Abstract
This study examined mental health risk/protective factors for DSM-IV psychiatric symptoms in children with an autism spectrum disorder (ASD) and their contribution to functioning separate from ASD symptom severity. Mothers/teachers completed measures of risk/protection and social, adaptive, and school functioning in 6- to 12-year-olds with a diagnosed ASD (N = 238). Bivariate correlations and simultaneous regression analyses indicated a unique pattern of predictors for attention-deficit/hyperactivity disorder, aggression, anxiety, and depression symptoms. Moreover, psychiatric symptoms differentially predicted social and school performance. Findings indicate that co-occurring psychiatric symptoms and their associated mental health risk/protective factors may have important clinical implications and generally support a biopsychosocial model of psychopathology in children with an ASD that appears to share many similarities with models for nonASD children.
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Achenbach, T. M. (1991a). Manual for the Child Behavior Checklist/4–18 and 1991 profile. Burlington, VT: University of Vermont Department of Psychiatry.
Achenbach, T. M. (1991b). Manual for the teacher’s report form and 1991 profile. Burlington, VT: University of Vermont Department of Psychiatry.
Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: Implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101, 213–232.
Allen, N. B., Lewinsohn, P. M., & Seeley, J. R. (1998). Prenatal and perinatal influences on risk for psychopathology in childhood and adolescence. Development and Psychopathology, 10, 513–529.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, 4th ed. (DSM-IV). Washington, DC: American Psychiatric Association.
Badcock, C., & Crespi, B. (2006). Imbalanced genomic imprinting in brain development: An evolutional basis for the aetiology of autism. Journal of Evolutionary Biology, 19, 1007–1032.
Baillargeon, R. H., Boulerice, B., Tremblay, R. E., Zoccolillo, M., Vitaro, F., & Kohen, D. E. (2001). Modeling interinformant agreement in the absence of a “gold standard”. Journal of Child Psychology and Psychiatry, 42, 463–473.
Bauminger, N., & Kasari, C. (2000). Loneliness and friendship in high-functioning children with autism. Child Development, 71, 447–456.
Bauminger, N., Shulman, C., & Agam, G. (2003). Peer interactions and loneliness in high-functioning children with autism. Journal of Autism and Developmental Disorders, 33, 489–507.
Biederman, J., Faraone, S., Milberger, S., Curtis, S., Chen, L., Marrs, A., Ouellete, C., Moore, P., & Spencer, T. (1996). Predictors of persistence and remission of ADHD into adolescence: Results from a four-year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 343–351.
Cohen, P., Velez, C. N., Brook, J., & Smith, J. (1989). Mechanisms of the relation between perinatal problems, early childhood illness, and psychopathology in late childhood and adolescence. Child Development, 60, 701–709.
DeVincent, C. J., Gadow, K. D., Delosh, D., & Geller, L. (2007). Sleep disturbance and its relation to DSM-IV psychiatric symptoms in preschool-aged children with pervasive developmental disorder and community controls. Journal of Child Neurology, 22, 161–169.
DeVincent, C., Gadow, K. D., Strong, G., Schwartz, J., & Cuva, S. (2008). Screening for autism spectrum disorder with the Early Childhood Inventory-4. Journal of Developmental and Behavioral Pediatrics, 29, 1–10.
Dick, D. M., Viken, R. J., Kaprio, J., Pulkkinen, L., & Rose, R. J. (2005). Understanding the covariation among childhood externalizing symptoms: Genetic and environmental influences on conduct disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder symptoms. Journal of Abnormal Child Psychology, 33, 219–229.
Drabick, D. A. G., Beauchaine, T. P., Gadow, K. D., Carlson, G. A., & Bromet, E. J. (2006). Risk factors for conduct problems and depressive symptoms in a cohort of Ukrainian children. Journal of Clinical Child and Adolescent Psychology, 35, 244–252.
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G., & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives General Psychiatry, 26, 57–63.
Ford, T., Goodman, R., & Meltzer, H. (2004). The relative importance of child, family, school and neighborhood correlates of childhood psychiatric disorder. Social Psychiatry Psychiatric Epidemiology, 39, 487–496.
Gadow, K. D., & DeVincent, C. J. (2005). Clinical significance of tics and attention-deficit hyperactivity disorder (ADHD) in children with pervasive developmental disorder. Journal of Child Neurology, 20, 481–488.
Gadow, K. D., DeVincent, C. J., & Drabick, D. A. G. (a-in press). Oppositional defiant disorder as a clinical phenotype in children with pervasive developmental disorder. Journal of Autism and Developmental Disorders.
Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2006). ADHD symptom subtypes in children with pervasive developmental disorder. Journal of Autism and Developmental Disorders, 36, 271–283.
Gadow, K. D., DeVincent, C. J., Pomeroy, J., & Azizian, A. (2004a). Psychiatric symptoms in preschool children with PDD and clinic and comparison samples. Journal of Autism and Developmental Disorders, 34, 379–393.
Gadow, K. D., DeVincent, C. J., Pomeroy, J., & Azizian, A. (2005). Comparison of DSM-IV symptoms in elementary school-aged children with PDD versus clinic and community samples. Autism, 9, 392–415.
Gadow, K. D., Drabick, D. A. G., Loney, J., Sprafkin, J., Salisbury, H., Azizian, A., & Schwartz, J. (2004b). Comparison of ADHD symptom subtypes as source-specific syndromes. Journal of Child Psychology and Psychiatry, 45, 1135–1149.
Gadow, K. D., & Nolan, E. E. (2002). Differences between preschool children with ODD, ADHD, and ODD + ADHD symptoms. Journal of Child Psychology and Psychiatry, 43, 191–201.
Gadow, K. D., Nolan, E. E., Sprafkin, J., & Schwartz, J. (2002). Tics and psychiatric comorbidity in children and adolescents. Developmental Medicine & Child Neurology, 44, 330–338.
Gadow, K. D., Schwartz, J., DeVincent, C., Strong, G., & Cuva, S. (b-in press). Clinical utility of autism spectrum disorder scoring algorithms for the Child Symptom Inventory. Journal of Autism and Developmental Disorders.
Gadow, K. D., & Sprafkin, J. (1994). Child symptom inventories manual. Stony Brook, NY: Checkmate Plus.
Gadow, K. D., & Sprafkin, J. (2002). Child symptom inventory-4 screening and norms manual. Stony Brook, NY: Checkmate Plus.
Gadow, K. D., & Sprafkin, J. (2007). The symptom inventories: An annotated bibliography [On-line]. Available: www.checkmateplus.com
Gericke, G. S. (2006). Chromosomal fragility, structural rearrangements and mobile element activity may reflect dynamic epigenetic mechanisms of importance in neurobehavioral genetics. Medical Hypotheses, 66, 276–285.
Goodman, S. H., Hoven, C. W., Narrow, W. E., Cohen, P., Fielding, B., Alegria, M., Leaf, P. J., Kandel, D., Horwitz, S. M., Bravo, M., Moore, R., & Dulcan, M. K. (1998). Measurement of risk for mental disorders and competence in a psychiatric epidemiologic community survey: The National Institute of Mental Health Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study. Social Psychiatry Psychiatric Epidemiology, 33, 162–173.
Gottesman, I. I., & Gould, T. D. (2003). The endophenotype concept in psychiatry: Etymology and strategic intentions. American Journal of Psychiatry, 160, 636–645.
Gurney, J. G., McPheeters, M. L., & Davis, M. M. (2007). Parental report of health conditions and health care use among children with and without autism. Archives of Pediatric and Adolescent Medicine, 160, 825–830.
Hill, J. (2002). Biological, psychological and social processes in the conduct disorders. Journal of Child Psychology & Psychiatry, 43, 133–164.
Hollingshead, A. B. (1975). Four factor index of social status. New Haven, CT: Department of Sociology, Yale University.
Kandel, E., & Mednick, S. A. (1991). Perinatal complications predict violent offending. Criminology, 29, 519–529.
Kendler, K. S. (2005). Psychiatric genetics: A methodologic critique. American Journal of Psychiatry, 162, 3–11.
Klin, A., Lang, J., Cicchetti, D. V., & Volkmar, F. R. (2000). Brief report: Interrater reliability of clinical diagnoses and DSM-IV criteria for autistic disorder: Results of the DSM-IV autism field trial. Journal of Autism and Developmental Disorders, 30, 163–167.
Koskentausta, M., Iivanainen, M., & Almquist, F. (2007). Risk factors for psychiatric disturbance in children with intellectual disability. Journal of Intellectual Disability Research, 51, 43–53.
Lauritsen, M. B., Pedersen, C. B., & Mortensen, P. B. (2005). Effects of familial risk factors and place of birth on the risk of autism: A nation-wide register-based study. Journal of Child Psychology and Psychiatry, 46, 963–971.
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Jr., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.
Martin, A., Scahill, L., Klin, A., & Volkmar, F. R. (1999). Higher-functioning pervasive developmental disorders: Rates and patterns of psychotropic drug use. Journal of Child and Adolescent Psychiatry, 38, 923–931.
Martin, N., Scourfield, J., & McGuffin, P. (2002). Observer effects and heritability of childhood attention-deficit hyperactivity disorder symptoms. British Journal of Psychiatry, 180, 260–265.
O’Callaghan, E., Karkin, C., & Waddinggton, J. L. (1990). Obstetric complications in schizophrenia and the validity of maternal recall. Psychological Medicine, 20, 89–94.
Offord, D. R., Boyle, M. H., Racine, Y., Szatmari, P., Fleming, J. E., Sanford, M., & Lipman, E. L. (1996). Integrating assessment data from multiple informants. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1078–1085.
Robins, E., & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126, 983–987.
Rutter, M., Moffitt, T. E., & Caspi, A. (2006). Gene-environment interplay and psychopathology: Multiple varieties but real effects. Journal of Child Psychology and Psychiatry, 47, 226–261.
Rzhetsky, A., Wajngurt, D., Park, N., & Zheng, T. (2007). Probing genetic overlap among complex human phenotypes. Proceedings of the National Association of Science, 104, 11694–11699.
Sprafkin, J., Volpe, R. J., Gadow, K. D., Nolan, E. E., & Kelly, K. (2002). A DSM-IV-referenced screening instrument for preschool children: The Early Childhood Inventory-4. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 604–612.
Sprich-Buckminster, S., Biederman, J., Milberger, S., Faraone, S. V., & Lehman, B. K. (1993). Are perinatal complications relevant to the manifestations of ADD? Issues of comorbidity and familiality. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 1032–1037.
Sukhodolsky, D. G., Scahill, L., Gadow, K. D., Arnold, L. E., Aman, M. G., McDougle, C. J., MacCracken, J. T., Tierney, E., White, S. W, Lecavalier, L., & Vitiello, B. (2008). Parent-rated anxiety symptoms in children with pervasive developmental disorders: Frequency and association with core autism symptoms and cognitive functioning. Journal of Abnormal Child Psychology, 36, 117–128.
Szatmari, P., MacLean, J. E., Jones, M. B., Bryson, S. E., Zwaigenbaum, L., Bartolucci, G., Mahoney, W. J., & Tuff, L. (2000). The familial aggregation of the lesser variant in biological and nonbiological relatives of PDD probands: A family history study. Journal of Child Psychology and Psychiatry, 41, 579–586.
Szatmari, P., Reitsma-Street, M., & Offord, D. R. (1986). Pregnancy and birth complications in antisocial adolescents and their siblings. Canadian Journal of Psychiatry, 31, 513–516.
Sverd, J. (2003). Psychiatric disorders in individuals with pervasive developmental disorder. Journal of Psychiatric Practice, 9, 111–127.
Thapar, A., O’Donovan, M., & Owen, M. J. (2005). The genetics of attention deficit hyperactivity disorder. Human Molecular Genetics, 14(review Issue 2), R275–R282.
Weisbrot, D. M., Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2005). The presentation of anxiety in children with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 15, 477–496.
Witwer, A., & Lecavalier, L. (2005). Treatment incidence and patterns in children and adolescents with autism spectrum disorders. Journal of Child and Adolescent Psychopharmacology, 15, 671–681.
Wozniak, J., Biederman, J., Faraone, S. V., Frazier, J., Kim, J., Millstein, R., Gershon, J., Thornell, A., Cha, K., & Snyder, J. B. (1997). Mania in children with pervasive developmental disorder revisited. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1552–1559.
Yirmiya, N., & Shaked, M. (2005). Psychiatric disorders in parents of children with autism: A meta-analysis. Journal of Child Psychology and Psychiatry, 46, 69–83.
Zwaigenbaum, L., Szatmari, P., Jones, M. B., Bryson, S. E., MacLean, J. E., Mahoney, W. J., Bartolucci, G., & Tuff, L. (2002). Pregnancy and birth complications in autism and liability to the broader autism phenotype. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 572–579.
Acknowledgments
This study was supported, in part, by a grant from the Matt and Debra Cody Center for Autism and Developmental Disorders. The authors wish to thank Dr. John Pomeroy, M.D., for directing the ASD diagnoses. The authors also gratefully acknowledge the very helpful comments of the anonymous reviewers in the preparation of this manuscript.
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Gadow, K.D., DeVincent, C. & Schneider, J. Predictors of Psychiatric Symptoms in Children with an Autism Spectrum Disorder. J Autism Dev Disord 38, 1710–1720 (2008). https://doi.org/10.1007/s10803-008-0556-8
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DOI: https://doi.org/10.1007/s10803-008-0556-8