Danielle A Baribeau1, Simone Vigod2, Eleanor Pullenayegum3, Connor M Kerns4, Pat Mirenda5, Isabel M Smith6, Tracy Vaillancourt7, Joanne Volden8, Charlotte Waddell9, Lonnie Zwaigenbaum10, Teresa Bennett11, Eric Duku11, Mayada Elsabbagh12, Stelios Georgiades13, Wendy J Ungar14, Anat Zaidman Zait15, Peter Szatmari16. 1. The Hospital for Sick Children, University of Toronto, Canada. 2. Department of Psychiatry, Women's College Hospital; and Women's College Research Institute; and Department of Psychiatry and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. 3. Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute; and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 4. Department of Psychology, University of British Columbia, Vancouver, Canada. 5. Department of Educational and Counselling Psychology and Special Education, University of British Columbia, Vancouver, Canada. 6. Department of Pediatrics, Dalhousie University; and Autism Research Centre, Dalhousie University and IWK Health Centre, Halifax, Canada. 7. Faculty of Education, University of Ottawa, Ottawa, Canada. 8. Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada. 9. Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada. 10. Department of Pediatrics, University of Alberta; and Autism Research Centre, Edmonton, Canada. 11. Offord Centre for Child Studies; and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada. 12. Montreal Neurological Institute, McGill University, Montreal, Canada. 13. Department of Psychiatry and Behavioural Neurosciences, McMaster University; and Offord Centre for Child Studies, Hamilton, Canada. 14. Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute; and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. 15. Department of School Counseling and Special Education, Constantiner School of Education, Tel Aviv University, Israel; and School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada. 16. Centre for Addiction and Mental Health; and The Hospital for Sick Children; and Department of Psychiatry, University of Toronto, Toronto, Canada.
Abstract
BACKGROUND: Children with autism spectrum disorder (ASD) have increased susceptibility to anxiety disorders. Variation in a common ASD symptom, insistence on sameness behaviour, may predict future anxiety symptoms. AIMS: To describe the joint heterogeneous longitudinal trajectories of insistence on sameness and anxiety in children with ASD and to characterise subgroups at higher risk for anxiety. METHOD: In a longitudinal ASD cohort (n = 421), insistence on sameness behaviour was measured using the Autism Diagnostic Interview-Revised at approximately ages 3, 6 and 11 years. Anxiety was quantified at 8 time points between ages 3 and 11 years using the Child Behavior Checklist (CBCL) (parent report). Clusters of participants following similar trajectories were identified using group-based and joint trajectory modelling. RESULTS: Three insistence on sameness trajectories were identified: (a) 'low-stable' (41.7% of participants), (b) 'moderate-increasing' (52.0%) and (c) 'high-peaking' (i.e. increasing then stabilising/decreasing behaviour) (6.3%). Four anxiety trajectories were identified: (a) 'low-increasing' (51.0%), (b) 'moderate-decreasing' (16.2%), (c) 'moderate-increasing' (19.6%) and (d) 'high-stable' (13.1%). Of those assigned to the 'high-peaking' insistence on sameness trajectory, 95% jointly followed an anxiety trajectory that surpassed the threshold for clinical concern (T-score >65) by middle childhood (anxiety trajectories 3 or 4). Insistence on sameness and anxiety trajectories were similar in severity and direction for 64% of the sample; for 36%, incongruous patterns were seen (e.g. decreasing anxiety and increasing insistence on sameness). CONCLUSIONS: The concurrent assessment of insistence on sameness behaviour and anxiety in ASD may help in understanding current symptom profiles and anticipating future trajectories. High preschool insistence on sameness in particular may be associated with elevated current or future anxiety symptoms.
BACKGROUND:Children with autism spectrum disorder (ASD) have increased susceptibility to anxiety disorders. Variation in a common ASD symptom, insistence on sameness behaviour, may predict future anxiety symptoms. AIMS: To describe the joint heterogeneous longitudinal trajectories of insistence on sameness and anxiety in children with ASD and to characterise subgroups at higher risk for anxiety. METHOD: In a longitudinal ASD cohort (n = 421), insistence on sameness behaviour was measured using the Autism Diagnostic Interview-Revised at approximately ages 3, 6 and 11 years. Anxiety was quantified at 8 time points between ages 3 and 11 years using the Child Behavior Checklist (CBCL) (parent report). Clusters of participants following similar trajectories were identified using group-based and joint trajectory modelling. RESULTS: Three insistence on sameness trajectories were identified: (a) 'low-stable' (41.7% of participants), (b) 'moderate-increasing' (52.0%) and (c) 'high-peaking' (i.e. increasing then stabilising/decreasing behaviour) (6.3%). Four anxiety trajectories were identified: (a) 'low-increasing' (51.0%), (b) 'moderate-decreasing' (16.2%), (c) 'moderate-increasing' (19.6%) and (d) 'high-stable' (13.1%). Of those assigned to the 'high-peaking' insistence on sameness trajectory, 95% jointly followed an anxiety trajectory that surpassed the threshold for clinical concern (T-score >65) by middle childhood (anxiety trajectories 3 or 4). Insistence on sameness and anxiety trajectories were similar in severity and direction for 64% of the sample; for 36%, incongruous patterns were seen (e.g. decreasing anxiety and increasing insistence on sameness). CONCLUSIONS: The concurrent assessment of insistence on sameness behaviour and anxiety in ASD may help in understanding current symptom profiles and anticipating future trajectories. High preschool insistence on sameness in particular may be associated with elevated current or future anxiety symptoms.
Authors: Anita K Chisholm; Kristina M Haebich; Natalie A Pride; Karin S Walsh; Francesca Lami; Alex Ure; Tiba Maloof; Amanda Brignell; Melissa Rouel; Yael Granader; Alice Maier; Belinda Barton; Hayley Darke; Gabriel Dabscheck; Vicki A Anderson; Katrina Williams; Kathryn N North; Jonathan M Payne Journal: Mol Autism Date: 2022-01-04 Impact factor: 7.509
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Authors: Mirko Uljarević; Booil Jo; Thomas W Frazier; Lawrence Scahill; Eric A Youngstrom; Antonio Y Hardan Journal: Mol Autism Date: 2021-05-27 Impact factor: 7.509