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1.
PLoS One ; 15(12): e0243298, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33320901

RESUMO

The network approach to psychological phenomena advances our understanding of the interrelations between autism and well-being. We use the Perceived Causal Relations methodology in order to (i) identify perceived causal pathways in the well-being system, (ii) validate networks based on self-report data, and (iii) quantify and integrate clinical expertise in autism research. Trained clinicians served as raters (N = 29) completing 374 cause-effects ratings of 34 variables on well-being and symptomatology. A subgroup (N = 16) of raters chose intervention targets in the resulting network which we found to match the respective centrality of nodes. Clinicians' perception of causal relations was similar to the interrelatedness found in self-reported client data (N = 323). We present a useful tool for translating clinical expertise into quantitative information enabling future research to integrate this in scientific studies.


Assuntos
Transtorno Autístico/psicologia , Felicidade , Adolescente , Adulto , Idoso , Transtorno Autístico/terapia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato
2.
Nat Protoc ; 15(10): 3464-3477, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32895524

RESUMO

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and other behavioral abnormalities. The three-chamber social preference test is often used to assess social deficits in mouse models of ASD. However, varying and often contradicting phenotypic descriptions of ASD mouse models can be found in the scientific literature, and the substantial variability in the methods used by researchers to assess social deficits in mice could be a contributing factor. Here we describe a standardized three-chamber social preference protocol, which is sensitive and reliable at detecting social preference deficits in several mouse models of ASD. This protocol comprises three phases that can all be completed within 1 d. The test mouse is first habituated to the apparatus containing two empty cups in the side chambers, followed by the pre-test phase in which the mouse can interact with two identical inanimate objects placed in the cups. During the test phase, the mouse is allowed to interact with a social stimulus (an unfamiliar wild-type (WT) mouse) contained in one cup and a novel non-social stimulus contained in the other cup. The protocol is thus designed to assess preference between social and non-social stimuli under conditions of equal salience. The broad implementation of the three-chamber social preference protocol presented here should improve the accuracy and consistency of assessments for social preference deficits associated with ASD and other psychiatric disorders.


Assuntos
Análise do Comportamento Aplicada/métodos , Transtorno Autístico/psicologia , Modelos Animais de Doenças , Animais , Transtorno do Espectro Autista/fisiopatologia , Transtorno do Espectro Autista/psicologia , Transtorno Autístico/fisiopatologia , Comportamento Animal/fisiologia , Camundongos , Proteínas dos Microfilamentos/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Comportamento Social , Transtornos do Comportamento Social/fisiopatologia
3.
Medicine (Baltimore) ; 99(36): e21651, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32898998

RESUMO

BACKGROUND/OBJECTIVE: Teaching has been found to be 1 of the most stressful occupations worldwide. Stress associated with teaching is more critical among teachers teaching children with special needs in general and those with autism specifically, partly due to the heterogeneous nature of the disorders. The purpose of this study was to investigate the effectiveness of Rational Emotive Occupational Health Coaching (REOHC) in minimizing job stress in teachers of children with autism (CWA). METHODS: A group-randomized waitlist control-trial design was adopted. A sample of 87 teachers of CWA who participated in the study was randomized into the immediate intervention group (IIG) and waitlist group (WLG). Participants were evaluated on 3 occasions: pretest, post-test and follow-up. Three instruments (Occupational Stress Index, Perceived Occupational Stress Scale and Stress Symptom Scale) were used to measure dimensions of job stress. After the pretest exercise, the IIG participated in a 2-hour REOHC programme weekly for a period of 12 weeks. Post- and follow-up evaluations were conducted respectively at 2 weeks and 3 months after the REOHC programme. Those in WLG were exposed to the REOHC after the follow-up assessment. Data collected were analysed using t-test statistics, repeated measures analysis of variance and bar charts. RESULTS: Results revealed that the perceived stress and stress symptoms of the REOHC group reduced significantly over WLG at post-test, and follow-up assessments. Changes in the occupational stress index scores across pre-, post- and follow-up measurements were minimal and could not account for a significant difference between the IIG and WLG. CONCLUSION: It was concluded that REOHC is effective in reducing subjective feelings and physiological symptoms of job stress, even when the objective stressors remain constant among teachers of CWA and other employees who work in stressful occupational environments.


Assuntos
Terapia Comportamental/métodos , Estresse Ocupacional/prevenção & controle , Professores Escolares/psicologia , Adulto , Transtorno Autístico/psicologia , Criança , Pré-Escolar , Crianças com Deficiência/educação , Feminino , Humanos , Masculino , Inquéritos e Questionários
4.
Nat Commun ; 11(1): 3959, 2020 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-32770077

RESUMO

It is unclear whether transgender and gender-diverse individuals have elevated rates of autism diagnosis or traits related to autism compared to cisgender individuals in large non-clinic-based cohorts. To investigate this, we use five independently recruited cross-sectional datasets consisting of 641,860 individuals who completed information on gender, neurodevelopmental and psychiatric diagnoses including autism, and measures of traits related to autism (self-report measures of autistic traits, empathy, systemizing, and sensory sensitivity). Compared to cisgender individuals, transgender and gender-diverse individuals have, on average, higher rates of autism, other neurodevelopmental and psychiatric diagnoses. For both autistic and non-autistic individuals, transgender and gender-diverse individuals score, on average, higher on self-report measures of autistic traits, systemizing, and sensory sensitivity, and, on average, lower on self-report measures of empathy. The results may have clinical implications for improving access to mental health care and tailoring adequate support for transgender and gender-diverse individuals.


Assuntos
Transtorno Autístico/diagnóstico , Transtorno Autístico/psicologia , Pessoas Transgênero/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalos de Confiança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Autorrelato , Adulto Jovem
5.
Nature ; 584(7820): 252-256, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32760004

RESUMO

A fundamental challenge in developing treatments for autism spectrum disorders is the heterogeneity of the condition. More than one hundred genetic mutations confer high risk for autism, with each individual mutation accounting for only a small fraction of cases1-3. Subsets of risk genes can be grouped into functionally related pathways, most prominently those involving synaptic proteins, translational regulation, and chromatin modifications. To attempt to minimize this genetic complexity, recent therapeutic strategies have focused on the neuropeptides oxytocin and vasopressin4-6, which regulate aspects of social behaviour in mammals7. However, it is unclear whether genetic risk factors predispose individuals to autism as a result of modifications to oxytocinergic signalling. Here we report that an autism-associated mutation in the synaptic adhesion molecule Nlgn3 results in impaired oxytocin signalling in dopaminergic neurons and in altered behavioural responses to social novelty tests in mice. Notably, loss of Nlgn3 is accompanied by a disruption of translation homeostasis in the ventral tegmental area. Treatment of Nlgn3-knockout mice with a new, highly specific, brain-penetrant inhibitor of MAP kinase-interacting kinases resets the translation of mRNA and restores oxytocin signalling and social novelty responses. Thus, this work identifies a convergence between the genetic autism risk factor Nlgn3, regulation of translation, and oxytocinergic signalling. Focusing on such common core plasticity elements might provide a pragmatic approach to overcoming the heterogeneity of autism. Ultimately, this would enable mechanism-based stratification of patient populations to increase the success of therapeutic interventions.


Assuntos
Transtorno Autístico/metabolismo , Transtorno Autístico/psicologia , Modelos Animais de Doenças , Ocitocina/metabolismo , Comportamento Social , Animais , Moléculas de Adesão Celular Neuronais/deficiência , Moléculas de Adesão Celular Neuronais/genética , Fator de Iniciação 4E em Eucariotos/metabolismo , Masculino , Proteínas de Membrana/deficiência , Proteínas de Membrana/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Proteínas do Tecido Nervoso/deficiência , Proteínas do Tecido Nervoso/genética , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Fosforilação/efeitos dos fármacos , Biossíntese de Proteínas/efeitos dos fármacos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Transdução de Sinais/efeitos dos fármacos , Área Tegmentar Ventral/citologia , Área Tegmentar Ventral/efeitos dos fármacos
6.
Mol Autism ; 11(1): 61, 2020 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-32698850

RESUMO

The new coronavirus disease (COVID-19) pandemic is changing how society operates. Environmental changes, disrupted routines, and reduced access to services and social networks will have a unique impact on autistic individuals and their families and will contribute to significant deterioration in some. Access to support is crucial to address vulnerability factors, guide adjustments in home environments, and apply mitigation strategies to improve coping. The current crisis highlights that our regular care systems are not sufficient to meet the needs of the autism communities. In many parts of the world, people have shifted to online school and increased use of remote delivery of healthcare and autism supports. Access to these services needs to be increased to mitigate the negative impact of COVID-19 and future epidemics/pandemics. The rapid expansion in the use of telehealth platforms can have a positive impact on both care and research. It can help to address key priorities for the autism communities including long waitlists for assessment and care, access to services in remote locations, and restricted hours of service. However, system-level changes are urgently needed to ensure equitable access and flexible care models, especially for families and individuals who are socioeconomically disadvantaged. COVID-19 mandates the use of technology to support a broader range of care options and better meet the diverse needs of autistic people and their families. It behooves us to use this crisis as an opportunity to foster resilience not only for a given individual or their family, but also the system: to drive enduring and autism-friendly changes in healthcare, social systems, and the broader socio-ecological contexts.


Assuntos
Adaptação Psicológica , Transtorno Autístico/psicologia , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Resiliência Psicológica , Populações Vulneráveis/psicologia , Acesso aos Serviços de Saúde , Humanos , Redes Sociais Online , Pandemias , Fatores Socioeconômicos , Telemedicina/estatística & dados numéricos
8.
Medicina (Kaunas) ; 56(5)2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32413984

RESUMO

In a special issue that focuses on complex presentations related to Autism, we ask the question in this editorial whether an Autism Spectrum Condition without complexity is a disorder, or whether it represents human diversity? Much research into Autism Spectrum Conditions (ASCs) over the years has focused on comparisons between neuro-typical people and people with Autism Spectrum Conditions. These comparisons have tended to draw attention to 'deficits' in cognitive abilities and descriptions of behaviours that are characterised as unwanted. Not surprisingly, this is reflected in the classification systems from the World Health Organisation and the American Psychiatric Association. Public opinion about ASC may be influenced by presentations in the media of those with ASC who also have intellectual disability. Given that diagnostic systems are intended to help us better understand conditions in order to seek improved outcomes, we propose a more constructive approach to descriptions that uses more positive language, and balances descriptions of deficits with research finding of strengths and differences. We propose that this will be more helpful to individuals on the Autism Spectrum, both in terms of individual self-view, but also in terms of how society views Autism Spectrum Conditions more positively. Commentary has also been made on guidance that has been adjusted for people with ASC in relation to the current COVID-19 pandemic.


Assuntos
Transtorno Autístico , Opinião Pública , Transtorno do Espectro Autista , Transtorno Autístico/complicações , Transtorno Autístico/diagnóstico , Transtorno Autístico/psicologia , Betacoronavirus , Infecções por Coronavirus , Pessoas com Deficiência , Humanos , Meios de Comunicação de Massa , Pandemias , Pneumonia Viral , Autoimagem
10.
Encephale ; 46(3S): S99-S106, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32405083

RESUMO

COVID-19 is a multi-organ disease due to an infection with the SARS-CoV2 virus. It has become a pandemic in early 2020. The disease appears less devastating in children and adolescents. However, stress, quarantine and eventually mourning have major impacts on development. It is difficult to describe what this pandemic implies for a child psychiatrist, other than by giving a first-hand account. I propose to go through the main ethical questions that have arisen; to describe how my hospital team has reorganized itself to meet the new demands and questions, in particular by opening a unit dedicated to people with autism and challenging behaviors affected by COVID-19; and to address, in a context of national discussion, how the discipline has sought to understand the conditions of a certain well-being during quarantine. Finally, I will try to conclude with more speculative reflections on re-opening.


Assuntos
Psiquiatria do Adolescente , Atitude do Pessoal de Saúde , Transtorno Autístico/terapia , Betacoronavirus , Psiquiatria Infantil , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Psiquiatria , Adolescente , Comportamento do Adolescente , Psiquiatria do Adolescente/ética , Transtorno Autístico/complicações , Transtorno Autístico/psicologia , Criança , Comportamento Infantil , Psiquiatria Infantil/ética , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/transmissão , Infecção Hospitalar/complicações , Infecção Hospitalar/psicologia , Infecção Hospitalar/terapia , Exposição Ambiental , França , Acesso aos Serviços de Saúde , Reestruturação Hospitalar , Unidades Hospitalares/organização & administração , Humanos , Controle de Infecções/métodos , Serviços de Saúde Mental/ética , Serviços de Saúde Mental/organização & administração , Transtornos do Olfato/etiologia , Transtornos do Olfato/psicologia , Pandemias/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde , Equipe de Assistência ao Paciente , Isolamento de Pacientes/psicologia , Ludoterapia , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Pneumonia Viral/transmissão , Prática Profissional/ética , Equipamentos de Proteção , Fatores de Risco , Estresse Psicológico/etiologia
11.
Pediatrics ; 145(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32471843

RESUMO

Down syndrome disintegrative disorder (DSDD), a developmental regression in children with Down syndrome (DS), is a clinical entity that is characterized by a loss of previously acquired adaptive, cognitive, and social functioning in persons with DS usually in adolescence to early adulthood. Initially reported in 1946 as "catatonic psychosis," there has been an increasing interest among the DS community, primary care, and subspecialty providers in this clinical area over the past decade. This condition has a subacute onset and can include symptoms of mood lability, decreased participation in activities of daily living, new-onset insomnia, social withdrawal, autistic-like regression, mutism, and catatonia. The acute phase is followed by a chronic phase in which baseline functioning may not return. No strict criteria or definitive testing is currently available to diagnose DSDD, although a comprehensive psychosocial and medical evaluation is warranted for individuals presenting with such symptoms. The etiology of DSDD is unknown, but in several hypotheses for regression in this population, psychological stress, primary psychiatric disease, and autoimmunity are proposed as potential causes of DSDD. Both psychiatric therapy and immunotherapies have been described as DSDD treatments, with both revealing potential benefit in limited cohorts. In this article, we review the current data regarding clinical phenotypes, differential diagnosis, neurodiagnostic workup, and potential therapeutic options for this unique, most disturbing, and infrequently reported disorder.


Assuntos
Atividades Cotidianas/psicologia , Transtorno Autístico/epidemiologia , Transtorno Autístico/psicologia , Síndrome de Down/epidemiologia , Síndrome de Down/psicologia , Adolescente , Transtorno Autístico/diagnóstico , Catatonia/diagnóstico , Catatonia/epidemiologia , Catatonia/psicologia , Criança , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/psicologia , Síndrome de Down/diagnóstico , Feminino , Humanos , Masculino , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Transtornos do Humor/psicologia , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Literatura de Revisão como Assunto
12.
Psychiatry Res ; 288: 112937, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32315876

RESUMO

Most children with autism have ADHD, and children with ADHD-Combined and children with autism have high rates of irritable, oppositional, and aggressive behavior. Despite similar symptoms, prescribing practices may differ between autism and ADHD, which has not been examined in a single study. 1407 children with autism and 1036 with ADHD without autism, 2-17 years, were compared with 186 typical peers. Symptom scores were maternal Pediatric Behavior Scale ratings in eight areas (ADHD, oppositional/aggressive, irritable/angry, anxious, depressed, and social, writing, and learning problems). Psychotropics were prescribed to 38.0% with ADHD-Combined, 33.3% with autism, and 20.2% with ADHD-Inattentive, most often an ADHD medication (22.1% stimulant, 2.3% atomoxetine), antipsychotic (7.8%), SSRI (5.5%), and alpha agonist (4.9%). ADHD medications were more often prescribed than other medications in all diagnostic groups. Compared to autism, children with ADHD-Combined were more likely to be prescribed an ADHD medication, whereas antipsychotics and SSRIs were more likely to be prescribed in autism than in ADHD-Combined. Children with ADHD-Inattentive were least impaired and least likely to be medicated. More severely impaired children were more often medicated regardless of diagnosis. Symptom scores were far worse for treated and untreated children with ADHD and with autism than for typical peers.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno Autístico/diagnóstico , Transtorno Autístico/tratamento farmacológico , Psicotrópicos/uso terapêutico , Adolescente , Antipsicóticos/uso terapêutico , Cloridrato de Atomoxetina/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno Autístico/psicologia , Estimulantes do Sistema Nervoso Central/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Masculino
13.
BMC Psychiatry ; 20(1): 127, 2020 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-32183793

RESUMO

BACKGROUND: Many persons with autism spectrum disorder (ASD) are treated in long-term specialised care. In this population, suicidal behaviour troubles patients, families, and specialists in the field because it is difficult to treat. At present, there is no documented effective therapy for suicidal behaviour in ASD (Autism Research 7:507-521, 2014; Crisis 35:301-309, 2014). Dialectical Behaviour Therapy (DBT) is an efficacious treatment programme for chronically suicidal and/or self-harm behaviour in patients with Borderline Personality Disorder (J Psychiatry 166:1365-1374, 2014; Linehan MM. Cognitive behavioural therapy of borderline personality disorder. 1993). This study will evaluate the efficacy of DBT in persons with ASD and suicidal/ self- destructive behaviour in a multicentre randomised controlled clinical trial. METHOD: One hundred twenty-eight persons with autism and suicidal and/or self-harming behaviour will be recruited from specialised mental healthcare services and randomised into two conditions: 1) the DBT condition in which the participants have weekly individual cognitive behavioural therapy sessions and a 2.5 h skills training group session twice per week during 6 months, and 2) the treatment as usual condition which consists of weekly individual therapy sessions of 30-45 min with a psychotherapist or social worker. Assessments will take place at baseline, at post-treatment (6 months), and after a follow-up period of 12 months. The mediators will also be assessed at 3 months. The primary outcome is the level of suicidal ideation and behaviour. The secondary outcomes are anxiety and social performance, depression, core symptoms of ASD, quality of life, and cost-utility. Emotion regulation and therapeutic alliance are hypothesised to mediate the effects on the primary outcome. DISCUSSION: The results from this study will provide an evaluation of the efficacy of DBT treatment in persons with ASD on suicidal and self-harming behaviour. The study is conducted in routine mental health services which enhances the generalisability of the study results to clinical practice. TRIAL REGISTRATION: ISRCTN96632579. Registered 1 May 2019. Retrospectively registered.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Transtorno da Personalidade Borderline , Terapia do Comportamento Dialético , Comportamento Autodestrutivo , Suicídio , Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/terapia , Transtorno Autístico/psicologia , Transtorno Autístico/terapia , Terapia Comportamental , Feminino , Humanos , Masculino , Qualidade de Vida , Comportamento Autodestrutivo/terapia , Método Simples-Cego , Suicídio/prevenção & controle , Resultado do Tratamento
14.
Medicina (B Aires) ; 80 Suppl 2: 17-20, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32150707

RESUMO

We start from the evidence that confirms a greater vulnerability to anxiety in people with autism and to wonder to what extent the intolerance to the uncertainty mediates in that anxiety. In addition, the alterations of the predictive abilities in autism could explain the coherence between greater intolerance to uncertainty and some peculiarities inherent in autism such as patterns of restrictive and stereotyped behaviors, interests and activities, and particularities in the processing of sensory information. This information will allow us to develop interventions specifically focused on this construct for the prevention and improvement of anxiety symptoms in autism in cases that the severity of intolerance to uncertainty constitutes a significant risk factor.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Autístico/psicologia , Incerteza , Transtornos de Ansiedade/terapia , Transtorno Autístico/terapia , Humanos , Fatores de Risco , Transtornos das Sensações/psicologia , Comportamento Estereotipado
15.
PLoS Comput Biol ; 16(3): e1007700, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32176684

RESUMO

Autism is still diagnosed on the basis of subjective assessments of elusive notions such as interpersonal contact and social reciprocity. We propose to decompose reciprocal social interactions in their basic computational constituents. Specifically, we test the assumption that autistic individuals disregard information regarding the stakes of social interactions when adapting to others. We compared 24 adult autistic participants to 24 neurotypical (NT) participants engaging in a repeated dyadic competitive game against artificial agents with calibrated reciprocal adaptation capabilities. Critically, participants were framed to believe either that they were competing against somebody else or that they were playing a gambling game. Only the NT participants did alter their adaptation strategy when they held information regarding others' competitive incentives, in which case they outperformed the AS group. Computational analyses of trial-by-trial choice sequences show that the behavioural repertoire of autistic people exhibits subnormal flexibility and mentalizing sophistication, especially when information regarding opponents' incentives was available. These two computational phenotypes yield 79% diagnosis classification accuracy and explain 62% of the severity of social symptoms in autistic participants. Such computational decomposition of the autistic social phenotype may prove relevant for drawing novel diagnostic boundaries and guiding individualized clinical interventions in autism.


Assuntos
Adaptação Psicológica/fisiologia , Transtorno Autístico/fisiopatologia , Transtorno Autístico/psicologia , Comportamento Social , Adulto , Biologia Computacional , Simulação por Computador , Feminino , Humanos , Relações Interpessoais , Masculino , Recompensa , Análise e Desempenho de Tarefas , Adulto Jovem
16.
Intellect Dev Disabil ; 58(1): 19-33, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32011223

RESUMO

Although the significance of sibling relationships is widely affirmed, little is known about these relationships in young adulthood. In this study, we examined the experiences and perspectives of 155 siblings (ages 18-30) of individuals with intellectual disability or autism. Our focus was on how young adults spend time with their brother or sister with a disability, the ways in which they view their relationship, and the expectations they hold for the future. We found that most siblings spent time together engaging in a wide range of activities, described their relationships as of high quality, and held varied expectations regarding their brother's or sister's future. Several factors were associated with more time spent together and higher quality relationships. We address implications for practice and suggest future directions for research.


Assuntos
Transtorno Autístico/psicologia , Deficiência Intelectual/psicologia , Relações entre Irmãos , Irmãos/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
17.
J Autism Dev Disord ; 50(8): 2806-2818, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32026172

RESUMO

Autistic adults have decreased independence in community mobility and driving, which is associated with decreased participation in work, education and community participation. This is the first exploration of the development of community mobility, driving and participation skills over adolescence and emerging adulthood. Interviews with 15 mothers of autistic youth, capable of independence, were qualitatively analysed using grounded theory. Four major themes emerged: mothers gently pushing, teaching, letting go and working towards hopes and dreams. These results suggest earlier intervention across adolescence to address social skills, communication and anxiety in normative community environments, is required for successful development of community mobility and driving skills. Further understanding the critical role of confidence, feeling safe and accepted, could ultimately improve independence.


Assuntos
Transtorno Autístico/psicologia , Condução de Veículo , Participação da Comunidade , Mães/psicologia , Poder Familiar/psicologia , Adolescente , Adulto , Fatores Etários , Ansiedade/complicações , Ansiedade/terapia , Transtorno Autístico/complicações , Transtorno Autístico/terapia , Comunicação , Intervenção Médica Precoce , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Habilidades Sociais , Adulto Jovem
18.
Adv Neurobiol ; 24: 97-141, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32006358

RESUMO

Autism spectrum disorder (ASD) is a complex heterogeneous consortium of pervasive development disorders (PDD) which ranges from atypical autism, autism, and Asperger syndrome affecting brain in the developmental stage. This debilitating neurodevelopmental disorder results in both core as well as associated symptoms. Core symptoms observed in autistic patients are lack of social interaction, pervasive, stereotyped, and restricted behavior while the associated symptoms include irritability, anxiety, aggression, and several comorbid disorders.ASD is a polygenic disorder and is multifactorial in origin. Copy number variations (CNVs) of several genes that regulate the synaptogenesis and signaling pathways are one of the major factors responsible for the pathogenesis of autism. The complex integration of various CNVs cause mutations in the genes which code for molecules involved in cell adhesion, voltage-gated ion-channels, scaffolding proteins as well as signaling pathways (PTEN and mTOR pathways). These mutated genes are responsible for affecting synaptic transmission by causing plasticity dysfunction responsible, in turn, for the expression of ASD.Epigenetic modifications affecting DNA transcription and various pre-natal and post-natal exposure to a variety of environmental factors are also precipitating factors for the occurrence of ASD. All of these together cause dysregulation of glutamatergic signaling as well as imbalance in excitatory: inhibitory pathways resulting in glial cell activation and release of inflammatory mediators responsible for the aberrant social behavior which is observed in autistic patients.In this chapter we review and provide insight into the intricate integration of various genetic, epigenetic, and environmental factors which play a major role in the pathogenesis of this disorder and the mechanistic approach behind this integration.


Assuntos
Transtorno do Espectro Autista/genética , Transtorno do Espectro Autista/fisiopatologia , Epigênese Genética , Interação Gene-Ambiente , Transtorno do Espectro Autista/psicologia , Transtorno Autístico/genética , Transtorno Autístico/fisiopatologia , Transtorno Autístico/psicologia , Variações do Número de Cópias de DNA , Humanos
19.
Adv Neurobiol ; 24: 535-545, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32006372

RESUMO

Along with the issues of inflated social and financial burden associated with autism spectrum disorder (ASD), specific treatment for this disorder has also not been developed. Having a thorough look at previous trials done to treat autism, we find that nutrition intervention had been used frequently as a complementary form of therapy. Indeed, an early diagnosis of nutrition deficiency and metabolic disorders done concomitantly with accurate therapeutic interventions can be a cornerstone for improving cognitive and behavioral aptitudes of people with autism. Several studies have showed that increasing the intake of specific nutrients can reduce the symptoms and comorbidities associated with autism. Consequently, nutrition intervention and appropriate supplementation can be crucial in managing and treating autism. This paper will discuss recent literature on the significance of metabolic aspects in autistic disorder and highlight the influence of nutrition intervention on the symptoms of autism.


Assuntos
Transtorno do Espectro Autista/dietoterapia , Transtorno do Espectro Autista/psicologia , Transtorno Autístico/dietoterapia , Transtorno Autístico/psicologia , Humanos
20.
Adv Neurobiol ; 24: 587-600, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32006375

RESUMO

Characterized by a wide range of behavioural, social and language problems, autism is a complex developmental disability that affects an individual's capacity to communicate and interact with others. Although the real causes that lead to the development of autism are still unclear, the gastrointestinal tract has been found to play a major role in the development of autism. Alterations in macrobiotic compositions have been reported in autistic children. Irregularities in carbohydrate digestion and absorption could also explain some of the gastrointestinal problems reported in autistic patients, although their role in the neurological and behavioural problems remains uncertain. A relationship between improved gut health and decrease of symptoms in autism has been reported as well. Studies done to evaluate the gluten-free diets, casein-free diets, pre- and probiotic and multivitamin supplementation have shown promising results. Probiotics have been thought to alleviate the progression of autism and reduce cognitive and behavioural deficits.


Assuntos
Transtorno Autístico/dietoterapia , Encéfalo/fisiopatologia , Trato Gastrointestinal/fisiopatologia , Probióticos/uso terapêutico , Transtorno Autístico/metabolismo , Transtorno Autístico/psicologia , Carboidratos da Dieta/metabolismo , Humanos
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