Social attribution processes and comorbid psychiatric symptoms in children with Asperger syndrome

Abstract

The factors that place children with Asperger syndrome at risk for comorbid psychiatric symptoms, such as anxiety and depression, remain poorly understood. We investigated the possibility that the children's emotional and behavioral difficulties are associated with social information and attribution processing. Participants were children with either Asperger syndrome (n = 31) or typical development (n = 33).To assess social information and attribution processing, children responded to hypothetical social vignettes.They also completed self-report measures of social difficulties and psychological functioning. Their parents provided information on social competence and clinical presentation. Children with Asperger syndrome showed poor psychosocial adjustment, which was related to their social information and attribution processing patterns. Cognitive and social-cognitive abilities were associated with aspects of social information processing tendencies, but not with emotional and behavioral difficulties. Results suggest that the comorbid symptoms of children with Asperger syndrome may be associated with their social perception, understanding, and experience. KeywordsAsperger syndrome; comorbid symptoms; social information processing In his original case descriptions, Asperger (1944) highlighted pervasive deficits in the children's capacity to understand social interaction, awareness of their social difficulties, and emotional symptoms, including anxiety and depression (Wing, 1981). Since then, emotional symptoms in adolescents and young adults with Asperger syndrome have been emphasized in a number of reports (Volkmar et al., 2000;Wolff and Chick, 1980;Wolff and McGuire, 1995;Wing, 1981). Recently, several empirical studies have documented comorbid psychiatric symptoms, such as anxiety and depression, in individuals with high-functioning autism (HFA) and Asperger syndrome (Ghaziuddin et al., 1998;Green et al., 2000;Hill et al., 2004;Howlin, 2000;Kim et al., 2000;Rinehart et al., 2002;Rumsey et al., 1985;Tonge et al., 1999). Disruptive and aggressive behavior has also been reported (Eaves et al., 1994;Muris and Correspondence should be addressed to: JESSICA A. MEYER, PhD, Tavistock Clinic and Institute of Child Health, UCL, Developmental Psychopathology Research Unit, 120 Belsize Lane, London NW3 5BA, UK. e-mail: Jessica.Meyer@ucl.ac.uk. Steerneman, 1998;Pomeroy, 1998;Rinehart et al., 2002;Tantam, 2000;Tonge et al., 1999). However, the factors giving rise to these comorbid psychiatric symptoms remain unclear. NIH Public AccessDespite the often intense desire to do so, many individuals with Asperger syndrome find it extremely difficult to establish reciprocal relationships with others (Barnard et al., 2000;Green et al., 2000;Sigman and Ruskin, 1999). Limitations in the capacity for intersubjective contact with others (Hobson, 1992;Mundy and Sigman, 1989), coupled with repeated experiences of negative, unsuccessful social interactions (Bauminger, 2002;Frith, 1996;2004;Tantam, 2000;2003) may place children wit...

The Modifier Model of Autism and Social Development in Higher Functioning Children

“…Their long-term outcomes, though, can be highly variable as some display improved social and communication skills, but others display a deterioration of these skills (Piven, Harper, Palmer, & Arndt, 1996). Moreover, variability in the social and emotional status of these children and their treatment is often complicated by symptoms of anxiety and other comorbid emotional or behavioral disorders (Ghaziuddin, Weidmer, & Ghaziuddin, 1998;Kim et al, 2000;Meyer et al, 2006;Soderstrom et al, 2002;Tonge, Bremerton, Gray, & Einfeld, 1999).A small empirical literature has begun to emerge regarding intervention development for these children. Several recent studies have used group comparison designs to examine the effects of social stories, verbal, and nonverbal social skills training, interactions with typical peers, cognitive behavioral therapy (CBT), and computer face processing games as treatments for these children (Barnhill, Cook, Tebbenkamp, & Myles, 2002;Bauminger, 2002;Carter et al, 2004;Chiang, Lee, Frey, & McCormick, 2004;Nakabayashi & Matsumoto, 2003;Pakenham, Samios, & Sofronoff, 2005;Smith, Lovaas, & Lovaas, 2002;Solomon, Goodlin-Jones, & Anders, 2004;Sofronoff, Anthony, & Brown, 2004).…”

“…Nevertheless, recent theory and research suggest that several core psychological processes may be especially important in this regard. One of these involves the capacity to make attributions about the behaviors of others (Meyer et al, 2006), another involves motivational tendencies associated with approach and withdrawal (Sutton et al, 2005), and a third involves the capacity to selfmonitor goal-directed behavior . …”

“…Specifically, the children with HFA appeared to be aware of their social difficulties and their impact on others in that they not only reported more social difficulties on the BASC Interpersonal Relations Scale but they also reported higher rates of fear of negative evaluations by others on the revised Social Anxiety Scale for Children (SASC-R;La Greca & Stone, 1993). Interestingly, the initial attempts to publish these data were met with reviewer skepticism regarding the reliability and validity of children with HFA's self-reports on measures relating to social awareness.To address this issue, we ultimately gathered data that indicated that 18 children with HFA provided self-report with significant test-retest reliability on the BASC and the SASC-R measures across an 18-month interval, r = .41 to .68, ps < .05 (Meyer et al, 2006). Thus, these data suggested that (a) children with HFA present with mores symptoms of affective, anxiety, and externalizing disorders than controls, that (b) the children with HFA display stable individual differences in the self-report of these problems, and (c) that the children with HFA more frequently reported attributions involving fear of negative evaluations by others than did controls.…”

Measuring the Plasticity of Social Approach: A Randomized Controlled Trial of the Effects of the PEERS Intervention on EEG Asymmetry in Adolescents with Autism Spectrum Disorders

“…A well-documented phenomenon, especially in high-functioning samples, is that of high rates of depression, withdrawal, anxiety, and negative affect or mood in ASD (Kim et al 2000;Meyer et al 2006;Schwartz et al 2009). Given the links of depression/negative mood with right-hemisphere dominance (Pizzagalli et al 2005;Sutton and Davidson 1997), it will be important for future treatment research to examine whether these co-occurring negative mood states are a cardinal aspect of the autism taxon, or are a true, separable, additional challenge experienced by many individuals on the autism spectrum.…”

“…Importantly, modifier processes, such as temperament/personality, cognitive style, and approach orientation, produce individual differences in well-being outcomes experienced by all people (Mundy et al 2007). These modifiers may also affect the phenotypic presentation and course of ASD, especially in highfunctioning individuals (Burnette et al 2011;Meyer et al 2006;Mundy et al 2007;Sutton et al 2005). Thus, it will be important to consider that treatments for ASD affecting these modifier processes may enhance well-being and adjustment via meeting psychological accessed by following the link in the citation at the bottom of the page.…”