Autism

Question 1

What is autism (2 definitions)

Answer 1

Very problematic descriptions currently
1. Persistent deficits in social communication and social interaction

2. Restricted, repetitive patterns of behaviour, interests, or activities

Question 2

What is the current gender differences in autism?

And why it is wrong?

Answer 2

Male:female ration = 4:1

-wrong because the diagnostic criteria is not inclusive enough to pick autism up in females.

Question 3

Mental-health co-morbilities within autsitic people?

Answer 3

Mental health comorbidities: 50% - 74% (Belardinelli et al., 2016)

Lots of people with autism suffer from other mental health disorders.

Social anxiety disorder (29.2% - 42%)
At least one episode of major depression (70%)

Extremely high numbers

Question 4

What is the issue with co-morbidity and autism?

Answer 4

People with autism will not display depression/anxiety the same way it is normally perceived.

Question 5

what is the Anxiety and autism in children and adolescents prevalence?

Answer 5

Wide range of findings: 11% - 84% of autistic children experience some degree of impairing anxiety

Question 6

Why is there a wide range of findings within austism and anxiety?

Answer 6

The research is extremely variant depending on the measures used, the culture used…

Big replicability crisis in psychology

Question 7

How is anxiety different in autistic people?

Answer 7

Anxiety seems to stem around factors such as:

Routine (22%)
specific fears (12%)
Social fearness (8%)

Question 8

Why do autistic people engage in compulsive behaviours, and how do they differ to OCD

Answer 8

Autistic people do not engage in compulsive / ritualistic behaviours to REDUCE STRESS. They just engage in them, and if they cannot do so, they BECOME STRESSED

Question 9

According to South & Rodgers, 2017, there are 3 main reasons to why people with autism may experience anxiety.

What are they?

Answer 9

1. Atypical sensory functioning
2. Difficulty labeling and identifying emotions
3. Intolerance of uncertainty

Question 10

What are Atypical sensory functioning’s?

Answer 10

• Over-responsivity and under-responsivity - not all autistic people are hyper-sensitive to things, they may need to engage in sensory information.

Stemming - self soothing methods - not always accepted by society due to social norms.

Habituation - getting settled in a new enviroment (may take longer in people with autism)

-Another reason why lab studies on autistic people are so problematic.

Question 11

Why are Lab studies hard to carry out with autistic people?

Answer 11

Habituation - takes longer for them to get settled in a new place.

Question 12

Stress and anxiety in people with autism in regards to Atypical sensory functioning

Evidence?

Answer 12

Higher activitation of primary sensory areas such as amygdala in response to auditory stimuli when comparing autism to non autism.
(Green et al., 2013),

Higher activation of these areas also correlated with higher parent-reported anxiety.

Another study showed that higher cortisol levels were displayed in those with higher sensory dysfunctioning. -argueable that cortisol is not the best measurement of stress?

Question 13

What is the scientific name for not being able to label emotions?

Answer 13

Alexithymia

Question 14

How does alexithymia explain anxiety in people with autism?

Answer 14

• If you cannot label an emotion, it is more difficult to accept that emotion.
• Alexithymia = decreased emotional acceptance = anxiety in autism

Question 15

What is intolerance of uncertainty?

Answer 15

It involves the “tendency to react negatively on an emotional, cognitive, and behavioural level to uncertain situations and events” (Buhr and Dugas 2009).

(IU) is a cognitive construct referring to decreased thresholds for the perception of ambiguity (more than one interpretation) and enhanced discomfort with (more than one interpretation) ambiguity (Dugas et al., 1998)

Significantly higher levels of IU and anxiety in autistic children and adults (Boulter et al., 2014)

Question 16

What is the most common type of anxiety for autistic people

What it the current and lifetime prevalence of it

Answer 16

Social anxiety

lifetime prevalence of 56%
Current prevalence of 40%

Question 17

Why might social anxiety affect people with autisim?

Answer 17

An individual who is aware of their difficulties in social skills (ie understanding social cues) may experience heightened anxiety in social situations

Question 18

What does social anxiety stem from in non-autistic children vs autistic children?

Answer 18

Non-autistic =
-fear of negative evaluations from others (in developing children)

Autistic =
-concerns relating to the violation of logical rules
-unpredictability of the social environment [Bolling et al., 2011a

Question 19

What behaviour can social anxiety trigger?

Answer 19

Isolation and lonliness

Question 20

How is anxiety diagnostic criterium not suitable for people with autism

Answer 20

1. • Anxiety experienced by autistic children is not the same than anxiety experienced by non-autistic children (Kerns et al., 2014).
2. responding more intensely, aversively, or persistently toward stimuli that appear harmless or minor to most others without autism
3. struggle reporting anxieties
4. overall:
   Existing measures do not entirely capture the experience of anxiety in autism
5. Therefore: limiting the reliability and validity of measurement with tools designed for non-autistic children.

Question 21

New scale Anxiety scale for ASD

What are the 4 subscales

and is it reliable for autistic samples

Answer 21

• Four subscales:
  1. Performance Anxiety,
  2. Uncertainty,
  3. Anxious Arousal,
  4. Separation Anxiety
• Higher reliability and validity in the autistic sample

Question 22

The benefits of adapted treatment:

-what treatments have been adapted and what are the effects?

Answer 22

CBT was moderated to fit autistic sample.

Before, children would have moderate effect size after CBT treatment

However, once treatment was adapted, it significantly improves anxiety in autistic people.

Question 23

Treatment 2: CUEs (roger et al)

(Coping with uncertainty in everyday situations)

What is this?
What are the aims?

Answer 23

-parent based intervention
-aims to develop a young persons autonomy through tolerance and flexibility of uncertanties in everyday situations.

Question 24

How is CUE’s (roger et al) different to other treatments

Answer 24

Enables children to TOLERATE uncertainties rather than attempting to reduce the uncertainty
-more applicable to everyday life, provides them with autonomy

Question 25

What were the outcomes of CUE's treatment

Answer 25

Anxiety scores in autistic children decreased and for intolerance of uncertainty

Question 26

Autism part two is...

Answer 26

Gender differences -males are more diagnosed than females across age groups

Question 27

Male:Female ratios in population in clinical

Answer 27

In population 3:1 in clinical 4:1

Question 28

Why is there a gender difference?

Answer 28

* Female Protective Effect theory (Robinson et al., 2013) * Female Autism Phenotype: (Dworzynski et al., 2012; Russell et al., 2011) * The 'extreme male brain' theory of autism (Baron-Cohen, 2002) * Women and girls are often better at masking or camouflaging their difficulties (Hull et al., 2020). * Autism traits in girls are under-reported by teachers.

Question 29

What is female autism phenotype?

Answer 29

The theory that states that autism is expressed differently in females compared to males. * According to this theory, more men are diagnosed in men because autism looks different in females in comparison to males. * If autism is different in females, it is more difficult to screen for that due to the measures being different to this. Females require more additional difficulties than males to receive an autism diagnosis, despite having equivalent levels of autistic characteristics Females also receive their diagnosis at a later date compared to men

Question 30

What has IQ got to do with autism diagnosis?

Answer 30

Females with low IQ are more likely to receive a diagnosis than females with high IQ

Question 31

Reason for gender differences in diagnosis of autism

Answer 31

Autistic symptoms seem more relevant to the male brain. The more testosterone you have, the more autistic you can seem.

Question 32

Social masking What is it? How does it explain Missdiagnosis in women

Answer 32

Social Masking- is behaving/ adapting behaviours to fit in with the norm. Autistic people feel they have to mask all the time because they believe the way they behave normally is wrong or different. Due to this masking, peers may not notice symptoms, therefore female goes undiagnosed.

Question 33

What are the additional behaviours females have that are not included in the DSM-5?

Answer 33

-social relationships (females have higher social motivation due to less social impairments) BUT -long-term relationships and friendships are less likely in females compared to men with autism -Conflict in social relationships is harder to deal with in autistic females than males 2. Relational interests Autistic females’ special interests may be in different areas to males, and so may be underestimated - more interested in male interests than female. 3. Internalizing problems Autistic females are significantly more likely to have co-occurring internalising disorders than males Potentially overriding autism Females are more vulnerable to serious mental health conditions and more likely to be mis- or under-diagnosed. - probably due to having no support for autism… 4. Camouflaging * Pretending to be normal: by: mimic their peers’ social behaviours and interests (e.g. facial expressions, eye contact) -hiding authentic self (e.g. stop talking about an interest)

Question 34

What are the motivations for camouflaging

Answer 34

* the desire to fit in with others * to avoid bullying or other negative treatment * wanting to form connections with others

Question 35

What are the consequences for camouflaging?

Answer 35

* physical and emotional exhaustion * losing authentic self (Hull et al. 2017) * difficulty accessing support and diagnosis