Review on Contributing Factors to Anxiety in High-Functioning Autism

Individuals with autism spectrum disorder are characterised by difficulties in social communication, by restricted, repetitive behaviour and interests. Autism is a highly heterogeneous disorder; high-functioning individuals with autism have average or higher intelligence and superficially normal language skills. The lack of intellectual disability does not mean that they can overcome inherent difficulties in social communication and interaction. They struggle to negotiate social interactions and manage daily tasks in a neurotypical world. They are at risk of experiencing mental health difficulties compared to general population. One of the most common mental health difficulties co-occurring with high-functioning autism is anxiety, which is associated with poor individual, family, and social outcomes. The chapter reviews studies on the contributing factors to anxiety in high-functioning autism. Psychological, cognitive, and social factors seem to be important, while there are indications for the existence of some neurobiological basis. It also considers ideas as to how to tackle anxiety.

High Intellectual Potential and High Functioning Autism: Clinical and Neurophysiological Features in a Pediatric Sample

High Intellectual Potential (HIP) and High Functioning Autism (HFA) are two different conditions sharing some clinical and neurobiological features. The aim of the present study was to characterize a sample of HIP children (n: 16; M/F: 14/2; median age: 10 years) in comparison to those with HFA (n: 17; M/F: 16/1; median age: 13 years) and to neurotypically developed (NTD) children (n: 10; M/F: 4/6; median age: 11 years) from a clinical and neurophysiological perspective. Specifically, a standardized clinical assessment of cognitive and adaptive skills, autistic symptoms, executive functions and behavioral features was performed. Moreover, event-related potentials (ERPs) were recorded, referring specifically to the mismatch negativity (MMN) and P300 paradigm. Our data highlighted the presence of similarities between the intellectually gifted individuals and the ones with autism (i.e., a nonhomogeneous intellective profile, an adaptive skills impairment, subthreshold autistic symptoms and increased perfectionism). Interestingly, a distinct neurophysiological characterization between groups came out, with evidence of a reduced MMN amplitude only in the HFA group. Furthermore, no differences within groups in the P300 component emerged. Therefore, our results start to provide a more informative characterization of the HIP phenotype in comparison to those of HFA and NTD, highlighting the potential role of the MMN amplitude index in helping clinicians and researchers to distinguish between HIP and HFA. Nevertheless, further research on the topic is strongly needed.

A New Framework for Examining Impact of Neurodiversity in Couples in Intimate Relationships

Background: Many health professionals have a limited understanding of autism and little to no experience working with neurodiverse (ND) couples. Applying traditional practice without an informed approach to assist ND couples is bound to fail. Purpose: Whether limited executive functioning skills, typical of many ND people, may be overcome using technology that provides social interactions, without the extreme stressors of in-person interactions. Methodology: This article examines a new systemic framework and related practice for navigating the impact of neurodiversity in couples. A discourse analysis of data gathered from interactions with ND clients was performed and the findings are reported. Conclusions: Social norms contribute to considerable anxiety, worry, fear, and difficulties such as the inability to interpret meaning, read nonverbal communications. An individual's ability to consider others’ perspectives increases the likelihood of relational success. Digital communication platforms facilitated social interactions among those diagnosed with high functioning autism spectrum disorder. Implications: A new framework that incorporates structural plasticity- and technology-based relational tools in resources offered to aid social interactions, and more specifically, romantic relationships for ND individuals may be warranted, considering the unmet needs that exist in society.

Effect of training program on sexual knowledge and social skills of adolescents with high-functioning autism in puberty

Purpose Autism spectrum disorder (ASD) refers to a group of complex neurodevelopmental disorders characterized by repetitive and characteristic patterns of behavior and difficulties with social communication and interaction. Puberty is an important period for teenagers with ASD. The purpose of this study was to investigate the effect of educational program on increasing social skills (SS) and sexual knowledge (SK) in adolescent boys with high-functioning autism (HFA) disorder. Design/methodology/approach This study was conducted using a single-subject design. Participants were three boys diagnosed with HFA disorder, selected using purposive sampling. The social skills improvement system scale and the sexual knowledge questionnaire were used to measure SS and SK. The training program consisted of 49 sessions. Findings Results showed that, given the comparison of scores before and after the intervention, the training program was effective in improving SS and SK. Originality/value With regard to the importance of puberty, training programs for parents and adolescents play an effective role in increasing SS and SK of adolescents with HFA disorder.

Emotional ego- and altercentric biases in high-functioning autism spectrum disorder: Behavioral and neurophysiological evidence

Self-other distinction is a crucial aspect of social cognition, as it allows us to differentiate our own mental and emotional states from those of others. Research suggests that this ability might be impaired in individuals with autism spectrum disorder (ASD), but convincing evidence of self-other distinction deficits in the emotional domain is lacking. Here we aimed at evaluating emotional self-other distinction abilities in adults with and without ASD, in two behavioral pilot studies and one fMRI study. By using a newly developed virtual ball-tossing game that induced simultaneous positive and negative emotional states in each participant and another person, we were able to measure emotional egocentric and altercentric biases (namely the tendency to ascribe self-/other-related emotions to others/ourselves, respectively). Despite no behavioral differences, individuals with ASD showed decreased activation 1) in the right temporoparietal junction (rTPJ) during active overcoming of the emotional egocentric bias vs. passive game viewing, and 2) in the right supramarginal gyrus (rSMG) during ego- vs. altercentric biases, compared to neurotypical participants. These results suggest a different recruitment of these two regions in ASD when dealing with conflicting emotional states of oneself and another person. Furthermore, they highlight the importance of considering different control conditions when interpreting the involvement of rTPJ and rSMG during self-other distinction processes.

Emotional Rational Education Training Associated with Mindfulness for Managing Anxiety within Adolescents Affected by High-Functioning Autism: A Descriptive Study

Background: Autism spectrum disorder (ASD) is a chronic and persistent pervasive developmental disorder (PDD) whose characteristic deficit is represented by social difficulties, semantic–pragmatic alterations and a limited, unusual and repetitive pattern of interests and behaviors. Specifically, individuals with high-functioning autism (HFA) frequently exhibit associated internalizing symptoms that are not part of the diagnostic criteria but which, nonetheless, tend to impair daily functioning. In this study, we investigated how some forms of treatment could be useful in subjects with HFA who display internalizing symptoms. Theoretical background relates to standard cognitive therapy (SCT) and rational education training with mindfulness (M-ERE). Methods: In this study, we investigated how some forms of treatment could be useful in subjects with HFA and internalizing symptoms, focusing on standard cognitive therapy (SCT) and mindfulness associated with emotional rational education training (M-ERE). We selected two groups of HFA patients with significant internalizing symptoms and performed two different forms of treatment for six months: SCT and M-ERE. The aim of the study was to verify the effectiveness of an M-ERE protocol with respect to anxious and depressive symptoms in subjects with HFA. Furthermore, we wanted to compare the results obtained with this combined treatment with those obtained in HFA subjects treated with SCT. Results: Our analyses showed an improvement in the internalizing symptoms (especially those related to the anxiety dimension) of the group that followed a treatment based on mindfulness and rational emotional education for 6 months compared to the group that had instead performed a 6-month treatment based on the SCT. Conclusions: Our hypotheses were supported by the results, which highlighted the efficacy of mindfulness-based interventions in the treatment of internalizing symptoms in adolescents with HFA, and specifically showed that an M-ERE intervention appears more effective in managing anxiety compared to treatment with SCT and appears to be equally effective in the management of depressive symptoms. Not only was the M-ERE treatment effective for the management of anxious and depressive symptoms in subjects with HFA, but the efficacy for the management of anxious symptoms was greater than the SCT treatment.