Investigating Orthorexia Nervosa With The ORTO-R in a Sample of University Students With Or Without Subthreshold Autism Spectrum: Focus On Dietary Habits and Sex Differences

Purpose: The aim of the present study was to investigate the presence of ON symptoms, measured by means of the ORTO-R, in a sample of University students with or without AT, specifically focusing on evaluating the role of sex and of dietary habits in the association between ON and autism spectrum. Methods: Subjects were requested to anonymously fulfil the ORTO-R and the Adult Autism Subthreshold Autism Spectrum (AdAS Spectrum) through an online form. Results: 2140 students participated in the study. Subjects with significant AT reported significantly higher ORTO-R scores than subjects without AT. Females and subjects following a vegetarian/vegan diet reported significantly higher ORTO-R scores than males and than subjects following an omnivorous diet, respectively. Significant positive correlations were found between ORTO-R and AdAS Spectrum scores. A decision tree model, with sex, type of diet and presence of AT as independent variables and ORTO-R score as dependent variable, showed in the first step the presence of significantly higher ORTO-R scores among females than among males, and in the second step showed in both sexes the presence of higher ORTO-R scores among subjects with AT than in those without. A significant interaction of sex and presence/absence of AT was reported on ORTO-R score, with a higher increasing trend of ORTO-R score with the increase of AdAS Spectrum score among females than among males. Conclusions: Our results further highlighted the association between AT and ON, in particular among females.

Childhood diagnoses in individuals identified as autistics in adulthood

Background Autism is a developmental condition, where symptoms are expected to occur in childhood, but a significant number of individuals are diagnosed with autism for the first time in adulthood. Here, we examine diagnoses given in childhood among individuals that are diagnosed with autism in adulthood, to investigate whether the late autism diagnosis might be explained by misdiagnosis in childhood or diagnostic overshadowing. Methods Through the Danish National Patient Registry, we identified individuals diagnosed with autism in adulthood (N = 2199), as well as a control sample with no records of an autism diagnosis (N = 460,798) and calculated how many had received different psychiatric or neurological diagnoses in childhood. Results We found that most childhood diagnoses were overrepresented in those with an adult autism diagnosis, and attention-deficit hyperactivity disorder, affective disorders, anxiety, and stress disorders were the most prevalent childhood conditions in this group. However, 69% of males and 61% of females with adult autism diagnoses were not found to have received any of the investigated diagnoses before 18 years of age, and most childhood diagnoses were given after the age of 12. Limitations Milder to moderate cases of psychiatric conditions that have been solely treated by family physicians or school psychologists may not be fully included in our dataset. The study is based on data from the Danish health care system, and further research is needed to assess whether the findings can be generalized to other countries. Conclusion A majority of those with an adult autism diagnosis had no records of having received any of the investigated diagnoses in childhood. In these cases, the late autism diagnosis is therefore unlikely to be explained by either misdiagnosis or overshadowing. This result is at odds with the prevailing notion that autistic symptoms tend to diminish with age. Therefore, further research is warranted to examine how and if early signs of autism may have manifested among these individuals, and how similar they are to autistic people diagnosed earlier in their development.

Raising Awareness about Adult Autism Spectrum Disorder

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Brief Report: The Application of Skills and Knowledge (ASK) model: A novel conceptualization of social performance to guide instrument development and advance adult autism research

Current conceptualizations of social competency often focus on value judgments (e.g., appropriateness) that are influenced by a combination of individual and environmental factors, such as a social partner’s understanding of autism. We posit that social performance is an understudied, but critical contributor to adult social functioning and present the Application of Skills and Knowledge (ASK) model to stimulate research in this area. The ASK model aims to separate social performance from other factors that may promote or adversely impact social functioning, therefore allowing for identification of treatment targets that do not solely rest on the individual. This framework can be used to accelerate future instrument and intervention development efforts to support well-being and community participation for autistic adults.

Predicting diagnostic outcome in adult autism spectrum disorder using the autism diagnostic observation schedule, second edition

Background The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) module four assessment for diagnosing autism spectrum disorder in adults has shown good sensitivity and specificity in research settings. Method This study aimed to evaluate the predictive accuracy of the ADOS-2 module four by investigating the components of the assessment, in relation to diagnostic outcome in a clinical setting. Data from 88 service users referred to a Specialist Adult Autism Service was explored. Results ADOS-2 scores failed to predict the diagnostic outcome (overall sensitivity = 92%, specificity = 57%). Interestingly, scores from the ‘restricted interests’ component of the ADOS-2 have the potential to predict diagnostic outcome, despite this domain not been included in the scoring algorithm. Conclusions Based on our findings, we recommend clinicians are cautious when interpreting results of the ADOS-2 assessment.

Defining the Optimal Threshold Scores for Adult Autism Subthreshold Spectrum (AdAS Spectrum) in Clinical and General Population

Background: The Adult Autism Subthreshold Spectrum (AdAS Spectrum) is a recently developed instrument tailored to assess the broad range of full-threshold as well as sub-threshold manifestations related to the autism spectrum. Although it has proved to be a valuable instrument for quantitative assessment of autistic symptoms, the AdAS Spectrum still lacks validated diagnostic thresholds. Objective: The aim of this study was to define the best cut-off scores of the AdAS Spectrum for determining the presence of subthreshold autistic traits as well as a clinically significant autism spectrum disorder (ASD). Methods: Our sample was composed of 39 patients with full-blown ASD, 73 subjects with autistic traits, and 150 healthy controls. Subjects were evaluated by trained psychiatrists, who performed a clinical diagnosis according to DSM-5 and then assessed with the AdAS Spectrum and the Autism Spectrum Quotient. Results: Our results showed that the most discriminant cut-off scores were 70 for identifying subjects with full-blown ASD, and 43 for determining the presence of significant autistic traits. Conclusion: The threshold values proposed here showed satisfying levels of specificity and sensibility, as well as a good agreement with the diagnosis according to DSM-5 criteria, confirming the validity of the AdAS Spectrum as a psychometric tool for measuring ASD-related conditions in the clinical and general population.