scholarly journals Autism and Chronic Ill Health: An Observational Study of Symptoms and Diagnoses of Central Sensitivity Syndromes in Autistic Adults

2021 ◽  
Author(s):  
Sarah Louise Grant ◽  
Sam Norton ◽  
Ricarda F. Weiland ◽  
Anke M. Scheeren ◽  
Sander Begeer ◽  
...  
Keyword(s):  
Mental Health ◽  
Reliability And Validity ◽  
Autistic Traits ◽  
Hierarchical Regression ◽  
Control Group ◽  
Physical And Mental Health ◽  
Sensory Sensitivity ◽  
Confirmatory Factor Analyses ◽  
The Central Nervous System ◽  
Autistic Adults

Abstract Background Autistic adults, particularly women, are more likely to experience chronic ill health than the general population. Central sensitivity syndromes (CSS) are a group of related conditions that are thought to include an underlying sensitisation of the central nervous system; heightened sensory sensitivity is a common feature. Anecdotal evidence suggests autistic adults may be more prone to developing a CSS. This study aimed to investigate the occurrence of CSS diagnoses and symptoms in autistic adults, and to explore whether CSS symptoms were related to autistic traits, mental health, sensory sensitivity, or sex. MethodsParticipants included 982 autistic adults (male = 409, female = 563, other = 9, mean age = 44.5) registered at the Netherlands Autism Register, who completed questionnaires assessing autistic traits, sensory sensitivity, CSS, physical and mental health symptoms. The reliability and validity of the Central Sensitization Inventory (CSI) in an autistic sample was established using exploratory and confirmatory factor analyses. Chi2 analyses, independent t-tests, ANOVA, hierarchical regression analysis and path analysis were used to analyse relationships between CSS symptoms, autistic traits, measures of mental health and wellbeing, sensory sensitivity, age and assigned sex. Results21% of participants reported one or more CSS diagnoses, and 60% scored at or above the clinical cut-off for a CSS. Nonbinary and female autistics were more likely to report a CSS diagnosis and experienced more CSS symptoms than males. Sensory sensitivity, anxiety, age and sex were significant predictors of CSS symptoms, with sensory sensitivity and anxiety fully mediating the relationship between autistic traits and CSS symptoms. Limitations Although this study included a large sample of autistic adults, we did not have a control group or a CSS only group. ConclusionsCSS diagnoses and symptoms appear to be very common in the autistic population. Increased awareness of an association between autism and CSS should inform clinicians and guide diagnostic practice, particularly for females where CSS is common and autism under recognised.

scholarly journals Autonomic dysfunction in autism: The roles of anxiety, depression, and stress

Autism ◽  
2021 ◽  
pp. 136236132098565
Author(s):  
Emily C Taylor ◽  
Lucy A Livingston ◽  
Mitchell J Callan ◽  
Chris Ashwin ◽  
Punit Shah
Keyword(s):  
Mental Health ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Autistic Traits ◽  
Physical Symptoms ◽  
Autism Spectrum ◽  
Physical And Mental Health ◽  
Autonomic Nervous ◽  
Autistic Adults ◽  
Anxiety Depression

Autism spectrum disorder (ASD) is associated with atypical autonomic nervous system (ANS) function. However, little is known about this relationship, while accounting for co-occurring mental health conditions (e.g. anxiety) that are also associated with ANS dysfunction. In addition, research on the ANS has typically involved physiological measurements, without using more clinically meaningful measures of ANS dysfunction, such as the self-reported frequency of ANS-related physical health symptoms. Furthermore, very little is known about ANS function in autistic adults, given that previous research has focused on ANS dysfunction in children with ASD. Addressing these gaps in the literature, we compared ANS function in adults with(out) ASD (Study 1). Although autistic adults reported greater ANS dysfunction than matched neurotypical controls, this difference was not significant after controlling for anxiety and depression. Similarly, in a large nonclinical sample (Study 2), we found that anxiety and stress mediated the relationship between autistic traits and ANS dysfunction. Together, we conclude that ANS dysfunction is not a feature of ASD per se, but instead attributable to the high levels of anxiety and stress in autistic adults. We discuss the clinical relevance of these findings for managing ANS dysfunction and other physical and mental health concerns in autistic adulthood. Lay abstract The autonomic nervous system (ANS) is responsible for the functioning of the heart, bladder, pupils and several other bodily functions. Therefore, when the ANS functions abnormally, individuals can experience a number of physical symptoms, including dizziness, abnormal sweating and digestive difficulties. Currently, it is unclear if autistic adults experience ANS dysfunction. Therefore, in this study, we investigated whether autistic adults report more ANS-related physical symptoms, indicating greater ANS dysfunction, and whether this may be related to autism, or rather anxiety, depression, or stress. The findings suggest that ANS dysfunction, where found in autism, is due to co-occurring stress and anxiety. We therefore propose that treating stress and anxiety may be an effective way to ameliorate ANS-related health problems in autistic adults.

Camouflaging in non-autistic adults is associated with poorer mental health

2019 ◽  
Author(s):  
Mark Somerville ◽  
Sarah E. MacPherson ◽  
Sue Fletcher-Watson
Keyword(s):  
Mental Health ◽  
Executive Function ◽  
Autistic Traits ◽  
Self Report ◽  
Linear Regression Models ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Autistic People ◽  
Autistic Adults ◽  
The Relationship

Camouflaging is a frequently reported behaviour in autistic people, which entails the use of strategies to compensate for and mask autistic traits in social situations. Camouflaging is associated with poor mental health in autistic people. This study examined the manifestation of camouflaging in a non-autistic sample, examining the relationship between autistic traits, camouflaging, and mental health. In addition, the role of executive functions as a mechanism underpinning camouflaging was explored. Sixty-three non-autistic adults completed standardised self-report questionnaires which measured: autistic traits, mental health symptoms, and camouflaging behaviours. In addition, a subset (n=51) completed three tests of executive function measuring inhibition, working memory, and set-shifting. Multiple linear regression models were used to analyse data. Results indicated that autistic traits are not associated with mental health symptoms when controlling for camouflaging, and camouflaging predicted increased mental health symptoms. Camouflaging did not correlate with any measure of executive function. These findings have implications for understanding the relationship between autistic traits and mental health in non-autistic people and add to the growing development of theory and knowledge about the mechanism and effects of camouflaging.

scholarly journals Impact of The Daily Mile on children’s physical and mental health, and educational attainment in primary schools: iMprOVE cohort study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045879
Author(s):  
Bina Ram ◽  
Anna Chalkley ◽  
Esther van Sluijs ◽  
Rachel Phillips ◽  
Tishya Venkatraman ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Cohort Study ◽  
Educational Attainment ◽  
Primary School ◽  
Primary Schools ◽  
Intervention Group ◽  
Control Group ◽  
Physical And Mental Health ◽  
School Year

IntroductionSchool-based active mile initiatives such as The Daily Mile (TDM) are widely promoted to address shortfalls in meeting physical activity recommendations. The iMprOVE Study aims to examine the impact of TDM on children’s physical and mental health and educational attainment throughout primary school.Methods and analysisiMprOVE is a longitudinal quasi-experimental cohort study. We will send a survey to all state-funded primary schools in Greater London to identify participation in TDM. The survey responses will be used for non-random allocation to either the intervention group (Daily Mile schools) or to the control group (non-Daily Mile schools). We aim to recruit 3533 year 1 children (aged 5–6 years) from 77 primary schools and follow them up annually until the end of their primary school years. Data collection taking place at baseline (children in school year 1) and each primary school year thereafter includes device-based measures of moderate-to-vigorous physical activity (MVPA) and questionnaires to measure mental health (Strengths and Difficulties Questionnaire) and educational attainment (ratings from ‘below expected’ to ‘above expected levels’). The primary outcome is the mean change in MVPA minutes from baseline to year 6 during the school day among the intervention group compared with controls. We will use multilevel linear regression models adjusting for sociodemographic data and participation in TDM. The study is powered to detect a 10% (5.5 min) difference between the intervention and control group which would be considered clinically significant.Ethics and disseminationEthics has been approved from Imperial College Research Ethics Committee, reference 20IC6127. Key findings will be disseminated to the public through research networks, social, print and media broadcasts, community engagement opportunities and schools. We will work with policy-makers for direct application and impact of our findings.

scholarly journals Assessing the impact of the European resilience curriculum in preschool, early and late primary school children

2021 ◽  
pp. 014303432110250
Author(s):  
Celeste Simões ◽  
Anabela C. Santos ◽  
Paula Lebre ◽  
João R. Daniel ◽  
Cátia Branquinho ◽  
...  
Keyword(s):  
Mental Health ◽  
Intervention Group ◽  
Well Being ◽  
Primary School Children ◽  
Control Group ◽  
Physical And Mental Health ◽  
Quasi Experimental ◽  
Mental Health Difficulties ◽  
Prosocial Behaviours ◽  
The Impact

Resilience is an individual’s ability to adapt successfully to and persevere during and after significant challenges. Resilience programmes based on a socioemotional learning approach have been associated with an increase in protextive factors (e.g., prosocial competencies), improvements in physical and mental health, and a decrease in internalised and externalised symptoms. The present study aimed to evaluate the impact of the RESCUR curriculum implemented in Portuguese schools on students’ academic, behavioural, and socioemotional outcomes, based on child and teacher reports. Participants included 1,084 children (53.2% male) aged 3-15 ( M = 7.24, SD = 2.31). A quasi-experimental study compared outcomes for an experimental intervention group (AIG) with a waiting list control group (WG). The results showed the RESCUR programme decreased mental health difficulties while increasing both prosocial behaviours and well-being. In addition, academic performance increased for those in preschool after implementation. Both teachers and children consistently reported positive behavioural changes in resilience-related competencies after implementing RESCUR. Our findings contribute to the recent research on the potential of RESCUR to address key socioemotional competencies and improve relevant protextive factors. Study limitations and future recommendations are addressed.

scholarly journals Is social camouflaging associated with anxiety and depression in autistic adults?

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Laura Hull ◽  
Lily Levy ◽  
Meng-Chuan Lai ◽  
K. V. Petrides ◽  
Simon Baron-Cohen ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Social Anxiety ◽  
Online Survey ◽  
Mental Health Problems ◽  
Autistic Traits ◽  
Health Problems ◽  
Autistic People ◽  
Autistic Adults ◽  
Anxiety Depression

Abstract Background There is inconsistent evidence for a clear pattern of association between ‘camouflaging’ (strategies used to mask and/or compensate for autism characteristics during social interactions) and mental health. Methods This study explored the relationship between self-reported camouflaging and generalised anxiety, depression, and social anxiety in a large sample of autistic adults and, for the first time, explored the moderating effect of gender, in an online survey. Results Overall, camouflaging was associated with greater symptoms of generalised anxiety, depression, and social anxiety, although only to a small extent beyond the contribution of autistic traits and age. Camouflaging more strongly predicted generalised and social anxiety than depression. No interaction between camouflaging and gender was found. Limitations These results cannot be generalised to autistic people with intellectual disability, or autistic children and young people. The sample did not include sufficient numbers of non-binary people to run separate analyses; therefore, it is possible that camouflaging impacts mental health differently in this population. Conclusions The findings suggest that camouflaging is a risk factor for mental health problems in autistic adults without intellectual disability, regardless of gender. We also identified levels of camouflaging at which risk of mental health problems is highest, suggesting clinicians should be particularly aware of mental health problems in those who score at or above these levels.

scholarly journals The EU referendum and mental health in the short term: a natural experiment using antidepressant prescriptions in England

2018 ◽  
Vol 73 (2) ◽  
pp. 168-175 ◽  
Author(s):  
Sotiris Vandoros ◽  
Mauricio Avendano ◽  
Ichiro Kawachi
Keyword(s):  
Mental Health ◽  
Relative Increase ◽  
Control Group ◽  
Unexpected Result ◽  
Physical And Mental Health ◽  
Drug Classes ◽  
Defined Daily Doses ◽  
The Impact ◽  
Rule Out ◽  
The Eu

BackgroundPrevious research has highlighted the impact of economic conditions and uncertainty on physical and mental health. The unexpected result of the Brexit referendum in 2016 triggered high levels of economic uncertainty.ObjectiveTo examine whether prescriptions for antidepressants increased after the referendum result, benchmarking them against other drug classes.MethodsWe used GP practice prescribing data to compile the number of defined daily doses per capita every month in each of the 326 voting areas in England over the period 2011–2016. We used a difference-in-differences (DID) approach to identify the effects of Brexit on antidepressant prescriptions, compared with trends in a control group (antigout and iron preparations) that were unlikely to be associated with uncertainty and depression.ResultsAntidepressant prescribing continued to increase after the referendum but at a slower pace. Therapeutic classes used as controls showed a decrease. The DID approach shows that there was a relative increase of 13.4% in antidepressants compared with other therapeutic classes (DID coeff: 0.134; 95% CI 0.093 to 0.174).ConclusionOur results are open to different interpretations and should be treated with caution. This relative increase in antidepressant prescribing after the referendum may be attributed to increased uncertainty for certain parts of the population, but does not rule out an improvement in mood for others. Alternatively, some other factor—for example, distraction, might have contributed to a decrease in the control therapeutic classes. A possible policy implication is that programmes for the promotion of mental health may need to be intensified during periods of uncertainty.

scholarly journals Physical Health Profile and Associated Behavior During the COVID-19 Pandemic in Patients With Bipolar Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Jon Dyg Sperling ◽  
Nina Dalkner ◽  
Christina Berndt ◽  
Eva Fleischmann ◽  
Michaela Ratzenhofer ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Public Mental Health ◽  
Brief Symptom Inventory ◽  
Self Report ◽  
Control Group ◽  
Healthy Controls ◽  
Physical And Mental Health ◽  
Healthy Control ◽  
Mental And Physical Health

Background: The COVID-19 pandemic has led to an increased psychological strain on public mental health and may impact behavioral, mental, and physical health, presumably with effects on patients with severe mental disorders. This study examines pandemic-related physical and mental health and (compensatory) behavioral changes, in patients with BD as compared to healthy control individuals.Method: Physical and mental health and self-reported changes in daily structure and behavior due to the pandemic were assessed using a self-constructed questionnaire and the brief symptom inventory (BSI) in Germany, Austria, and Denmark in individuals with BD and a healthy control group.Results: The present study included 118 individuals with BD and 215 healthy controls. Individuals with BD reported statistically significant higher physical risk burden, increased weight gain, more physical comorbidities, and a decrease in physical activity and they further reported higher rates of COVID-19 testing, had more worries concerning health, and experienced more anxiety but less social distancing.Conclusion: The COVID-19 pandemic seems to have a greater impact on physical health in individuals with BD than in healthy controls. Individuals with BD appear to be having more difficulties compensating their behavior due to the pandemic which could amplify the effect of risk factors associated with poorer physical health. This highlights the necessity for optimizing and targeting the overall treatment of both mental and physical health in patients with BD during periods with far-reaching changes such as the COVID-19 pandemic.Limitations: Sampling issues and self-report forms, selectivity (missing elderly, and those lacking access or knowledge of technology).

scholarly journals Barriers to healthcare for autistic adults: Consequences & policy implications. A cross-sectional study

2020 ◽  
Author(s):  
Mary Doherty ◽  
Stuart D Neilson ◽  
Jane D O'Sullivan ◽  
Laura Carravallah ◽  
Mona Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Clinic Appointment ◽  
Autistic People ◽  
Autistic Adults

AbstractBackgroundAutistic people experience significantly poorer physical and mental health along with reduced life expectancy.AimTo identify self-reported barriers to primary care by autistic adults compared to parents of autistic children and non-autistic adults and link these barriers to self-reported adverse health consequences.Design and SettingFollowing consultation with the autistic community at an autistic conference, Autscape, a quantitative and qualitative survey was developed.MethodThe self-report survey was administered online through social media platforms.ResultsThe 57-item online survey was completed by 507 autistic adults, 196 parents of autistic children and 157 control subjects. 79.7% of autistic adults, 52.8% of parents and 36.5% of controls reported difficulty visiting a GP. The highest-rated barriers by autistic adults were deciding if symptoms warrant a GP visit (72.2%), difficulty making appointments by telephone (61.9%), not feeling understood (55.8%), difficulty communicating with their doctor (53.1%) and the waiting room environment (50.5%).Autistic adults reported a preference for online or text based appointment booking, facility to email in advance the reason for consultation, first or last clinic appointment and a quiet place to wait.Increased adverse health outcomes reported by autistic adults correlated with difficulty attending, including untreated physical and mental health conditions, not attending specialist referral or screening programmes, requiring more extensive treatment or surgery due to late presentations, and untreated potentially life threatening conditions.ConclusionReduction of healthcare inequalities for autistic people requires that healthcare providers understand autistic perspectives and communication needs. Adjustments for autism specific needs are as necessary as ramps for wheelchair users.How this fits inAdverse health outcomes are common among autistic people and so it is important to understand how we can promote access to primary care.This cross sectional study indicates that 79.7% of autistic patients (compared to 36.5% of controls) reported difficulty visiting a GP.Common barriers were: deciding if symptoms warrant a GP visit, difficulty using the telephone to book appointments, not feeling understood and difficulty communicating with their doctor.Common suggestions to promote access included: online or text based appointment booking facility, emailing in advance the reason for consultation, providing first or last clinic appointment and having a quiet place to wait.

scholarly journals A Randomized Controlled Trial of Tai Chi for Tension Headaches

2007 ◽  
Vol 4 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Ryan B. Abbott ◽  
Ka-Kit Hui ◽  
Ron D. Hays ◽  
Ming-Dong Li ◽  
Timothy Pan
Keyword(s):  
Mental Health ◽  
Intervention Program ◽  
Tai Chi ◽  
Controlled Trial ◽  
Adult Population ◽  
Well Being ◽  
Control Group ◽  
Physical And Mental Health ◽  
Tension Type Headaches ◽  
Headache Impact

This study examined whether a traditional low-impact mind–body exercise, Tai Chi, affects health-related quality-of-life (HRQOL) and headache impact in an adult population suffering from tension-type headaches. Forty-seven participants were randomly assigned to either a 15 week intervention program of Tai Chi instruction or a wait-list control group. HRQOL (SF-36v2) and headache status (HIT-6™) were obtained at baseline and at 5, 10 and 15 weeks post-baseline during the intervention period. Statistically significant (P< 0.05) improvements in favor of the intervention were present for the HIT score and the SF-36 pain, energy/fatigue, social functioning, emotional well-being and mental health summary scores. A 15 week intervention of Tai Chi practice was effective in reducing headache impact and also effective in improving perceptions of some aspects of physical and mental health.

Barriers to Accessing Healthcare: Perspectives from Autistic Adults and Carers

2021 ◽  
pp. 104973232110503
Author(s):  
Shenae Calleja ◽  
Jonathan Kingsley ◽  
Fakir M Amirul Islam ◽  
Rachael McDonald
Keyword(s):  
Mental Health ◽  
Healthcare Access ◽  
Primary Caregivers ◽  
Phenomenological Approach ◽  
Health Needs ◽  
Evidence Based ◽  
Physical And Mental Health ◽  
Face To Face ◽  
Autistic Adults ◽  
Perceived Experiences

Autistic adults have higher health needs compared to most, yet they continue to experience barriers to accessing appropriate healthcare. Presently, no qualitative research exists exploring these barriers which impact overall physical and mental health. We conducted a qualitative analysis in Victoria (Australia) of the perceived experiences of healthcare access for autistic adults ( n = 9) and primary caregivers of autistic adults ( n = 7). Specifically, a three-staged phenomenological approach was applied involving: (i) a communicative checklist, (ii) a health status survey and (iii) face-to-face interviews. Elements such as support, responsibilities and protective factors exhibited by caregivers, may impact healthcare access for autistic adults. Results indicate the need for further research exploring interdependent factors that impact healthcare access by caregivers, so evidence-based interventions can be developed to support caregivers in the future.

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