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Neurocognitive functioning and psychiatric symptoms in children and adolescents with higher functioning autism spectrum disorders

Year: 2018
Type: dissertation
Study design: Observational Study
Abstract: Autism spectrum disorders (ASD) are characterized by social interaction and communication difficulties, and by restrictive, repetitive and stereotyped patterns of behavior. In many ways, ASD is a highly heterogeneous disorder, and it is not known why some individuals with ASD end up having a poor outcome while others may cope well. Understanding of associated neurocognitive and psychiatric factors in ASD is crucial for enabling planning suitable follow-ups, as well as planning effective interventions. This thesis investigates neurocognitive functioning and psychiatric symptoms comprehensively in children and adolescents with higher functioning ASD (HF-ASD) in four studies. In Studies I and II, the neurocognitive functioning of children and adolescents with HF-ASD were compared with that of typically developing (TD) children and adolescents. In Study III, psychiatric symptoms of children and adolescents with HF-ASD were compared to that of TD children and adolescents, and to the reported prevalence rates of psychiatric symptoms by Ford, Goodman, and Melzer (2003). In Study IV, children and adolescents with HF-ASD were divided into three groups based on the level of symptoms of sluggish cognitive tempo (SCT): the ASD+High SCT group, the ASD+Medium SCT group, and the ASD+Low SCT group. The groups were compared on social skills and academic functioning, internalizing and externalizing psychiatric symptoms and processing speed. The present results showed that children and adolescents with HF-ASD had strengths in verbal reasoning skills and weaknesses in attention and executive functions (EF), facial recognition memory, and visuomotor functions. Overall, the neurocognitive deficits in children and adolescents with HF-ASD at the group-level were mild. In contrast, children and adolescents with HF-ASD had high rates of co-occurring psychiatric symptoms. Particularly anxiety and depression, attention deficit hyperactivity disorder and tic disorders were frequent in these individuals. Finally, the HF-ASD+High SCT group and the HF-ASD+Medium SCT group had more pronounced social difficulties than the HF-ASD+Low SCT group. Additionally, the HF-ASD+High SCT group had a higher rate of symptoms of anxiety and depression compared to the HF-ASD+Low SCT group. To conclude, these results suggest that children and adolescents with HF-ASD are characterized by mild neurocognitive deficits in single clinical neuropsychological subtests. High co-occurrence of psychiatric symptoms in children and adolescents with HF-ASD emphasize the importance of evaluating psychiatric symptoms systematically in HF-ASD. Results on SCT symptoms in HF-ASD indicate that individuals with HF-ASD and high levels of SCT symptoms may be at risk for pronounced social difficulties and internalizing psychiatric symptoms. Therefore, identifying individuals with HF-ASD and with symptoms of SCT would be important for planning systematical follow-ups and preventive support for these individuals.
Language: English
Open Access status: green
OpenAlex ID: W2804665440
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Cited by: 1
Related to: 10