Brief Report: Alexithymia Trait Severity, not Autistic Trait Severity, Relates to Caregiver Reactions to Autistic Children's Negative Emotions

Alexithymia impacts an individual’s ability to recognize and understand emotions and frequently co-occurs with autism. This study investigated the relationship between children’s alexithymia, autistic traits, and caregiver reactions to their child’s negative emotions. Caregivers of 54 autistic and 51 non-autistic children between the ages of 7 and 12 years rated their child’s alexithymia and autistic trait severity and their reactions to their child’s negative emotions. Caregivers of autistic children reported greater supportive reactions and fewer restrictive/controlling reactions to their child’s negative emotions when their child had more alexithymia traits. This study extends previous research by demonstrating that caregivers of autistic children with co-occurring alexithymia traits represent a specific subgroup of caregivers that respond more positively to their child’s negative emotions.

Autism Through the Ages: A Mixed Methods Approach to Understanding How Age and Age of Diagnosis Affect Quality of Life

A significant proportion of autistic adults today were not diagnosed until later in life, a group referred to as the ‘lost generation,’ which may affect mental health. In Study 1 we explored quality of life and autistic trait levels in 420 autistic and TD adults, and in Study 2 we explored the experiences of 8 autistic adults diagnosed as adults. We found that autistic adults had lower quality of life outcomes and higher autistic trait levels which related to age of diagnosis, and qualitative findings indicated that while adults were empowered by their new diagnosis, they still require specialized supports. Our findings are discussed, emphasizing future directions and implications for the current care system in place for autistic adults.

Child Autistic Traits, Food Selectivity and Diet Quality: A Population-Based Study

Objectives Children with Autism Spectrum Disorders (ASD) tend to have sensory disturbances and behavioral rigidity which may predispose them to be selective in their food intake, potentially compromising their nutritional status. While ASD captures severe levels of impairment, autistic traits vary on a continuum throughout the general population. Yet, little is known about how subclinical autistic traits relate to dietary intake. Therefore, this study study examines how autistic traits throughout early childhood are associated with diet quality (DQ) in mid-childhood and explores the mediating role of food selectivity. Methods Participants were children (n = 4061) from the population-based birth cohort, Generation R (the Netherlands). Parents completed assessments on their child's autistic traits at 1.5, 3 and 6 years, food selectivity at 4 years and food intake at 8 years (via a Food Frequency Questionnaire), from which a DQ score (comprising of 10 food groups, scale 0 to 10) was derived based on adherence to age-specific dietary guidelines. Multiple linear regression models examined the association between autistic trait SD score at each assessment wave and DQ. A mediation analysis was performed using structural equation modeling to examine the indirect effect of autistic traits at 3 years and DQ at 8 years through food selectivity at 4 years. Models adjusted for child sex, age, energy intake, ethnicity, birth weight, BMIz score, and maternal age and education. Results Autistic trait SD score at each wave was associated with decreased DQ score (e.g., 3 years: β = −0.06; 95% CI: −0.10, −0.03). Post-hoc analyses showed that associations between autistic traits and DQ were consistently driven by lower consumption of fruit, vegetable and whole grain food groups at each wave. The indirect effect of food selectivity (β = −0.03, 95% CI: −0.03, −0.02) explained 60% of the total association between autistic traits and DQ. Conclusions Expression of autistic traits across childhood is associated with poorer DQ in mid-childhood, and food selectivity may be one key behavioral mechanism explaining this association. Dietary interventions intended to optimize nutrition in children with elevated autistic traits may integrate behavioral strategies to support parents’ appropriately responding to and managing food selectivity. Funding Sources European Union's Horizon 2020 programme.

Examining the association between childhood autistic traits and adolescent hypomania: a longitudinal twin study

Background There is evidence that autism spectrum disorders (ASDs) co-occur with bipolar disorder (BD) relatively frequently. Individuals with BD often report symptoms of mania and hypomania during adolescence, prior to the age of onset for BD. It is unknown whether these symptoms are associated with ASDs. We examined whether diagnoses of ASDs and autistic traits were associated with hypomania in a large, population-based Swedish twin sample. Methods Parental structured interviews assessed autistic traits, and were used to assign screening diagnoses of ASDs, when twins were aged 9 or 12 (N = 13 533 pairs). Parents then completed questionnaires assessing hypomania when the twins were aged 15 and 18 (N = 3852 pairs at age 15, and 3013 pairs at age 18). After investigating the phenotypic associations between these measures, we used the classical twin design to test whether genetic and environmental influences on autistic traits influence variation in adolescent hypomania. Results Autistic traits and ASD diagnoses in childhood were associated with elevated scores on the measures of adolescent hypomania. Twin analyses indicated that 6–9% of the variance in hypomania was explained by genetic influences that were shared with autistic traits in childhood. When repeating these analyses for specific autistic trait domains, we found a stronger association between social interaction difficulties and hypomania than for other autistic trait domains. Conclusions These results indicate a genetic link between autistic traits and hypomania in adolescence. This adds to the growing evidence base of genetic factors associated with ASDs showing links with psychiatric outcomes across childhood and into adulthood.

Impaired odor identification ability and olfactory hedonic capacity in children with elevated autistic traits

Background: Atypical olfactory function in autism spectrum disorder has been documented in numerous studies, but little is known about its occurrence in individuals with autistic traits. The aim of the current study was to investigate odor identification ability and olfactory hedonic capacity in children with autistic traits. Methods: The study included 91 children in a high autistic trait group, and 128 children in a low autistic trait group, as determined based on Short Autism Spectrum Quotient scores. The Universal Sniff (U-Sniff) test was used to measure odor identification ability and olfactory hedonic capacity. Olfactory hedonic capacity was also measured using the child’s version of the Chemosensory Pleasure Scale (CPS-C). Results: Children in the high autistic trait group exhibited significantly impaired odor identification and olfactory hedonic capacity measured by CPS-C than those in the low autistic trait group, but there was no significant difference in olfactory hedonic capacity measured by U-Sniff between the two groups. Impaired odor identification was significantly correlated with olfactory hedonic capacity measured by CPS-C. Limitations: Only a self-reporting questionnaire was used to screen children for autistic trait. The combination of a self-reporting scale and diagnosis by a clinical expert would result in more accurate screening of individuals for autistic trait.Conclusions: Children with high autistic trait exhibited poorer odor identification ability and olfactory trait hedonic capacity than children without high autistic trait. These results pertaining to odor identification and olfactory hedonic capacity may be the endophenotypic markers for autism spectrum disorder.

Measuring Clinical Efficacy Through the Lens of Audit Data in Different Adult Eating Disorder Treatment Programmes

Background: Audit data is important in creating a clear picture of clinical reality in clinical services, and evaluating treatment outcomes. This paper explored the data from an audit of a large national eating disorder (ED) service and evaluated the outcome of inpatient and day treatment programmes for patients with anorexia nervosa (AN) with and without autistic traits.Methods: Four hundred and seventy-six patients receiving treatment for AN at inpatient (IP), day-care (DC) and step-up (SU) programmes were assessed at admission and at discharge on the following measures: autistic traits, body-mass-index (BMI), ED symptoms, depression and anxiety symptoms, work and social functioning, and motivation for change. Outcomes were analyzed first at a within-group level based on change in mean scores and then at an individual level based on the clinical significance of improvement in eating disorder symptoms. Outcomes were compared between patients with high autistic traits (HAT) and low autistic traits (LAT) in each programme.Results: The findings suggest that 45.5% of DC and 35.1% of IP patients showed clinically significant changes in ED symptoms following treatment. Co-occurring high autistic traits positively predicted improvement in ED symptoms in IP setting, but was a negative predictor in DC. In IP, more HAT inpatients no longer met the BMI cut-off for AN compared to LAT peers. In terms of general psychopathology, patients with AN and HAT exhibited more severe depression symptoms, anxiety symptoms and social functioning impairment than their LAT peers, and these symptoms stayed clinically severe after treatment.Conclusions: Patients with AN and hight autistic traits are more likely than their peers with low autistic traits to show weight restoration and improvement in ED systems after inpatient treatment. This reverses in DC, with high autistic trait patients less likely to improve after treatment compared to low autistic trait patients. Our results suggest that inpatient treatment with individualized and structured routine care may be an effective model of treatment for patients with AN and high autistic traits.