Autism spectrum disorders

Autism is one of the most hotly debated disorders listed in the current Diagnostic and Statistical Manual (DSM), eliciting passionate and often conflicting opinions among health professionals, medical practitioners, parents and researchers. Despite moving on from the early and notorious 'refrigerator mother' pathogenic theories (where autism was said to be caused by emotionally distant parents) to more modem epigenetic conceptualisations (where autism is viewed as being caused by an interaction between a genetic susceptibility and an environmental trigger), surprisingly little has changed in regards to autism as a diagnostic construct. The exclusive use of a triad of behavioural indicators (impaired social interaction and communication, and restricted and repetitive behaviour) to diagnose autism appears to be increasingly out of step with contemporary research into 'biomarkers' or biomedical aspects of the condition. An understanding of the tensions and conflicts surrounding autism is critical in order to fully appreciate tlte conservative nature of information provided in the DSM. This chapter will touch on some of the controversies as they apply to the inclusion of autism in the DSM, ultimately, leading us to consider the most controversial question of all: Does autism belong in the DSM at all

An investigation of the potential association between mercury and Autism Spectrum Disorder: an interdisciplinary approach

 Dr Shandley took a novel approach to investigate the mercury-autism hypothesis. Her studies unearthed conflicting results. Contrary to previous biological studies, autistic children did not demonstrate a pattern of mercury toxicity. However, in a world first study, Dr Shandley found that the rate of autism among children with a family history of mercury sensitivity was 6-7 times higher than the general population

Reconceptualizing autism : moving beyond the behavioral to address cause, cure and prevention

Since the publication of Leo Kanner\u27s seminal paper in 1943, there has been essentially no definitive light shed on the cause, prevention or cure of autism. It is our contention that the reason lies, at least in part, with the original psychiatric conceptualization of the condition and the subsequent acceptance of this framework by health professionals ever since. We suggest an urgent revision of autism as a disease state such that its operationalization in major diagnostic systems such as the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases recognizes the biological variables known to be associated with autism

The players’ perspective of Reach Out Central : a therapeutic interactive online game

Therapeutic online games are potentially a valuable way of improving the mental health of young people. The purpose of this paper is to discuss the qualitative component of a formal evaluation conducted on Reach Out Central (ROC), an online game for 16-25 year olds which aims to improve mental health. Participants completing a post-program survey from the evaluation (n=154) were required to respond to two open-ended questions; what they liked most, and least, about ROC. Responses indicate that online games can be a successful way of educating, as well as attracting and engaging, young people. Suggestions are made regarding issues future developers should take into consideration when developing programs of a similar nature

A pilot trial of \u27panic online\u27 as a self-guided treatment for panic disorder

Panic Online (PO) is a well-established evidence-based internet intervention program for panic disorder (PD) (with or without agoraphobia), when supported by a therapist (email or face-to-face). However, there has been no exploration to date as to whether PO is also effective when administered in a self-guided format (i.e. with no therapist assistance provided). The objective of this pilot trial was to examine whether PO as a self-guided program was effective at reducing panic symptomatology and furthermore, whether participants found the program format satisfactory. Pre- and post-treatment clinical interviews were conducted by telephone with six participants and experience of using the self-guided PO program was also explored. Paired samples t-tests revealed that PD and agoraphobia were significantly reduced by post-treatment, but panic frequency (over the previous month) did not significantly change. Qualitatively, all participants reported being satisfied with the program, however all participants reported that access to human support during the intervention (e.g. to answer questions, to be heard, to help motivate) was preferable. Initial pilot data suggests that PO self-guided works effectively as a stand-alone clinical internet-based treatment program for PD, however additional research is required to definitively establish its efficacy

Suicidality among older Australian adults

Background: Vulnerability to suicidality is a concern among older adults, particularly as this proportion of the population is growing. Determining what factors contribute to suicidality will help to create a framework for understanding and assessing suicidal risk among older adults and developing effective treatments. This study examined suicidality among older Australian adults. Methods: This study forms part of a larger study to trial a survey to collect cross-sectional data on the mental and physical health of older Australian adults across time. One hundred and fourteen Australian residents aged 65 years and over completed an anonymous survey online or by returning a paper-and-pencil version of the survey by post. The survey took approximately 25 min to complete and comprised of (1) sociodemographic questions (e.g., age, gender, education), (2) validated questionnaires measuring depression, general anxiety, psychological distress, insomnia, substance dependence, problem gambling, and stress, and (3) mental and physical health and wellbeing items (e.g., religiosity, assistance with daily tasks, and mental health service usage in the last 12-months). The dependent variable, suicidality, was measured by asking participants whether they had ever seriously thought about committing suicide. Results: Associations with suicidality were analyzed using Chi-squares and independent samples t-tests. The results found suicidality to be significantly associated with lower levels of satisfaction with the frequency of seeing and/or communicating with friends, and inadequate levels of community engagement. Conclusion: The results of this survey reinforce the importance of social connectedness as a central and significant protective factor against suicidality among older adults. Copyright © 2023 Klein, Shandley, McLaren, Clinnick and Nguyen

The intergenerational transmission of problem gambling : the mediating role of parental psychopathology

The present study investigated the intergenerational transmission of problem gambling and the potential mediating role of parental psychopathology (problem drinking, drug use problems, and mental health issues). The study comprised 3953 participants (1938 males, 2015 females) recruited from a large-scale Australian community telephone survey of adults retrospectively reporting on parental problem gambling and psychopathology during their childhood. Overall, 4.0% [95%CI 3.0, 5.0] (n = 157) of participants reported paternal problem gambling and 1.7% [95%CI 1.0, 2.0] (n = 68) reported maternal problem gambling. Compared to their peers, participants reporting paternal problem gambling were 5.1 times more likely to be moderate risk gamblers and 10.7 times more likely to be problem gamblers. Participants reporting maternal problem gambling were 1.7 times more likely to be moderate risk gamblers and 10.6 times more likely to be problem gamblers. The results revealed that the relationships between paternal-and-participant and maternal-and-participant problem gambling were significant, but that only the relationship between paternal-and-participant problem gambling remained statistically significant after controlling for maternal problem gambling and sociodemographic factors. Paternal problem drinking and maternal drug use problems partially mediated the relationship between paternal-and-participant problem gambling, and fully mediated the relationship between maternal-and-participant problem gambling. In contrast, parental mental health issues failed to significantly mediate the transmission of gambling problems by either parent. When parental problem gambling was the mediator, there was full mediation of the effect between parental psychopathology and offspring problem gambling for fathers but not mothers. Overall, the study highlights the vulnerability of children from problem gambling households and suggests that it would be of value to target prevention and intervention efforts towards this cohort. © 2016 Elsevier Ltd. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Shane Thomas” is provided in this record*

Pregnancy complications and their association with postpartum depression symptoms : a retrospective study

Objective: Postpartum depression affects around 17% of the women worldwide and has considerable implications for maternal and child health. While some risk factors have been identified, the association between pregnancy and delivery complications and postpartum depression is less well understood. This study aims to determine whether specific pregnancy complications are associated with risk of postpartum depression symptoms (PPDS). Method: This study analysed a subset of variables collected as part of a larger study exploring pregnancy circumstances and maternal-foetal health outcomes. Mothers residing in Australia provided information on their biological children aged 3–13 years. Pregnancy complications were analysed using bivariate analyses and binary logistic regression. Results: Mothers (N = 1,926) reported on N = 3,210 pregnancies (mean number of pregnancies = 1.27, SD = 0.97). At the time of childbirth, mothers were on average 30.1 years old (SD = 5.14). Experiencing a pregnancy complication increased the risk of PPDS (X2 = 16.45, df = 1, p < 0.001) However, logistic regression analyses indicated an increased risk of PPDS was associated with the specific pregnancy complications of cytomegalovirus (AOR = 7.06, 95% CI[1.51,32.98]), emergency caesarean (AOR = 1.67, 95% CI[1.31,2.12]), foetal distress before birth (AOR = 1.49, 95% CI[1.16,1.91]), induced labour (AOR = 1.55, 95% CI[1.25,1.91]) and placenta previa (AOR = 2.60, 95% CI[1.44,4.71]). Conclusion: Specific pregnancy complications were associated with PPDS, suggesting that some complications may pose a greater risk for PPDS than others. This study contributes to the growing understanding of peripartum risk factors for postpartum depression, and suggests that early clinical identification of at-risk mothers and early prophylactic and supportive care may be warranted to reduce that risk. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

Internet-based treatment for panic disorder : does frequency of therapist contact make a difference?

Internet-based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty-seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8-week Internet-based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e-mails per week) or infrequent (one e-mail per week) support from a psychologist. Posttreatment, intention-to-treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panicrelated cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end-state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet-based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost-effective than previously reported.<br /

Ancestry of Pink Disease (Infantile Acrodynia) Identified as a Risk Factor for Autism Spectrum Disorders

Pink disease (infantile acrodynia) was especially prevalent in the first half of the 20th century. Primarily attributed to exposure to mercury (Hg) commonly found in teething powders, the condition was developed by approximately 1 in 500 exposed children. The differential risk factor was identified as an idiosyncratic sensitivity to Hg. Autism spectrum disorders (ASD) have also been postulated to be produced by Hg. Analogous to the pink disease experience, Hg exposure is widespread yet only a fraction of exposed children develop an ASD, suggesting sensitivity to Hg may also be present in children with an ASD. The objective of this study was to test the hypothesis that individuals with a known hypersensitivity to Hg (pink disease survivors) may be more likely to have descendants with an ASD. Five hundred and twenty-two participants who had previously been diagnosed with pink disease completed a survey on the health outcomes of their descendants. The prevalence rates of ASD and a variety of other clinical conditions diagnosed in childhood (attention deficit hyperactivity disorder, epilepsy, Fragile X syndrome, and Down syndrome) were compared to well-established general population prevalence rates. The results showed the prevalence rate of ASD among the grandchildren of pink disease survivors (1 in 25) to be significantly higher than the comparable general population prevalence rate (1 in 160). The results support the hypothesis that Hg sensitivity may be a heritable/genetic risk factor for ASD