1. Brosnan M, Gavin J. The impact of higher levels of autistic traits on risk of hikikomori (pathological social withdrawal) in young adults. PLoS One;2023;18(2):e0281833.

BACKGROUND: Hikikomori is an extreme state of social withdrawal, originally identified in Japan but more recently recognised internationally. Many countries imposed restrictions during the COVID-19 pandemic which may have had a detrimental impact on those at risk of hikikomori, specifically young adults and those with high levels of autistic traits. AIMS: To explore whether levels of autistic traits mediate the relationship between psychological wellbeing and hikikomori risk. We also looked at whether autistic traits mediated between lockdown experiences (e.g. not leaving the house) and hikikomori risk. METHODS: 646 young people (aged 16-24) from a wide range of countries completed an online questionnaire assessing psychological wellbeing, autistic traits and experiences of lockdown for this cross-sectional study. RESULTS: Autistic traits mediated the relationship between both psychological wellbeing and hikikomori risk, as well as frequency of leaving the house during lockdown and hikikomori risk. Greater hikikomori risk was associated with poor psychological wellbeing, higher autistic traits and leaving the house less frequently during the COVID-19 pandemic. CONCLUSIONS: These findings suggest similarities with Japanese hikikomori research and are consistent with suggestions that psychological wellbeing and COVID-19 restrictions are associated with increased hikikomori risk in young adults, and both associations are mediated by higher levels of autistic traits.

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2. Correia BSB, de Moraes Pontes JG, Nani JVS, Villalta F, Mor NC, Bordini D, Brunoni D, Brentani H, Mari JJ, Hayashi MAF, Tasic L. (1)H NMR Metabolomics and Lipidomics To Monitor Positive Responses in Children with Autism Spectrum Disorder Following a Guided Parental Intervention: A Pilot Study. ACS Chem Neurosci;2023 (Feb 21)

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that is characterized by patients displaying at least two out of the classical symptoms, such as impaired social communication, impaired interactions, and restricted repetitive behavior. Early parent-mediated interventions, such as video modeling for parental training, were demonstrated to be a successful low-cost way to deliver care for children with ASD. Nuclear magnetic resonance (NMR)-based metabolomics/lipidomics has been successfully employed in several mental disorder studies. Metabolomics and lipidomics of 37 ASD patients (children, aged 3-8 years), who were divided into two groups, one control group with no parental-training intervention (N = 18) and the other in which the parents were trained by a video modeling intervention (ASD parental training, N = 19), were analyzed by proton NMR spectroscopy. Patients in the ASD parental-training group sera were seen to have increased glucose, myo-inositol, malonate, proline, phenylalanine, and gangliosides in their blood serum, while cholesterol, choline, and lipids were decreased, compared to the control group, who received no parental-training. Taken together, we demonstrated here significant changes in serum metabolites and lipids in ASD children, previously demonstrated to show clinical positive effects following a parental training intervention based on video modeling, delivered over 22 weeks. We demonstrate the value of applying metabolomics and lipidomics to identify potential biomarkers for clinical interventions follow-up in ASD.

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3. Keesler JM, Purcell A, Thomas-Giyer J. Advancing trauma-informed care in intellectual and developmental disability services: A pilot study of a digital training with direct service providers. J Appl Res Intellect Disabil;2023 (Feb 21)

BACKGROUND: As trauma-informed care advances in the service delivery system for people with intellectual and developmental disabilities, additional resources are needed to foster staff development. This article describes the development and pilot evaluation of a digital training on trauma-informed care among direct service providers (DSPs) in the disability service industry. METHOD: Following an AB design, a mixed methods approach was used to analyse the responses of 24 DSPs to an online survey at baseline and at follow-up. RESULTS: The training was associated with increased staff knowledge in some domains and greater alignment with trauma-informed care. Staff expressed a strong likelihood of using trauma-informed care in practice and identified organisational assets and barriers to implementation. CONCLUSIONS: Digital trainings can facilitate staff development and the advancement of trauma-informed care. Although additional efforts are warranted, this study fills a gap in the literature regarding staff training and trauma-informed care.

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4. Lee SH, Lee S, Kang H, Lee J, Lee WS. Increased Risk of Alopecia Areata in Patients with Autism Spectrum Disorders: A Korean Nationwide Population-based Study. J Am Acad Dermatol;2023 (Feb 21)

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5. Shields RH, Kaat A, Sansone SM, Michalak C, Coleman J, Thompson T, McKenzie FJ, Dakopolos A, Riley K, Berry-Kravis E, Widaman KF, Gershon RC, Hessl D. Sensitivity of the NIH Toolbox to Detect Cognitive Change in Individuals With Intellectual and Developmental Disability. Neurology;2023 (Feb 21);100(8):e778-e789.

BACKGROUND AND OBJECTIVE: Individuals with intellectual disability (ID) experience protracted cognitive development compared with typical youth. Sensitive measurement of cognitive change in this population is a critical need for clinical trials and other intervention studies, but well-validated outcome measures are scarce. This study’s aim was to evaluate the sensitivity of the NIH Toolbox Cognition Battery (NIHTB-CB) to detect developmental changes in groups with ID-fragile X syndrome (FXS), Down syndrome (DS), and other ID (OID)-and to provide further support for its use as an outcome measure for treatment trials. METHODS: We administered the NIHTB-CB and a reference standard cross-validation measure (Stanford-Binet Intelligence Scales, Fifth Edition [SB5]) to 256 individuals with FXS, DS, and OID (ages 6-27 years). After 2 years of development, we retested 197 individuals. Group developmental changes in each cognitive domain of the NIHTB-CB and SB5 were assessed using latent change score models, and 2-year growth was evaluated at 3 age points (10, 16, and 22 years). RESULTS: Overall, effect sizes of growth measured by the NIHTB-CB tests were comparable with or exceeded those of the SB5. The NIHTB-CB showed significant gains in almost all domains in OID at younger ages (10 years), with continued gains at 16 years and stability in early adulthood (22 years). The FXS group showed delayed gains in attention and inhibitory control compared with OID. The DS group had delayed gains in receptive vocabulary compared with OID. Unlike the other groups, DS had significant growth in early adulthood in 2 domains (working memory and attention/inhibitory control). Notably, each group’s pattern of NIHTB-CB growth across development corresponded to their respective pattern of SB5 growth. DISCUSSION: The NIHTB-CB is sensitive to developmental changes in individuals with ID. Comparison with levels and timing of growth on the cross-validation measure shows that the NIHTB-CB has potential to identify meaningful trajectories across cognitive domains and ID etiologies. Sensitivity to change within the context of treatment studies and delineation of clinically meaningful changes in NIHTB-CB scores, linked to daily functioning, must be established in future research to evaluate the battery more completely as a key outcome measure.

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6. Yang Y, Jiang L, He R, Song P, Xu P, Wang Y, Li F. Repetitive transcranial magnetic stimulation modulates long-range functional connectivity in autism spectrum disorder. J Psychiatr Res;2023 (Feb 21);160:187-194.

Repetitive transcranial magnetic stimulation (rTMS) is growingly applied in autism spectrum disorder (ASD) due to its potential therapeutic value, however, its effects on functional network configuration and the mechanism underlying clinical improvement are still unclear. In this study, we examined the alternations of functional connectivity induced by rTMS using resting-state electroencephalogram (EEG) in children with ASD. Resting-state EEG was obtained from 24 children with ASD before and after rTMS intervention and from 24 age- and gender-matched typically developing (TD) children. The rTMS intervention course consisted of five 5-s trains at 15 Hz, with 10-min inter-train intervals, on the left parietal lobe each consecutive weekday for 3 weeks (15 sessions in total). Children with ASD showed significantly hypo-connected networks and sub-optimal network properties at both global and local levels, compared with TD peers. After rTMS intervention, long-range intra- and inter-hemispheric connections were significantly promoted, especially those within the alpha band. Meanwhile, network properties at both local and global levels were greatly promoted in the delta, theta, and alpha bands. Consistent with the changes in the network connectivities and properties, the core symptoms in ASD were also relieved measured by clinical scales after treatment. The findings of this study demonstrate that high-frequency rTMS over the parietal lobe is potentially an effective strategy to improve core symptoms by enhancing long-range connectivity reorganization in ASD.

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