Asperger syndrome in males over two decades: stability and predictors of diagnosis

Helles, Adam; Gillberg, C; Billstedt, Eva

doi:10.1111/jcpp.12334

Cited by 52 publications

(62 citation statements)

References 37 publications

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“…In Helles et al (2015) a thorough analysis of attrition was presented. Of the 100 males at T0, 76 participated at T1 and 50 at T2, 47 participated in all three studies.…”

Section: Methods Participantsmentioning

confidence: 99%

“…It usually persists into early adulthood, and is still diagnosable according to stringent criteria in about 45 % of the male cases [and in another 25-30 % of male cases as other autism spectrum disorders (ASD)] around 30 years of age (Helles et al 2015). It is currently subsumed under the ASD umbrella of the DSM-5 (APA 2013), where it is coded with the other clinical presentations of ASD, including the category that was previously separately coded as autistic disorder (AD) (APA 1994).…”

Section: Introductionmentioning

confidence: 99%

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Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis

Gillberg

Helles

Billstedt

et al. 2015

J Autism Dev Disord

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We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had never met criteria for an additional psychiatric/neurodevelopmental diagnosis and more than half had ongoing comorbidity (most commonly either ADHD or depression or both). Any psychiatric comorbidity increased the risk of poorer outcome. The minority of the AS group who no longer met criteria for a full diagnosis of an autism spectrum disorder were usually free of current psychiatric comorbidity. The high rate of psychiatric/neurodevelopmental comorbidities underscores the need for a full psychiatric/neurodevelopmental assessment at follow-up of males with AS.

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“…In Helles et al (2015) a thorough analysis of attrition was presented. Of the 100 males at T0, 76 participated at T1 and 50 at T2, 47 participated in all three studies.…”

Section: Methods Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis

Gillberg

Helles

Billstedt

et al. 2015

J Autism Dev Disord

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“…Understanding the developmental course of ASD is crucially important for managing life care and planning treatment. However, ASD occurs with many varied developmental paths (Fountain et al 2012;Lord et al 2015), and there is no one consistent life outcome (Fein et al 2013;Helles et al 2015;Steinhausen et al 2016). Variation in ASD developmental course has ranged from typical development in infancy that becomes atypical in early childhood, to marked infant impairment in social and cognitive skills that changes to become optimal adaptive functioning in adulthood (Anderson et al 2014;Fein et al 2013;Fountain et al 2012;Helles et al 2015;Howlin et al 2013;Levy and Perry 2011;Lord et al 2015;Yirmiya and Charman 2010).…”

Section: Do Shared Features Provide Construct Validity For An Asd Spementioning

confidence: 99%

“…Blumberg et al (2015) reported that 13 % of 1607 individuals diagnosed with ASD in childhood no longer met criteria for ASD: 9 % had been initially misdiagnosed and 4 % Blostt heir ASD due to treatment or maturation. Helles et al (2015) found that 24 % of individuals diagnosed initially with Asperger's disorder no longer met criteria for any developmental disorder. However, developmental changes are complex.…”

Section: Predictors Of Asd Outcome Are Variedmentioning

confidence: 99%

“…The only broadly successful ASD treatment has been early behavioral intervention programs (Kasari 2015;Schreibman et al 2015;Smith and Iadarola 2015;), but these treatments are not unique to ASD (Losinski et al 2014), and the long-term effectiveness of these programs is not yet known (Fernell et al 2011. Researchers who studied infant siblings of children with ASD concluded no single early behavior could predict ASD diagnoses (Zwaigenbaum et al 2015), and ASD has been found with widely varied trajectories of development (Fountain et al 2012;Lord et al 2015) and varied life outcomes (Fein et al 2013;Helles et al 2015;Steinhausen et al 2016). …”

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confidence: 99%

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ASD Validity

Waterhouse

London

Gillberg

2016

Rev J Autism Dev Disord

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ASD research is at an important crossroads. The ASD diagnosis is important for assigning a child to early behavioral intervention and explaining a child's condition. But ASD research has not provided a diagnosis-specific medical treatment, or a consistent early predictor, or a unified life course. If the ASD diagnosis also lacks biological and construct validity, a shift away from studying ASD-defined samples would be warranted. Consequently, this paper reviews recent findings for the neurobiological validity of ASD, the construct validity of ASD diagnostic criteria, and the construct validity of ASD spectrum features. The findings reviewed indicate that the ASD diagnosis lacks biological and construct validity. The paper concludes with proposals for research going forward.Keywords DSM-5 . ASD . Autism . Diagnosis . Validity . Comorbidity . HeterogeneityThe goal of the DSM-3 nosology (American Psychiatric Association 1980) was to create reliable and standard categorical psychiatric diagnoses (Robins and Guze 1970). However, in the past 30 years, clinical, genetics, and neuroscience findings have revealed that the DSM diagnoses are not biologically valid. The National Institutes of Mental Health (NIMH) responded by proposing the Research Domain Criteria (RDoC) framework for a brain-based transdiagnostic psychiatric symptom nosology (Cuthbert and Insel 2013;Insel et al. 2010;Lilienfeld and Treadway 2016). Peterson (2015) and Weinberger et al. (2015) argued that the RDoC could not replace the DSM-5 psychiatric nosology (American Psychiatric Association 2013) or the parallel International Classification of Diseases (ICD) psychiatric nosology (World Health Organization 2012). But BFor the foreseeable future, RDoC is not envisioned as a system of psychiatric classification in its own right. Instead, in the near term, RDoC and DSM-ICD are expected to coexist. Nevertheless, RDoC is intended to provide scaffolding for a large-scale research program that will ultimately yield an alternative to DSM-ICD^ (Lilienfeld and Treadway 2016, p. 445).RDoC advocates accept that DSM-5/ICD psychiatric categories remain necessary in clinical practice, but argue that researchers should shift to RDoC study designs immediately. They assert that studying psychiatric categories lacking biological validity blocks the discovery of brain bases for psychopathology and thus cannot lead to effective medical treatments for specific psychiatric symptoms (Cuthbert and Insel 2013;Insel et al. 2010;Lilienfeld and Treadway 2016;Yee et al. 2015). Against this RDoC imperative for biological validity, Weinberger et al. (2015) countered that current DSM-5 psychiatric behavioral diagnoses were valid when they yielded effective medical treatment, clear prognosis, and a life course specific to a diagnosis.Autism spectrum disorder (ASD) research has been productive (Dawson 2016;de la Torre-Ubieta et al. 2016;Szatmari et al. 2016), but no ASD research findings have met the validity criteria of Weinberger et al. (2015). DSM-5 ASD research has found no s...

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Age differences in broader autism phenotype traits from young adulthood to older adulthood

Chopik

Nuttall

et al. 2021

Autism Research

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Much of past research has been dedicated to refining the operationalization and correlates of the broader autism phenotype (BAP) and less on how the BAP differs by socio-demographic characteristics, like age-particularly after midlife. This gap is important because other nonclinical trait-like characteristics (e.g., personality) have shown considerable age differences, leading to work assessing the malleability of psychological characteristics and improving outcomes for individuals and their significant others. In the current study, we examined cross-sectional age differences in the BAP in a large sample of adults ranging in age from 18 to 85. We recruited a sample of 2966 adults ranging in age from 18 to 85 (M age = 36.53, SD = 12.61; 58.9% Female; 1.1% with an ASD diagnosis) recruited from an online survey service. We found that total BAP scores were higher in younger adults and lower among older adults. These differences were particularly true for pragmatic language difficulties, with this component of the BAP showing the most dramatic age differences. Aloofness showed similar negative associations with age, albeit much smaller. Rigidity was not significantly associated with age. The results are consistent with other research showing an abatement of symptoms among individuals with autism spectrum disorders (ASDs) across early life and theories predicting changes in other psychological characteristics (e.g., personality). The results are discussed in the context of the malleability of ASD and BAP traits across life, the clinical implications of these changes, and the origins and consequences for lifespan differences in BAP.Lay Summary: Little is known about how subclinical autistic-like traits among middle-aged and older adults compare to younger adults. We found that these subclinical traits were highest in young adults and lowest in older adults. Knowing how these traits differ by age can provide researchers and clinicians with a sense of how much these traits might change across life, if the traits might be sensitive to interventions, and when in development it might be best to intervene.

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Asperger syndrome in males over two decades: stability and predictors of diagnosis

Cited by 52 publications

References 37 publications

Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis

Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis

ASD Validity

Age differences in broader autism phenotype traits from young adulthood to older adulthood

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