Commentary: Thinking flexibly about mental health and autism – a commentary on Ozsivadjian et al. (2020)

Abstract

Research on mental health in autism has quite rightly flourished over the past fifteen years, and there is now clear evidence that autistic people are at heightened risk of experiencing mental health concerns. Recent research has shown that common mental health conditions may be experienced differently by autistic people, meaning that assessment and intervention techniques that were developed with and for neurotypical individuals are potentially less sensitive and effective for those on the spectrum. The upshot of this work is that we need to get better at all of these aspects of identification, support and intervention and that will only be possible with a clear understanding of the mechanisms of mental distress for autistic people. The work described in Ozsivadjian et al. (2020) makes a welcome addition to this literature. In this commentary, we explore the strengths and limitations of the work and consider its contribution to research and clinical practice in the field of autism and mental health.

Examining the relationship between cognitive inflexibility and internalizing and externalizing symptoms in autistic children and adolescents: A systematic review and meta‐analysis

“…As cognitive flexibility can support individuals to flexibly adapt to different situational demands (Kashdan, 2010), clinicians should more consistently evaluate individual differences in CI to guide assessment and personalization of treatment approach when working with autistic adolescents. Current adaptations to evidence-based treatment for autistic adolescents with mental health conditions often focus on changing the format of communication and session structure, such as by having more frequent sessions and adopting more visual aids to make session material more concrete (Rodgers & South, 2021). However, such adaptations do not directly address constructs such as CI (Scarpa et al, 2021), which might affect engagement and response to therapeutic The Halo Effect refers to the concept that a reporter rating on someone else's behavior may fail to distinguish between distinct and independent aspects of the behaviors observed, resulting in inflated inflation of correlation between the different types of behaviors observed (Saal et al, 1980).…”

“…approaches that aim to increase awareness of alternative patterns of thinking and behavior (e.g., Cognitive Behavioral Therapy) (Rodgers & South, 2021), and reduce intervention effectiveness.…”

“…Current adaptations to evidence‐based treatment for autistic adolescents with mental health conditions often focus on changing the format of communication and session structure, such as by having more frequent sessions and adopting more visual aids to make session material more concrete (Rodgers & South, 2021 ). However, such adaptations do not directly address constructs such as CI (Scarpa et al, 2021 ), which might affect engagement and response to therapeutic approaches that aim to increase awareness of alternative patterns of thinking and behavior (e.g., Cognitive Behavioral Therapy) (Rodgers & South, 2021 ), and reduce intervention effectiveness.…”

Gut microbiome-brain axis and inflammation in temperament, personality and psychopathology

“…Whilst self-Judgement appeared unrelated to a general peripheral marker of inflammation known as C-reactive protein (CRP), CRP (but not Lactobacillus or Bifidobacterium) was associated with poor cognitive empathy [65], another psychometric vulnerability marker for depression (as well as autism [69], dark personality traits and personality disorders [70,71]). In Heym et al [65], cognitive empathy may have acted as a proxy for cognitive flexibility [72], which would hold ties to plasticity (extraversion, openness [73,74]). In line with this, Sumich et al [75] report associations between plasticity and certain fatty acids with established antiinflammatory action, whilst those with pro-inflammatory action were associated with Instability (neuroticism, low agreeableness, low conscientiousness).…”

Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa

“…Como ya ha quedado descrito, la manifestación de la ansiedad en niños y adolescentes autistas difiere en varios aspectos de la ansiedad que se observa en los jóvenes neurotípicos (Wigham y McConachie, 2014). Recientemente, las investigaciones han demostrado que las condiciones comunes de salud mental (como la ansiedad) pueden ser experimentadas de manera diferente por las personas autistas, significando que las técnicas de evaluación e intervención desarrolladas con y para individuos neurotípicos pueden ser menos sensibles y efectivas para ellos (Rodgers y South, 2021). En respuesta a estos hallazgos, se han venido realizando esfuerzos significativos para desarrollar y probar intervenciones que aborden la variedad de condiciones de salud mental que se observan entre las personas autistas (véase Keefer et al, 2018;Vetter, 2018;White et al, 2018).…”