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.

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.

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.

scholarly journals Gaze to faces across interactive contexts in infants at heightened risk for autism

Autism ◽  
2017 ◽  
Vol 22 (6) ◽  
pp. 763-768 ◽  
Author(s):  
Devon N Gangi ◽  
AJ Schwichtenberg ◽  
Ana-Maria Iosif ◽  
Gregory S Young ◽  
Fam Baguio ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Social Partner ◽  
Infant Behavior ◽  
Gaze Behavior ◽  
Communicative Behavior ◽  
The Face ◽  
High Risk Infants ◽  
Social Communicative

Infant social-communicative behavior, such as gaze to the face of an interactive partner, is an important early developmental skill. Children with autism spectrum disorder exhibit atypicalities in social-communicative behavior, including gaze and eye contact. Behavioral differences in infancy may serve as early markers of autism spectrum disorder and help identify individuals at highest risk for developing the disorder. Researchers often assess social-communicative behavior in a single interactive context, such as during assessment with an unfamiliar examiner or play with a parent. Understanding whether infant behavior is consistent across such contexts is important for evaluating the validity of experimental paradigms and the generalizability of findings from one interactive context/partner to another. We examined infant gaze to the face of a social partner at 6, 9, and 12 months of age in infants who were later diagnosed with autism spectrum disorder, as well as low- and high-risk infants without autism spectrum disorder outcomes, across two interactive contexts: structured testing with an unfamiliar examiner and semi-structured play with a parent. By 9 months, infant gaze behavior was significantly associated between the two contexts. By 12 months, infants without autism spectrum disorder outcomes exhibited higher mean rates of gaze to faces during parent–child play than Mullen testing, while the gaze behavior of the autism spectrum disorder group did not differ by context—suggesting that infants developing autism spectrum disorder may be less sensitive to context or interactive partner. Findings support the validity of assessing infant social-communicative behavior during structured laboratory settings and suggest that infant behavior exhibits consistency across settings and interactive partners.

Gastrointestinal problems are associated with increased repetitive behaviors but not social communication difficulties in young children with autism spectrum disorders

Autism ◽  
2020 ◽  
pp. 136236132095950
Author(s):  
Payal Chakraborty ◽  
Kimberly L H Carpenter ◽  
Samantha Major ◽  
Megan Deaver ◽  
Saritha Vermeer ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Symptom Severity ◽  
Gastrointestinal Symptom ◽  
Gastrointestinal Symptoms ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Spectrum Disorder ◽  
Behavioral Symptoms ◽  
Behavioral Symptom ◽  
Communication Difficulties

Individuals with autism spectrum disorder are more likely than typically developing individuals to experience a range of gastrointestinal abnormalities, including chronic diarrhea, constipation, food sensitivities, and abdominal pain. These gastrointestinal symptoms have been associated with higher levels of irritability and aggressive behavior, but less is known about their relationship with core autism spectrum disorder symptoms. We investigated the relationship between autism spectrum disorder and gastrointestinal symptom severity while accounting for three associated behavioral symptom domains (Irritability, Aggressiveness, and Specific Fears), in a sample of 176 children (140 males and 36 females) ages 2–7 years old with autism spectrum disorder. Most participants had at least one reported gastrointestinal symptom (93.2%) and had more than one gastrointestinal symptom (88.1%). After accounting for each associated behavioral symptom domain, repetitive behaviors and stereotypies were positively associated with gastrointestinal symptom severity. Social and communication difficulties were not significantly associated with gastrointestinal symptom severity after accounting for associated behavioral symptoms. Our findings replicate a previously described association between irritability and aggression and gastrointestinal symptoms. Furthermore, gastrointestinal symptom severity is associated with repetitive behaviors, a subset of core autism spectrum disorder symptoms. This suggests that gastrointestinal symptoms may exacerbate repetitive behaviors, or vice versa, independent from other associated behavioral symptoms. Lay Abstract Individuals with autism spectrum disorder are more likely than typically developing individuals to experience a range of gastrointestinal abnormalities, including chronic diarrhea, constipation, food sensitivities, and abdominal pain. These gastrointestinal symptoms have been associated with higher levels of irritability and aggressive behavior, but less is known about their relationship with core autism spectrum disorder symptoms. We investigated the relationship between autism spectrum disorder symptom severity and gastrointestinal symptoms while accounting for three associated behavioral symptom domains (Irritability, Aggressiveness, and Specific Fears), in a sample of 176 children (140 males and 36 females) ages 2–7 years old with autism spectrum disorder. A large majority (93.2%) of the sample had at least one reported gastrointestinal symptom, and most (88.1%) participants had more than one gastrointestinal symptom. Various types of gastrointestinal symptoms were reported; the most common symptoms reported were constipation, food limits, gas/bloating, and stomach pain. After accounting for each associated behavioral symptom domain, repetitive behaviors and stereotypies were significantly associated with gastrointestinal symptom severity. Increased severity of autism spectrum disorder symptoms was correlated with increased gastrointestinal symptom severity. Social and communication difficulties were not significantly associated with gastrointestinal symptom severity after accounting for associated behavioral symptoms. Our findings replicate a previously described association between irritability and aggression and gastrointestinal symptoms. Furthermore, we found that repetitive behaviors, but not social or communication symptoms, are associated with gastrointestinal symptom severity, even after accounting for associated behavioral symptoms. This suggests that gastrointestinal symptoms may exacerbate repetitive behaviors, or vice versa, independent from other associated behavioral symptoms.

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