Current Psychiatry Reports

, 19:92 | Cite as

Anxiety Disorders and Obsessive-Compulsive Disorder in Individuals with Autism Spectrum Disorder

  • Valentina Postorino
  • Connor M. Kerns
  • Giacomo Vivanti
  • Jessica Bradshaw
  • Martina Siracusano
  • Luigi Mazzone
Anxiety Disorders (A Pelissolo, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Anxiety Disorders

Abstract

Purpose of Review

This review aims to synthesize the most recent research on anxiety disorders and obsessive-compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD) and discuss the relationship between these conditions and challenges for assessment. Furthermore, implications for treatment and future directions are discussed.

Recent Findings

Research suggests that anxiety disorders and OCD are highly prevalent in individuals with ASD. However, the significant overlap of ASD features with anxiety and OCD symptomology makes differential diagnosis of these disorders particularly challenging. Though several treatments for anxiety have been adapted for youth with ASD (e.g., cognitive behavior therapy), pharmacological treatments and treatments for adults are still marked undeveloped.

Summary

Despite the high prevalence of anxiety disorders and OCD in ASD and some recent advances in assessment and treatment, research is needed to clarify the multifaceted relationship of these conditions and develop tailored assessment and treatment approaches appropriate for a full range of individuals with ASD.

Keywords

Anxiety Obsessive-compulsive disorder Autism spectrum disorder Repetitive behaviors 

Notes

Compliance with Ethical Standards

Conflict of Interest

Valentina Postorino, Giacomo Vivanti, Jessica Bradshaw, Martina Siracusano, and Luigi Mazzone declare that they have no conflicts of interest.

Connor Kerns receives book royalties from Elsevier. Dr. Kerns is owner of Connor M. Kerns, PhD, LCC, which provides training in the ADIS/ASA.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted: • Of importance •• Of major importance

  1. 1.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders-5. Washington, DC: American Psychiatric Association; 2013.CrossRefGoogle Scholar
  2. 2.
    • van Steensel FJ, Bögels SM, Perrin S. Anxiety disorders in children and adolescents with autistic spectrum disorders: a meta-analysis. Clin Child Fam Psychol Rev. 2011;14(3):302–17. An important systematic review and meta-analysis of 31 studies involving 2121 young people with ASD evaluating the presence of anxiety disorders in this clinical population using standardized questionnaire or diagnostic interviews CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Mazzone L, Ruta L, Reale L. Psychiatric comorbidities in Asperger syndrome and high functioning autism: diagnostic challenges. Ann General Psychiatry. 2012;11(1):16.CrossRefGoogle Scholar
  4. 4.
    •• Mazzone L, Vitiello B: Psychiatric symptoms and comorbidities in autism spectrum disorder. Springer Eds, 2016. This is an important book that explains in detail the diagnosis, management, and treatment of comorbid disorders in patients with autism spectrum disorders . Google Scholar
  5. 5.
    Hallett V, Lecavalier L, Sukhodolsky DG, Cipriano N, Aman MG, McCracken JT, et al. Exploring the manifestations of anxiety in children with autism spectrum disorders. J Autism Dev Disord. 2013;43(10):2341–52.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    White SW, Bray BC, Ollendick TH. Examining shared and unique aspects of social anxiety disorder and autism spectrum disorder using factor analysis. J Autism Dev Disord. 2012;42(5):874–84.CrossRefPubMedGoogle Scholar
  7. 7.
    Pugliese CE, White BA, White SW, Ollendick TH. Social anxiety predicts aggression in children with ASD: clinical comparisons with socially anxious and oppositional youth. J Autism Dev Disord. 2013;43(5):1205–13.CrossRefPubMedGoogle Scholar
  8. 8.
    • Lecavalier L, Wood JJ, Halladay AK, Jones NE, Aman MG, Cook EH, et al. Measuring anxiety as a treatment endpoint in youth with autism spectrum disorder. J Autism Dev Disord. 2014;44(5):1128–43. This is a systematic review performed by a panel of expert in the field assembled by Autism Speaks to examine strengths and weaknesses of available instruments for measuring anxiety in youth with ASD CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    • Kerns CM, Kendall PC, Zickgraf H, Franklin ME, Miller J, Herrington J. Not to be overshadowed or overlooked: functional impairments associated with comorbid anxiety disorders in youth with ASD. Behav Ther. 2015;46(1):29–39. This study examines associations between comorbid anxiety disorders and difficulties commonly attributed to both anxiety and ASD in a well-characterized sample of youth with ASD CrossRefPubMedGoogle Scholar
  10. 10.
    Gotham K, Brunwasser SM, Lord C. Depressive and anxiety symptom trajectories from school age through young adulthood in samples with autism spectrum disorder and developmental delay. J Am Acad Child Adolesc Psychiatry. 2015;54(5):369–76.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    McDougle CJ, Kresch LE, Goodman WK, Naylor ST, Volkmar FR, Cohen DJ, et al. A case-controlled study of repetitive thoughts and behavior in adults with autistic disorder and obsessive-compulsive disorder. Am J Psychiatry. 1995;152(5):772–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Russell AJ, Mataix-Cols D, Anson M, Murphy DG. Obsessions and compulsions in Asperger syndrome and high-functioning autism. Br J Psychiatry. 2005;186:525–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Ruta L, Mugno D, D’Arrigo VG, Vitiello B, Mazzone L. Obsessive-compulsive traits in children and adolescents with Asperger syndrome. Eur Child Adolesc Psychiatry. 2010;19(1):17–24.CrossRefPubMedGoogle Scholar
  14. 14.
    Cadman T, Spain D, Johnston P, Russell A, Mataix-Cols D, Craig M, et al. Obsessive-compulsive disorder in adults with high-functioning autism spectrum disorder: what does self-report with the OCI-R tell us? Autism Res. 2015;8(5):477–85.CrossRefPubMedGoogle Scholar
  15. 15.
    Zandt F, Prior M, Kyrios M. Repetitive behaviour in children with high functioning autism and obsessive compulsive disorder. J Autism Dev Disord. 2007;37(2):251–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Scahill L, Dimitropoulos A, McDougle CJ, Aman MG, Feurer ID, McCracken JT, et al. Children’s Yale-Brown obsessive compulsive scale in autism spectrum disorder: component structure and correlates of symptom checklist. J Am Acad Child Adolesc Psychiatry. 2014;53(1):97–107.e1.CrossRefPubMedGoogle Scholar
  17. 17.
    • Scahill L, Challa SA. Repetitive behavior in children with autism spectrum disorder: similarities and differences with obsessive-compulsive disorder. In: Mazzone L, Vitiello B, editors. Psychiatric symptoms and comorbidities in autism spectrum disorder: Springer Eds; 2016. An important book chapter that examines the similarities and differences of repetitive behavior in children with ASD and OCD and help clinicians disentangle the repetitive behaviors attributable to OCD from those attributable to ASD.Google Scholar
  18. 18.
    Kerns CM, Kendall PC. The presentation and classification of anxiety in autism spectrum disorder. Clin Psychol-Sci Pr. 2012;19(4):323–47.CrossRefGoogle Scholar
  19. 19.
    White SW, Oswald D, Ollendick T, Scahill L. Anxiety in children and adolescents with autism spectrum disorders. Clin Psych Rev. 2009;29(3):216–29.CrossRefGoogle Scholar
  20. 20.
    Lever AG, Geurts HM. Psychiatric co-occurring symptoms and disorders in young, middle-aged, and older adults with autism spectrum disorder. J Autism Dev Disord. 2016;46(6):1916–130.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
  22. 22.
    Costello EJ, Egger HL, Angold A. The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. Child Adolesc Psychiatr Clin N Am. 2005;14:631–48.CrossRefPubMedGoogle Scholar
  23. 23.
    Sukhodolsky DG, Scahill L, Gadow KD, Arnold LE, Aman MG, McDougle CJ, et al. Parent-rated anxiety symptoms in children with pervasive developmental disorders: frequency and association with core autism symptoms and cognitive functioning. J Abnorm Child Psychol. 2008;36(1):117–28.CrossRefPubMedGoogle Scholar
  24. 24.
    van Steensel FJ, Heeman EJ. Anxiety levels in children with autism spectrum disorder: a meta-analysis. J Child Fam Stud. 2017:1–15.Google Scholar
  25. 25.
    • Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008;47(8):921–9. This study identifies the rates and type of psychiatric comorbidity associated with ASD and reports that one of the most common diagnoses in this sample was social anxiety disorder (29.2%) CrossRefPubMedGoogle Scholar
  26. 26.
    Davis TE, Moree BN, Dempsey T, Reuther ET, Fodstad JC, Hess JA, et al. The relationship between autism spectrum disorders and anxiety: the moderating effect of communication. Res Autism Spectr Disord. 2011;5(1):324–9.CrossRefGoogle Scholar
  27. 27.
    Magiati I, Ong C, Lim XY, Tan JWL, Ong AYL, Patrycia F, et al. Anxiety symptoms in young people with autism spectrum disorder attending special schools: associations with gender, adaptive functioning and autism symptomatology. Autism. 2016;20(3):306–20.CrossRefPubMedGoogle Scholar
  28. 28.
    Thede LL, Coolidge FL. Psychological and neurobehavioral comparisons of children with Asperger’s disorder versus high-functioning autism. J Autism Dev Disord. 2007;37:847–54.CrossRefPubMedGoogle Scholar
  29. 29.
    Gadow KD, DeVincent CJ, Pomeroy J, Azizian A. Comparison of DSM-IV symptoms in elementary school-age children with PDD versus clinic and community samples. Autism. 2005;9:392–415.CrossRefPubMedGoogle Scholar
  30. 30.
    Rogers SJ, Vismara L, Wagner AL, McCormick C, Young G, Ozonoff S. Autism treatment in the first year of life: a pilot study of infant start, a parent-implemented intervention for symptomatic infants. J Autism Dev Disord. 2014;44(12):2981–95.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Magiati I, Ozsivadjian A, Kerns C. Phenomenology and presentation of anxiety in autism spectrum disorder. anxiety in children and adolescents with autism spectrum disorder: evidence-based assessment and treatment. 2017: 33–54.Google Scholar
  32. 32.
    Berthoz S, Hill EL. The validity of using self-reports to assess emotion regulation abilities in adults with autism spectrum disorder. Eur Psychiatry. 2005;20(3):291–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Hill EL, Berthoz S, Frith U. Brief report: cognitive processing of own emotions in individuals with autistic spectrum disorder and in their relatives. J Autism Dev Disord. 2004;34(2):229–35.CrossRefPubMedGoogle Scholar
  34. 34.
    Turner-Brown LM, Lam KS, Holtzclaw TN, Dichter GS, Bodfish JW. Phenomenology and measurement of circumscribed interests in autism spectrum disorders. Autism. 2011;15(4):437–56.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Wu MS, Rudy BM, Storch EA. Obsessions, compulsions, and repetitive behavior: autism and/or OCD. In: Handbook of autism and anxiety: Springer International Publishing; 2014. p. 107–20.Google Scholar
  36. 36.
    White SW, Mazefsky CA, Dichter GS, Chiu PH, Richey JA, Ollendick TH. Social-cognitive, physiological, and neural mechanisms underlying emotion regulation impairments: understanding anxiety in autism spectrum disorder. Int J Dev Neurosci. 2014;39:22–36.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Wood JJ, Gadow KD. Exploring the nature and function of anxiety in youth with autism spectrum disorders. Clin Psychol-Sci Pr. 2010;17(4):281–92.CrossRefGoogle Scholar
  38. 38.
    Mikita N, Simonoff E, Pine DS, Goodman R, Artiges E, Banaschewski T, et al. Disentangling the autism−anxiety overlap: fMRI of reward processing in a community-based longitudinal study. Transl Psychiatry. 2016;6(6):e845.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    • Uljarevic M, Nuske H, Vivanti G. Anxiety in autism spectrum disorder. In: Mazzone L, Vitiello B, editors. Psychiatric symptoms and comorbidities in autism spectrum disorder: Springer International Publishing; 2016. p. 21–38. This book chapter critically evaluate the current state of knowledge on the nature of anxiety issues in individuals with ASD, provide an overview of clinical management issues and best practices, and discuss current and future research directions.Google Scholar
  40. 40.
    Gepner B, Féron F. Autism: a world changing too fast for a mis-wired brain? Neurosci Biobehav Rev. 2009;33(8):1227–42.CrossRefPubMedGoogle Scholar
  41. 41.
    Vivanti G, McCormick C, Young GS, Abucayan F, Hatt N, Nadig A, et al. Intact and impaired mechanisms of action understanding in autism. Dev Psychol. 2011;47(3):841.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Vivanti G, Dawson G, Rogers SJ. Early learning in autism. 2017: 1–12. In Vivanti et al. Implementing the Group-Based Early Start Denver Model for Preschoolers with Autism. Springer International Publishing.Google Scholar
  43. 43.
    Hollocks MJ, Jones CR, Pickles A, Baird G, Happé F, Charman T, Simonoff E. The association between social cognition and executive functioning and symptoms of anxiety and depression in adolescents with autism spectrum disorders. Autism Res. 2014;7(2):216–28.CrossRefPubMedGoogle Scholar
  44. 44.
    Mazefsky CA, Herrington J, Siegel M, Scarpa A, Maddox BB, Scahill L, et al. The role of emotion regulation in autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2013;52(7):679–88.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Rigles B. The relationship between adverse childhood events, resiliency and health among children with autism. J Autism Dev Disord. 2017;47(1):187–202.CrossRefPubMedGoogle Scholar
  46. 46.
    Wehmeyer ML, Shogren K. Self-determination and learners with autism spectrum disorders. 2008: 433-476. In R. Simpson & B. Myles (Eds.), Educating children and youth with autism: strategies for effective practice (2nd Ed.) Austin, TX: Pro-Ed Publishers, Inc.Google Scholar
  47. 47.
    Cappadocia MC, Weiss JA, Pepler D. Bullying experiences among children and youth with autism spectrum disorders. J Autism Dev Disord. 2012;42(2):266–77.CrossRefPubMedGoogle Scholar
  48. 48.
    Zablotsky B, Bradshaw CP, Anderson C, Law PA. The association between bullying and the psychological functioning of children with autism spectrum disorders. J Dev Behav Pediatr. 2013;34(1):1–8.CrossRefPubMedGoogle Scholar
  49. 49.
    Shattuck PT, Wagner M, Narendorf S, Sterzing P, Hensley M. Post–high school service use among young adults with an autism spectrum disorder. Arch Pediatr Adolesc Med. 2011;165(2):141–6.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Developmental Disabilities Monitoring Network Surveillance Year 2010 Principal Investigators; Centers for Disease Control and Prevention (CDC). Prevalence of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveill Summ. 2014;63(2):1–21.Google Scholar
  51. 51.
    Moskowitz L, Rosen T, Lerner M, Levine K. Assessment of anxiety in youth with autism spectrum disorder. In: Kerns CM, Renno P, Storch EA, Kendall PC, Wood JJ, editors. Anxiety in children and adolescents with autism spectrum disorder: evidence based assessment and treatment. London: Elsevier Academic Press; 2017.Google Scholar
  52. 52.
    Matson JL, Wilkins J. Reliability of the Autism Spectrum Disorders-Comorbid for Children (ASD-CC). J Dev Phys Disabil. 2008;20(4):327–36.CrossRefGoogle Scholar
  53. 53.
    Rodgers J, Wigham S, McConachie H, Freeston M, Honey E, Parr JR. Development of the anxiety scale for children with autism spectrum disorder (ASC-ASD). Autism Res. 2016;9(11):1205–15.CrossRefPubMedGoogle Scholar
  54. 54.
    Bearss K, Taylor CA, Aman MG, Whittemore R, Lecavalier L, Miller J, et al. Using qualitative methods to guide scale development for anxiety in youth with autism spectrum disorder. Autism 2015: 1362361315601012.Google Scholar
  55. 55.
    Baldwin JS, Dadds MR. Reliability and validity of parent and child versions of the multidimensional anxiety scale for children in community samples. J Am Acad Child Adolesc Psychiatry. 2007;46(2):252–60.CrossRefPubMedGoogle Scholar
  56. 56.
    Chorpita BF, Moffitt CE, Gray J. Psychometric properties of the revised child anxiety and depression scale in a clinical sample. Behav Res Ther. 2005;43(3):309–22.CrossRefPubMedGoogle Scholar
  57. 57.
    Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M. Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry. 1999;38(10):1230–6.CrossRefPubMedGoogle Scholar
  58. 58.
    Mazefsky CA, Kao J, Oswald DP. Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders. Res Autism Spectr Disord. 2011;5(1):164–74.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Kerns CM, Kendall PC, Berry L, Souders MC, Franklin ME, Schultz RT, et al. Traditional and atypical presentations of anxiety in youth with autism spectrum disorder. J Autism Dev Disord. 2014;44(11):2851–61.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Kerns CM, Renno P, Kendall PC, Wood JJ, Storch EA. Anxiety disorders interview schedule–autism addendum: reliability and validity in children with autism spectrum disorder. J Clin Child Adolesc Psychol. 2017;46(1):88–100.CrossRefPubMedGoogle Scholar
  61. 61.
    Witwer AN, Lecavalier L, Norris M. Reliability and validity of the children’s interview for psychiatric syndromes-parent version in autism spectrum disorders. J Autism Dev Disord. 2012;42(9):1949–58.CrossRefPubMedGoogle Scholar
  62. 62.
    Scahill L, McDougle CJ, Williams SK, Dimitropoulos A, Aman MG, McCracken JT, et al. Children’s Yale-Brown Obsessive Compulsive Scale modified for pervasive developmental disorders. J Am Acad Child Adolesc Psychiatry. 2006;45(9):1114–23.CrossRefPubMedGoogle Scholar
  63. 63.
    Lord C, Rutter M, Le Couteur A. Autism diagnostic interview—revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord. 1994;24:659–85.CrossRefPubMedGoogle Scholar
  64. 64.
    Turner M. Repetitive behaviour and cognitive functioning in autism. Unpublished PhD thesis, University of Cambridge 1995.Google Scholar
  65. 65.
    Turner MA. Towards an executive dysfunction account of repetitive behavior in autism. In: Russell J, editor. Autism as an executive disorder. Oxford: Oxford University Press; 1997. p. 57–100.Google Scholar
  66. 66.
    Bodfish JW, Symons FJ, Parker DE, Lewis MH. Varieties of repetitive behavior in autism: comparisons to mental retardation. J Autism Dev Disord. 2000;30(3):237–43.CrossRefPubMedGoogle Scholar
  67. 67.
    Vasa RA, Carroll LM, Nozzolillo AA, Mahajan R, Mazurek MO, Bennett AE, et al. A systematic review of treatments for anxiety in youth with autism spectrum disorders. J Autism Dev Disord. 2014;44(12):3215–29.CrossRefPubMedGoogle Scholar
  68. 68.
    Sukhodolsky DG, Bloch MH, Panza KE, Reichow B. Cognitive-behavioral therapy for anxiety in children with high-functioning autism: a meta-analysis. Pediatrics. 2013;132(5):e1341–50.CrossRefPubMedPubMedCentralGoogle Scholar
  69. 69.
    Moree BN, Davis TE. Cognitive-behavioral therapy for anxiety in children diagnosed with autism spectrum disorders: modification trends. Res Autism Spectr Disord. 2010;4(3):346–54.CrossRefGoogle Scholar
  70. 70.
    •• Kerns CM, Wood JJ, Kendall PC, Renno P, Crawford EA, Mercado RJ, et al. The Treatment of Anxiety in Autism Spectrum Disorder (TAASD) study: rationale, design and methods. J Child Fam Stud. 2016;25(6):1889–902. This is a study protocol paper describing the Treatment of Anxiety in Autism Spectrum Disorder study, an ongoing three-site randomized controlled trial investigating the relative efficacy of a modular CBT protocol for anxiety in ASD versus standard CBT for pediatric anxiety and a treatment-as-usual control. CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Spek AA, Van Ham NC, Nyklíček I. Mindfulness-based therapy in adults with an autism spectrum disorder: a randomized controlled trial. Res Dev Disabil. 2013;34(1):246–53.CrossRefPubMedGoogle Scholar
  72. 72.
    Russell AJ, Jassi A, Fullana MA, Mack H, Johnston K, Heyman I, et al. Cognitive behavior therapy for comorbid obsessive-compulsive disorder in high-functioning autism spectrum disorders: a randomized controlled trial. Depress Anxiety. 2013;30(8):697–708.CrossRefPubMedGoogle Scholar
  73. 73.
    Rosen TE, Connell JE, Kerns CM. A review of behavioral interventions for anxiety-related behaviors in lower-functioning individuals with autism. Behav Interv. 2016;31(2):120–43.CrossRefGoogle Scholar
  74. 74.
    Baldwin DS, Anderson IM, Nutt DJ, Allgulander C, Bandelow B, den Boer JA, et al. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology. J Psychopharmacol. 2014;28(5):403–39.CrossRefPubMedGoogle Scholar
  75. 75.
    Reinblatt SP, DosReis S, Walkup JT, Riddle MA. Activation adverse events induced by the selective serotonin reuptake inhibitor fluvoxamine in children and adolescents. J Child Adolesc Psychopharmacol. 2009;19(2):119–26.CrossRefPubMedPubMedCentralGoogle Scholar
  76. 76.
    King BH, Hollander E, Sikich L, McCracken JT, Scahill L, Bregman JD, et al. Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism. Arch Gen Psychiatry. 2009;66(6):583.CrossRefPubMedPubMedCentralGoogle Scholar
  77. 77.
    Groden J, Goodwin MS, Baron MG, Groden G, Velicer WF, Lipsitt LP, et al. Assessing cardiovascular responses to stressors in individuals with autism spectrum disorders. Focus Autism Other Dev Disabl. 2005;20:244–52.CrossRefGoogle Scholar
  78. 78.
    Goodwin MS, Groden J, Velicer WF, Lipsitt LP, Baron MG, Hofmann SG, Groden G. Cardiovascular arousal in individuals with autism. Focus Autism Other Dev Disabl. 2006;21:100–23.CrossRefGoogle Scholar
  79. 79.
    Mathewson KJ, Drmic IE, Jetha MK, Bryson SE, Goldberg JO, Hall GB, et al. Behavioral and cardiac responses to emotional stroop in adults with autism spectrum disorders: influence of medication. Autism Res. 2011;4:98–108.CrossRefPubMedGoogle Scholar
  80. 80.
    Guy L, Souders M, Bradstreet L, DeLussey C, Herrington JD. Brief report: emotion regulation and respiratory sinus arrhythmia in autism spectrum disorder. J Autism Dev Disord. 2014:1–7.Google Scholar
  81. 81.
    •• Häge A, Banaschewski T, Buitelaar JK, Dijkhuizen RM, Franke B, Lythgoe DJ, et al. Glutamatergic medication in the treatment of obsessive compulsive disorder (OCD) and autism spectrum disorder (ASD) - study protocol for a randomised controlled trial. Trials 2016: 17(1):141. This is a study protocol describing an ongoing randomised, double-blind, placebo-controlled design of treatment with memantine in patients with OCD and ASD and is part of the large, translational project TACTICS that is funded by the European Union and investigates the neural, genetic, and molecular factors involved in the pathogenesis of compulsivity.Google Scholar
  82. 82.
    Schohl KA, Van Hecke AV, Carson AM, Dolan B, Karst J, Stevens S. A replication and extension of the PEERS intervention: examining effects on social skills and social anxiety in adolescents with autism spectrum disorders. J Autism Dev Disord. 2014;44(3):532–45.CrossRefPubMedGoogle Scholar
  83. 83.
    Hill TL, Gray SA, Baker CN, Boggs K, Carey E, Johnson C, et al. A pilot study examining the effectiveness of the PEERS program on social skills and anxiety in adolescents with autism spectrum disorder. J Autism Dev Disord. 2017:1–12.Google Scholar
  84. 84.
    Kenworthy L, Anthony LG, Naiman DQ, Cannon L, Wills MC, Luong-Tran C, et al. Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum. J Child Psychol Psychiatry. 2014;55(4):374–83.CrossRefPubMedGoogle Scholar
  85. 85.
    Lawson RA, Papadakis AA, Higginson CI, Barnett JE, Wills MC, Strang JF, et al. Everyday executive function impairments predict comorbid psychopathology in autism spectrum and attention deficit hyperactivity disorders. Neuropsychology. 2015;29(3):445.CrossRefPubMedGoogle Scholar
  86. 86.
    Wallace GL, Kenworthy L, Pugliese CE, Popal HS, White EI, Brodsky E, et al. Real-world executive functions in adults with autism spectrum disorder: profiles of impairment and associations with adaptive functioning and co-morbid anxiety and depression. J Autism Dev Disord. 2016;46(3):1071–83.CrossRefPubMedPubMedCentralGoogle Scholar
  87. 87.
    de Bruin EI, Blom R, Smit FM, van Steensel FJ, Bögels SM. MYmind: Mindfulness training for Youngsters with autism spectrum disorders and their parents. Autism. 2015;19(8):906–14.CrossRefPubMedGoogle Scholar
  88. 88.
    Green J, Pickles A, Pasco G, Bedford R, Wan MW, Elsabbagh M, et al. Randomised trial of a parent-mediated intervention for infants at high risk for autism: longitudinal outcomes to age 3 years. J Child Psychol Psychiatry. 2017;Google Scholar
  89. 89.
    Bradshaw J, Steiner AM, Gengoux G, Koegel LK. Feasibility and effectiveness of very early intervention for infants at-risk for autism spectrum disorder: a systematic review. J Autism Dev Disord. 2015;45(3):778–94.CrossRefPubMedGoogle Scholar
  90. 90.
    Vivanti G, Dissanayake C, Victorian ASELCC Team. Outcome for children receiving the Early Start Denver Model before and after 48 months. J Autism Dev Disord. 2016:1–9.Google Scholar
  91. 91.
    Wetherby AM, Guthrie W, Woods J, Schatschneider C, Holland RD, Morgan L, et al. Parent-implemented social intervention for toddlers with autism: an RCT. Pediatrics. 2014;134(6):1084–93.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Valentina Postorino
    • 1
    • 2
  • Connor M. Kerns
    • 3
  • Giacomo Vivanti
    • 3
  • Jessica Bradshaw
    • 1
    • 2
  • Martina Siracusano
    • 4
  • Luigi Mazzone
    • 4
  1. 1.The Marcus Autism CenterAtlantaUSA
  2. 2.Department of PediatricsEmory University School of MedicineAtlantaUSA
  3. 3.A.J. Drexel Autism InstituteDrexel UniversityPhiladelphiaUSA
  4. 4.Child Neurology and Psychiatry Unit, Systems Medicine DepartmentTor Vergata University Hospital of RomeRomeItaly

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