Prevalence of ID w ASD in children - answer about one third of children
Comorbidity in children w ASD - answer high rates of at least one comorbid dx
- almost half have 2 additional diagnoses
Prevalence and comorbidity in adults w ASD - answer About one third are minimally
verbal
About one third psychiatric
About half are overweight
Important dimensions of ASD - answerSocial-communication
Language (pattern of onset; receptive ability)
Cognitive (IQ; EF)
Emotion ("comorbidities;" personality)
Restricted / repetitive bx
3 levels of mental health assessment - answer1. broadband
2. specific screeners
3. diagnostic interviews
considerations for assessment of ASD - answer- assessment of a typically presenting
person is often differently focused
- diagnosis is based on symptoms we can SEE, but many symptoms aren't specific to
ASD
- Can overlap with depression and anxiety assessments
- Assessments are affected by age, language, IQ, psychiatric symptoms
**High scores on ASD measures may not reflect only ASD severity
Leo Kanner - answerFirst person to describe and study Autism in 1943
There are changes in symptoms from childhood to adulthood; so why do adults still
meet diagnostic criteria? - answerLimited success in ameliorating core ASD symptoms
with behavioral or pharmacological interventions; treatments often target observable
symptoms
What are some possible factors that impact mental health in individuals with autism? -
answerSome possible factors that impact mental health in autism are, lack of
understanding of ASD in others, which sometimes leaves others to make assumptions
that are not accurate. Another factor is an individual's experiences and perception of
,autism acceptance. And a third factor is sensory sensitivities, which impacts anxiety in
adults with autism.
*Describe how the act of "masking" or "camouflaging" could relate to higher rates of
depression in adults with ASD?* - answerStress from trying to "fit in" with non-autistic
populations, feelings of lack of acceptance from having to "hide" their true selves
The results of the Cage et al., 2018 study showed that external sources of acceptance
can have effects on mental health for people with ASD. List two possible effects: -
answerAnswer 1: Lower levels of social acceptance over the past week is correlated
with higher levels of depression.
Answer 2: Lower levels of social acceptance can encourage camouflaging behavior,
which can predict higher levels of depression.
Answer 3: When individuals with ASD perceive less autism acceptance from the
community, they may become more stressed.
What dimension did the qualitative responses in the Cage et al., 2018 study enable the
researchers to identify in the majority of adults with Autism Spectrum Disorder? -
answerParticipants exhibited camouflaging which contributed to mental illness and
severely affected their psychological well-being.
In the Gaigg et al., 2018 study, what conclusion did the researchers attain when
comparing Bermond-Vorst Alexithymia Questionnaire (BVAQ) score and the association
of objective and subjective measures of arousal? - answerAn inverse relationship in
which a higher BVAQ score correlated with lower physiological arousal
Although the participants in the autism spectrum disorder (ASD) group produced higher
scores on the SRS-2-ASR than the anxiety disorder (ANX) and typical comparison
(TYP) groups, what was an issue with validity in the South et al., 2017 study? -
answerParticipants in the ANX group produced anxiety scores that could function as a
clinical diagnosis for Autism Spectrum Disorder.
According to The Psychophysiological Mechanisms of Alexithymia in Autism Spectrum
Disorder by Gaigg and colleagues, what percentage range is most accurate regarding
the affect alexithymia has on individuals with Autism Spectrum Disorder? - answer40-
50%
*What factors contribute to comorbid mental health issues in individuals with ASD?* -
answera. External factors
b. Sensory sensitivity
c. Intolerance to uncertainty
(all)**
*Studying alexithymia is important because:* - answera. All people with ASD are also
diagnosed with alexithymia
,b. Difficulties with identifying and describing emotions are not a feature of ASD, but a
feature of co-morbid alexithymia
c. People with ASD commonly seek treatment for comorbid mental health difficulties,
such as anxiety and depression, and alexithymia can have negative impacts on
psychotherapy.
d. B & C**
Sensitivity - answerability to identify the group that you are trying to identify; proportion
of people with ASD above the cut off out of the total number of people with that
diagnosis
ex. would have a perfect instrument of measurement if you have 100% sensitivity
Specificity - answerability to rule out the group that you are not trying to pick up;
proportion of who don't have autism who fall below the cut off out of the total number of
people who don't have autism
ex. would have a perfect instrument of measurement if you have 100% specificity
If you make your criteria more stringent... - answeryou get worse sensitivity and better
specificity → less false positives
If you make the criteria less stringent - answeryou get better sensitivity and worse
specificity → early intervention, early dx, you don't wanna miss anyone. Probably won't
hurt to get some intervention
Multi-modal, comprehensive assessments: - answer- Inform understanding of strengths
and challenges
- Identify co-morbid medical or psychiatric disorders
- Inform treatment plan
How to differentiate "adult" psychopathology? - answer- childhood psychology is
focused on development, but adult is more about psychosis
- there are different expectations and information now than there used to be
What is wrong with "autistic phenotypes"? - answer- aka impaired social-communication
= autistic phenotype
- Using ASD instruments to characterize non-ASD sample is an oversimplification of
complex bx
- And it fails to recognize that observable differences may result from different
underlying mechanisms
How do people with ASD get missed? - answer- historical context (expectations of
children in the past are very different than today; social emotional development is way
more monitored now)
- misdiagnosis
, methodological limitations to diagnosing women? - answer- most measurements are
based on clinic sample and women are sometimes not highly represented
- women present different symptoms than men sometimes
positivity of late life ASD diagnosis - answer- explanation for bx
- sense of relief (no more blame)
- seeking support; informs treatment
- increased validation of experiences
- putting experiences into context
- social network
- increased self-worth
reasons co-occuring psychiatric condition in late life dx of ASD - answer- shared
psychiatry
- consequences of living with ASD
- overlap in diagnostic material
gender imbalance in ASD - answer- males are more at risk than women biologically
- also, women are better at camouflaging
- diagnostic criteria are often more suited toward men
why are adults diagnosed later in life? - answer- inaccurate reflection of childhood
- co-occurring conditions
- camouflaging
cons of later life dx of ASD - answer- frustration/anger about implications
- stigma
- your experiences may not match others' with ASD
- lack of services
What a dx does not do: - answer- no answers
- does not make people more understanding or improve relationships
- doesn't define you: you're the same before and after diagnosis
*Why in some cases does an ASD diagnosis in adulthood bring positivity?* -
answerASD indicators have improved by the time they're adults
**It gives an alternate explanation for their behavior
There are subtle difficulties and no significant developmental delays
They can now "camouflage" their behavior
Which of the following are challenges in diagnosing ASD in adults? - answerOther
informants may not be around and information from those that are may be inaccurate
Patients may have learned coping and camouflaging
ASD might be overshadowed by co-occurring psychological or medical disorders
All of these pose challenges**
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