1. Black CJ, Hogan AL, Smith KD, Roberts JE. Early behavioral and physiological markers of social anxiety in infants with fragile X syndrome. Journal of neurodevelopmental disorders. 2021; 13(1): 11.

BACKGROUND: Social anxiety is highly prevalent in neurotypical children and children with fragile X syndrome (FXS). FXS is a genetic syndrome that is characterized by intellectual disability and an increased risk for autism spectrum disorder. If social anxiety is left untreated, negative outcomes are highly prevalent later in life. However, early detection of social anxiety is challenging as symptoms are often subtle or absent very early in life. Given the prevalence and impairment associated with childhood social anxiety, efforts have accelerated to identify risk markers of anxiety. A cluster of early features of anxiety have been identified including elevated behavioral inhibition, attentional biases, and physiological dysregulation that index early emerging markers of social anxiety. Infants with FXS provide a unique opportunity to study the earlier predictors of social anxiety. The current study utilized a multi-method approach to investigate early markers of social anxiety in 12-month-old infants with FXS. METHOD: Participants included 32 infants with FXS and 41 low-risk controls, all approximately 12 months old. Parent-reported social behavioral inhibition was recorded from the Infant Behavior Questionnaire (IBQ-R). Direct observations of behavioral inhibition and attention were measured during a stranger approach task with respiratory sinus arrhythmia collected simultaneously. RESULTS: Parent-reported social behavioral inhibition was not significantly different between groups. In contrast, direct observations suggested that infants with FXS displayed elevated behavioral inhibition, increased attention towards the stranger, and a blunted respiratory sinus arrhythmia response. CONCLUSIONS: Findings suggest that infants with FXS show both behavioral and physiological markers of social anxiety at 12 months old using a biobehavioral approach with multiple sources of input. Results highlight the importance of a multi-method approach to understanding the complex early emergent characteristics of anxiety in infants with FXS.

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2. Canals-Sans J, Esteban-Figuerola P, Morales-Hidalgo P, Arija V. Do Children with Autism Spectrum Disorders Eat Differently and Less Adequately than Those with Subclinical ASD and Typical Development? EPINED Epidemiological Study. Journal of autism and developmental disorders. 2022; 52(1): 361-75.

Food consumption in children with ASD, subclinical ASD and with typical development (TD), and their adequacy to dietary recommendations was studied. A school population sample of 77 children with ASD, 40 with subclinical ASD, and 333 with TD participated. Compared to children with TD, pre-schoolers with ASD consumed fewer raw vegetables and less fish and eggs, while primary school children consumed fewer legumes, raw vegetables, citrus fruits, cheese/yogurt and olive oil, and more meat. All groups consumed an excess of sugar but those with ASD consumed even a greater amount than their peers. The higher prevalence of obesity found in primary school children with ASD may be the consequence of a less healthy eating pattern sustained over time.

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3. Keluskar J, Reicher D, Gorecki A, Mazefsky C, Crowell JA. Understanding, Assessing, and Intervening with Emotion Dysregulation in Autism Spectrum Disorder: A Developmental Perspective. Child and adolescent psychiatric clinics of North America. 2021; 30(2): 335-48.

This article provides a comprehensive review of emotion dysregulation (ED) in individuals with autism spectrum disorder (ASD). The authors describe ED from a developmental perspective, and highlight how aberrations in social development and a restricted-repetitive repertoire of behaviors, render individuals with ASD more vulnerable to ED. The article also summarizes how ED in children and adolescents with ASD has been measured and conceptualized in research and clinic settings. Evidence-based pharmacologic and cognitive behavioral interventions targeting ED in ASD are summarized, with a focus on how such approaches are tailored to the developmental needs of individuals with ASD.

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4. Nenadić I, Meller T, Evermann U, Schmitt S, Pfarr JK, Abu-Akel A, Grezellschak S. Subclinical schizotypal vs. autistic traits show overlapping and diametrically opposed facets in a non-clinical population. Schizophrenia research. 2021; 231: 32-41.

BACKGROUND: The overlap of autism spectrum disorder (ASD) and psychosis or schizophrenia spectrum disorders (SSD) has exposed problems central to conceptualising and understanding co-morbidity in psychiatric disorders. METHODS: In the present study, we demonstrate that a deep phenotyping approach aids clarification of both overlapping and diametrically opposed features of ASD and SSD on the level of trait facets. RESULTS: We first show overlap of negative and disorganised (but not positive) features of schizotypy with autistic traits in a sample of n = 376 German non-clinical subjects using multiple psychometric measures of schizotypy (MSS multidimensional schizotypy scale, OLIFE Oxford-Liverpool Inventory of Feelings and Experiences, and SPQ-B schizotypal personality questionnaire – brief) and the AQ autism spectrum quotient, with control measures for affective spectrum pathology (BDI). Findings were then replicated in a French-Swiss sample (n = 264) using MSS, OLIFE, AQ, and in addition the Community Assessment of Psychic Experiences (CAPE). Additional principal component analysis confirmed our finding of the co-existence of both overlapping (loss of function, social communication deficit, and negative schizotypy) as well as diametrically opposed features (AQ attention to detail, positive schizotypy) across the two spectra. Results were validated with Horn’s parallel analyses, affirming two component solutions, and PCA using sample-specific, factor-analysis-derived schizotypy scores. CONCLUSIONS: Providing a framework for multi-dimensional transdiagnostic characterisation of ASD vs. SSD phenotypes we point out overlapping vs. discriminating facets. In addition to the use of novel multidimensional schizotypy scales, it also shows transcultural consistency of findings, and highlights a particular role for the attention to detail AQ subscale.

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5. Waldren LH, Clutterbuck RA, Shah P. Erroneous NICE guidance on autism screening. The lancet Psychiatry. 2021; 8(4): 276-7.

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