient evidence for inclusion of motor deficits in the ASD diagnostic criteria: A response to Bhat (2021). Autism Res;2022 (Jul 2)
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3. Mazzoli F, Cassioli E, Ristori J, Castellini G, Rossi E, Cocchetti C, Romani A, Angotti T, Giovanardi G, Mosconi M, Lingiardi V, Speranza AM, Ricca V, Vignozzi L, Maggi M, Fisher AD. Apparent autistic traits in transgender people: a prospective study of the impact of gender-affirming hormonal treatment. J Endocrinol Invest;2022 (Jul 2)
PURPOSE: We evaluated differences in Autism Spectrum Quotient (AQ) scores between a sample of hormone-naïve transgender and cisgender people and the impact of gender-affirming hormonal treatment (GAHT) on AQ scores across time. Furthermore, we assessed alexithymia and social anxiety as possible mediators of changes in AQ scores. METHODS: A cross-sectional comparison between cisgender and transgender people before GAHT and a prospective study on the effects of GAHT over time were performed. Transgender and cisgender people completed several psychometric tests. A total sample of 789 persons (n = 229 cismen; n = 172 ciswomen; n = 206 transmen; n = 182 transwomen) referring to the Florence and Rome Gender Clinics between 2018 and 2020 was enrolled. Of these, 62 participants referring to the Florence Gender Clinic were evaluated in a prospective study at baseline and 12 months after GAHT. RESULTS: Groups showed significant differences in terms of autistic traits: ciswomen showed lower scores of AQ, while cismen reported higher scores of AQ than all other groups. Transgender individuals showed significant higher levels of Gender Dysphoria (GD), body uneasiness, alexithymia and social anxiety, compared to cisgender ones. No significant differences in general psychopathology were found between groups. Across time, transmen and transwomen showed a significant reduction in AQ scores. The decrease in alexithymia and social anxiety after GAHT did not predict the change in AQ scores. CONCLUSIONS: The autistic traits in our sample may represent an epiphenomenon of GD rather than being part of an Autism Spectrum Disorder (ASD) condition, since they significantly decreased after 12 months of GAHT.
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4. Reece AS, Hulse GK. Impact of converging sociocultural and substance-related trends on US autism rates: combined geospatiotemporal and causal inferential analysis. Eur Arch Psychiatry Clin Neurosci;2022 (Jul 2)
Whilst cannabis is known to be toxic to brain development, it is unknown if it is driving rising US autism rates (ASMR). A longitudinal epidemiological study was conducted using national autism census data from the US Department of Education Individuals with Disabilities Act (IDEA) 1991-2011 and nationally representative drug exposure (cigarettes, alcohol, analgesic, and cocaine abuse, and cannabis use monthly, daily, and in pregnancy) datasets from National Survey of Drug Use and Health and US Census (income and ethnicity) and CDC Wonder population and birth data. Analysis was conducted in R. 266,950 were autistic of a population of 40,119,464 8-year-olds in 1994-2011. At national level after adjustment, daily cannabis use was significantly related to ASMR (β estimate = 4.37 (95%C.I. 4.06, 4.68), P < 2.2 × 10(-16)) as was first pregnancy trimester cannabis exposure (β estimate = 0.12 (0.08, 0.16), P = 1.7 × 10(-12)). At state level following adjustment for cannabis, cannabigerol (from β estimate = - 13.77 (- 19.41, 8.13), P = 1.8 × 10(-6)) and Δ9-tetrahydrocannabinol (from β estimate = 1.96 (0.88-3.04), P = 4 × 10(-4)) were significant. Geospatial state-level modelling showed exponential relationship between ASMR and Δ9-tetrahydrocannabinol and cannabigerol exposure. Exponential coefficients for the relationship between modelled ASMR and Δ9-tetrahydrocannabinol and cannabigerol exposure were 7.053 (6.39-7.71) and 185.334 (167.88-202.79; both P < 2.0 × 10(-7)). E-values are an instrument related to the evidence for causality in observational studies. High E-values were noted. Dichotomized legal status was linked with elevated ASMR. Data show cannabis use is associated with ASMR, is powerful enough to affect overall trends, and persists after controlling for other major covariates. Cannabinoids are exponentially associated with ASMR. The cannabis-autism relationship satisfies criteria of causal inference.
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5. Susanin A, Cooper M, Makara A, Kuschner ES, Timko CA. Autistic characteristics in youth with anorexia nervosa before and after treatment. Eur Eat Disord Rev;2022 (Jul 3)
OBJECTIVE: Cognitive characteristics common to autistic individuals are often seen in adults with anorexia nervosa (AN), raising the question of whether autistic people and people with AN may share an endophenotype. We need to examine autistic characteristics during the early stages of AN to accurately parse true symptom co-occurrence from behavioural alterations due to prolonged illness. METHODS: We conducted a post-hoc analysis examining autistic characteristics in 59 youth with AN. Adolescents and parents participating in a randomised-clinical trial for AN completed questionnaires probing autistic characteristics at baseline and treatment end. We categorised participants as above or below cut-offs of clinical indicators of autism using the Autism Probability Index (API) and the Autism Spectrum Quotient-10. RESULTS: Rates of high autistic characteristics ranged between 0% and 36% depending on the instrument used and how the data was obtained (i.e., by informant report or self-report). Paternal report of autistic characteristics differed across treatment completers versus non completers and maternal report indicated lower weight gain for those with elevated characteristics. CONCLUSIONS: Low rates of autism and fluctuations in autistic features during treatment underscore the importance of longitudinal examinations of autistic characteristics in adolescents with AN. Future studies need to replicate findings in a larger adolescent sample. TRIAL REGISTRATION: ClinicalTrails.gov Identifier NCT03928028.
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6. Wiscons LZ. Particularizing the picture: Features and uses of instantiation stories told by clinicians doing autism diagnosis. Soc Sci Med;2022 (Jun 24);306:115163.
Diagnosis is the narrative process through which professional clinicians transform experiences of illness and disability into disease (Hunter, 1991; Jutel, 2009; Kleinman et al., 1978). Maynard and Turowetz (2017a) found that the narrative structure for autism diagnosis consists of two primary story types concerning the conduct of children under assessment: (1) tendency stories about propensities or quantifications of behavior, and (2) instantiation stories that describe single instances of conduct occurring at a specific time or place. Instantiation stories represent a mechanism by which clinicians might preserve particulars about children under assessment in a way that is informative for configuring diagnoses that attend to the child’s individuality rather than as a generic autistic child. This paper constitutes an investigation into the uses and features of instantiation stories as told by clinicians doing autism diagnosis. Clinicians primarily use instantiation stories to support generalizations about the child that relate to official diagnostic criteria (Excerpt 1). Clinicians also use instantiation stories to index instances of conduct that apparently misalign with a tendency description and the diagnostic picture (Excerpt 2). In such cases, clinicians work to demonstrate how the generalization endures despite the apparent misalignment. Furthermore, clinicians may use instantiation stories to tell about humorous or otherwise « storyable » (Sacks, 1992) conduct (Excerpt 3). Finally, clinicians sometimes use instantiation stories to mitigate the delivery of a diagnosis (Excerpt 4).
