ASD Traits Among Youth with Obsessive–Compulsive Disorder
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Abstract
Research has shown high rates of comorbid psychiatric disorders among samples of youth with obsessive–compulsive disorder (OCD) (Farrell et al., Psychiatry Res 199(2):115–123, 2012; Lewin et al., Psychiatry Res 178(2):317–322, 2010; POTS Team, J Am Med Assoc 292(16):1969–1976, 2004). Autism and autistic traits co-occur at high rates within clinical samples of youth with OCD (Ivarsson and Melin in J Anxiety Disord 22(6):969–978, 2008; Stewart et al. in Child Psychiatry Hum Dev 1–9, 2016). This study extends the literature by examining the relationship between ASD traits, family accommodation, and functional impairment in a sample of youth with OCD across a wide age range (n = 80; aged 7–17 years). Results indicated that autistic traits, as measured by the social responsiveness scale (SRS), were elevated in 32.5% of youth (based on a T-score of 66T and above) relative to typically developing youth, as well as youth with non-autism-related psychiatric disorders (Constantino and Gruber in Social responsiveness scale, Western Psychogical Services, Torrance, 2012). Furthermore, 27.5% of youth scored within a moderate range (66T–75T) and 5% of youth scored within a severe range (76T or higher) on the SRS, typical of children with ASD (Constantino and Gruber in Social responsiveness scale, Western Psychogical Services, Torrance, 2012). Additionally, ASD traits were associated with greater functional impairment above OCD severity. Furthermore, family accommodation mediated the relationship between ASD traits and functional impairment. Implications of these findings are discussed in the context of clinical assessment and direction for further research.
Keywords
OCD Autism Autistic traits Functional impairmentReferences
- 1.Farrell L, Waters A, Milliner E, Ollendick T (2012) Comorbidity and treatment response in pediatric obsessive–compulsive disorder: a pilot study of group cognitive-behavioral treatment. Psychiatry Res 199(2):115–123CrossRefPubMedGoogle Scholar
- 2.Lewin AB, Chang S, McCracken J, McQueen M, Piacentini J (2010) Comparison of clinical features among youth with tic disorders, obsessive–compulsive disorder (OCD), and both conditions. Psychiatry Res 178(2):317–322CrossRefPubMedPubMedCentralGoogle Scholar
- 3.POTS Team (2004) Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive–compulsive disorder: the pediatric OCD treatment study (POTS) randomized controlled trial. J Am Med Assoc 292(16):1969–1976CrossRefGoogle Scholar
- 4.Ivarsson T, Melin K (2008) Autism spectrum traits in children and adolescents with obsessive–compulsive disorder (OCD). J Anxiety Disord 22(6):969–978CrossRefPubMedGoogle Scholar
- 5.Stewart E, Cancilliere MK, Freeman J, Wellen B, Garcia A, Sapyta J et al (2016) Elevated autism spectrum disorder traits in young children with OCD. Child Psychiatry Hum Dev 47(6):993–1001CrossRefPubMedGoogle Scholar
- 6.Constantino JN, Gruber CP (2012) Social responsiveness scale, second edition (SRS-2). Western Psychogical Services, TorranceGoogle Scholar
- 7.Anholt GE, Cath DC, van Oppen P, Eikelenboom M, Smit JH, van Megen H et al (2010) Autism and ADHD symptoms in patients with OCD: are they associated with specific OC symptom dimensions or OC symptom severity? J Autism Dev Disord 40:580–589CrossRefPubMedGoogle Scholar
- 8.Bejerot S, Nylander L, Lindström E (2001) Autistic traits in obsessive–compulsive disorder. Nord J Psychiatry 55(3):169–176CrossRefPubMedGoogle Scholar
- 9.Cath DC, Ran N, Smit JH, Van Balkom AJLM, Comijs HC (2007) Symptom overlap between autism spectrum disorder, generalized social anxiety disorder and obsessive–compulsive disorder in adults: a preliminary case-controlled study. Psychopathology 41(2):101–110CrossRefPubMedGoogle Scholar
- 10.Farrell L, Barrett P, Piacentini J (2006) Obsessive–compulsive disorder across the developmental trajectory: clinical correlates in children, adolescents and adults. Behav Chang 23:103–120CrossRefGoogle Scholar
- 11.Leyfer OT, Folstein SE, Bacalman S, Davis NO, Dinh E, Morgan J et al (2006) Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord 36(7):849–861CrossRefPubMedGoogle Scholar
- 12.Neil N, Sturmey P (2014) Assessment and treatment of obsessions and compulsions in individuals with autism spectrum disorders: a systematic review. Rev J Autism Dev Disord 1(1):62–79CrossRefGoogle Scholar
- 13.American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders: DSM-IV, vol 4th. American Psychiatric Association, WashingtonGoogle Scholar
- 14.American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders: DSM-IV-TR. vol 4th, text revision. American Psychiatric Association, WashingtonGoogle Scholar
- 15.Mukaddes NM, Fateh R (2010) High rates of psychiatric co-morbidity in individuals with Asperger’s disorder. World J Biol Psychiatry 11(2–2):486–492CrossRefPubMedGoogle Scholar
- 16.Mukaddes NM, Hergüner S, Tanidir C (2010) Psychiatric disorders in individuals with high-functioning autism and Asperger’s disorder: similarities and differences. World J Biol Psychiatry 11(8):964–971CrossRefPubMedGoogle Scholar
- 17.Chasson GS, Timpano KR, Greenberg JL, Shaw A, Singer T, Wilhelm S (2011) Shared social competence impairment: another link between the obsessive–compulsive and autism spectrums? Clin Psychol Rev 31(4):653–662CrossRefPubMedGoogle Scholar
- 18.Griffiths DL, Farrell LJ, Waters AM, White S (2016) Obsessive–compulsive disorder in autism: clinical expression and treatment response, in Manuscript submitted for publicationGoogle Scholar
- 19.Zandt F, Prior M, Kyrios M (2009) Similarities and differences between children and adolescents with autism spectrum disorder and those with obsessive compulsive disorder: executive functioning and repetitive behaviour. Autism 13(1):43–57CrossRefPubMedGoogle Scholar
- 20.Scahill L, Riddle MA, McSwiggin-Hardin M, Ort SI (1997) Children’s Yale-Brown obsessive compulsive scale: reliability and validity. J Am Acad Child Adolesc Psychiatry 36(6):844–852CrossRefPubMedGoogle Scholar
- 21.Caporino NE, Morgan J, Beckstead J, Phares V, Murphy TK, and Storch EA (2012) A structural equation analysis of family accommodation in pediatric obsessive-compulsive disorder. J Abnorm Child Psychol 40(1):133–143CrossRefPubMedGoogle Scholar
- 22.Merlo LJ, Lehmkuhl HD, Geffken GR, Storch EA (2009) Decreased family accommodation associated with improved therapy outcome in pediatric obsessive-compulsive disorder. J Consult Clin Psychol 77(2):355–360CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Storch EA, Geffken GR, Merlo, LJ, Jacob, ML, Murphy TK, Goodman WK et al (2007) Family accommodation in pediatric obsessive-compulsive disorder. J Clin Child Adolesc Psychol 36(2):207–216CrossRefPubMedGoogle Scholar
- 24.Lebowitz ER, Panza KE, Su J, Bloch, MH (2012) Family accommodation in obsessive-compulsive disorder. Expert Rev Neurother 12(2):229–238CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Garcia AM (2010) Predictors and moderators of treatment outcome in the pediatric obsessive compulsive treatment study (POTS I). J Am Acad Child Adolesc Psychiatry 49(10):1024–1033CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Mazefsky CA, Herrington J, Siegel M, Scarpa A, Maddox BB, Scahill L et al (2013) The role of emotion regulation in autism spectrum disorder. J Am Acad Child Adolesc Psychiatry 52(7):679CrossRefPubMedPubMedCentralGoogle Scholar
- 27.White SW, Mazefsky CA, Dichter GS, Chiu PH (2014) Social-cognitive, physiological, and neural mechanisms underlying emotion regulation impairments: understanding anxiety in autism spectrum disorder. Int J Dev Neurosci 39:22–36CrossRefPubMedPubMedCentralGoogle Scholar
- 28.American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, WashingtonCrossRefGoogle Scholar
- 29.Conners CK, March JS (1996) Conners–March developmental questionnaire (CMDQ). Multi-Health Symstems Inc, TorontoGoogle Scholar
- 30.Silverman WK, Albano AM (1996) Anxiety disorders interview schedule for DSM-IV: parent interview schedule. Oxfor University Press, New YorkGoogle Scholar
- 31.Silverman WK, Nelles WB (1988) The anxiety disorders interview schedule for children. J Am Acad Child Adolesc Psychiatry 27(6):772–778CrossRefPubMedGoogle Scholar
- 32.Silverman WK, Saavedra LM, Pina AA (2001) Test-retest reliability of anxiety symptoms and diagnoses with the anxiety disorders interview schedule for dsm-iv: child and parent versions. J Am Acad Child Adolesc Psychiatry 40(8):937–944CrossRefPubMedGoogle Scholar
- 33.Kendall PC (1994) Treating anxiety disorders in children: results of a randomized clinical trial. J Consult Clin Psychol 62(1):100–110CrossRefPubMedGoogle Scholar
- 34.Barrett PM, Dadds MR, Rapee RM (1996) Family treatment of childhood anxiety: a controlled trial. J Consult Clin Psychol 64(2):333–342CrossRefPubMedGoogle Scholar
- 35.Ollendick TH, Ost LG, Reuterskiold L, Costa N, Cederlund R, Sirbu C et al (2009) One-session treatment of specific phobias in youth: a randomized clinical trial in the United States and Sweden. J Consult Clin Psychol 77(3):504–516CrossRefPubMedGoogle Scholar
- 36.Knox LS, Albano AM, Barlow DH (1996) Parental involvement in the treatment of childhood obsessive compulsive disorder: a multiple-baseline examination incorporating parents. Behav Ther 27(1):93–114CrossRefGoogle Scholar
- 37.Waters TL, Barrett PM, March JS (2001) Cognitive-behavioral family treatment of childhood obsessive–compulsive disorder: preliminary findings. Am J Psychother 55(3):372–387PubMedGoogle Scholar
- 38.Barrett P, Healy-Farrell L, March JS (2004) Cognitive-behavioral family treatment of childhood obsessive–compulsive disorder: a controlled trial. J Am Acad Child Adolesc Psychiatry 43(1):46–62CrossRefPubMedGoogle Scholar
- 39.Farrell LJ, Waters AM, Boschen MJ, Hattingh L, McConnell H, Milliner EL et al (2013) Difficult-to-treat pediatric obsessive–compulsive disorder: feasibility and preliminary results of a randomized pilot trial of d-cycloserine-augmented behavior therapy. Depression Anxiety 30(8):723–731CrossRefPubMedGoogle Scholar
- 40.Piacentini J, Jaffer M, Bergman RL, McCracken J (2001) Measuring impairment in childhood OCD: Psychometric properties of the COIS. In: Proceedings of the American Academy of Child and Adolescent Psychiatry MeetingGoogle Scholar
- 41.Bruni TP (2014) Test review: social responsiveness scale—second edition (SRS-2). J Psychoeduc Assess 32(4):365–369CrossRefGoogle Scholar
- 42.Rutter M, Bailey A, Lord C (2001) Social communication questionnaire (SCQ). Western Psychology Services, Los AngelesGoogle Scholar
- 43.Bishop DVM (1998) Development of the children’s communication checklist (CCC): a method for assessing qualitative aspects of communicative impairment in children. J Child Psychol Psychiatry Allied Discip 39(6):879–891CrossRefGoogle Scholar
- 44.Calvocoressi L, Lewis B, Harris M, Trufan SJ, Goodman WK, McDougle CJ et al (1995) Family accommodation in obsessive–compulsive disorder. Am J Psychiatry 152(3):441–443CrossRefPubMedGoogle Scholar
- 45.Flessner CA, Freeman JB, Sapyta J, Garcia A, Franklin ME, March JS et al (2011) Predictors of parental accommodation in pediatric obsessive–compulsive disorder: findings from the pediatric obsessive–compulsive disorder treatment study (POTS) trial. J Am Acad Child Adolesc Psychiatry 50(7):716–725CrossRefPubMedPubMedCentralGoogle Scholar
- 46.March JS, Mulle K (1998) OCD in children and adolescents: a cognitive-behavioral treatment manual. Guilford Press, New YorkGoogle Scholar
- 47.Edwards B (2014) Growing up in Australia: the longitudinal study of Australian children: entering adolescence and becoming a young adult. Fam Matters 95:5–14Google Scholar
- 48.Hayes AF (2013) An introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guilford Press, New YorkGoogle Scholar
- 49.Pine DS, Guyer AM, Goldwin M, Towbin KE, Leibenluft E (2008) Autism spectrum disorder scale scores in pediatric mood and anxiety disorders. J Am Acad Child Adolesc Psychiatry 47(6):652–661CrossRefPubMedPubMedCentralGoogle Scholar
- 50.Towbin KE, Pradella A, Gorrindo T, Pine DS, Leibenluft E (2005) Autism spectrum traits in children with mood and anxiety disorders. J child Adolesc Psychopharmacol 15(3):452–464CrossRefPubMedGoogle Scholar
- 51.Gilmour J, Hill B, Place M, Skuse DH (2004) Social communication deficits in conduct disorder: a clinical and community survey. J Child Psychol Psychiatry 45(5):967–978CrossRefPubMedGoogle Scholar
- 52.Liew SM, Thevaraja N, Hong RY, Magiati I (2015) The relationship between autistic traits and social anxiety, worry, obsessive–compulsive, and depressive symptoms: specific and non-specific mediators in a student sample. J Autism Dev Disord 45(3):858–872CrossRefPubMedGoogle Scholar
- 53.Storch EA, Larson MJ, Merlo LJ, Keeley ML, Jacob ML, Geffken GR et al (2008) Comorbidity of pediatric obsessive–compulsive disorder and anxiety disorders: impact on symptom severity and impairment. J Psychopathol. Behav Assess 30(2):111–120CrossRefGoogle Scholar
- 54.Rasmussen SA, Eisen JL (1990) Epidemiology of obsessive compulsive disorder. J Clin Psychiatry 51(2 Suppl.):10–13PubMedGoogle Scholar
- 55.Lewin AB, Wood JJ, Gunderson S, Murphy TK, Storch EA (2001) Phenomenology of comorbid autism spectrum and obsessive–compulsive disorders among children. J Dev Phys Disabil 23(6):543–553CrossRefGoogle Scholar
- 56.Castro J, Toro J, Van der Ende J, Arrindell WA (1993) Exploring the feasibility of assessing perceived parental rearing styles in Spanish children with the EMBU. Int J Soc Psychiatry 39(1):47–57CrossRefPubMedGoogle Scholar
- 57.Caron C, Rutter M (1991) Comorbidity in child psychopathology: concepts, issues and research strategies. J Child Psychol Psychiatry Allied Discip 32(7):1063–1080CrossRefGoogle Scholar