Date: 31 May 2011

Assessment of Comorbid Psychopathology

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People with autism spectrum disorders (ASD) may also have other conditions such as intellectual disability (ID) and mental health disorders (see Chapters 6 and 7, respectively). The relationships between these conditions are complex and remain under-researched (Matson & Shoemaker, 2009; McCarthy et al., 2009). Recognizing and assessing comorbid psychopathology in individuals with ASD is challenging (Tsakanikos, Sturmey, Costello, Holt, & Bouras, 2006; Tsakanikos, Costello, Holt, Sturmey, & Bouras, 2007b). There is considerable overlap between the characteristics of ASD and some symptoms of comorbid psychopathology, e.g., obsessive-compulsive disorder, which may make it difficult for clinicians to determine whether a specific problem reflects features of ASD or an additional mental health problem (Helvershou, Bakken, & Martinsen, 2009; LoVullo & Matson, 2009). This diagnostic overshadowing can result in symptoms of psychopathology going unrecognized (Xenitidis, Paliokosta, Maltezos, & Pappas, 2007). There is also growing evidence that the presentation of psychopathology in people with ASD is atypical compared with the general population (Hutton, Goode, Murphy, Le Couteur, & Rutter, 2008). In addition, people with ASD often have difficulty understanding and expressing their own thoughts and feelings, and their ability to grasp the meaning of questions about their symptoms may also be impaired (Kannabiran & McCarthy, 2009; Leyfer et al., 2006; MacNeil, Lopes, & Minnes, 2009).