Open access article: https://acamh.onlinelibrary.wiley.com/doi/full/10.1002/jcv2.70038

Abstract

Background

Accounts of emotional dysregulation in autism and attention-deficit/hyperactivity disorder (ADHD) are typically based on external adult observations anchored in neurotypical notions of emotional responding. These often fail to place neurodivergent people's emotional responses in the context of the upsetting experiences they face; information best provided by the young people themselves.

Methods

We interviewed 57 adolescents (11–15 years; 19 females) with diagnoses of ADHD (n = 24), autism (n = 21) or both (n = 12), about their experience of upsetting events using a co-designed semi-structured interview schedule. Reflexive thematic analysis generated shared themes with diagnosis-specific nuances.

Results

Four themes were extracted: social dislocation, alienation and conflict; need to mask; self-doubt, loathing, embarrassment; and over stimulation/sensory mismatch. Upsetting experiences, for ADHD participants, were typically perceived as instigated by external agents trying to impose control, and/or a sense of injustice; for autistic participants they often related to feelings of ‘not belonging’ and alienation. Masking, for autistic participants, included ‘hiding’ negative emotions to protect others from their intensity; whereas in ADHD, masking usually involved supressing emotional upset to protect oneself from conflict or consequences. Those with a joint diagnosis reported a combination of these experiences, often felt more intensely.

Conclusions

First-person accounts of emotional responding could provide new insights with potential to refine current dysregulation-based accounts of ADHD or autism.

Citation: Pavlopoulou, G., Chandler, S., Lukito, S., Kakoulidou, M., Jackson, I., Ly, E., Matejko, M., Balwani, B., Boyens, T., Poulton, D., Harvey-Nguyen, L., Baker, S., Sonuga-Barke, E. J. S. Sonuga-Barke, E., Chandler, S., Danese, A., Downs, J., Funnell, E., Griffiths, K., … Wilson, A. (2025). Upsetting experiences in the lives of neurodivergent young people: A qualitative analysis of accounts of adolescents diagnosed with attention-deficit/hyperactivity disorder and/or autism. JCPP Advances, e70038. https://doi.org/10.1002/jcv2.70038

Open access article: https://link.springer.com/article/10.1186/s40001-024-01916-2

Abstract

Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders that affect individuals' social interactions, communication skills, and behavioral patterns, with significant individual differences and complex etiology. This article reviews the definition and characteristics of ASD, epidemiological profile, early research and diagnostic history, etiological studies, advances in diagnostic methods, therapeutic approaches and intervention strategies, social and educational integration, and future research directions. The highly heritable nature of ASD, the role of environmental factors, genetic–environmental interactions, and the need for individualized, integrated, and technology-driven treatment strategies are emphasized. Also discussed is the interaction of social policy with ASD research and the outlook for future research and treatment, including the promise of precision medicine and emerging biotechnology applications. The paper points out that despite the remarkable progress that has been made, there are still many challenges to the comprehensive understanding and effective treatment of ASD, and interdisciplinary and cross-cultural research and global collaboration are needed to further deepen the understanding of ASD and improve the quality of life of patients.

Citation: Qin, L., Wang, H., Ning, W. et al. New advances in the diagnosis and treatment of autism spectrum disorders. Eur J Med Res 29, 322 (2024). https://doi.org/10.1186/s40001-024-01916-2

Open access article: https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0044-1788269

Abstract

Almost two decades before Kanner's and Asperger's works, the original paper by child psychiatrist Grunya Efimovna Sukhareva had already been written. It was published in 1926 by Sukhareva in a German scientific journal of psychiatry and neurology, with a detailed description of children who presented clinical conditions whose characteristics and evolution closely resemble autism, according to current criteria. In the present historical note, we intend to present Sukhareva's pioneering work and retrieve the meaning of her original contribution.

Citation: Cristina Maria Pozzi, Rudimar dos Santos Riesgo, Francisco Baptista Assumpção Junior. Revisiting the history of autism before Kanner and Asperger: a tribute to Grunya Sukhareva. Arq Neuropsiquiatr 2024; 82: s00441788269. DOI: 10.1055/s-0044-1788269

Open access article: https://www.preprints.org/manuscript/202406.0856/v1

Abstract

Autism Spectrum Disorder (ASD), a neurodevelopmental disorder, is increasingly diagnosed and significantly affects communication, behavior, and social interaction. The current diagnostic framework, guided by the DSM-5, has limitations that may lead to clinical gaps due to overlapping symptoms of ASD and other disorders. This study proposes a comprehensive approach to enhance ASD diagnosis through clinical stratification based on comorbidities. We applied precision medicine techniques to identify and categorize ASD into ten clinical profiles. Our findings contribute to a more profound understanding of ASD, including its varied clinical manifestations and comorbidities, and facilitate the development of personalized therapeutic strategies.

Οpen access article: (https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13806)

Abstract

After attention was drawn in the late 1960s to the poor reproducibility of psychiatric diagnosis between clinicians, methods and procedures used to diagnose psychiatric disorders were greatly improved. Sources of variance contributing to the poor reliability of psychiatric diagnosis were identified that included: information variance (how clinicians go about enquiring about symptoms), interpretation variance (how clinicians weigh the observed symptomatology towards diagnostic formulations), and criterion variance (how clinicians arrange symptom constellations to generate specific diagnoses). To improve the reliability of diagnosis, progresses were made in two major directions. First, diagnostic instruments were developed to standardize the way symptoms are elicited, evaluated, and scored. These diagnostic interviews were either highly structured for use in large-scale studies (e.g. the DIS), by lay interviewers without a clinical background, and with a style of questioning that emphasized adherence to the exact wording of probes, reliance on closed questions with simple response formats (Yes/No) and recording respondents' answers without interviewer's judgment contribution. By contrast, semi-structured interviews (e.g. the SADS) were designed to be used by clinically trained interviewers and adopted a more flexible, conversational style, using open-ended questions, utilizing all behavioral descriptions generated in the interview, and developing scoring conventions that called upon the clinical judgment of the interviewer. Second, diagnostic criteria and algorithms were introduced in nosographies in 1980 for the DSM and soon after in ICD. Algorithm-derived diagnoses could subsequently be tested for their validity using follow-up, family history, treatment response studies, or other external criteria.

Citation: Fombonne, E. (2023), Editorial: Is autism overdiagnosed?. J Child Psychol
Psychiatr, 64: 711-714. https://doi.org/10.1111/jcpp.13806