Pubmed du 11/03/09

Pubmed du jour

2009-03-11 12:03:50

1. Aldred CR, Green J. {{Early social communication interventions for autism}}. {Br J Hosp Med} (Lond);2009 (Mar 11);70(3):143-145.

Given the impact of autism as a disorder there has been surprisingly little rigorous research into its treatment. Positive findings from pilot trials of parent–child interventions have led to funding of the Pre-school Autism Communication Trial, which will be an important step in developing an evidence base for early intervention.

2. Bejerot S, Mortberg E. {{Do Autistic Traits Play a Role in the Bullying of Obsessive-Compulsive Disorder and Social Phobia Sufferers?}} {Psychopathology};2009 (Mar 11);42(3):170-176.

Background: Social phobia and obsessive-compulsive disorder (OCD) share several similarities: both are categorized as anxiety disorders, avoidant personality disorder and depression are common in both, they have a similar age of onset and course, and both disorders respond to treatments with serotonin reuptake inhibitors and cognitive behavioural therapy. However, OCD and social phobia differ in respect to their relation to autism spectrum disorders (ASD; i.e. Asperger’s syndrome, autism, pervasive disorder not otherwise specified). Findings that suggest a link between OCD and ASD have no parallel in social phobia. Moreover, obsessive-compulsive, paranoid and schizotypal personality disorders are prevalent in OCD and in ASD, but not in social phobia. Individuals with ASD are known to be frequent targets of bullying. We hypothesised that individuals with autistic traits would have been frequent targets for bullies during their childhood, as opposed to people without such traits. Methods: Adult patients with social phobia (n = 63) or OCD (n = 65) were assessed regarding autistic traits, and interviewed about being bullied at school. A reference group (n = 551) responded to questions about being bullied. Results: There was a significant difference in the prevalence of being bullied between OCD (50%), social phobia patients (20%) and the reference group (27%). Autistic traits were more common in OCD than in social phobia. A history of being bullied was related to autistic traits among patients. Conclusions: Falling victim to bullying is not a random event. Autistic traits, i.e. low social skills, may be a predictor of being bullied in school. The high rate of bullying victims in persons who later develop OCD is suggested to be related to the overlap between OCD and ASD.

3. Deeley Q, Murphy D. {{Pathophysiology of autism: evidence from brain imaging}}. {Br J Hosp Med} (Lond);2009 (Mar 11);70(3):138-142.

Autism spectrum disorders involve pervasive developmental abnormalities in social communication, socio-emotional reciprocity, and restricted and repetitive interests. They are likely to be caused by abnormalities in multiple brain regions, includingunderconnectivity between components of networks subserving a variety of cognitive functions.

4. Gaigg SB, Bowler DM. Brief Report: Attenuated Emotional Suppression of the Attentional Blink in Autism Spectrum Disorder: Another Non-Social Abnormality? J Autism Dev Disord;2009 (Mar 11)

Twenty-five individuals with Autism Spectrum Disorder and 25 typically developed individuals participated in an Attentional Blink paradigm to determine whether emotional words would capture attention similarly in the two groups. Whilst the emotionality of words facilitated attention in typical comparison participants, this effect was attenuated in the ASD group. The magnitude of the emotional modulation of attention in ASD also correlated significantly with participants’ VIQ, which was not observed for the comparison group. Together these observations replicate and extend the findings of Corden et al. (J Autism Develop Disord 38:1072-1080, 2008) and implicate abnormalities in emotional processes outside the broader context of social cognition in ASD. We discuss our findings in relation to possible abnormalities in amygdala function that may underlie the disorder.

5. Gomez JC. {{Embodying meaning: Insights from primates, autism, and Brentano}}. {Neural Netw};2009 (Mar);22(2):190-196.

In this paper I offer an analysis of social meaning in terms of coding intentional relations between agents and objects. This analysis is amenable to embodied interpretations of intentionality and Theory of mind and may prove of help for the task of simulating the attribution of intentionality with neural networks. Work with non-human primates suggests that evolution first dealt with the problem domain of social meaning by selecting specific adaptations for coding behaviour as intentional in the sense of Brentano, i.e., as directed to or being about objects (for example, gaze following behaviours). Work with autism suggests that alterations in these basic mechanisms of intentional attribution may explain some of the most prevalent problems with social meaning in this condition. Brentanian mechanisms for encoding intentional relations between agents and objects are more basic and evolutionarily more primitive than representational theories of mind. However, some of the key components of representational theories of mind may be already present in the intentional abilities of primates, suggesting that the decisive evolutionary step may have consisted of a re-organization of existing abilities rather than the creation of new skills. Neural network models and models of the evolution and development of primitive mechanisms for intentional encoding may benefit from mutual cross-fertilization.

6. Jordan R.{{ Medicalization of autism spectrum disorders: implications for services}}. {Br J Hosp Med} (Lond);2009 (Mar 11);70(3):128-129.

Medicine exists in social and cultural contexts and diagnosis has wide implications. Autism was introduced as a medical category in 1943 by Kanner and for four decades the main thrust of scientific research around diagnosis was to establish the distinctness of this category, developing internally consistent criteria for diagnosis and differentiating it from other categories such as intellectual retardation and childhood schizophrenia. In spite of growing evidence of the biological aetiology of the disorder, no distinct biological markers were established and autism is still diagnosed on the basis of patterns of development with behavioural ‘signposts’.

7. Lord C, Bishop SL. {{The autism spectrum: definitions, assessment and diagnoses}}. {Br J Hosp Med} (Lond);2009 (Mar 11);70(3):132-135.

This article summarizes current research related to autism spectrum disorders. Current epidemiological trends, theories about aetiology, and relevant issues in assessment and diagnosis of autism spectrum disorders are discussed.

8. Niederhofer H. {{First preliminary results of an observation of Ginkgo Biloba treating patients with autistic disorder}}. {Phytother Res};2009 (Mar 9)

Deficits in reciprocal social interaction, verbal and nonverbal communication, and imaginative activity are the main characteristics of autism. From the psychopharmacological point of view, clonidine, metylphenidate and neuroleptics may improve some of these aspects, but with a remarkable risk of adverse side effects. In our observational study, three patients received 2 x 100 mg Ginkgo Biloba EGb 761 for 4 weeks and showed some improvement on the Aberrant Behavior and Symptom Checklist. These results suggest, that Ginkgo Biloba might be effective at least as an add-on therapy. Copyright (c) 2009 John Wiley & Sons, Ltd.

9. Niederhofer H. {{St John’s Wort treating patients with autistic disorder}}. {Phytother Res};2009 (Mar 9)

Problems of eye contact and expressive language limit the effectiveness of educational and behavioral interventions in patients suffering from pervasive developmental disorders. For that reason, additive psychopharmacological interventions are sometimes needed to improve symptomatology. In our preliminary open trial, three male patients with autistic disorder, diagnosed by ICD-10 criteria, completed an open trial of St John’s Wort. Subjects were included in the study if their eye contact and expressive language was inadaequate for their developmental level and if they had not tolerated or responded to other psychopharmacologic treatments (methylphenidate, clonidine or desipramine). Parent and mentor ratings on the Aberrant Behavior Checklist, irritability, stereotypy, and inappropriate speech factors improved slightly during treatment with St John’s Wort. Clinician ratings (Psychiatric Rating Scale Autism, Anger and Speech Deviance factors; Global Assessment Scale; Clinical Global Impressions efficacy) did not improve significantly. St John’s Wort was only modestly effective in the short-term treatment of irritability in some patients with autistic disorder. Copyright (c) 2009 John Wiley & Sons, Ltd.