Association between autistic traits and binge drinking: Findings from Japan.

PURPOSE: Substance misuse may be elevated in some individuals with autism spectrum disorder (ASD). As yet, however, little is known about the association between autistic traits (AT) and substance use/misuse in adults. This study examined the association between AT and binge drinking (BD) among individuals in Japan. METHODS: Data were analyzed from 1452 individuals aged 18 and above collected during an online survey in February 2021. Self-reported information was obtained on BD assessed as consuming 5 or more (males) or 4 or more (females) drinks containing any kind of alcohol within a 2-h period. AT were assessed with the Japanese version of the Autism Spectrum Quotient - the AQ-J-10. Logistic regression analysis was used to examine associations. RESULTS: The prevalence of past-month BD was significantly higher in individuals with AT compared to those without AT (42.7% > 27.6%). In a fully adjusted analysis that controlled for mental health (anxiety, depression) and attention-deficit/hyperactivity disorder symptoms, individuals with AT had significantly higher odds for BD once a week or more often (OR: 1.54, 95%CI: 1.04-2.29). AT were also associated with significantly higher odds for BD among women (OR: 2.27, 95%CI: 1.08-4.76), and those aged 18-34 (OR: 2.37, 95%CI: 1.09-5.18) and aged 60 and above (OR: 2.15, 95%CI: 1.02-4.53). CONCLUSION: Individuals with AT have higher odds for BD. Increased efforts to detect alcohol use/misuse in adults with AT and AT in adults misusing alcohol may be efficacious in efforts to manage symptoms and eliminate harmful alcohol misuse.

Emotional and behavioral problems in Japanese preschool children with subthreshold autistic traits: findings from a community-based sample.

BACKGROUND: Recently, there has been a growing recognition that autistic traits exist along a continuum beyond diagnostic categories and that even subclinical symptoms may be associated with an increased risk for the psychosocial well-being and mental health of children. However, as yet, there has been little research on whether preschool children with autism spectrum disorder (ASD) symptoms, who do not meet the diagnostic criteria for ASD, are more likely to experience difficulties. To address this deficit this study examined whether young children with subthreshold autistic traits have an increased risk for emotional/behavioral difficulties. METHODS: Data were analyzed from 1057 Japanese preschool children aged 5-years old collected during the first wave of the Tama Children's Survey (TCS) cohort study. Parent-reported autistic traits were assessed with the Social Responsiveness Scale (SRS), while they provided information on their child's emotional/behavioral problems using the Strengths and Difficulties Questionnaire (SDQ). Logistic regression analysis was used to examine associations. RESULTS: Preschool children with mild-to-moderate autistic traits, corresponding to subclinical autism were significantly more likely to score above the clinical thresholds for emotional/behavioral problems compared to children with fewer autistic traits. Follow-up diagnostic assessments and analyses of 72 children from the cohort confirmed these findings and showed that these children with subthreshold autistic traits also had a significantly lower intelligence quotient (IQ) as measured by the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). CONCLUSIONS: Although subthreshold autistic traits are difficult to define due to the sometimes vague border between typical and atypical development, there may be a large number of preschool children with subthreshold autistic traits, who may have an increased risk for a variety of different emotional/behavioral difficulties as well as lower cognitive functioning.

Emotional and behavioral problems in Japanese preschool children with motor coordination difficulties: the role of autistic traits.

There has been little research on whether younger children with developmental coordination disorder (DCD) symptoms have an increased risk for emotional and behavioral problems. This study examined whether coordination difficulties are associated with emotional and behavioral problems (emotional symptoms, conduct problems, hyperactivity/inattention, peer problems, reduced prosocial behavior) in preschool children and the role of autistic traits in this association. Data (N = 1042, age 58-71 months) were analyzed from the Tama Children's Survey (TCS). The Little Developmental Coordination Disorder Questionnaire (LDCDQ) was used to measure coordination difficulty symptoms. Information was obtained on emotional/behavioral problems using the Strengths and Difficulties Questionnaire (SDQ) and on autistic traits with the Social Responsiveness Scale (SRS). Higher autistic traits were based on SRS cutoff scores (53.5 for boys and 52.5 for girls). Logistic regression analysis was used to assess associations between the variables. In adjusted models, children with probable DCD (pDCD) were significantly more likely to score above the clinical thresholds on all SDQ emotional/behavioral domains. However, nearly all of these associations became nonsignificant after including autistic traits in the analysis. Additional analyses showed that children with pDCD with higher autistic traits had significantly increased odds for emotional problems (odds ratio [OR]: 4.47, 95% confidence interval [CI]: 1.52-13.19), hyperactivity/inattention (OR: 3.74, 95% CI: 1.45-9.64), peer problems (OR: 15.81, 95% CI: 5.96-41.99), and total difficulties (OR: 28.78, 95% CI: 7.23-114.57), compared to children with pDCD alone. These results indicate that the increased risk of emotional/behavioral difficulties in preschool children with pDCD might be mediated by autistic traits.

Attention-deficit/hyperactivity disorder symptoms and suicidal behavior in adult psychiatric outpatients.

AIM: We aimed to examine the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and suicidal behavior in psychiatric outpatients and whether this association differs among patients with different psychiatric disorders. METHODS: Cross-sectional data came from the Japan Prevalence Study of Adult ADHD at Psychiatric Outpatient Care, which included psychiatric outpatients aged 18-65 years recruited from one university hospital and three general psychiatric outpatient clinics in Kitakyushu City, Fukuoka, Japan from April 2014 to January 2015 (N = 864). The Adult ADHD Self-Report Scale (ASRS) Screener was used to collect information on ADHD symptoms. Reports of current and lifetime suicidal behavior were also obtained. A multivariable Poisson regression analysis was used to examine the association between ADHD symptoms and suicidal behavior. RESULTS: After adjusting for covariates there was a strong association between possible ADHD (ASRS ≥14) and suicidal behavior with prevalence ratios ranging from 1.17 (lifetime suicidal ideation) to 1.59 (lifetime suicide attempt) and 2.36 (current suicidal ideation). When ASRS strata were used, there was a dose-response association between increasing ADHD symptoms and suicidal ideation and suicide attempts. Analyses of individual ICD-10 psychiatric disorders showed that associations varied across disorders and that for anxiety disorder, ADHD symptoms were significantly linked to all forms of suicidal behavior. CONCLUSION: ADHD symptom severity is associated with an increased risk for suicidal behavior in general psychiatric outpatients. As ADHD symptoms are common among adult psychiatric outpatients, detecting and treating ADHD in this population may be important for preventing suicidal behavior.

Correlation of reduced social communicational and interactional skills with regional grey matter volumes in schizophrenia patients.

OBJECTIVE: Recent studies have detected similarities between autism spectrum disorder and schizophrenia. We investigated structural abnormalities associated with autistic-like traits in patients with schizophrenia by voxel-based morphometry. METHODS: Patients with schizophrenia and healthy subjects were evaluated by the adult version of the social responsiveness scale (SRS-A), which is sensitive to autistic traits and symptoms even under subthreshold conditions, and magnetic resonance imaging. RESULTS: There were significant decreases in the anterior cingulate cortex, bilateral hippocampi, cerebellums, and right insula of patients with schizophrenia, compared with healthy subjects. We found significant negative correlations of the social communication and interaction (SCI) score, a subscale of SRS-A, with grey matter volume in the left posterior superior temporal region of schizophrenia patients. When subscales of SCI were examined separately in schizophrenic patients, negative correlations were observed between the social cognition score and the volumes of the left posterior superior temporal region, and between social motivation and the posterior cingulate cortex. CONCLUSION: We found significant negative correlation between the SCI score and the grey matter volume in the left posterior superior temporal region of schizophrenia patients. This area was the region affected in previous studies of autistic spectrum disorders. Further, this area was associated with the theory of mind. Schizophrenia patients not necessarily show the impairment of SCI, nor this correlated region was not always the point with schizophrenia-specific change. However, we reveal the relationship between the left posterior superior temporal gyrus and the severity of the SCI in schizophrenia by using with SRS-A.

Current viewpoints on DSM-5 in Japan.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, and its official Japanese version was published in 2014. The Japanese Government uses classifications from the 10th revision of the I nternational C lassification of D iseases (ICD-10) to categorize disorders and determine treatment fees. However, since the publication of the DSM-III, the use of the DSM system has become prevalent in research and educational settings in Japan. In addition to traditional psychiatry, both the ICD and the DSM are taught by many Japanese medical schools, and virtually all clinical research and trials refer to the DSM to define targeted disorders. Amid the current backdrop in which the reputation of the DSM-5 is being established, the editorial board of P sychiatry and C linical N eurosciences has asked Japanese experts across 12 specialties to examine the structure of the DSM-5, including the following categories: Neurodevelopmental Disorders, Schizophrenia Spectrum Disorders, Major Depression, Bipolar Disorders, Obsessive-Compulsive Disorders, Somatic Symptom Disorder, Eating Disorders, Substance-Related and Addictive Disorders, Gender Dysphoria, and Neurocognitive Disorders. Although opinions were only obtained from these selected experts, we believe that we have succeeded, to a certain extent, in presenting views that are representative of each specialty.

Evaluation of chromID strepto B as a screening media for Streptococcus agalactiae.

BACKGROUND: Streptococcus agalactiae (Group B Streptococcus, GBS), a leading cause of sepsis and meningitis in infants, can be transmitted vertically from mother to infant during passage through the birth canal. Detection of GBS colonization in perinatal women is a major strategy for the prevention of postpartum neonatal disease. The U.S. Centers for Disease Control and Prevention recommends that all women undergo vaginal-rectal screening for GBS colonization at 35-37 weeks of gestation. ChromID Strepto B (STRB) is a chromogenic GBS screening media on which GBS colonies appear pink or red, while other bacteria are either inhibited or form colonies in other colors. In this study, we compared STRB with a conventional GBS detection method using 5% sheep blood agar (BA) followed by a selective enrichment broth. METHODS: Anovaginal swabs were collected from 1425 women during weeks 35 to 37 of their pregnancies. The swabs were used to inoculate both STRB and BA plates after enrichment with selective Todd Hewitt Broth (THB). A GBS latex agglutination test was used to confirm the identity of isolates from each plate. RESULTS: GBS was recovered from 319 (22.4%) samples with one or both media: 318 on STRB compared to 299 using BA. One false negative was observed on STRB, and 20 false negatives were observed on BA. In addition, non-hemolytic GBS was recovered from 19 (6.0%) samples using STRB. CONCLUSIONS: STRB offers effectiveness and convenience over BA for GBS screening in clinical laboratories. STRB produces fewer false negatives, has a higher detection rate and uses a simple color screen that is ideal for technician-level applications. We recommend STRB as the media of choice for GBS screening.

Verification of the utility of the social responsiveness scale for adults in non-clinical and clinical adult populations in Japan.

BACKGROUND: Recently great attention has been paid to the still unmet clinical needs of most adults with autism spectrum disorder (ASD) who live in the community, an increasing number of whom visit psychiatric clinics to seek accurate diagnosis and treatment of concurrent psychiatric symptoms. However, different from the case of children diagnosed with ASD in childhood, it is difficult in adults to identify the ASD symptoms underlying psychopathology and to differentiate ASD from other psychiatric disorders in general psychiatric practice. This study aimed to verify the utility of the Social Responsiveness Scale-Adult version (SRS-A), a quantitative measure for identifying ASD symptoms, in non-clinical and clinical adult populations in Japan. METHODS: The total sample aged 19 to 59 years consisted of a non-clinical population (n =592) and clinical population with and without ASD (n =142). We examined score distributions of the Japanese version of the scale, and the effects of gender, age, and rater on the distribution. We analyzed factor structure and internal consistency in the non-clinical normative sample, and analyzed convergent, divergent, and discriminative validities in the clinical sample. We applied receiver operator characteristic (ROC) analysis to determine optimal cutoff scores discriminating the ASD clinical population from the non-ASD clinical population. RESULTS: The score distributed continuously, which replicated findings in children. For non-clinical adults, except in men aged 19 to 24 years, we found no or few gender, age, or rater effects. Both single- and two-factor models were supported for adults. Total SRS-A scores demonstrated high internal consistency and capably discriminated adults with ASD from those with non-ASD psychiatric disorders such as major depressive disorder, schizophrenia, and bipolar disorder with an overlap across diagnoses. Moderate to high correlations of the SRS-A with other-rated ASD measures indicated sufficient convergent validity. Based on the ROC analysis, we recommend cutoff points by gender for use in clinical settings. CONCLUSION: This study provides additional supportive evidence that the Japanese version SRS-A can reliably and validly measure ASD symptoms in non-clinical and clinical adult populations, and thus can serve as a useful tool for ASD research as well as for secondary screening in Japanese adults.

[Characteristics and adaptive problems of adults with subthreshold ASD in cognitive-behavioral intervention research for emotion regulation].

Autism spectrum disorders (ASD) are developmental disorders that have social communication deficits as a core symptom. Even adults with high-functioning ASD have difficulties in social communication and, therefore, have deficits in understanding others' minds. Recent research has found that they are unable to understand not only others' minds, but also their own minds. This could lead to difficulties in self-regulation. Some studies have reported the effectiveness of cognitive-behavioral therapy (CBT) in improving self-regulation, especially in reducing anxiety in children and teenagers with ASD. However, few studies have examined adults with ASD. Therefore, this study investigated the efficacy of group-based CBT for adults with ASD. Our hypothesis is that adults with ASD can understand their own emotions. exercise self-regulation, and thus alleviate their own secondary symptoms, such as anxiety and depression. The study is a randomized open-blind study with centralization using minimization and blind assessors. In this paper, we introduce the protocol for this study and examine the characteristics and adaptive problems of people with subthreshold ASD interested in joining this study.

[Psychiatric issues of children and adults with autism spectrum disorders who remain undiagnosed].

Individuals of normal intelligence with autism spectrum disorders (ASD) tend to be diagnosed with ASD late in childhood or sometimes in adulthood, despite a persistent symptomatology. When such patients visit psychiatric clinics for co-occurring psychiatric symptoms, the diagnostic procedure can be challenging due to a lack of accurate developmental information and a mixed clinical presentation. The same is true for those with subthreshold autistic symptoms. Although individuals with subthreshold ASD also have social adjustment difficulties of a similar degree to those with ASD, the relative clinical significance of this population is unclear. Here, data from a large national population sample of schoolchildren were examined to determine the psychiatric needs of children with threshold and subthreshold autistic symptoms. First, autistic symptoms or traits assessed by the Social Responsiveness Scale (SRS), a quantitative behavioral measure, showed a continuous distribution in the general child population (n = 22,529), indicating no evidence of a natural gap that could differentiate children diagnosed with ASD from subthreshold or unaffected children. Second, data from 25,075 children demonstrated that having threshold autistic symptoms predicted a high psychiatric risk, as indicated by higher scores on the Strengths and Difficulties Questionnaire (SDQ; odds ratio [OR] 200.52, 95% confidence interval [CI]: 152.12-264.33), and that having subthreshold autistic symptoms indicated the same (OR 12.78, 95% CI: 11.52-14.18). Having threshold autistic symptoms predicted emotional problems (OR 20.19, 95% CI: 17.00-24.00), as did having subthreshold autistic symptoms (OR 5.90, 95% CI: 5.29-6.58). Third, among 2,250 children at a high psychiatric risk, most had threshold or subthreshold autistic symptoms (21 and 44%, respectively). These findings have important implications for the comprehensive psychiatric and developmental evaluation and treatment of this patient population, whose diagnosis and treatment are often delayed, and a further in-depth study is warranted.

Associations between media exposure and mental health among children and parents after the Great East Japan Earthquake.

Background: Exposure to natural disaster media coverage is associated with mental health problems, but its long-term impacts are still unclear. Also, no study has analysed the psychological impact of exposure to natural disaster media coverage among children who are generally sensitive to threatening events.Objective: We aimed to examine how television images of victims after the 2011 Great East Japan Earthquake were associated with mental health among children and their parents.Methods: In 2012, questionnaires for sociodemographic factors were distributed to 2053 families. Parents who provided written consent were contacted in 2013 and invited to provide information on mental health problems (outcome) and retrospectively provide information on television watching at the time of the earthquake (exposure). We used data from 159 parents who completed the survey as the final sample. We used a dichotomous variable to evaluate exposure to media coverage. Multivariable regression was used to examine the association between exposure to television images of victims and mental health, adjusting for potential confounders. Bias-corrected and accelerated bootstrap confidence intervals (CIs) were used.Results: Exposure to television images of victims was significantly associated with worse psychopathology among children (ß, 1.51; 95% CI, 0.07-2.96) and greater psychological distress among their parents (ß, 1.49; 95% CI, 0.28-2.70). Child psychopathology and parental psychological distress were significantly correlated (r = 0.36, p < .001).Conclusions: Exposure to television images of disaster victims may produce long-term impacts on mental health among children and their parents. To reduce the likelihood of mental health problems associated with disasters, clinicians may recommend reducing exposure to television images of victims.

Television images of victims after the 2011 Great East Japan Earthquake were associated with worse psychopathology among children in 2013, adjusted for potential confounders.Similar associations were found in psychological distress among their parents.Child psychopathology and parental psychological distress were correlated with each other.

Training types associated with knowledge and experience in public health workers.

BACKGROUND: Training non-specialist workers in mental healthcare improves knowledge, attitude, confidence, and recognition of mental illnesses. However, still little information is available on which type of mental health training is important in the improvement of these capacities. METHODS: We studied web-based survey data of 495 public health workers to examine training types associated with knowledge and experience in supporting individuals with mental illness. Multivariable logistic regression analysis was conducted to evaluate the association between a lack of knowledge and experience (outcome) and mental health training (exposure). We fitted three regression models. Model 1 evaluated unadjusted associations. Model 2 adjusted for age and sex. Model 3 adjusted for age, sex, years of experience, mental health full-time worker status, and community population. Bias-corrected and accelerated bootstrap confidence intervals (CIs) were used. RESULTS: For all training types, the association between a lack of knowledge and experience and mental health training attenuated as the model developed. In Model 3, a lack of knowledge and experience was significantly associated with training in specific illness (OR, 0.54; 95% CI, 0.32-0.93) and screening and assessment (OR, 0.63; 95% CI, 0.39-0.99). Non-significant results were produced for training in counseling, psychosocial support, collaborative work, and law and regulation in Model 3. CONCLUSIONS: We believe that the present study provides meaningful information that training in specific illness and screening and assessment may lead to knowledge and experience of public health workers. Further studies should employ a longitudinal design and validated measurements.

Preliminary efficacy of cognitive-behavioral therapy on emotion regulation in adults with autism spectrum disorder: A pilot randomized waitlist-controlled study.

Previous studies have demonstrated the clinical utility of cognitive-behavioral therapy in improving emotion regulation in children on the autism spectrum. However, no studies have elucidated the clinical utility of cognitive-behavioral therapy in improving emotion regulation in autistic adults. The aim of the present pilot study was to explore the preliminary clinical utility of a group-based cognitive-behavioral therapy program designed to address emotion regulation skills in autistic adults. We conducted a clinical trial based on a previously reported protocol; 31 participants were randomly allocated to the intervention group and 29 to the waitlist control group. The intervention group underwent an 8-week program of cognitive-behavioral therapy sessions. Two participants from the intervention group withdrew from the study, leaving 29 participants (93.5%) in the group. Compared with the waitlist group, the cognitive-behavioral therapy group exhibited significantly greater pre-to-post (Week 0-8) intervention score improvements on the attitude scale of the autism spectrum disorder knowledge and attitude quiz (t = 2.21, p = 0.03, d = 0.59) and the difficulty describing feelings scale of the 20-item Toronto Alexithymia Scale (t = -2.07, p = 0.04, d = -0.57) in addition to pre-to-follow-up (Week 0-16) score improvements on the emotion-oriented scale of the Coping Inventory for Stressful Situations (t = -2.14, p = 0.04, d = -0.59). Our study thus provides preliminary evidence of the efficacy of the group-based cognitive-behavioral therapy program on emotion regulation in autistic adults, thereby supporting further evaluation of the effectiveness of the cognitive-behavioral therapy program in the context of a larger randomized clinical trial. However, the modest and inconsistent effects underscore the importance of continued efforts to improve the cognitive-behavioral therapy program beyond current standards.

Association between sleep habits/disorders and emotional/behavioral problems among Japanese children.

Actual sleep status and the association between sleep habits/disorders and emotional/behavioral problems among children in the development stage have not been fully clarified. A questionnaire survey was conducted on the sleep habits/disorders (Brief Child Sleep Questionnaire; BCSQ) and emotional/behavioral problems (Strengths and Difficulties Questionnaire; SDQ) of 87,548 children enrolled in ordinary classes in nine grade levels from the first grade of elementary school to the third grade of junior high school from December 2009 to April 2010. As school grade increased, children's bedtimes were delayed and sleep duration was reduced by 2.0 h over the nine grade levels. Based on the BCSQ, 18.3% of children were judged to have some type of sleep disorder, and about 30% to 40% of children had sleep symptoms at bedtime, during sleep, and at wake time. Multiple regression analysis showed that emotional and behavioral problems were associated with presence of any sleep symptom, longer sleep latency, and longer awake time after sleep onset, whereas total sleep time was not. Sleep symptoms at wake time were most strongly associated with emotional and behavioral problems. Status of sleep habits/disorders should be considered when interpreting emotional/behavioral problems in school-age children.

Changes in self-efficacy in Japanese school-age children with and without high autistic traits after the Universal Unified Prevention Program: a single-group pilot study.

BACKGROUND: Research has shown the efficacy of school-based programs for mental health problems in children. However, few studies have focused on the strengths of children, such as resilience, which is essential in preventing mental health problems. Moreover, no research has investigated the effect of a universal school-based program on children with increased autistic traits in mainstream classes. We examined the changes in children's self-efficacy, social skills, and general mental health after the implementation of a newly developed universal program, the Universal Unified Prevention Program for Diverse Disorders (Up2-D2), and whether similar changes occurred in children with and without higher autistic traits. METHODS: To assess possible changes associated with the program, questionnaires were collected from 396 children (207 boys and 189 girls) aged 9-12 years old before (T1), immediately after (T2), and three months after (T3) the implementation of the program. RESULTS: Results from a linear mixed-effects model showed a significant increase in children's self-efficacy at T2 (adjusted difference 0.49, 95% CI 0.03-0.94; p < 0.05) and T3 (0.78, 95% CI 0.32-1.23; p < 0.001). There were also significant positive changes in social skills and general mental health. Similar changes were observed in children with high autistic traits. Autistic traits at T1 did not contribute to the degree of change in self-efficacy. CONCLUSIONS: Our pilot study suggests that a universal program has the potential to promote positive attitudes and mental health in both at-risk and not-at-risk children.

Attention-deficit/hyperactivity disorder symptoms and sleep problems in preschool children: the role of autistic traits.

BACKGROUND: Sleep problems are elevated in children with attention-deficit/hyperactivity disorder (ADHD). However, until now there has been comparatively little research on the role of autistic traits in this association. The current study examined the association between ADHD symptoms and sleep problems in Japanese preschool children and whether autistic traits might also be important for this relationship. METHODS: Data were analyzed from 1053 children (average age 64.14 months, range 58-71; 50.3% male) that were drawn from the Tama Children's Survey (TCS). Parent-reported information was obtained on ADHD symptoms using the Strengths and Difficulties Questionnaire (SDQ) and autistic traits with the Social Responsiveness Scale Second Edition (SRS-2). Parents also provided information on three different categories of sleep problems experienced by their children - parasomnias, sleep disordered breathing and awakening/daytime problems. Ordinal logistic regression analysis was used to examine the associations. RESULTS: In analyses adjusted for sociodemographic factors, the mother's mental health and child's emotional problems, compared to children with no ADHD symptoms or autistic traits, children with only ADHD symptoms had significantly increased odds for only one of 11 individual sleep problems - waking in a negative mood. In contrast, children with comorbid ADHD symptoms and autistic traits had elevated odds for five sleep problems with odds ratios ranging from 2.10 (takes time to become alert in the morning) to 3.46 (excessive body movement while sleeping). CONCLUSIONS: Sleep problems may be especially elevated in children with comorbid ADHD symptoms and autistic traits.

Practical applications of brief screening questionnaires for autism spectrum disorder in a psychiatry outpatient setting.

OBJECTIVES: This study was designed to examine the diagnostic performance of the social and communication disorders checklist (SCDC) and strength and difficulties questionnaire (SDQ) to detect autism spectrum conditions (ASC), along with the social responsiveness scale-second edition (SRS-2) as reference, in a psychiatry outpatient setting. METHODS: We translated the SCDC into Japanese since its Japanese version was unavailable. We examined its test-retest reliability as well as the internal consistency reliability and diagnostic performance of the three questionnaires among 41 Japanese psychiatric outpatients, using the best-estimate diagnosis of ASC based on the diagnostic interview for social and communication disorders, as a gold standard. RESULTS: The test-retest reliability was high for the SCDC. Although the internal consistency reliability was high for the SCDC and SRS-2, that was low for the prosocial and peer problem subscales of the SDQ. The performance of the SCDC, SDQ, and SRS-2 to detect ASC was moderate: the area under the ROC curve of 0.78, 0.78, and 0.84, respectively. CONCLUSIONS: Although questionnaires to detect ASC, including the three examined, generally have only moderate performance in this setting, these can be successfully applied to high-risk populations such as psychiatry outpatients, when multi-level rather than dichotomous likelihood ratios are used.

Utility of the Japanese version of the Checklist for Autism in Toddlers for predicting pervasive developmental disorders at age 2.

We evaluated the utility of the Japanese version of the Checklist for Autism in Toddlers for predicting pervasive developmental disorders (PDD) among 2-year-old children in clinical settings. Confirmed diagnosis revealed that the pass rate on four items (social interest, proto-imperative pointing, proto-declarative pointing and joint-attention) was significantly lower in 52 PDD children than in 48 non-PDD children, and if abnormal development was reported in two or more items, the sensitivity, specificity, and positive/negative predictive values for PDD diagnosis were 0.85, 0.73, and 0.77/0.81, respectively. This simple screening tool can provide valuable information to clinicians when diagnosing PDD.

Sex differences in WISC-III profiles of children with high-functioning pervasive developmental disorders.

Using the Japanese version of the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), 26 girls with high-functioning (IQ > or = 70) pervasive developmental disorders (HFPDD) (mean age, 8.2 years) were compared with 116 boys with HFPDD (mean age, 9.0 years). Compared with the boys, the girls scored significantly higher on the Processing Speed index, Coding, and Symbol Search, but scored significantly lower on Block Design. Although both groups showed weakness on Comprehension in the verbal domain, the girls' subtest profile in the performance domain was relatively even and significantly different from the boys', which was characterized by a peak on Block Design. Such differences should be replicated, and possible behavioral, neurological, and genetic links to these sex differences should be clarified.

The orbitofrontal cortex modulates parenting stress in the maternal brain.

Many mothers are adaptive, deploying successful coping strategies that mitigate the deleterious effects of parenting stress on caregiving, nevertheless, the neural mechanisms underlying these adaptive responses remain unclear. We utilized functional magnetic resonance imaging to investigate brain activity in 28 healthy mothers of typically developing, 2-to-3-year-old children in response to the feeding behavior of their own children versus that of other children. We then examined the correlation between maternal brain activation and subjective feelings of parenting stress. Brain regions associated with maternal motivation including the orbitofrontal cortex (OFC), ventral pallidum, periaqueductal gray (PAG), dorsal raphe nucleus (DRN), and anterior insular cortex (AIC)-as well as those associated with the recognition of one's own child's state (e.g., cerebellum)-exhibited significant activation in response to their own children. While mothers with higher activation in the OFC showed less parenting stress related to one's sense of competence in the parental role, mothers with higher co-activation of the OFC with both of the AIC and PAG/DRN, and with the cerebellum showed less parenting stress caused by child characteristics. Our findings suggest that well-balanced maternal brain mechanisms integrated by the OFC may provide effective adaptive responses in daily parenting scenarios.