Journal of Autism and Developmental Disorders

, Volume 45, Issue 1, pp 192–202 | Cite as

Repetitive Behaviors in Autism and Obsessive–Compulsive Disorder: New Perspectives from a Network Analysis

Original Paper

Abstract

The association between autism and obsessive–compulsive disorder (OCD) seems largely dependent upon observed similarities in the repetitive behaviors that manifest in both disorders. The aim of this study was to use a network approach to explore the interactions between these behaviors. We constructed a network based on clinician’s perceptions as well as a network based on 213 clinically diagnosed children. In all networks, autism and OCD emerged as two distinct symptom clusters and obsessions and compulsions showed few direct associations with autism symptoms. Further, sensory interests were identified as behaviors that may contribute to the link between autism and OCD. Through network analysis, we expose the symptom pathways that may lead to the perceived association between autism and OCD.

Keywords

Autism Obsessive–compulsive disorder OCD Repetitive behaviors Network analysis 

Notes

Acknowledgments

The clinical sample was collected during the PhD of Dr. Hilde M. Geurts at the Vrije University, Amsterdam, The Netherlands. We want to thank her mentors, Jaap Oosterlaan, Joe Sergeant, and Herbert Roeyers for supervising the data collection. We would especially like to thank Sylvie Verté, who collected a large portion of this data during her PhD at the University of Gent, Belgium.

References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.Google Scholar
  2. Baker, A., Lane, A., Angley, M. T., & Young, R. L. (2008). The relationship between sensory processing patterns and behavioural responsiveness in autistic disorder: A pilot study. Journal of Autism and Developmental Disorders, 38(5), 867–875.PubMedCrossRefGoogle Scholar
  3. Baron-Cohen, S. (1989). Do autistic children have obsessions and compulsions? British Journal of Clinical Psychology, 28(3), 193–200.PubMedCrossRefGoogle Scholar
  4. Bartz, J. A., & Hollander, E. (2006). Is obsessive–compulsive disorder an anxiety disorder? Progress in Neuro-Psychopharmacology and Biological Psychiatry, 30(3), 338–352.PubMedCrossRefGoogle Scholar
  5. Bejerot, S. (2007). An autistic dimension: A proposed subtype of obsessive–compulsive disorder. Autism, 11(2), 101–110.PubMedCrossRefGoogle Scholar
  6. Borsboom, D., & Cramer, A. O. (2013). Network analysis: An integrative approach to the structure of psychopathology. Annual Review of Clinical Psychology, 9, 91–121.PubMedCrossRefGoogle Scholar
  7. Borsboom, D., Cramer, A. O., Schmittmann, V. D., Epskamp, S., & Waldorp, L. J. (2011). The small world of psychopathology. PLoS ONE, 6(11), e27407.PubMedCentralPubMedCrossRefGoogle Scholar
  8. Boyd, B. A., McBee, M., Holtzclaw, T., Baranek, G. T., & Bodfish, J. W. (2009). Relationships among repetitive behaviors, sensory features, and executive functions in high functioning autism. Research in Autism Spectrum Disorders, 3(4), 959–966. doi: 10.1016/j.rasd.2009.05.003.PubMedCentralPubMedCrossRefGoogle Scholar
  9. Bringmann, L. F., Vissers, N., Wichers, M., Geschwind, N., Kuppens, P., Peeters, F., et al. (2013). A network approach to psychopathology: New insights into clinical longitudinal data. PLoS ONE, 8(4), e60188.PubMedCentralPubMedCrossRefGoogle Scholar
  10. Cath, D. C., Ran, N., Smit, J. H., van Balkom, A. J. L. M., & Comijs, H. C. (2008). Symptom overlap between autism spectrum disorders, generalized social anxiety disorder and obsessive–compulsive disorder in adults: A preliminary case-controlled study. Psychopathology, 41, 101–110.PubMedCrossRefGoogle Scholar
  11. Chen, Y., Rodgers, J., & McConachie, H. (2009). Restricted and repetitive behaviours, sensory processing and cognitive style in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(4), 635–642. doi: 10.1007/s10803-008-0663-6.PubMedCrossRefGoogle Scholar
  12. Cramer, A. O., Waldorp, L. J., van der Maas, H. L., & Borsboom, D. (2010). Comorbidity: A network perspective. Behavioral and Brain Sciences, 33(2–3), 137–150.Google Scholar
  13. Dar, R., Kahn, D. T., & Carmeli, R. (2012). The relationship between sensory processing, childhood rituals and obsessive–compulsive symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 43(1), 679–684.PubMedCrossRefGoogle Scholar
  14. Epskamp, S., Cramer, A. O. J., Waldorp, L. J., Schmittmann, V. D., & Borsboom, D. (2011). Qgraph: Network representations of relationships in data. Journal of Statistical Software, 48(4), 1–18.Google Scholar
  15. Esbensen, A. J., Seltzer, M. M., Lam, K. S., & Bodfish, J. W. (2009). Age-related differences in restricted repetitive behaviors in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(1), 57–66.PubMedCentralPubMedCrossRefGoogle Scholar
  16. Ferdinand, R. F., & van der Ende, J. (2000). NIMH DISC-IV: Diagnostic interview schedule for children: Authorized Dutch translation. Rotterdam, The Netherlands: Erasmus MC Sophia.Google Scholar
  17. Freeman, L. C. (1979). Centrality in social networks conceptual clarification. Social Networks, 1(3), 215–239.CrossRefGoogle Scholar
  18. Frewen, P. A., Allen, S. L., Lanius, R. A., & Neufeld, R. W. J. (2011). Perceived causal relations: Novel methodology for assessing client attributions about causal associations between variables including symptoms and functional impairment. Assessment, 19(4), 480–493.PubMedCrossRefGoogle Scholar
  19. Geurts, H. M., Grasman, R. P., Verté, S., Oosterlaan, J., Roeyers, H., Kammen, S. M. V., et al. (2008). Intra-individual variability in ADHD, autism spectrum disorders and tourette’s syndrome. Journal of Child Psychology and Psychiatry, 46(13), 3030–3041.Google Scholar
  20. Geurts, H. M., Verté, S., Oosterlaan, J., Roeyers, H., & Sergeant, J. A. (2004). How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism? Journal of Child Psychology and Psychiatry, 45(4), 836–854.PubMedCrossRefGoogle Scholar
  21. Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., et al. (1989). The Yale-Brown obsessive–compulsive scale: I. Development, use, and reliability. Archives of general psychiatry, 46(11), 1006–1011.Google Scholar
  22. Haasen, P. V., de Bruyn, E., Pij, Y., Poortinga, Y., & Lutje Spelberg, H. (1986). Wechsler intelligence scale for children-revised; Dutch edition. Lisse, The Netherlands: Swets, Zeitlinger.Google Scholar
  23. Hazen, E., Reichert, E., Piacentini, J., Miguel, E. C., do Rosario, M. C., Pauls, D., et al. (2008). Case series: Sensory intolerance as a primary symptom of pediatric OCD. Annals of Clinical Psychiatry, 2004(20), 4.Google Scholar
  24. Hollander, E., Phillips, A., Chaplin, W., Zagursky, K., Novotny, S., Wasserman, S., et al. (2005). A placebo controlled crossover trial of liquid fluoxetine on repetitive behaviors in childhood and adolescent autism. Neuropsychopharmacology, 30(3), 582–589.PubMedCrossRefGoogle Scholar
  25. Honey, E., Rodgers, J., & McConachie, H. (2012). Measurement of restricted and repetitive behaviour in children with autism spectrum disorder: Selecting a questionnaire or interview. Research in Autism Spectrum Disorders, 6(2), 757–776.CrossRefGoogle Scholar
  26. Ivarsson, T., & Melin, K. (2008). Autism spectrum traits in children and adolescents with obsessive–compulsive disorder (OCD). Journal of Anxiety Disorders, 22(6), 969–978.PubMedCrossRefGoogle Scholar
  27. Kalisch, M., Mächler, M., Colombo, D., Maathuis, M. H., & Bühlmann, P. (2010). Causal inference using graphical models with the R package pcalg. Journal of Statistical Software, 47(11), 1–26.Google Scholar
  28. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2(3), 217–250.Google Scholar
  29. King, B. H., Hollander, E., Sikich, L., McCracken, J. T., Scahill, L., Bregman, J. D., et al. (2009). Lack of efficacy of citalpram in children with autism spectrum disorders and high levels of repetitive behaviors. Archives of General Psychiatry, 66, 583–590.PubMedCentralPubMedCrossRefGoogle Scholar
  30. Lam, K. S. L., Bodfish, J. W., & Piven, J. (2008). Evidence for three subtypes of repetitive behavior in autism that differ in familiality and association with other symptoms. The Journal of Child Psychology and Psychiatry, 49, 1193–1200.CrossRefGoogle Scholar
  31. Langen, M., Leemans, A., Johnston, P., Ecker, C., Daly, E., Murphy, C. M., et al. (2011). Fronto-striatal circuitry and inhibitory control in autism: Findings from diffusion tensor imaging tractography. Cortex, 48(2), 183.PubMedCrossRefGoogle Scholar
  32. Langen, M., Schnack, H. G., Nederveen, H., Bos, D., Lahuis, B. E., de Jonge, M. V., et al. (2009). Changes in the developmental trajectories of striatum in autism. Biological Psychiatry, 66(4), 327–333.PubMedCrossRefGoogle Scholar
  33. le Couteur, A., Rutter, M., Lord, C., Rios, P., Robertson, S., Holdgrafer, M., et al. (1989). Autism diagnostic interview: A standardized investigator-based instrument. Journal of Autism and Developmental Disorders, 19(3), 363–387.PubMedCrossRefGoogle Scholar
  34. Leekam, S. R., Prior, M. R., & Uljarevic, M. (2011). Restricted and repetitive behaviors in autism spectrum disorders: A review of research in the last decade. Psychological Bulletin, 137(4), 562.PubMedCrossRefGoogle Scholar
  35. Leonard, R. C., & Riemann, B. C. (2012). The co-occurrence of obsessions and compulsions in OCD. Journal of Obsessive–Compulsive and Related Disorders, 1(3), 211–215.CrossRefGoogle Scholar
  36. Lewin, A. B., Wood, J. J., Gunderson, S., Murphy, T. K., & Storch, E. A. (2011). Phenomenology of comorbid autism spectrum and obsessive–compulsive disorders among children. Journal of Developmental and Physical Disabilities, 23(6), 543–553.CrossRefGoogle Scholar
  37. Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.PubMedCrossRefGoogle Scholar
  38. Markarian, Y., Larson, M. J., Aldea, M. A., Baldwin, S. A., Good, D., Berkeljon, A., et al. (2010). Multiple pathways to functional impairment in obsessive–compulsive disorder. Clinical Psychology Review, 30(1), 78–88.PubMedCrossRefGoogle Scholar
  39. Mazefsky, C. A., Oswald, D. P., Day, T. N., Eack, S. M., Minshew, N. J., & Lainhart, J. E. (2012). ASD, a psychiatric disorder, or both? Psychiatric diagnoses in adolescents with high-functioning ASD. Journal of Clinical Child & Adolescent Psychology, 41(4), 516–523.CrossRefGoogle Scholar
  40. McDougle, C., Kresch, L. E., Goodman, W. K., Naylor, S. T., & Volkmar, F. R. (1995). A case-controlled study of repetitive thoughts and behavior in adults with autistic disorder and obsessive–compulsive disorder. American Journal of Psychiatry, 152, 773.Google Scholar
  41. Opsahl, T., Agneessens, F., & Skvoretz, J. (2010). Node centrality in weighted networks: Generalizing degree and shortest paths. Social Networks, 32(3), 245–251.CrossRefGoogle Scholar
  42. Pearl, J. (2000). Causality: Models, reasoning and inference. Cambridge: MIT Press.Google Scholar
  43. Rogers, S. J., & Ozonoff, S. (2005). Annotation: What do we know about sensory dysfunction in autism? A critical review of the empirical evidence. Journal of Child Psychology and Psychiatry, 46(12), 1255–1268.PubMedCrossRefGoogle Scholar
  44. Russell, A. J., Mataix-Cols, D., Anson, M., & Murphy, D. G. M. (2005). Obsessions and compulsions in asperger syndrome and high-functioning autism. The British Journal of Psychiatry, 186(6), 525–528.PubMedCrossRefGoogle Scholar
  45. Ruta, L., Mugno, D., D’Arrigo, V. G., Vitiello, B., & Mazzone, L. (2010). Obsessive–compulsive traits in children and adolescents with asperger syndrome. European Child and Adolescent Psychiatry, 19(1), 17–24.PubMedCrossRefGoogle Scholar
  46. Schmittmann, V. D., Cramer, A. O. J., Waldorp, L. J., Epskamp, S., Kievit, R. A., & Borsboom, D. (2011). Deconstructing the construct: A network perspective on psychological phenomena. New Ideas in Psychology, 31(1), 43–53.CrossRefGoogle Scholar
  47. Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39(1), 28–38.PubMedCrossRefGoogle Scholar
  48. South, M., Ozonoff, S., & McMahon, W. M. (2005). Repetitive behavior profiles in asperger syndrome and high-functioning autism. Journal of Autism and Developmental Disorders, 35(2), 145–158.PubMedCrossRefGoogle Scholar
  49. Spirtes, P., Glymour, C., & Scheines, R. (2001). Causation, prediction, and search. Cambridge: MIT press.Google Scholar
  50. Storch, E., Abramowitz, J., & Goodman, W. (2008). Where does obsessive–compulsive disorder belong in DSM-V. Depression and Anxiety, 25(4), 336–347.PubMedCrossRefGoogle Scholar
  51. Verté, S., Geurts, H. M., Roeyers, H., Rosseel, Y., Oosterlaan, J., & Sergeant, J. A. (2006). Can the children’s communication checklist differentiate autism spectrum subtypes? Journal of Child Psychology and Psychiatry, 10(3), 266–287.Google Scholar
  52. Weidle, B., Melin, K., Drotz, E., Jozefiak, T., & Ivarsson, T. (2012). Preschool and current autistic symptoms in children and adolescents with obsessive–compulsive disorder (OCD). Journal of Obsessive–Compulsive and Related Disorders, 1(3), 168–174. doi: 10.1016/j.jocrd.2012.04.002.CrossRefGoogle Scholar
  53. Williams, M. T., Farris, S. G., Turkheimer, E., Pinto, A., Ozanick, K., Franklin, M. E., et al. (2011). Myth of the pure obsessional type in obsessive–compulsive disorder. Depression and Anxiety, 28(6), 495–500.PubMedCentralPubMedCrossRefGoogle Scholar
  54. Zandt, F., Prior, M., & Kyrios, M. (2007). Repetitive behaviour in children with high functioning autism and obsessive–compulsive disorder. Journal of Autism and Developmental Disorders, 37(2), 251–259.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Laura Ruzzano
    • 1
    • 2
  • Denny Borsboom
    • 3
  • Hilde M. Geurts
    • 1
    • 2
    • 3
    • 4
  1. 1.Research and Development, Dr. Leo KannerhuisCenter for AutismAmsterdamThe Netherlands
  2. 2.Dutch Autism and ADHD Research Center (d’Arc)University of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of PsychologyUniversity of AmsterdamAmsterdamThe Netherlands
  4. 4.Cognitive Science Center AmsterdamUniversity of AmsterdamAmsterdamThe Netherlands

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