Lack of mental flexibility as endophenotype in autism spectrum disorder and obsessive comulsive disorder families

2011 ◽  
Vol 26 (S2) ◽  
pp. 970-970
Author(s):  
V. Goussé ◽  
A. Hagi ◽  
J.-L. Stilgenbauer ◽  
R. Delorme
Keyword(s):  
Autism Spectrum Disorder ◽  
Executive Functions ◽  
Principal Component ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Spectrum Disorder ◽  
Central Coherence ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
First Degree Relatives

IntroductionResults from clinical and molecular genetic studies suggest that autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD) could have a shared pattern of heritability. Among a large number of clinical variables evaluated, obsessive compulsive/repetitive behaviors have been found to be highly correlated among autism probands and their relatives. Empirical evidence from neuropsychological studies suggest that an appropriate model for repetitive behaviours is a deficit of executive functions specifically flexibility. Given the lack of flexibility observed in ASD and OCD probands, we hypothesised that it could represent a shared endophenotype in both families.MethodsSeven cognitive tests belonging to executive functions, central coherence and theory of mind were proposed to 58 unaffected first-degree relatives of probands with ASD and 61 unaffected first-degree relatives of OCD patients and compared with 34 healthy controls. A principal component analysis (PCA) was performed.ResultsASD relatives - specifically mothers - performed significantly worse on all the tests than OCD relatives and controls. Moreover, inside the OCD group, female individuals performed significantly worse than males. Finally, the PCA indicate that the cognitive profiles of the ASD relatives and the OCD relatives were similar but distinct from controls.ConclusionLack of cognitive flexibility is observed in ASD and OCD families and might constitute a shared intermediate cognitive phenotype. Our study constitutes an effort to clarify the relationship between ASD and OCD having implications for our nosological understanding of both disorders.

Differentiating Autism Spectrum Disorder and OCD

2017 ◽  
Author(s):  
Robert E. Accordino ◽  
Philip Bartel ◽  
Isobel W. Green ◽  
Christen L. Kidd ◽  
Christopher J. McDougle
Keyword(s):  
Autism Spectrum Disorder ◽  
Autistic Traits ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Spectrum Disorder ◽  
Obsessive Compulsive ◽  
Communicative Behavior ◽  
Compulsive Disorder ◽  
Communication Difficulties ◽  
Social Communicative

This chapter explores the overlapping clinical presentation and shared genetics and neurobiology of autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD). ASD often presents with repetitive behaviors reminiscent of OCD, whereas OCD, at times, can include autistic traits involving social and communication difficulties. This can lead to difficult diagnostic distinctions, which can at times have relevance to treatment. The distinction between compulsions and autistic stereotypies merits particular discussion. Clinical features that should lead to exploration of a diagnosis of ASD include stereotypies such as hand flapping, body rocking or twirling; fixed interests or preoccupations that are ego-syntonic; and impaired social-communicative behavior.

Co-occurrence of Obsessive-Compulsive Disorder and Autism Spectrum Disorder

2021 ◽  
pp. 332-351
Author(s):  
Saashi A. Bedford ◽  
Michelle Hunsche ◽  
Connor M. Kerns
Keyword(s):  
Autism Spectrum Disorder ◽  
Obsessive Compulsive Disorder ◽  
Social Communication ◽  
Neurodevelopmental Disorder ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Spectrum Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Communication Deficits

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and, similar to obsessive-compulsive disorder (OCD), restricted and repetitive behaviors. The restricted, repetitive patterns of behaviors and interests that are characteristic of ASD often resemble the obsessions and compulsions of OCD, which can make it difficult to distinguish or differentiate the two conditions. A common challenge in diagnosing comorbid ASD and OCD is the apparent overlap in symptoms between the two disorders. This chapter discusses the differentiation between OCD and ASD, the assessment and diagnosis of OCD within the context of ASD, and the treatment of this presentation of OCD.

scholarly journals Shared and Disorder-Specific Neurocomputational Mechanisms of Decision-Making in Autism Spectrum Disorder and Obsessive-Compulsive Disorder

2017 ◽  
Vol 27 (12) ◽  
pp. 5804-5816 ◽  
Author(s):  
Christina O Carlisi ◽  
Luke Norman ◽  
Clodagh M Murphy ◽  
Anastasia Christakou ◽  
Kaylita Chantiluke ◽  
...  
Keyword(s):  
Decision Making ◽  
Autism Spectrum Disorder ◽  
Obsessive Compulsive Disorder ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Spectrum Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Neurobiological Substrates ◽  
Comparable Performance

Abstract Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) often share phenotypes of repetitive behaviors, possibly underpinned by abnormal decision-making. To compare neural correlates underlying decision-making between these disorders, brain activation of boys with ASD (N = 24), OCD (N = 20) and typically developing controls (N = 20) during gambling was compared, and computational modeling compared performance. Patients were unimpaired on number of risky decisions, but modeling showed that both patient groups had lower choice consistency and relied less on reinforcement learning compared to controls. ASD individuals had disorder-specific choice perseverance abnormalities compared to OCD individuals. Neurofunctionally, ASD and OCD boys shared dorsolateral/inferior frontal underactivation compared to controls during decision-making. During outcome anticipation, patients shared underactivation compared to controls in lateral inferior/orbitofrontal cortex and ventral striatum. During reward receipt, ASD boys had disorder-specific enhanced activation in inferior frontal/insular regions relative to OCD boys and controls. Results showed that ASD and OCD individuals shared decision-making strategies that differed from controls to achieve comparable performance to controls. Patients showed shared abnormalities in lateral-(orbito)fronto-striatal reward circuitry, but ASD boys had disorder-specific lateral inferior frontal/insular overactivation, suggesting that shared and disorder-specific mechanisms underpin decision-making in these disorders. Findings provide evidence for shared neurobiological substrates that could serve as possible future biomarkers.

scholarly journals Felt but not seen: Observed restricted repetitive behaviors are associated with self-report—but not parent-report—obsessive-compulsive disorder symptoms in youth with autism spectrum disorder

Autism ◽  
2020 ◽  
Vol 24 (4) ◽  
pp. 983-994 ◽  
Author(s):  
Lee A Santore ◽  
Alan Gerber ◽  
Ayla N Gioia ◽  
Rebecca Bianchi ◽  
Fanny Talledo ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Obsessive Compulsive Disorder ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Spectrum Disorder ◽  
Self Report ◽  
Obsessive Compulsive ◽  
Restricted And Repetitive Behaviors ◽  
Compulsive Disorder ◽  
The Difference

Repetitive behaviors are observed in autism spectrum disorder and obsessive-compulsive disorder. Clinically, obsessive-compulsive disorder obsessions are thought to drive repetitive or ritualistic behavior designed to neutralize subjective distress, while restricted and repetitive behaviors are theorized to be reward- or sensory-driven. Both behaviors are notably heterogeneous and often assessed with parent- or clinician-report, highlighting the need for multi-informant, multi-method approaches. We evaluated the relationship between parent- and child self-reported obsessive-compulsive disorder symptoms with parent-reported and clinician-indexed restricted and repetitive behaviors among 92 youth with autism spectrum disorder (ages 7–17 years). Regression analyses controlling for the social communication and interaction component of parent-reported autism spectrum disorder symptoms indicated child self-reported, but not parent-reported, symptoms of obsessive-compulsive disorder were associated with clinician-observed restricted and repetitive behaviors. Although both parent- and child self-reported obsessive-compulsive disorder symptoms were associated with parent-reported restricted and repetitive behaviors, the overlap between parent-reports of obsessive-compulsive disorder symptoms and restricted and repetitive behaviors were likely driven by their shared method of parent-reported measurement. Results suggest that children experience restricted and repetitive behaviors in ways that more closely resemble traditional obsessive-compulsive disorder-like compulsions, whereas their parents view such behaviors as symptoms of autism spectrum disorder. These findings provide guidance for better understanding, distinguishing, and ultimately treating obsessive-compulsive disorder behavior in youth with autism spectrum disorder and introduce new conceptualizations of the phenotypic overlap between these conditions. Lay abstract Youth with autism spectrum disorder often exhibit symptoms of obsessive-compulsive disorder; however, it can be difficult for parents and clinicians to tell the difference between the restricted and repetitive behaviors often seen in autism spectrum disorder and symptoms of obsessive-compulsive disorder. This difficulty in distinguishing symptoms may arise from the fact that these symptoms appear the same to observers but are typically differentiated based on whether the motivation for the behavior is to reduce stress (restricted and repetitive behaviors) or whether the behavior itself is stressful (obsessive-compulsive disorder). It is important to know the difference between these two symptoms as it may impact the treatment prescribed. The goal of this study was to better determine the difference between restricted and repetitive behaviors and symptoms of obsessive-compulsive disorder in youth with autism spectrum disorder. It was found that although parents and clinicians had trouble differentiating between the two, the children were able to provide insight as to their own motivations for behavior, and thus whether they were restricted and repetitive behaviors or symptoms of obsessive-compulsive disorder. It was also found that children may actually have subjective negative experiences when engaging in restricted and repetitive behaviors, which complicates their classification. These results provide guidance for better understanding, distinguishing, and ultimately treating obsessive-compulsive disorder behavior in youth with autism spectrum disorder.

scholarly journals Disentangling Restrictive and Repetitive Behaviors and Social Impairments in Children and Adolescents with Gilles de la Tourette Syndrome and Autism Spectrum Disorder

2020 ◽  
Vol 10 (5) ◽  
pp. 308 ◽  
Author(s):  
Mariangela Gulisano ◽  
Rita Barone ◽  
Salvatore Alaimo ◽  
Alfredo Ferro ◽  
Alfredo Pulvirenti ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Children And Adolescents ◽  
Tourette Syndrome ◽  
Rating Scale ◽  
Large Population ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Spectrum Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Gilles de la Tourette syndrome (GTS) and autism spectrum disorder (ASD) are two neurodevelopmental disorders with male predominance, frequently comorbid, that share clinical and behavioral features. The incidence of ASD in patients affected by GTS was reported to be between 2.9% and 22.8%. We hypothesized that higher ASD rates among children affected by GTS previously reported may be due to difficulty in discriminating GTS sub-phenotypes from ASD, and the higher scores in the restrictive and repetitive behaviors in particular may represent at least a “false comorbidity”. We studied a large population of 720 children and adolescents affected by GTS (n = 400) and ASD (n = 320), recruited from a single center. Patients were all assessed with The Yale Global Tic Severity Rating Scale (YGTSS), The Autism Diagnostic Observation Schedule (ADOS), The Autism Diagnostic Interview Revised (ADI-R), The Children’s Yale–Brown Obsessive–Compulsive Scale (CY-BOCS), and The Children’s Yale–Brown Obsessive–Compulsive Scale for autism spectrum disorder (CY-BOCS ASD). Our results showed statistically significant differences in ADOS scores for social aspects between GTS with comorbid attention deficit hyperactivity disorder (ADHD) and obsessive–compulsive disorder (OCD) sub-phenotypes and ASD. No differences were present when we compared GTS with comorbid ASD sub-phenotype to ASD, while repetitive and restrictive behavior scores in ASD did not present statistical differences in the comparison with GTS and comorbid OCD and ASD sub-phenotypes. We also showed that CY-BOCS ASD could be a useful instrument to correctly identify OCD from ASD symptoms.

Adapted cognitive behavior therapy for obsessive–compulsive disorder with co-occurring autism spectrum disorder: A clinical effectiveness study

Autism ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 190-199
Author(s):  
Oskar Flygare ◽  
Erik Andersson ◽  
Helene Ringberg ◽  
Anna-Clara Hellstadius ◽  
Johan Edbacken ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Cognitive Behavior ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Obsessive–compulsive disorder and autism spectrum disorder commonly co-occur. Adapted cognitive behavior therapy for obsessive–compulsive disorder in adults with autism spectrum disorder has not previously been evaluated outside the United Kingdom. In this study, 19 adults with obsessive–compulsive disorder and autism spectrum disorder were treated using an adapted cognitive behavior therapy protocol that consisted of 20 sessions focused on exposure with response prevention. The primary outcome was the clinician-rated Yale–Brown Obsessive–Compulsive Scale. Participants were assessed up to 3 months after treatment. There were significant reductions on the Yale–Brown Obsessive–Compulsive Scale at post-treatment (d = 1.5), and improvements were sustained at follow-up (d = 1.2). Self-rated obsessive–compulsive disorder and depressive symptoms showed statistically significant reductions. Improvements in general functioning and quality of life were statistically non-significant. Three participants (16%) were responders at post-treatment and four (21%) were in remission from obsessive–compulsive disorder. At follow-up, three participants (16%) were responders and one (5%) was in full remission. Adapted cognitive behavior therapy for obsessive–compulsive disorder in adults with co-occurring autism spectrum disorder is associated with reductions in obsessive–compulsive symptoms and depressive symptoms. However, outcomes are modest; few patients were completely symptom free, and treatment engagement was low with few completed exposures and low adherence to homework assignments. We identify and discuss the need for further treatment refinement for this vulnerable group.

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