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Autistic individuals encounter challenges in recognizing emotional expressions of others. Pupillary response has been proposed as an indicator of arousal dysregulation or cognitive load. The pupillary response of autistic individuals during socio-affective tasks remains unclear. This study investigated pupillary response in autistic adults when viewing emotional faces/eyes and recognizing emotions during the Reading the Mind in the Eyes Test (RMET) and watching interpersonal touch scenes in the social touch task. The study included 98 participants diagnosed with autism spectrum disorder and 37 typically developing controls (TD). Pupil size was measured using the Tobii X2-30 Eye Tracker. The results showed that autistic adults had larger maximal pupil sizes, smaller minimal pupil sizes, and greater change rates of pupil size, particularly during the RMET Eyes task. Clinical correlations revealed that attention switching difficulty positively correlated with mean pupil size in TD participants, while social communication deficits positively correlated with mean pupil size in autistic participants. In conclusion, our findings suggest atypical pupillary responses in autistic adults during socio-affective tasks, indicating heightened cognitive demand. Further investigation is necessary to understand the underlying mechanisms and their association with autistic traits.
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The deficit in social interaction skills among individuals with autism spectrum disorder (ASD) is strongly influenced by personal experiences and social environments. Neuroimaging studies have previously highlighted the link between social impairment and brain activity in ASD. This study aims to develop a method for assessing and identifying ASD using a social cognitive game-based paradigm combined with electroencephalo-graphy (EEG) signaling features. Typically developing (TD) participants and autistic preadolescents and teenagers were recruited to participate in a social game while 12-channel EEG signals were recorded. The EEG signals underwent preprocessing to analyze local brain activities, including event-related potentials (ERPs) and time-frequency features. Additionally, the global brain network's functional connectivity between brain regions was evaluated using phase-lag indices (PLIs). Subsequently, machine learning models were employed to assess the neurophysiological features. Results indicated pronounced ERP components, particularly the late positive potential (LPP), in parietal regions during social training. Autistic preadolescents and teenagers exhibited lower LPP amplitudes and larger P200 amplitudes compared to TD participants. Reduced theta synchronization was also observed in the ASD group. Aberrant functional connectivity within certain time intervals was noted in the ASD group. Machine learning analysis revealed that support-vector machines achieved a sensitivity of 100%, specificity of 91.7%, and accuracy of 95.8% as part of the performance evaluation when utilizing ERP and brain oscillation features for ASD characterization. These findings suggest that social interaction difficulties in autism are linked to specific brain activation patterns. Traditional behavioral assessments face challenges of subjectivity and accuracy, indicating the potential use of social training interfaces and EEG features for cognitive assessment in ASD.
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Transtorno do Espectro Autista , Eletroencefalografia , Potenciais Evocados , Aprendizado de Máquina , Humanos , Transtorno do Espectro Autista/fisiopatologia , Adolescente , Eletroencefalografia/métodos , Criança , Masculino , Feminino , Potenciais Evocados/fisiologia , Córtex Cerebral/fisiopatologia , Córtex Cerebral/diagnóstico por imagem , Jogos de Vídeo , Algoritmos , Smartphone , Interação SocialRESUMO
Individuals with autism spectrum disorder (ASD) often experience lifelong social communication challenges and are more vulnerable to school bullying. Addressing their social difficulties and school bullying requires evidence-based interventions. PEERS® (Program for the Education and Enrichment of Relational Skills) was adapted and translated for Taiwanese adolescents. This randomized controlled study aimed to examine the effectiveness of the Taiwanese version of PEERS® in reducing school bullying and enhancing social function among autistic adolescents. Twenty-one autistic adolescents (mean age 14.29 ± 1.67 years; female n = 733.33%) were randomized to a treatment group (TG, n = 10) or a delayed treatment control group (DTG, n = 11). The outcome measures (school bullying, social challenges, social skills knowledge, and social skills performance) were assessed at baseline, post-treatment, and follow-up. The group and time interaction analyses revealed greater magnitudes of reduction in general school bullying (p < 0.001), victimization (p < 0.001), perpetration (p = 0.012), social challenges (p = 0.001), and peer conflicts (p < 0.001), and improvement in social knowledge (p < 0.001) in the TG group than the DTG group. The findings suggest that the PEERS® program tailored for Taiwanese adolescents is effective in reducing school bullying, decreasing social challenges, and enhancing social skills among autistic adolescents, with very large effect sizes (Cohen's d ranging from 1.19 to 2.88). Consequently, participation in the PEERS® program is recommended for adolescents with social difficulties to improve their social communication and interactions to offset school bullying and other social challenges related to adverse outcomes.
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Transtorno do Espectro Autista , Bullying , Grupo Associado , Instituições Acadêmicas , Humanos , Bullying/prevenção & controle , Feminino , Masculino , Adolescente , Taiwan , Habilidades Sociais , Transtorno Autístico/psicologia , Vítimas de Crime/psicologia , CriançaRESUMO
BACKGROUND: This study aimed to estimate the population-attributable fraction (PAF) of psychiatric and physical disorders for suicide among older adults, focusing on sex- and age-specific factors. METHODS: Data from Taiwan's National Health Insurance Research Data and National Death Registry included 9136 cases of suicide in individuals aged 65+, with 89,439 matched controls. Physical and psychiatric disorders were identified through diagnostic records. Conditional logistic regression assessed risk factors, and PAF was calculated using disorder prevalence and adjusted odds ratios. RESULTS: Major suicide risk factors among older adults were depressive disorders, anxiety disorders, and sleep disorders. Physical disorders like hypertension, peptic ulcers, and cancer also showed significant PAF values. The combined PAF of physical disorders equaled that of psychiatric disorders. Psychiatric disorders had a greater impact on women and the youngest-old adults, while physical disorders had a higher contribution among men, middle-old adults, and oldest-old adults. LIMITATIONS: Relying solely on claim data to identify psychiatric and physical disorders may underestimate their prevalence and associations with suicide due to unrecorded cases of individuals not seeking help and the absence of key risk factors like social isolation and family support. CONCLUSIONS: This study identifies preventable or treatable risk factors for older adult suicide, emphasizing the need to target specific psychiatric and physical disorders in suicide prevention efforts while taking into account sex- and age-specific considerations. It also underscores the importance of establishing social welfare support systems to address the unique challenges older adults face.
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Transtornos Mentais , Suicídio , Humanos , Taiwan/epidemiologia , Masculino , Feminino , Idoso , Suicídio/estatística & dados numéricos , Fatores de Risco , Idoso de 80 Anos ou mais , Transtornos Mentais/epidemiologia , Fatores Sexuais , Prevalência , Fatores Etários , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Neoplasias/epidemiologia , Neoplasias/psicologia , Úlcera Péptica/epidemiologia , Hipertensão/epidemiologiaRESUMO
BACKGROUND: Quality of life (QoL) has been suggested as an indicator of outcomes in autistic adults. Factors associated with QoL in autistic individuals remain unclear. This study aims to examine the subjective QoL for autistic adults in Taiwan and investigate the determinants for different domains of QoL. METHODS: The study comprised 90 autistic adults (aged 26.9, SD 7.3; males, 80.9%). We used Taiwanese version of World Health Organization Quality of Life-BREF to measure QoL. Four domains of QoL were compared with 61 non-autistic controls, including physical, psychological, social, and environment. To identify the correlates of QoL domains, we assessed IQ, personality trait, family support, anxiety/depressive symptoms, autistic severity, and sensory symptoms by various questionnaires, and assessed their association with QoL by correlation analyses and model selection. RESULTS: Our results showed that autistic adults reported lower QoL on the World Health Organization Quality of Life (WHOQOL)-BREF across all domains. QoL was significantly associated with autistic symptom severity, harm avoidance, family support, sensory symptoms, anxiety, and depression, but not intelligence. Model selections revealed male sex, poor paternal support, autism severity, depression, anxiety, and sensory symptoms were associated with specific QoL domains. CONCLUSION: Findings supported lower QoL in autistic adults. Modifying the QoL correlates may improve life quality in autistic adults. Furthermore, our findings revealed the importance of sensory symptoms and paternal support in QoL of autistic adults, which was a novel finding in this population.
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This study applied the functional near-infrared spectroscopy (fNIRS) to investigate frontal activity in autism when performing verbal fluency test and emotion recall task. We recruited 32 autistic adults without intellectual disability and 30 typically-developing controls (TDC). Prefrontal hemodynamic changes were evaluated by fNIRS when the participants performed the verbal fluency test and emotion recall task. fNIRS signals in the prefrontal cortex were compared between autism and TDC. Compared to TDC, autistic adults showed comparable performance on the verbal fluency test but exhibited lower frontal activity on the vegetable category. In the verbal fluency test, left frontal activity in TDC significantly increased in the vegetable category (vs. fruit category). In the emotion recall task, left frontal activity increased significantly in TDC when recalling emotional (vs. neutral) events. This increase of left frontal activity on the more difficult works was not found in autism. Similarly, brain activities were related to test performance only in TDC but not in autism. In addition, more severe social deficits were associated with lower frontal activity when recalling emotional events, independent of autism diagnosis. Findings suggested reduced frontal activity in autism, as compared to TDC, when performing verbal fluency tests. The reduction of left frontal activation in verbal fluency test and emotion recall tasks might reflect on the social deficits of the individual. The fNIRS may potentially be applied in assessing frontal lobe function in autism and social deficits in general population. Trial registration number: NCT04010409.
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BACKGROUND: Examining patients with first-episode psychosis (FEP) provides opportunities to better understand the mechanism underlying these illnesses. By incorporating quantitative measures in FEP patients, we aimed to (1) determine the baseline distribution of clinical features; (2) examine the impairment magnitude of the quantitative measures by comparing with external controls and then the counterparts of schizophrenia patients of different familial loadings; and (3) evaluate whether these quantitative measures were associated with the baseline clinical features. METHODS: Patients with FEP were recruited from one medical center, two regional psychiatric centers, and two private clinics in northern Taiwan with clinical features rated using the Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance (PSP) scale. Quantitative measurements included the Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST), niacin response abnormality (NRA), and minor physical anomalies and craniofacial features (MPAs). To evaluate the relative performance of the quantitative measures in our FEP patients, four external comparison groups from previous studies were used, including three independent healthy controls for the CPT, WCST, and NRA, respectively, and one group of treatment-resistant schizophrenia patients for the MPAs. Additionally, patients from simplex families and patients from multiplex families were used to assess the magnitude of FEP patients' impairment on the CPT, WCST, and NRA. RESULTS: Among the 80 patients with FEP recruited in this study (58% female, mean age = 25.6 years, mean duration of untreated psychosis = 132 days), the clinical severity was mild to moderate (mean PANSS score = 67.3; mean PSP score = 61.8). Patients exhibited both neurocognitive and niacin response impairments (mean Z-scores: -1.24 for NRA, - 1.06 for undegraded d', - 0.70 for degraded d', - 0.32 for categories achieved, and 0.44 for perseverative errors) but did not show MPAs indicative of treatment resistance. Among these quantitative measures, three of the four neurocognitive indices were correlated with the baseline clinical features, whereas NRA did not show such correlation. CONCLUSIONS: This FEP study of Taiwanese patients revealed the presence of neurocognitive performance and niacin response and their different relationships with clinical features, rendering this sample useful for future follow-up and incorporation of multiomics investigation.
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Niacina , Transtornos Psicóticos , Esquizofrenia , Humanos , Feminino , Adulto , Masculino , Esquizofrenia/tratamento farmacológico , Esquizofrenia/complicações , Taiwan , Testes Neuropsicológicos , Transtornos Psicóticos/psicologiaRESUMO
OBJECTIVE: Occupational function assessment is essential for rehabilitation of severe mental illness but lacks comprehensive tools. METHOD: This study examines the psychometric properties of the Chinese versions of the Vocational Cognitive Rating Scale (VCRS) and the Work Behavior Inventory (WBI) in 60 chronic patients from a psychiatric daycare center and identifies clinical correlates of occupational function measured on the Positive and Negative Syndrome Scale (PANSS). RESULTS: The Chinese VCRS and WBI showed adequate internal consistency, interrater and test-retest reliability, and good convergent validity with the Comprehensive Occupational Therapy Evaluation Scale. Factor analysis favored a one-factor solution of the VCRS; and a four-factor structure in the WBI including Efficiency, Social Interaction, Appropriateness, and Regularity. The VCRS and Efficiency were predicted by fewer disorganization but greater affective symptoms. Social Interaction was negatively predicted by resistance symptoms. Appropriateness was associated with all but negative symptoms. Regularity was predicted by fewer negative symptoms. Considering work behavior altogether, WBI total scores were predicted by fewer negative, fewer disorganization, and greater affective symptoms. CONCLUSIONS AND IMPLICATION FOR PRACTICE: Findings suggest that the Chinese VCRS and WBI have sound psychometric properties and are suitable for both clinical trials and for planning personalized rehabilitation programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Transtornos Mentais , Desempenho Profissional , Humanos , Reprodutibilidade dos Testes , Transtornos Mentais/reabilitação , Cognição , PsicometriaRESUMO
LAY ABSTRACT: Childhood factors that predict real-world executive function in autism spectrum disorder during the transition into adulthood are largely unknown. This study aimed to identify the predictors for the behavioral and cognitive aspects of real-world executive function in late adolescent and young adult autistic populations. We followed up 289 autistic youth (mean age 11.6 years) and 203 non-autistic controls (10.7 years) to their ages of 16.9 and 15.8, respectively. The Behavior Rating Inventory of Executive Function scale was used to measure the real-world executive function at late adolescence and young adulthood at follow-up. Potential predictors such as autistic symptoms, inattention or hyperactivity symptoms, peer relationship, emotional symptoms, and parenting styles were assessed in childhood at first enrollment. The results showed that childhood inattention, withdrawn behaviors, social communication difficulties, and child-reported emotion and inattention/hyperactivity may predict real-world lower executive function in late adolescence and young adults with autism. When separating executive function into behavioral and cognitive aspects, we found that oppositional behaviors and peer problems were specific predictors for behavioral regulation and cognitive function, respectively. Our findings suggested that treating common predictors in childhood, such as inattention, may potentially improve real-world executive function in autism during the transition into adulthood.
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Transtorno do Espectro Autista , Transtorno Autístico , Adulto Jovem , Humanos , Adolescente , Adulto , Criança , Transtorno Autístico/psicologia , Função Executiva/fisiologia , Transtorno do Espectro Autista/psicologia , Cognição , EmoçõesRESUMO
Individuals with autism spectrum disorder (ASD) often exhibit joint hypermobility and connective tissue disorders. However, it remains unclear if ASD individuals also have structural alterations in the connective tissue of the cornea. This study aims to determine whether the Kobayashi structure (K-structure) characteristics differ between adults with ASD and typically developing controls (TDC) and explore the clinical correlates of the K-structure abnormality. We recruited 30 ASD adults and 35 TDC. Corneal structures, particularly the K-structure in the Bowman's layer, of the participants were examined using in vivo confocal microscopy (IVCM), and a K-grading ranging from 1 to 4 was given to each eye based on the level of morphological mosaicism. The ASD participants' eyes received a significantly higher single-eye K-grading than that of the TDC eyes (p < 0.001), and the medians [25th, 75th percentile] of bilateral-eye summed K-grading were 8 [7, 8] and 5 [4, 6] in ASD and TDC, respectively (p < 0.001). A significantly higher K-grading in the ASD participants' eyes was still observed after adjusting for the within-subject inter-eye correlation (p < 0.001). Youden Index showed the optimal cutoffs to differentiate ASD from TDC by bilateral-eye summed K-grading and single-eye K-grading was >6 and >3, respectively. Additionally, a higher K-grading was associated with fewer visual sensation seeking in ASD (Spearman's correlation coefficient ρ = -0.518, p = 0.008) and low visual registration (i.e., higher sensory threshold) in TDC (ρ = 0.446, p = 0.023). This study provided novel evidence of corneal structural alterations in ASD by IVCM. Our findings may not only support the prior hypothesis of the association between ASD and connective tissue abnormalities but also shed light on the relationship between connective tissue disorder and neurodevelopmental disorders.
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Transtorno do Espectro Autista , Transtornos do Neurodesenvolvimento , Adulto , Humanos , Córnea , Projetos de Pesquisa , Microscopia ConfocalRESUMO
Autism spectrum disorder requires early detection and treatment. Thus, we developed a method to obtain reliable neurophysiological biomarkers to assist in diagnosing autism. This method includes a simple but typical jigsaw puzzle that allows participants to play and interact with each other. While playing this game, brain signals of the participants were observed and analyzed. The patients with autism were found to have differences in the time range of some event-related potential, such as P300 and N400. Altered patterns of function connectivity were also found in delta frequency bands in the patients while interacting with other people. Working around patients' capabilities, the jigsaw puzzle game was designed as easy to complete; this caused fewer mismatch conditions. The result suggested that these patterns are promising neurophysiological biomarker to assist doctors in social cognitive assessment in autism.Clinical Relevance-This study demonstrated the possibility of using hyperscanning technique for social cognitive assessment of autism spectrum disorder.
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Transtorno do Espectro Autista , Eletroencefalografia , Humanos , Masculino , Feminino , Transtorno do Espectro Autista/diagnóstico , Potenciais Evocados/fisiologia , Encéfalo , CogniçãoRESUMO
Autism spectrum disorder (ASD) is associated with a high prevalence of visual dysfunction. This study aimed to investigate the rates of amblyopia, refractive errors, and strabismus, as well as their clinical correlates in ASD. This population-based matched-cohort study used data from the Taiwan National Health Insurance Research Database. A total of 3,551 youths with ASD and 35,510 non-autistic control participants matched by age and sex were included. All the participants were followed-up until they were 18 years old. The prevalence of amblyopia, refractive errors, and strabismus was compared between the ASD and control groups. Effect modifiers, including sex, ASD subgroup, and co-diagnosis of intelligence disability, were examined. Compared to the control group, youths with ASD had a significantly increased risk of amblyopia (adjusted odds ratio [aOR] = 1.75), anisometropia (aOR = 1.66), astigmatism (aOR = 1.51), hypermetropia (aOR = 2.08), exotropia (aOR = 2.86), and esotropia (aOR = 2.63), but a comparable likelihood of myopia according to age. Males with ASD had a significantly lower likelihood of exotropia, but a higher likelihood of myopia than females with ASD. The autism subgroup had a higher OR for hypermetropia, but a lower OR for myopia than the other ASD subgroups. ASD youths with intelligence disabilities demonstrated significantly higher ORs for amblyopia, hypermetropia, and all types of strabismus and lower OR for myopia than those without intelligence disabilities. In conclusion, the rates of amblyopia, refractive errors, and strabismus were higher in youths with ASD. Ocular abnormalities in youths with ASD require a comprehensive assessment and management.
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BACKGROUND: Patients with remitted psychosis wish to reduce antipsychotic doses yet facing increased risks of relapse. Examining dose-tapering processes may provide insights to re-evaluate the risk-to-benefit balance. We aimed to depict and subgroup tapering trajectories, and explore factors associated with different dose-reduction patterns. METHODS: A 2-year open-label randomized prospective comparative trial from August 2017 to September 2022 in Taiwan. Patients with a history of schizophrenia-related psychotic disorders under stable medications and symptoms were eligible, randomizing a proportion to conduct guided dose reduction. We depicted the trajectories of individual patients and named subgroups based on dose-tapering patterns. Predictors of baseline characteristics for designated subgroups were examined by logistic regression analysis; changes in outcomes were compared by paired t-test. RESULTS: Fifty-one patients undergoing guided dose reduction, 18 (35.3%) reduced 4 steps consecutively (sequential reducers, SR), 14 (27.5%) reduced 1 to 3 steps (modest reducers, MR), 3 (5.9%) re-escalated to previous level (alert reducers, AR), 7 (13.7%) returned to baseline level (baseline returners, BR), 6 (11.7%) relapsed (failed reducers, FR) and 3 (5.9%) withdrew without relapse (early exits, EE). Patients with a history of relapse assumed a conservative dose-tapering pace; only the SR subgroup exhibited significant improvements in functioning and quality of life while failing to identify variables for predicting who would become SR or FR. CONCLUSIONS: Guided dose reduction comprises dynamic processes with differences between individual trajectories. The proposed naming of dose-tapering patterns/subgroups provides a framework depicting patients undergoing dose-tapering. Longer-term observation and more flexible tapering approaches are anticipated to reveal favorable outcomes.
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Antipsicóticos , Redução da Medicação , Transtornos Psicóticos , Humanos , Masculino , Feminino , Estudos Prospectivos , Transtornos Psicóticos/tratamento farmacológico , Antipsicóticos/uso terapêutico , Qualidade de Vida , Recidiva , Relação Dose-Resposta a Droga , Adulto , Pessoa de Meia-IdadeRESUMO
Background: Subjective sleep quality may reflect the mental well-being of migrant care workers; however, the related occupational factors remain unclear. This study examines the association between the characteristics of care labor and the subjective sleep quality of female migrants. Methods: In this cross-sectional study, Southeast Asian migrant care workers in Taiwan were recruited using convenience sampling. Data on working conditions, including workplace setting, wage, working hours, psychiatric symptoms of care recipients, and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI), were collected through computer-assisted personal interviews. Multiple linear regression analyses were performed to determine the independent relationship between working conditions and the PSQI global score. Results: There were 220 institution-(47.7%) and home-based (52.3%) care workers, and 47.7% had a PSQI score higher than 5. After controlling for covariates, the lowest tertile of wages and daily working hours (> 8 h) were independently correlated with poor sleep quality. Moreover, in the stepwise regression model, wage and working hours remained the most explainable correlates of poor sleep quality. Conclusion: This study lent support to the notion that low wages and long working hours are significant occupational factors that negatively impact the subjective sleep quality of female Southeast Asian migrant care workers in Taiwan.
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Distúrbios do Início e da Manutenção do Sono , Migrantes , Humanos , Feminino , Condições de Trabalho , Qualidade do Sono , Estudos Transversais , Local de TrabalhoRESUMO
BACKGROUND: Patients with remitted psychosis face a dilemma between the wish to discontinue antipsychotics and the risk of relapse. We test if an operationalized guided-dose-reduction algorithm can help reach a lower effective dose without increased risks of relapse. METHODS: A 2-year open-label randomized prospective comparative cohort trial from Aug 2017 to Sep 2022. Patients with a history of schizophrenia-related psychotic disorders under stable medications and symptoms were eligible, randomized 2:1 into guided dose reduction group (GDR) v. maintenance treatment group (MT1), together with a group of naturalistic maintenance controls (MT2). We observed if the relapse rates would be different between 3 groups, to what extent the dose could be reduced, and if GDR patients could have improved functioning and quality of life. RESULTS: A total of 96 patients, comprised 51, 24, and 21 patients in GDR, MT1, and MT2 groups, respectively. During follow-up, 14 patients (14.6%) relapsed, including 6, 4, and 4 from GDR, MT1, and MT2, statistically no difference between groups. In total, 74.5% of GDR patients could stay well under a lower dose, including 18 patients (35.3%) conducting 4 consecutive dose-tapering and staying well after reducing 58.5% of their baseline dose. The GDR group exhibited improved clinical outcomes and endorsed better quality of life. CONCLUSIONS: GDR is a feasible approach as the majority of patients had a chance to taper antipsychotics to certain extents. Still, 25.5% of GDR patients could not successfully decrease any dose, including 11.8% experienced relapse, a risk comparable to their maintenance counterparts.
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Antipsicóticos , Transtornos Psicóticos , Humanos , Antipsicóticos/uso terapêutico , Qualidade de Vida , Estudos Prospectivos , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/diagnóstico , RecidivaRESUMO
BACKGROUND/PURPOSE: The diagnosis of autism spectrum disorder (ASD), involving multiple components of clinical assessments, is challenging. The Autism Diagnostic Observation Schedule-Generic (ADOS-G), one of the standardized and validated instruments for ASD diagnostic evaluation, has been widely used in many countries. With the preparation of the Mandarin version of the ADOS-G (Mandarin-ADOS-G), this study aims to examine its psychometric properties, including reliability and validity. METHODS: The sample included 554 individuals clinically diagnosed with ASD (477 males, 86.1%) and 50 typically developing (TD) individuals (29 males, 58.0%) who were assessed with different modules of the Mandarin-ADOS-G between 4.1 and 34.0 years old with a mean age of 13.0 years (Module 1, n = 40; Module 2, n = 46; Module 3, n = 275; Module 4, n = 243). We evaluated the inter-rater reliability, test-retest reliability, internal consistency, and concurrent validity with the Chinese Autism Diagnostic Interview-Revised (ADI-R) and Social Responsiveness Scale (SRS) caregiver-report and self-report forms. The discriminative validity of Mandarin-ADOS-G was also examined. RESULTS: The Mandarin-ADOS-G demonstrated good inter-rater reliability (agreement of ADOS classification 0.91), good test-retest reliability (intraclass correlations 0.55-0.73), and low to high good internal consistency (Cronbach's alpha 0.27-0.86). The concurrent validity showed significant correlations with ADI-R (Pearson correlations 0.22-0.37) and the SRS caregiver-report form (Pearson correlations 0.15-0.23). Moreover, all Mandarin-ADOS-G domains successfully differentiated autistic individuals from TD individuals (all p-values <0.001). CONCLUSION: The Mandarin-ADOS-G is a reliable and valid instrument for assisting the diagnosis of ASD in the Mandarin-speaking population.
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Transtorno do Espectro Autista , Transtorno Autístico , Masculino , Humanos , Adolescente , Pré-Escolar , Criança , Adulto Jovem , Adulto , Transtorno Autístico/diagnóstico , Psicometria , Transtorno do Espectro Autista/diagnóstico , Reprodutibilidade dos Testes , AutorrelatoRESUMO
This study aimed to characterize the emotional features in Asian autistic adults without intellectual disability (n = 253) in comparison to non-autistic comparisons (n = 56) and schizophrenia (n = 56) by the Schutte's Emotion Intelligence Scale (SEIS). Among the autistic adults, 226 obtained results of both self-reported and mother-reported SEIS; 64 had repeated the SEIS within one month. We found low agreement between self-report and mother-report, particularly in autistic males. Overall, autistic adults showed difficulties in emotion perception and management that were differentiated from schizophrenia and were correlated with autistic features. Autistic adults may need more support and services in emotion perception and management.
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Transtorno do Espectro Autista , Transtorno Autístico , Deficiência Intelectual , Esquizofrenia , Masculino , Feminino , Humanos , Adulto , Transtorno do Espectro Autista/psicologia , Transtorno Autístico/psicologia , EmoçõesRESUMO
BACKGROUND: Most previous studies make psychiatric diagnoses based on diagnostic terms. In this study we sought to augment Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnostic criteria with deep neural network models to make psychiatric diagnoses based on psychiatric notes. METHODS: We augmented DSM-5 diagnostic criteria with self-attention-based bidirectional long short-term memory (BiLSTM) models to identify schizophrenia, bipolar, and unipolar depressive disorders. Given that the diagnostic criteria for psychiatric diagnosis include a certain symptom profile and functional impairment, we first extracted psychiatric symptoms and functional features with two approaches, including a lexicon-based approach and a dependency parsing approach. Then, we incorporated free-text discharge notes and extracted features for psychiatric diagnoses with the proposed models. RESULTS: The micro-averaged F1 scores of the two automatic annotation approaches were greater than 0.8. BiLSTM models with self-attention outperformed the rule-based models with DSM-5 criteria in the prediction of schizophrenia and bipolar disorder, while the latter outperformed the former in predicting unipolar depressive disorder. Approaches for augmenting DSM-5 criteria with a self-attention-based BiLSTM outperformed both pure rule-based and pure deep neural network models. In terms of classification of psychiatric diagnoses, we observed that the performance for schizophrenia and bipolar disorder was acceptable. CONCLUSION: This DSM-5-augmented deep neural network models showed good performance in identifying psychiatric diagnoses from psychiatric notes. We conclude that it is possible to establish a model that consults clinical notes to make psychiatric diagnoses comparably to physicians. Further research will be extended to outpatient notes and other psychiatric disorders.
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Transtorno Bipolar , Transtornos Mentais , Esquizofrenia , Humanos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos Mentais/diagnóstico , Esquizofrenia/diagnóstico , Transtorno Bipolar/diagnósticoRESUMO
LAY ABSTRACT: White matter is the neural pathway that connects neurons in different brain regions. Although research has shown white matter differences between autistic and non-autistic people, little is known about the properties of white matter in non-autistic siblings. In addition, past studies often focused on the whole neural tracts; it is unclear where differences exist in specific segments of the tracts. This study identified neural segments that differed between autistic people, their non-autistic siblings, and the age- and non-autistic people. We found altered segments within the tracts connected to anterior brain regions corresponding to several higher cognitive functions (e.g. executive functions) in autistic people and non-autistic siblings. Segments connecting to regions for social cognition and Theory of Mind were altered only in autistic people, explaining a large portion of autistic traits and may serve as neuroimaging markers. Segments within the tracts associated with fewer autistic traits or connecting brain regions for diverse highly integrated functions showed compensatory increases in the microstructural properties in non-autistic siblings. Our findings suggest that differential white matter segments that are shared between autistic people and non-autistic siblings may serve as potential "intermediate phenotypes"-biological or neuropsychological characteristics in the causal link between genetics and symptoms-of autism. These findings shed light on a promising neuroimaging model to refine the intermediate phenotype of autism which may facilitate further identification of the genetic and biological bases of autism. Future research exploring links between compensatory segments and neurocognitive strengths in non-autistic siblings may help understand brain adaptation to autism.