1. Chan EHC, Kong SDX, Park SH, Song YJC, Demetriou EA, Pepper KL, Glozier N, Hickie IB, Guastella AJ. {{Validation of the social functioning scale: Comparison and evaluation in early psychosis, autism spectrum disorder and social anxiety disorder}}. {Psychiatry Res}. 2019; 276: 45-55.
Social functioning is an important component of mental disorders for assessment and treatment. There is no recognised self-report instrument to measure social functioning across disorders where social impairment is significant. The Social Functioning Scale (SFS) has, however, been used to assess social functioning in psychotic disorders, including Schizophrenia and Early Psychosis. The current study investigated the reliability, validity and sensitivity of the SFS in Early Psychosis, Autism Spectrum Disorder (ASD), Social Anxiety Disorder (SAD) and neurotypical control populations. As expected, all clinical groups showed significant impairment on the total and sub-scale scores of the SFS. The SFS showed good internal consistency and concurrent validity for people diagnosed with SAD and Early Psychosis and a similar factors structure was found for these groups. Participants with ASD reported a relatively low internal consistency and poor concurrent validity, as well as a three-component solution. The SFS has also showed a good sensitivity to separate clinical populations and neurotypical controls. This study supports the use of the SFS for those with SAD and Early Psychosis. Lower internal consistency in ASD populations suggests further research in larger samples is required and that the relationship between its scales are likely different to other populations. Alternative scales or significant other reports may be required for adults with ASD.
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2. Cresswell L, Cage E. {{‘Who Am I?’: An Exploratory Study of the Relationships Between Identity, Acculturation and Mental Health in Autistic Adolescents}}. {J Autism Dev Disord}. 2019.
Autistic adolescents are at increased risk of mental health difficulties. One potential factor contributing to this is identity development, although this hypothesis has been little explored. These adolescents also have to consider how autism forms their identity, a process called acculturation. This exploratory study examined the relationships between identity, acculturation and mental health in autistic adolescents. Twenty-four participants completed measures investigating identity, acculturation and mental health. Findings suggested mental health was not related to personal identity. Mental health scores did not differ between acculturation groups, however those aligned to non-autistic culture tended to generate more positive self-statements than those aligned to neither culture. These findings suggest autistic adolescents should be encouraged to explore autistic culture and supported in constructing their identity.
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3. Dell’Osso L, Carpita B, Muti D, Morelli V, Salarpi G, Salerni A, Scotto J, Massimetti G, Gesi C, Ballerio M, Signorelli MS, Luciano M, Politi P, Aguglia E, Carmassi C, Maj M. {{Mood symptoms and suicidality across the autism spectrum}}. {Comprehensive psychiatry}. 2019.
BACKGROUND: Autism spectrum is a psychopathological dimension which encompasses a wide range of clinical presentations: from subthreshold forms and autistic traits (AT), that can be found in the general population, to full-blown autism spectrum disorder (ASD). Many studies reported high rates of comorbidity between both ASD and AT and mood disorders, as well as a high prevalence of suicidal ideation among patients with ASD/AT. The aim of this study was to investigate the presence of mood symptoms and suicidal ideation and behaviors in patients with full-blown ASD and in subjects with AT, as well in a healthy control (HC) group, with a specific focus on which of the autistic features may be predictive of suicidal ideation and behaviors. METHODS: We recruited 262 adult subjects: 34 with ASD without intellectual impairment or language disability (ASD group), 68 fulfilling only one symptom criterion for ASD according to DSM-5 but who do not meet criteria for a full-blown diagnosis of ASD (AT group), and 160 HC. All subjects were assessed with the Structured Clinical Interview for DSM-5 (SCID-5); in addition, they were asked to fill two questionnaires: The Mood Spectrum, Self-report (MOODS-SR) and the Adult Autism Subthreshold Spectrum (AdAS Spectrum). RESULTS: ASD subjects reported significantly higher AdAS Spectrum and MOODS-SR total scores, as well as higher MOODS-SR depressive component total scores, when compared with AT and HC subjects. AT subjects scored significantly higher than the HC group. No significant differences were reported between ASD and AT subjects for the suicidality score according to MOODS-SR, despite both groups scored significantly higher than the HC group. The strongest predictor of suicidality score were MOODS-SR depressive component score and AdAS Spectrum Restricted interests and rumination domain score. CONCLUSIONS: Our results highlight a correlation between autism and mood spectrum, as well as between suicidality and both ASD and AT. Subthreshold forms of ASD should be accurately investigated due to their relationship with suicidal thoughts and behaviors.
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4. Godfrey Born C, McClelland A, Furnham A. {{Mental health literacy for autism spectrum disorder and depression}}. {Psychiatry Res}. 2019.
In this study, three hundred and sixty-eight participants answered a questionnaire consisting of three vignettes describing a person with depression, severe Autism Spectrum Disorder (ASD), and high-functioning Autism Spectrum Disorder/Asperger’s Syndrome (AS). Each vignette was followed by thirteen questions concerning the participant’s knowledge about diagnosis, treatment, and prognosis. Participants demonstrated good mental health literacy (MHL) for depression, but were poor at diagnosing ASD. Drug therapy was rated as the least effective treatment and ‘talking to a family member of friend’ was rated as the most effective for each disorder. The highest prognosis ratings were given to depression, and the lowest given to ASD. Participants demonstrated better MHL than expected, possibly due to the availability of information on the Internet and the increase in prevalence of mental illnesses such as depression and ASD among the general population.
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5. Pantazakos T. {{Treatment for whom? Towards a phenomenological resolution of controversy within autism treatment}}. {Studies in history and philosophy of biological and biomedical sciences}. 2019.
Autism’s mainstream, behavioural treatment has recently faced allegations from neurodiversity activists, who claim that behaviourism is methodologically faulted and in serious breach of patient consent and human rights. In the present paper, I delve into this mounting controversy to suggest, contra behaviourism, that people with autism diagnoses do not just display a divergent set of behaviours, but should be seen to operate in ‘worlds’ different to those in typical neurological conditions. To philosophically accommodate this difference in ‘worlds’ and to utilise it in thinking about treatment orientation, I use Edmund Husserl’s concept of the life-world (lebenswelt). I proffer that the autistic life-worlds should be used as the basis of treatment evaluation. I suggest that phenomenological ways of approaching autism, currently understudied, should be further developed and that behavioural treatment should be accordingly ‘filtered’ to accommodate the autistic life-worlds, and with them certain criticisms from neurodiversity.
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6. Smith CJ, Bhanot A, Norman E, Mullett JE, Bilbo SD, McDougle CJ, Zurcher NR, Hooker JM. {{A Protocol for Sedation Free MRI and PET Imaging in Adults with Autism Spectrum Disorder}}. {J Autism Dev Disord}. 2019.
Imaging technologies such as positron emission tomography (PET) and magnetic resonance imaging (MRI) present unparalleled opportunities to investigate the neural basis of autism spectrum disorder (ASD). However, challenges such as deficits in social interaction, anxiety around new experiences, impaired language abilities, and hypersensitivity to sensory stimuli make participating in neuroimaging studies challenging for individuals with ASD. In this commentary, we describe the existent training protocols for preparing individuals with ASD for PET/MRI scans and our own experience developing a training protocol to facilitate the inclusion of low-functioning adults with ASD in PET-MRI studies. We hope to raise awareness of the need for more information exchange between research groups about lessons learned in this context in order to include the entire disease spectrum in neuroimaging studies.
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7. Utzerath C, Schmits IC, Kok P, Buitelaar J, de Lange FP. {{No evidence for altered up- and downregulation of brain activity in visual cortex during illusory shape perception in autism}}. {Cortex}. 2019; 117: 247-56.
Autism spectrum disorder (ASD) may be marked by an altered balance between sensory input and prior expectations. Because many illusions rely on integrating sensory input with prior information such as spatial context, individuals with ASD may therefore be less susceptible to visual illusions than typically developing (TD) individuals. Yet empirical evidence on the matter is rather divergent, varying depending on the type of illusion, study procedure, and population. Visual illusions lead to neural activity alterations in the visual system. In the so-called Kanizsa illusion, these are likely caused by top-down feedback to V1. Here we tested the hypothesis that a reduced susceptibility to illusions in ASD would manifest as diminished modulation of V1 activity by illusions, using functional magnetic resonance imaging (fMRI). We presented 22 adolescents with ASD and 22 age-, gender-, and intelligence-matched TD controls with displays that consisted of three circular inducers. These either formed an illusory triangle (Kanizsa illusion) or not. We identified regions in primary visual cortex (V1) that corresponded to (the visual field locations of) the illusory triangle and its inducers, and recorded their visual response. Previous research in healthy volunteers has shown a specific pattern of up- and down-regulation in regions of V1 that process the shape and inducers, respectively. Here, we replicated this pattern of up- and downregulation in V1, in both the TD and ASD groups, with no differences between groups. This suggests that illusory shape processing in primary visual cortex is equally present in ASD, suggesting unimpaired processing of spatial context.
