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      Distinguishing autism from co-existing conditions: a behavioural profiling investigation

      Advances in Autism
      Emerald Group Publishing Limited
      Anxiety, ADHD, Comorbidity, Behavioural phenotypes, High-functioning autism

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          Abstract

          Purpose – Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition for which there is no known cure. The rate of psychiatric comorbidity in autism is extremely high, which raises questions about the nature of the co-occurring symptoms. It is unclear whether these additional conditions are true comorbid conditions, or can simply be accounted for through the ASD diagnosis. The paper aims to discuss this issue. Design/methodology/approach – A number of questionnaires and a computer-based task were used in the current study. The authors asked the participants about symptoms of ASD, attention deficit hyperactivity disorder (ADHD) and anxiety, as well as overall adaptive functioning. Findings – The results demonstrate that each condition, in its pure form, can be clearly differentiated from one another (and from neurotypical controls). Further analyses revealed that when ASD occurs together with anxiety, anxiety appears to be a separate condition. In contrast, there is no clear behavioural profile for when ASD and ADHD co-occur. Research limitations/implications – First, due to small sample sizes, some analyses performed were targeted to specific groups (i.e. comparing ADHD, ASD to comorbid ADHD+ASD). Larger sample sizes would have given the statistical power to perform a full scale comparative analysis of all experimental groups when split by their comorbid conditions. Second, males were over-represented in the ASD group and females were over-represented in the anxiety group, due to the uneven gender balance in the prevalence of these conditions. Lastly, the main profiling techniques used were questionnaires. Clinical interviews would have been preferable, as they give a more objective account of behavioural difficulties. Practical implications – The rate of psychiatric comorbidity in autism is extremely high, which raises questions about the nature of the co-occurring symptoms. It is unclear whether these additional conditions are true comorbid conditions, or can simply be accounted for through the ASD diagnosis. Social implications – This information will be important, not only to healthcare practitioners when administering a diagnosis, but also to therapists who need to apply evidence-based treatment to comorbid and stand-alone conditions. Originality/value – This study is the first to investigate the nature of co-existing conditions in ASD in a New Zealand population.

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          Most cited references21

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          A continuous performance test of brain damage.

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            • Record: found
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            The epidemiology of autism spectrum disorders.

            Autism spectrum disorders (ASDs) are complex, lifelong, neurodevelopmental conditions of largely unknown cause. They are much more common than previously believed, second in frequency only to mental retardation among the serious developmental disorders. Although a heritable component has been demonstrated in ASD etiology, putative risk genes have yet to be identified. Environmental risk factors may also play a role, perhaps via complex gene-environment interactions, but no specific exposures with significant population effects are known. A number of endogenous biomarkers associated with autism risk have been investigated, and these may help identify significant biologic pathways that, in turn, will aid in the discovery of specific genes and exposures. Future epidemiologic research should focus on expanding population-based descriptive data on ASDs, exploring candidate risk factors in large well-designed studies incorporating both genetic and environmental exposure data and addressing possible etiologic heterogeneity in studies that can stratify case groups and consider alternate endophenotypes.
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              Executive dysfunction in autism☆

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                Author and article information

                Journal
                10.1108/AIA-09-2015-0018

                Psychology
                Anxiety,ADHD,Comorbidity,Behavioural phenotypes,High-functioning autism
                Psychology
                Anxiety, ADHD, Comorbidity, Behavioural phenotypes, High-functioning autism

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