Obsessive-Compulsive and Related Disorders in Autism Spectrum Disorder

2020 ◽  
pp. 91-113
Author(s):  
Lawrence Scahill ◽  
Andrea N. Evans
Keyword(s):  
Autism Spectrum Disorder ◽  
Psychosocial Functioning ◽  
Treatment Success ◽  
Externalizing Disorders ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Future Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Preliminary Research

Obsessive-compulsive and related disorders (OCRDs) are a group of diagnoses that center on compulsive behaviors and/or obsessive thoughts. They include obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder, excoriation disorder, and trichotillomania. Each of the OCRDs are associated with significant psychosocial impairment and family/caregiver burden. Furthermore, these disorders frequently co-occur with autism spectrum disorder (ASD) traits and diagnoses, and differential diagnosis can be difficult. OCD represents the most common of the OCRDs, and also the most well researched to date. Consequently, this chapter focuses on the nature and impact of comorbid OCD and ASD across the lifespan. Unfortunately, preliminary research indicates that individuals with OCD and ASD are significantly more disadvantaged by way of poorer psychosocial functioning, increased family burden/accommodation to symptoms, greater number of other comorbid conditions, and more likely to present with comorbid externalizing disorders. Future research is needed to determine what impact these unique complexities may have on treatment success. Preliminary research suggests that cognitive behavioral therapy (CBT) is of benefit to these individuals with comorbid ASD and OCD; however, modification may be necessary to improve engagement and outcomes (e.g., family inclusion in therapy). This chapter presents a case example of modified CBT for a child with comorbid ASD and OCD, delivered intensively. Future research should focus on the related OCRDs in individuals with ASD, as well as improving current assessment and treatment practices.

A-90 Personality Tests in Neuropsychological Assessment: Determining the Presence of Psychotic and Obsessive Compulsive Disorders in 3 Individuals with Autism Spectrum Disorder

2021 ◽  
Vol 36 (6) ◽  
pp. 1137-1137
Author(s):  
Kathleen Torsney
Keyword(s):  
Autism Spectrum Disorder ◽  
Psychiatric Disorders ◽  
Case Studies ◽  
Correct Diagnosis ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Future Research ◽  
Obsessive Compulsive ◽  
Personality Tests ◽  
Compulsive Disorder

Abstract Objective The assessment of personality and psychopathology in an individual who has symptoms of autism spectrum disorder (ASD) can be a challenging task due to the overlap of characteristic behaviors associated with ASD and markers of psychopathology. Through the examination of key factors in 3 case studies of neuropsychological assessments, this poster outlines steps to facilitate the correct diagnosis of psychiatric disorders in persons with autism spectrum disorder. Method This poster explores 3 case studies in which an individual exhibited signs of a psychiatric disorder as well as ASD. The author describes how the personality tests such as the MMPI-2 and MMPI-RF were administered and interpreted and how case history and test taking behavior affected the understanding of the results. Results The poster highlights critical factors in differentiating psychiatric disorders and symptoms that are part of the ASD. For example, in all 3 case studies, the individuals had significant difficulty with the computerized version of the test and needed to take it with paper and pencil. The author also outlines examples where the symptoms are manifestations of the ASD, such as perseveration and rigid thinking and when they are attributable to an obsessive–compulsive disorder. Further, the author differentiates signs of psychosis in a person with ASD from the typical tangential and circumstantial speech associated with ASD. Conclusion The author offers suggestions for administering personality tests to persons with ASD, for interpreting the results of the tests, and for conducting future research to facilitate the differentiation between symptoms consistent with ASD and with psychopathology.

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.

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.

A Case Report of Intensive Exposure-Based Cognitive Behavioral Therapy for a Child With Comorbid Autism Spectrum Disorder and Obsessive-Compulsive Disorder

2017 ◽  
Vol 31 (2) ◽  
pp. 118-123
Author(s):  
Katie L. Merricks ◽  
Joshua M. Nadeau ◽  
Amaya Ramos ◽  
Eric A. Storch
Keyword(s):  
Autism Spectrum Disorder ◽  
Cognitive Behavioral Therapy ◽  
Obsessive Compulsive Disorder ◽  
Treatment Modality ◽  
Behavioral Therapy ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Cognitive Behavioral ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) has proven to be an effective treatment modality for children with obsessive-compulsive disorder (OCD). Less research exists demonstrating efficacy for this treatment modality among children with comorbid diagnoses of OCD and autism spectrum disorder (ASD), and virtually, nothing has been reported examining intensive interventions for the most severe cases. As such, this article discusses the treatment of an adolescent male with severe OCD comorbid with ASD, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), and chronic tic disorder using a cognitive behavioral approach and ERP. We conclude with recommendations for continued clinical research to understand approaches to help nonresponders to standard therapeutic approaches with this challenging population.

scholarly journals Co‑occurring Obsessive‑compulsive Disorder, Autism Spectrum Disorder and Intellectual Disability: A Case Report

2021 ◽  
pp. 31-34
Author(s):  
Márcia Rodrigues ◽  
Alexandre Gomes ◽  
Emanuel Santos ◽  
Zélia Figueiredo
Keyword(s):  
Autism Spectrum Disorder ◽  
Intellectual Disability ◽  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Integrative Approach ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Wide Range

Autism spectrum disorders encompass a wide range of clinical presentations, including obsessive‑compulsive symptoms. The comorbidity between these disorders is significant, and it has therapeutic and prognostic implications. While there are a few references on the approach of such comorbid presentations, the literature is even scarcer when this co‑occurrence is superimposed on individuals with intellectual disability. We present the case of a 43‑years‑old male patient with comorbid treatment refractory obsessive‑compulsive disorder, autism spectrum disorder and intellectual disability, exhibiting subacute symptomatic recurrence including hetero‑aggressive outbursts and contamination obsessions. The phenomenological features and therapeutic strategies are discussed, highlighting the centrality of a patient‑centered and methodologically pluralistic approach. Symptomatic remission was achieved employing high end doses of fluvoxamine and haloperidol, alongside daily psychotherapy involving both symptom‑directed behavioral therapy and supportive psychodynamic techniques. An integrative approach may be the best option in the stabilization of complex cases as the one presented.

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