Suicide risk in adults with autism spectrum disorder: prevalence, assessment, and possible therapeutic interventions / Riesgo de suicidio en adultos con Trastorno del Espectro Autista: prevalencia, evaluación y posibles intervenciones terapéuticas.

Introduction: Suicide risk in autism spectrum disorder (ASD) has emerged as a long-neglected issue. This revision aims to explore the prevalence, methods of assessment, and available treatments for suicide risk in this population. Methods: A narrative review was carried out on three aspects related to the risk of suicide in the adult population with ASD: prevalence, evaluation and available evidence-based interventions. The bibliographic search was carried out using the Pubmed, Scielo, Dialnet and Psychinfo search engines, limited to articles published from 2010 onwards. In order to identify relevant literature, various combinations of keywords were used, such as "suicide risk," "autism spectrum disorder," and "suicide in autism," in both Spanish and English. Conclusions: The main findings suggest a high prevalence of suicide risk, highlighting the need of developing standardized protocols to assess such risk in the autistic population. Moreover, Dialectical Behavioral Therapy has shown promise as a therapeutic option to decrease suicidality, but further research is needed to establish its effectiveness and standardization as a treatment.

Introducción: El riesgo de suicidio en el Trastorno del Espectro Autista (TEA) ha emergido como una problemática poco considerada durante mucho tiempo. Esta revisión tiene como objetivo explorar la prevalencia, la evaluación y los tratamientos disponibles para el riesgo de suicidio en los adultos con autismo. Metodología: Se practicó una revisión narrativa sobre tres aspectos relacionados con el riesgo de suicido en la población adulta con TEA: la prevalencia, la evaluación y las intervenciones disponibles basadas en evidencia. La búsqueda bibliográfica fue realizada utilizando los buscadores de Pubmed, Scielo, Dialnet y Psychinfo, limitándose a artículos publicados a partir del año 2010 en adelante. Con el fin de identificar la literatura relevante, se utilizaron diversas combinaciones de palabras clave, tales como "riesgo de suicidio", "trastorno del espectro autista", y "suicidio en autismo", tanto en español como en inglés. Conclusión: Los hallazgos principales sugieren un elevado riesgo de suicidio en la población autista, lo que destaca la necesidad de desarrollar protocolos estandarizados para evaluarlo. Además, la Terapia Dialéctico Conductual se ha establecido como una opción terapéutica prometedora para disminuir la suicidabilidad en esta población, pero aún se requiere de mayor investigación para establecer su eficacia y estandarización como tratamiento.

Psychological therapy adaptations for adults on the autism spectrum / Adaptaciones de las terapias psicológicas para adultos con Trastornos del Espectro Autista sin Discapacidad Intelectual.

The prevalence of autism spectrum conditions has been increasing in recent decades. However, this has not been reflected in an increase in clinical research, so there is insufficient evidence on the supports and adaptations that psychological treatments require for this population. Evidence-based psychological therapies are frequently goal-focused, usually short-term, such as cognitive behavioral therapy, which integrates cognitive and behavioral modalities. Due to the high rates of comorbidity in people with autism, various psychological therapies are in the process of adapting their delivery. This review explores research-suggested adaptations to implement psychological therapies in adults with autism without intellectual disability. Both formal and intervention techniques adaptations are required. Adaptations at each stage of psychological therapies are important to support the differences, needs, and preferences of the adult with autism. Professional training aimed at working with this particular population, and research on how to optimize the access of this population to mental health services are essential for its correct implementation.

La prevalencia de las condiciones del espectro autista ha ido en aumento en las últimas décadas, aunque esto no se ha reflejado en un aumento de la investigación clínica, por lo que se cuenta con evidencia insuficiente sobre los apoyos y adaptaciones que requieren los tratamientos psicológicos para esta población. Las terapias psicológicas basadas en evidencia frecuentemente están centradas en objetivos, generalmente a corto plazo, como la terapia cognitivo conductual, que integra modalidades cognitivas y conductuales. Debido a las altas tasas de comorbilidad en las personas con autismo, diversas terapias psicológicas se encuentran en el proceso de adaptar su implementación. Esta revisión explora las adaptaciones sugeridas en la investigación para la implementación de las terapias psicológicas en adultos con autismo sin discapacidad intelectual. Se requieren tanto adaptaciones en el encuadre como en las técnicas de intervención. Las adaptaciones en cada etapa de las terapias psicológicas son importantes para apoyar las diferencias, necesidades y preferencias del adulto con autismo. Para su correcta implementación son esenciales la formación profesional orientada al trabajo con esta población particular, e investigaciones sobre cómo optimizar el acceso de esta población a los servicios de salud mental.

Attentional ERPs in consumers of smoked and insufflated cocaine associated with neuropsychological performance.

BACKGROUND: Cocaine consumption is associated with reduced attentional event-related potentials (ERPs), namely P3a and P3b, indicating bottom-up and top-down deficits respectively. At cognitive level, these impairments are larger for faster routes of administration (e.g., smoked cocaine [SC]) than slower routes (e.g., insufflated cocaine [IC]). Here we assess these ERPs considering the route of cocaine administration. We hypothesized that SC dependent (SCD) would exhibit reduced amplitude of the P3a, while both SCD and IC dependent (ICD) would show reduced amplitude of the P3b. METHODS: We examined 25 SCD, 22 ICD matched by poly-consumption profiles, and 25 controls matched by demographic variables. We combined EEG data from the Global-Local task with behavioral data from attentional cognitive tasks. RESULTS: At the behavioral level, SCD exhibited attentional deficits in both bottom-up and top-down processes, while ICD only showed a tendency for top-down deficits. The amplitude of P3a and P3b was lower in Users groups. We observed subtle route-based differences, with larger differences in the P3a for SCD and in the P3b for ICD. Neurophysiological and behavioral data converged, with the P3a associated to bottom-up performance and P3b to top-down. CONCLUSIONS: Different routes of administration lead to distinct attentional neurocognitive profiles. Specifically, SCD showed greater attentional impairment, mainly at bottom-up/P3a, while ICD showed a trend of top-down/P3b deficits. These findings emphasize the crucial role of considering the route of administration in both clinical and research settings and support the use of attentional ERPs as valid measures for assessing attentional deficits in substance Dependence.