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Clinical Correlates of Co-occurring Psychiatric and Autism Spectrum Disorder (ASD) Symptom-Induced Impairment in Children with ASD

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Abstract

Although psychiatric symptom severity and impairment are overlapping but nevertheless distinct illness parameters, little research has examined whether variables found to be associated with the severity are also correlated with symptom-induced impairment. Parents and teachers completed ratings of symptom-induced impairment for DSM-IV-referenced syndromes, and parents completed a background questionnaire for a consecutively referred sample of primarily male (81 %) 6-to-12 year olds with autism spectrum disorder (ASD) (N = 221). Some clinical correlates (e.g., IQ < 70, maternal level of education, pregnancy complications, current use of psychotropic medication, season of birth) were associated with impairment for several disorders, whereas others were correlated with only a few syndromes (e.g., gender, co-morbid medical conditions) or were not related to impairment in any disorder (e.g., family psychopathology). There was little convergence in findings for parents’ versus teachers’ ratings. Some clinical correlates (e.g., season of birth, current psychotropic medication, maternal education) were unique predictors of three or more disorders. Pregnancy complications were uniquely associated with social anxiety and schizoid personality symptom-induced impairment. IQ was a unique predictor of schizophrenia, ASD, oppositional defiant disorder symptom-induced impairment. Children whose mothers had relatively fewer years of education had greater odds for symptom-induced impairment in social anxiety, depression, aggression, and mania and greater number of impairing conditions. Season of birth was the most robust correlate of symptom-induced impairment as rated by teachers but not by parents. Children born in fall evidenced higher rates of co-occurring psychiatric and ASD symptom-induced impairment and total number of impairing conditions. Many variables previously linked with symptom severity are also correlated with impairment.

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Acknowledgments

This study was supported, in part, by the Matt and Debra Cody Center for Autism and Developmental Disabilities. The authors wish to thank Dr. John Pomeroy, M.D., for directing the ASD diagnoses and three anonymous reviewers for offering numerous helpful comments.

Direct inquiries about this manuscript to Dr. Ken Gadow, Ph.D., Department of Psychiatry, Health Sciences Center T-10, Stony Brook University, Stony Brook, NY 11794–8101.

Conflicts of Interest

Kenneth D. Gadow is shareholder in Checkmate Plus, publisher of the Child and Adolescent Symptom Inventory-4R. Greg Perlman, Lianne Ramdhany, and Janneke de Ruiter declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Psychiatry, Health Sciences Center T-10, Stony Brook, NY, 11794-8101, USA

    Kenneth D. Gadow

  2. Department of Psychiatry, Stony Brook University, Stony Brook, NY, 11794-8790, USA

    Greg Perlman & Lianne Ramdhany

  3. Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands

    Janneke de Ruiter

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  1. Kenneth D. Gadow
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  2. Greg Perlman
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  4. Janneke de Ruiter
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Correspondence to Kenneth D. Gadow.

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Gadow, K.D., Perlman, G., Ramdhany, L. et al. Clinical Correlates of Co-occurring Psychiatric and Autism Spectrum Disorder (ASD) Symptom-Induced Impairment in Children with ASD. J Abnorm Child Psychol 44, 129–139 (2016). https://doi.org/10.1007/s10802-015-9979-9

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