Abstract
This study compares severity of specific depression symptoms in boys with autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), or chronic multiple tic disorder (CMTD) and typically developing boys (Controls). Children were evaluated with parent and teacher versions of the Child Symptom Inventory-4 (CSI-4) and a demographic questionnaire. Mothers’ and teachers’ ratings generally indicated the most severe symptoms in boys with ASD ± ADHD. Associations of depression with ASD severity and IQ varied considerably for specific symptoms of depression, ASD functional domain, and informant. Findings provide additional support for the differential influence of neurobehavioral syndromes on co-occurring symptom severity and illustrate how more fine-grained analyses of clinical phenotypes may contribute to a better understanding of etiology and current nosology.
Similar content being viewed by others
References
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders, 3rd ed., revised (DSM-III-R). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, 4th ed. (DSM-IV). Washington, DC: American Psychiatric Association.
Attwood, T. (1998). Asperger’s syndrome: A guide for parents and professionals. London: Jessica Kingsley.
Barnhill, G. P., & Smith-Myles, B. (2001). Attributional style and depression in adolescents with Asperger syndrome. Journal of Positive Interventions, 3, 175–190.
Charlot, L., Deutsch, C. K., Albert, A., Hunt, A., Connor, D. F., & McIvane, W. J. (2008). Mood and anxiety symptoms in psychiatric inpatients with autism spectrum disorder and depression. Journal of Mental Health Research in Intellectual Disabilities, 1, 238–253.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Mahwah, NJ: Lawrence Erlbaum.
Comings, D. E., Wu, S., Chiu, C., Ring, R. H., Gade, R., Ahn, C., et al. (1996). Polygenetic inheritance of Tourette syndrome, stuttering, attention deficit hyperactivity, conduct, and oppositional defiant disorder. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 67B, 264–288.
Cook, E. H., Jr., Charak, D. A., Arida, J., Spohn, J. A., Roizen, N. J., & Leventhal, B. L. (1994). Depressive and obsessive-compulsive symptoms in hyperserotonemic parents of children with autistic disorder. Psychiatry Research, 52, 25–33.
Daviss, W. B. (2008). A review of co-morbid depression in pediatric ADHD: Etiologies, phenomenology, and treatment. Journal of Child and Adolescent Psychopharmacology, 18, 565–571.
Drabick, D. A. G., Gadow, K. D., & Loney, J. (2007). Source-specific oppositional defiant disorder: Comorbidity and risk factors in referred elementary school boys. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 92–101.
Drabick, D. A. G., Gadow, K. D., & Loney, J. (2008). Co-occurring ODD and GAD symptom groups: Source-specific syndromes and cross-informant comorbidity. Journal of Clinical Child and Adolescent Psychology, 37, 314–326.
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G., & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.
Feise, R. J. (2002). Do multiple outcome measures require p-value adjustment? BMC Medical Research Methodology, 2.
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., DeVincent, C., & Schneider, J. (2008). Predictors of psychiatric symptoms in children with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 38, 1710–1720.
Gadow, K. D., DeVincent, C. J., & Schneider, J. (2009). Comparative study of children with ADHD Only, autism spectrum disorder + ADHD, and chronic multiple tic disorder + ADHD. Journal of Attention Disorders, 12, 474–485.
Gadow, K. D., Nolan, E. E., Sprafkin, J., & Schwartz, J. (2002). Tics and psychiatric comorbidity in children and adolescents. Developmental Medicine and Child Neurology, 44, 330–338.
Gadow, K. D., & Sprafkin, J. (1986). Stony Brook Child Psychiatric Checklist-3. Stony Brook: Department of Psychiatry, State University of New York.
Gadow, K. D., & Sprafkin, J. (2002). Child symptom inventory-4 screening and norms manual. Stony Brook, NY: Checkmate Plus.
Gadow, K. D., & Sprafkin, J. (2010). The symptom inventories: An annotated bibliography. Available: www.checkmateplus.com [On-line].
Gadow, K. D., Sprafkin, J., Salisbury, H., Schneider, J., & Loney, J. (2004b). Further validity evidence for the teacher version of the Child Symptom Inventory-4. School Psychology Quarterly, 19, 50–71.
Gadow, K. D., Sverd, J., Nolan, E. E., Sprafkin, J., & Schneider, J. (2007). Immediate-release methylphenidate for ADHD in children with comorbid chronic multiple tic disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 840–848.
Ghaziuddin, M., Alessi, N., & Greden, J. (1995). Life events and depression in children with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 25, 495–502.
Ghaziuddin, M., Ghaziuddin, N., & Greden, J. (2002). Depression in persons with autism: Implications for research and clinical care. Journal of Autism and Developmental Disorders, 32, 299–306.
Ghaziuddin, M., & Greden, J. (1998). Depression in children with autism/pervasive developmental disorders: A case-control family history study. Journal of Autism and Developmental Disorders, 28, 111–115.
Ghaziuddin, M., Weidmer-Mikhail, E., & Ghaziuddin, N. (1998). Comorbidity in Asperger’s syndrome. A preliminary research. Journal of Intellectual Disability Research, 42, 279–283.
Girirajan, S., Rosenfeld, J. A., Cooper, G. M., Antonacci, F., Siswara, P., Itsara, A., et al. (2010). A recurrent 16p12.1 microdeletion supports a two-hit model for severe developmental delay. Nature Genetics, 42, 203–210.
Guttmann-Steinmetz, S., Gadow, K. D., & DeVincent, C. J. (2009). Oppositional defiant and conduct disorder behaviors in boys with autism spectrum disorder with and without attention-deficit hyperactivity disorder versus several comparison samples. Journal of Autism and Developmental Disorders, 39, 976–985.
Guttmann-Steinmetz, S., Gadow, K. D., DeVincent, C. J., & Crowell, J. (2010). Anxiety symptoms in boys with autism spectrum disorder, attention-deficit hyperactivity disorder, or chronic multiple tic disorder and community controls. Journal of Autism and Developmental Disorders, 40, 1006–1016.
Hallett, V., Ronald, A., & Happé, F. (2009). Investigating the association between autistic-like and internalizing traits in a community-based twin sample. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 618–627.
Happé, F., & Ronald, A. (2008). The ‘fractionable autism triad’: A review of evidence from behavioural, genetic, cognitive and neural research. Neuropsychology Review, 18, 287–304.
Hedley, D., & Young, R. (2006). Social comparison processes and depressive symptoms in children and adolescents with Asperger syndrome. Autism, 10, 139–153.
Hill, E., Berthoz, S., & Frith, U. (2004). Cognitive processing of own emotions in individuals with autistic spectrum disorder and in their relatives. Journal of Autism and Developmental Disorders, 34, 229–235.
Hollingshead, A. B. (1975). Four factor index of social status. New Haven, CT: Department of Sociology, Yale University.
Howlin, P. (2000). Outcome in adult life for more able individuals with autism or Asperger syndrome. Autism, 4, 63–83.
Kanne, S. M., Christ, S. E., & Reiersen, A. M. (2009). Psychiatric symptoms and psychosocial difficulties in young adults with autistic traits. Journal of Autism and Developmental Disorders, 39, 827–833.
Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism, 4, 117–132.
Lecavalier, L., Gadow, K. D., DeVincent, C. J., & Edwards, M. C. (2009). Validation of DSM-IV model of psychiatric syndromes in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 39, 278–289.
Lopata, C., Toomey, J. A., Fox, J. D., Volker, M. A., Chow, S. Y., Thomeer, M. L., et al. (2010). Anxiety and depression in children with HFASDs: Symptom levels and source differences. Journal of Abnormal Child Psychology, 38, 765–776.
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Jr, Leventhal, B. L., DiLavore, P. C., et al. (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.
Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., & Doshi, J. (2008). Psychotropic medication use among Medicaid-enrollled children with autism spectrum disorder. Pediatrics, 121, e441–e448.
Moffitt, T. E., Harrington, H., Caspi, A., Kim-Cohen, J., Goldberg, D., Gregory, A. M., et al. (2007). Depression and generalized anxiety disorder: Cumulative and sequential comorbidity in a birth cohort followed prospectively to age 32 years. Archives of General Psychiatry, 64, 651–660.
Perneger, T. V. (1998). What’s wrong with Bonferroni adjustments. British Medical Journal, 316, 1236–1238.
Pierre, C. B., Nolan, E. E., Gadow, K. D., Sverd, J., & Sprafkin, J. (1999). Comparison of internalizing and externalizing symptoms in children with attention-deficit hyperactivity disorder with and without comorbid tic disorder. Journal of Developmental and Behavioral Pediatrics, 20, 170–176.
Pine, D. S., Guyer, A., Goldwin, M., Towbin, K. A., & Leibenluft, E. (2008). Autism spectrum disorder scale scores in pediatric mood and anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 652–661.
Piven, J., & Palmer, P. (1999). Psychiatric disorder and the broad autism phenotype: evidence from a family study of multiple-incidence autism families. American Journal of Psychiatry, 156, 557–563.
Reich, W. (2000). Diagnostic Interview for Children and Adolescents (DICA). Journal of the American Academy of Child and Adolescent Psychiatry, 39, 59–66.
Rieffe, C., Oosterveld, P., Meerum Terwogt, M., Mootz, S., Van Leeuwen, E. & Stockmann, A. P. A. M. (2011). Emotion regulation and internalizing symptoms in children with Autism Spectrum Disorders. Autism. doi:10.1177/1362361310366571.
Robertson, M. M. (2006). Mood disorders and Gilles de la Tourette’s syndrome: an update on prevalence, etiology, comorbidity, clinical associations, and implications. Journal of Psychosomatic Research, 61, 349–358.
Robins, E., & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126, 983–986.
Rommelse, N. N. J., Franke, B., Geurts, H. M., Hartman, C. A., & Buitelaar, J. K. (2010). Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder. European Child and Adolescent Psychiatry, 19, 281–295.
Rothman, K. (1990). No adjustments are needed for multiple comparisons. Epidemiology, 1, 43–46.
Schneider, J., Gadow, K. D., Crowell, J. A., & Sprafkin, J. (2009). Anxiety in boys with ADHD with and without chronic multiple tic disorder. Journal of Child and Adolescent Psychopharmacology, 19, 1–12. doi:10.1089/cap.2009.0013.
Sprafkin, J., Gadow, K. D., Salisbury, H., Schneider, J., & Loney, J. (2002a). Further evidence of reliability and validity of the Child Symptom Inventory-4: Parent checklist in clinically referred boys. Journal of Clinical Child and Adolescent Psychology, 31, 513–524.
Sprafkin, J., Volpe, R. J., Gadow, K. D., Nolan, E. E., & Kelly, K. (2002b). 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.
Stewart, M. E., Barnard, L., Pearson, J., Hasan, R., & O’Brien, G. (2006). Presentation of depression in autism and Asperger syndrome A review. Autism, 10, 103–116.
Sukhodolsky, D. G., Scahill, L., Gadow, K. D., Eugene, A. L., Aman, M. G., McDougle, C. J., et al. (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.
Sverd, J. (2003). Psychiatric disorders in individuals with pervasive developmental disorder. Journal of Psychiatric Practice, 9, 111–127.
Vickerstaff, S., Heriot, S., Wong, M., Lopes, A., & Dossetor, D. (2007). Intellectual ability, self-perceived social competence, and depressive symptomatology in children with high-functioning autistic spectrum disorders. Journal of Autism and Developmental Disorders, 37, 1647–1664.
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.
White, S. W., & Roberson-Nay, R. (2009). Anxiety, social deficits, and loneliness in youth with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 1006–1013.
Wright, M., Banerjee, R., Hoek, W., Rieffe, C., & Novin, S. (2010). Depression and social anxiety in children: Differential links with coping strategies. Journal of Abnormal Child Psychology, 38, 405–419.
Zhang, J., Quan, H., Ng, J., & Stepanavage, M. E. (1997). Some statistical methods for multiple endpoints in clinical trials. Control Clin Trials, 18, 204–221.
Acknowledgments
This study was supported, in part, by grants awarded to Dr. Gadow from the Tourette Syndrome Association, Inc., National Institute of Mental Health (MH 45358), and the Matt and Debra Cody Center for Autism and Developmental Disorders. The authors wish to thank Dr. John Pomeroy, Dr. Joyce Sprafkin, and Dr. Jeff Sverd for their respective roles in the diagnostic evaluations and anonymous reviewers for their helpful comments.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gadow, K.D., Guttmann-Steinmetz, S., Rieffe, C. et al. Depression Symptoms in Boys with Autism Spectrum Disorder and Comparison Samples. J Autism Dev Disord 42, 1353–1363 (2012). https://doi.org/10.1007/s10803-011-1367-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-011-1367-x