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Brain Sciences
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Exploring the Mental Health of People with Autism
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Exploring the Mental Health of People with Autism

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuropsychology".

Deadline for manuscript submissions: closed (20 November 2024) | Viewed by 9385

Special Issue Editors

Dr. Domingo Garcia-Villamisar

E-Mail Website
Guest Editor
Department of Personality, Evaluation and Clinical Psychology, Universidad Complutense de Madrid, 28040 Madrid, Spain
Interests: psychopathology; transdiagnosis; dimensional classification; comorbidity; autism
Dr. María Álvarez-Couto

E-Mail Website
Guest Editor Assistant
Faculty of Education, Unit of Personality, Evaluation and Clinical Psychology, Complutense University of Madrid, 28040 Madrid, Spain
Interests: autism; intellectual disabilities; challenging behaviors; comorbidity; transdiagnosis
Dr. Gema Pilar Saez Suanes

E-Mail Website
Guest Editor Assistant
Faculty of Teacher Training and Education, Department of Educational and Developmental Psychology, Universidad Autónoma de Madrid, 28023 Madrid, Spain
Interests: autism; internalizing disorders; adulthood; intellectual disabilities; transdiagnosis

Special Issue Information

Dear Colleagues,

This Special Issue seeks to shed light on the complexities of mental health in individuals with autism spectrum disorder (ASD), providing a platform for the presentation of innovative research and novel perspectives.

The included articles (revision of literature, empirical, meta-analyses) will tackle various dimensions of mental health and comorbidity (anxiety, depression, stress, ADHD, challenging behaviors) in the context of autism, ranging from the identification and evaluation of common issues across different life stages to effective interventions and specialized care models. The aim is to offer insight and updates across the spectrum, making it interesting to encompass different realities, from individuals with ASD and intellectual disabilities to those with high abilities and even the broad autism phenotype.

The intersections between mental health and other aspects of the lives of individuals with autism are explored, such as the quality of life, social inclusion and family experiences in the diverse realities of people with ASD. The importance of inclusive and culturally sensitive approaches to understand and address mental health in this population is emphasized. This Special Issue aims to serve as a comprehensive resource for researchers, healthcare professionals and educators, providing valuable insights and practical guidance to enhance the quality of life and emotional well-being of individuals with autism.

Dr. Domingo Garcia-Villamisar
Guest Editor

Dr. María Álvarez-Couto
Dr. Gema Pilar Saez Suanes
Guest Editor Assistants

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • mental health
  • autism
  • internalizing psychopathology
  • externalizing psychopathology
  • comorbidity

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Published Papers (10 papers)

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17 pages, 466 KiB  
Article
Obsessive–Compulsive Traits and Problematic Internet Use Are Increased Among Adults with Autism Spectrum Disorder: Is There a Role of Obsessive Doubts and Communication Impairment?
by Barbara Carpita, Benedetta Nardi, Francesca Parri, Gianluca Cerofolini, Chiara Bonelli, Cristina Gaia Bocchino, Gabriele Massimetti, Ivan Mirko Cremone, Stefano Pini and Liliana Dell’Osso
Brain Sci. 2024, 14(12), 1170; https://doi.org/10.3390/brainsci14121170 - 22 Nov 2024
Abstract
Background: The link between autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD) and the complexity of their differential diagnosis has been vastly investigated. Growing attention has been paid to the presence of problematic Internet use (PIU) in autistic individuals. Studies assessing OCD traits [...] Read more.
Background: The link between autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD) and the complexity of their differential diagnosis has been vastly investigated. Growing attention has been paid to the presence of problematic Internet use (PIU) in autistic individuals. Studies assessing OCD traits in autistic individuals are scarce and even less take into account the role that this overlap may have on the development and maintenance of PIU. We aimed to investigate OCD features in ASD individuals and their association with autism severity and the prevalence of PIU, and the potential dimensions associated with a greater probability of PIU. Methods: a total of 46 participants with ASD and 53 controls were assessed with the Adult Autism Subthreshold Spectrum questionnaire and the Obsessive–Compulsive Spectrum—Short Version. Results: There were significantly higher OCD features in ASD participants along with important correlations between OCD and ASD dimensions and a higher prevalence of PIU in the ASD group. Participants with putative PIU reported greater scores on some ASD and OCD dimensions, the with Doubt and Non-verbal communication domains emerging as significant predictors of the presence of putative PIU. Conclusions: These results support the three-way link between ASD, OCD, and PIU, contributing to the hypothesis of a neurodevelopmental basis for those conditions. Full article
(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)
23 pages, 7363 KiB  
Article
Relevant Factors in the Schooling of Children with Autism Spectrum Disorder in Early Childhood Education
by Francisco Villegas Lirola and Antonio Codina Sánchez
Brain Sci. 2024, 14(12), 1167; https://doi.org/10.3390/brainsci14121167 - 22 Nov 2024
Abstract
Background: Educational professionals face significant challenges in determining the most appropriate educational placement for each child with ASD, which is a major concern for their parents. The purpose of this paper is to identify the factors in the development of students with ASD [...] Read more.
Background: Educational professionals face significant challenges in determining the most appropriate educational placement for each child with ASD, which is a major concern for their parents. The purpose of this paper is to identify the factors in the development of students with ASD (language development, cognitive development, and socio-emotional development) that are most relevant in determining the modalities of schooling in early childhood education. Methods: A total of 381 Psychopedagogical Evaluation Reports from students with ASD aged 3 to 5 years were reviewed. The importance of each variable was identified using artificial neural network analysis. Classification trees were used to determine their distribution in the two schooling modalities. Results: A total of 42.9% of boys aged 3–5 years with ASD and 54.12% of girls aged 3–5 years with ASD were enrolled in specific modalities. Conclusions: Cognitive development and comprehensive language were the two variables that best explained whether children with ASD were educated in specific or ordinary modalities. The presence of a significantly impaired level of cognitive development was the best predictor of schooling in specific modalities, and for the rest of the cognitive levels, the greater the difficulties in comprehensive language, the greater the likelihood of schooling in specific modalities. Full article
(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)
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15 pages, 1059 KiB  
Article
LEGO®-Based Therapy in School Settings for Social Behavior Stimulation in Children with Autism Spectrum Disorder: Comparing Peer-Mediated and Expert Intervention
by Luciana Oliveira Angelis, Fernanda Tebexreni Orsati and Maria Cristina Triguero Veloz Teixeira
Brain Sci. 2024, 14(11), 1114; https://doi.org/10.3390/brainsci14111114 - 1 Nov 2024
Viewed by 836
Abstract
Background: LEGO®-based therapy is a social development protocol that uses LEGO® activities to support the development of a wide range of interaction skills, enhancing prosocial behaviors and mitigating the challenges associated with mental health difficulties and behavioral issues commonly observed [...] Read more.
Background: LEGO®-based therapy is a social development protocol that uses LEGO® activities to support the development of a wide range of interaction skills, enhancing prosocial behaviors and mitigating the challenges associated with mental health difficulties and behavioral issues commonly observed in children with autism spectrum disorder (ASD). Objectives: This study aimed to explore the effects of LEGO®-based therapy on the social behavior and mental health of children with ASD, comparing stimulation mediated by expert and stimulation mediated by non-autistic peers. This study was approved by the Ethical Committee at Mackenzie Presbyterian University, ensuring adherence to ethical standards throughout the research process. Methods: This study involved 18 children with ASD, levels 1 or 2, with an intelligence quotient (IQ) above 70, and three typically developing peers, intelligence quotient (IQ) above 80, aged between 5 and 8 years old, of both sexes. Participants were randomized into three groups for stimulation (stimulation mediated by expert, by a non-autistic peer and control group). The measures were the Wechsler Abbreviated Scale of Intelligence, the Strengths and Difficulties Questionnaire (parent and teacher versions), the Inventory of Difficulties in Executive Functions, Regulation, and Aversion to Delay—Child Version, the Developmental Coordination Disorder Questionnaire, the Autism Behavior Checklist, and the Autistic Behavior Inventory. Results: After 14 sessions of 45 min in school settings, the participants of both groups (mediated by experts and non-autistic children) showed significant gains on social behavior. A statistically significant difference was observed between baseline sessions and probes (χ2 (5) = 25.905, p < 0.001). These gains were maintained in both follow-up points, 30 and 90 days after the completion of the stimulation sessions. Additionally, maladaptive behavior showed a significant decline when compared pre- and post-intervention. These improvements were sustained during follow-up assessments at 30 and 90 days. Conclusions: The results suggest that a structured intervention combined with peer-mediated stimulation may be an effective method for promoting adaptive and prosocial behaviors in children with ASD. Full article
(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)
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16 pages, 676 KiB  
Article
Autistic Sensory Traits and Psychological Distress: Mediating Role of Worry and Intolerance of Uncertainty
by Patricia Recio, Pilar Pozo, Cristina García-López and Encarnación Sarriá
Brain Sci. 2024, 14(11), 1088; https://doi.org/10.3390/brainsci14111088 - 29 Oct 2024
Viewed by 488
Abstract
Background/Objectives: Autistic adults exhibit core and comorbid features that can have an impact on their daily functioning and lead to considerable psychological distress. Significant and consistent associations have been identified between autism characteristics—restricted repetitive behaviors and sensory features—and high levels of stress and [...] Read more.
Background/Objectives: Autistic adults exhibit core and comorbid features that can have an impact on their daily functioning and lead to considerable psychological distress. Significant and consistent associations have been identified between autism characteristics—restricted repetitive behaviors and sensory features—and high levels of stress and anxiety. For a better understanding of the issue, it is necessary to consider the cognitive aspects that can help explain variations in stress and anxiety levels among adults with autism. We therefore aimed to model the contributions of worry and intolerance of uncertainty on the relationship between autism characteristics (sensory sensitivities and repetitive behaviors) and psychological distress (stress and anxiety). Methods: The sample comprised 144 autistic individuals with a mean age of 35.15 (SD = 11.44). They participated in the study by completing an online questionnaire to assess the study variables. Most of the participants reported being diagnosed with Asperger syndrome (63.6%) or Level 1 autism spectrum disorder (27.1%). Results: The model fit index values tested through path analysis indicated a good fit (χ2 = 5.65; p = 0.13 ns; CFI = 0.993; NFI = 0.985; RMSEA = 0.079; SRMR = 0.025) and identified worry and intolerance of uncertainty as significant mediating variables within a comprehensive explanatory model. Conclusions: These findings highlight the importance of worry and intolerance of uncertainty as specific targets in interventions aimed at improving stress and anxiety problems in autistic adults. Full article
(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)
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13 pages, 1044 KiB  
Article
Relationships between Anxiety, Repetitive Behavior and Parenting Stress: A Comparative Study between Individuals with Autism from Spain and Colombia
by Tíscar Rodríguez-Jiménez and Agustín E. Martínez-González
Brain Sci. 2024, 14(9), 910; https://doi.org/10.3390/brainsci14090910 - 9 Sep 2024
Viewed by 895
Abstract
The present study analyzed the association between anxiety, repetitive behavior and parental stress in individuals with autism from Spain (n = 60, mean age = 8.52, SD = 4.41) and Colombia (n = 58, mean age = 10.29, SD = 4.98). [...] Read more.
The present study analyzed the association between anxiety, repetitive behavior and parental stress in individuals with autism from Spain (n = 60, mean age = 8.52, SD = 4.41) and Colombia (n = 58, mean age = 10.29, SD = 4.98). Similarly, differences in anxiety, repetitive behavior and parental stress between both countries were analyzed. Outcomes revealed a strong relationship between anxiety and repetitive behavior in both populations. Furthermore, moderate positive associations were observed between anxiety, repetitive behavior and parental stress in the Spanish sample. However, parental stress was found to be moderately and negatively related with anxiety and repetitive behavior in the Colombian sample. Finally, no differences were found in anxiety and repetitive behavior between countries, but differences did emerge for parental stress which was found to be higher in the Colombian sample. In conclusion, differences in parental stress may be due to regional differences in socio-health resources, socio-economics, parenting styles, etc. Full article
(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)
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12 pages, 250 KiB  
Article
The Association between Attention-Deficit–Hyperactivity Disorder and Autistic Traits with Psychotic-like Experiences in Sample of Youths Who Were Referred to a Psychiatric Outpatient Service
by Laura Fusar-Poli, Chiara Avanzato, Giuliana Maccarone, Elide Di Martino, Gabriele Avincola, Stefania Grasso, Giovanni Rapisarda, Francesco Guarnieri and Maria Salvina Signorelli
Brain Sci. 2024, 14(8), 844; https://doi.org/10.3390/brainsci14080844 - 22 Aug 2024
Viewed by 957
Abstract
The aim of this study is to identify autism spectrum disorder (ASD) and attention-deficit–hyperactivity disorder (ADHD) traits in adolescents who experience psychotic-like experiences (PLEs), often ignored in clinical practice but widely prevalent in the general population. A total of 57 adolescents and young [...] Read more.
The aim of this study is to identify autism spectrum disorder (ASD) and attention-deficit–hyperactivity disorder (ADHD) traits in adolescents who experience psychotic-like experiences (PLEs), often ignored in clinical practice but widely prevalent in the general population. A total of 57 adolescents and young adults (aged between 16 and 24 years old) were recruited consecutively in the outpatient services. A total of 37 were females (64.9%), 18 were males (31.6%), and two participants (3.5%) were non-binary or gender non-conforming, with a mean age at referral of 18.26 ± 2.06. To investigate these symptoms, three sets of standardized questionnaires were used, as follows: the Autism Spectrum Quotient–short form (AQ-10), the Community Assessment of Psychic Experiences (CAPE-42), and the Adult ADHD Self-Report Scale (ASRS). We found significant associations between the ASRS and AQ-10 total scores and all CAPE scales. The model which explained the highest variance was CAPE Score’s Total Frequency score (p < 0.001). Our findings underline the importance of investigating the presence of subthreshold ASD and ADHD symptoms in clinical populations, particularly in the period of adolescence and young adulthood, to promptly identify the presence of PLEs and, thus, prevent the onset of a frank psychotic disorder, particularly in the presence of a comorbid psychopathological condition, leading to better diagnosis and treatment for individuals with two or more of these conditions. Full article
(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)
15 pages, 1095 KiB  
Article
School Participation Questionnaire (SPQ): Italian Translation, Cultural Adaptation, and Pilot Testing in Children with Neurodevelopmental Disorders
by Giorgia Pietragalla, Giovanni Galeoto, Marco Moresi, Martina Ruffini, Rachele Simeon, Francescaroberta Panuccio, Donatella Valente and Anna Berardi
Brain Sci. 2024, 14(7), 644; https://doi.org/10.3390/brainsci14070644 - 26 Jun 2024
Viewed by 1173
Abstract
Introduction: According to leading occupational therapy models, the environment appears to be a key element in fostering occupational performance and participation. There is an emerging need to identify an instrument that can assess these aspects in the school environment. Currently, there are no [...] Read more.
Introduction: According to leading occupational therapy models, the environment appears to be a key element in fostering occupational performance and participation. There is an emerging need to identify an instrument that can assess these aspects in the school environment. Currently, there are no rating scales in Italy for the school participation of children with neurodevelopmental disorders. For this reason, this study aims to culturally adapt and translate the School Participation Questionnaire (SPQ) to Italian and to pilot test the translated Italian version on children with neurodevelopmental disorders. Methods: The original scale was translated from English to Italian using the guidelines “Translation and Cultural Adaptation of Patient Reported Outcomes Measures—Principles of Good Practice”. The psychometric properties analyzed were the following: content validity, construct validity, cross-cultural validity, and internal consistency. Construct validity was assessed using the Italian version of the Sensory Processing Measure (SPM). Results: The Italian version of the SPQ was administered to 22 children. The mean ± SD of the score was 9.32 ± 1.36; Cronbach’s α was 0.935 (p < 0.01). The Pearson’s correlation coefficient with the SPM scores was −0.622 (p < 0.01). Conclusions: This pilot testing study for the validation of the Italian version of the SPQ showed good validity and reliability results. Thanks to this study, it would be possible to further analyze the tool for the evaluation of the environment and school participation of children with neurodevelopmental disorders, in particular autism spectrum disorder. It is a quick and easy instrument that focuses on the environment as an active variable in the child’s occupational performance. Full article
(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)
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17 pages, 973 KiB  
Systematic Review
The Effect of Autism Spectrum Disorder on Family Mental Health: Challenges, Emotional Impact, and Coping Strategies
by José Jesús Sánchez Amate and Antonio Luque de la Rosa
Brain Sci. 2024, 14(11), 1116; https://doi.org/10.3390/brainsci14111116 - 1 Nov 2024
Viewed by 926
Abstract
Background: Autism Spectrum Disorder (ASD) impacts not only diagnosed individuals, but also significantly affects the quality of life of both primary and secondary caregivers. These effects are particularly pronounced when compared to caregivers of individuals with other neurodevelopmental disorders. The emotional and physical [...] Read more.
Background: Autism Spectrum Disorder (ASD) impacts not only diagnosed individuals, but also significantly affects the quality of life of both primary and secondary caregivers. These effects are particularly pronounced when compared to caregivers of individuals with other neurodevelopmental disorders. The emotional and physical demands of caring for someone with ASD can profoundly alter family dynamics and interpersonal relationships, creating challenges that require a comprehensive approach to be understood and addressed. Methods: The methodological design is a narrative review study, based on a search conducted during May, June, July, and August 2024 in the Scopus, Dialnet, and WoS databases concerning the object of study. As a result, a total of 197 articles were qualitatively analyzed. Of these, 36 articles were selected for a more detailed qualitative analysis, leading to a final sample of 14 documents. The selected studies were examined through qualitative content analysis. The inclusion criteria for this selection were as follows: empirical studies or research published in English or Spanish; open access via the Internet; categories limited to “education/educational research” relevant to the proposed objectives; and specific documents related to students with Autism Spectrum Disorder (ASD). Results: The care of individuals with Autism Spectrum Disorder (ASD) has a significant and multifaceted impact on family life, deeply affecting the mental health of caregivers. These effects manifest in the form of chronic stress, anxiety, and interpersonal difficulties, altering family dynamics. The quality of life of caregivers varies depending on the coping strategies they employ, which are crucial for their emotional well-being. Conclusions: Understanding and optimizing these strategies is essential to mitigate the negative effects of caregiving and improving the overall well-being of families living with ASD. Full article
(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)
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21 pages, 490 KiB  
Systematic Review
Longitudinal Analyses of Mental Health in Autistic Individuals: A Systematic Review
by Maira Tafolla and Catherine Lord
Brain Sci. 2024, 14(10), 1033; https://doi.org/10.3390/brainsci14101033 - 18 Oct 2024
Viewed by 962
Abstract
Background/Objectives: Co-occurring mental health conditions affect autistic individuals at high rates, impacting their well-being and quality of life. Mental health conditions are often appropriate treatment targets that can improve the lives of autistic individuals. Because of this, there is growing interest in predictors [...] Read more.
Background/Objectives: Co-occurring mental health conditions affect autistic individuals at high rates, impacting their well-being and quality of life. Mental health conditions are often appropriate treatment targets that can improve the lives of autistic individuals. Because of this, there is growing interest in predictors of mental health and behavioral outcomes. Given the rapidly evolving evidence base and growing literature using longitudinal cohorts, it is unclear which predictors of symptoms of anxiety and depression are consistent, and which are not. Additionally, it is difficult to deduce which predictors of mental health symptoms at a given time also predict change over time. This can be partially due to the different statistical approaches that are implemented, including trajectory vs. non-trajectory methodologies. Methods: We conducted a systematic review to evaluate how non-trajectory and trajectory analyses inform our knowledge of how symptoms of anxiety and depression change over time. Additionally, we aimed to identify important predictors of change and later anxiety and depressive symptoms in autistic individuals. Results: There is variability in symptoms of anxiety and depression in autistic individuals. Adaptive skills arose as significant predictors of change and of later symptoms of both anxiety and depression. Peer relationships in school age seem to be particularly important in predicting later symptoms of depression. Conclusions: This review provides evidence that there are different trajectories and different patterns of mental health symptoms over the lifespan, providing further evidence that autism is a developmental condition that changes over time in different ways for different people. Implications and future directions are further discussed. Full article
(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)
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19 pages, 719 KiB  
Systematic Review
Mindfulness-Based Interventions for People with Autism Spectrum Disorder: A Systematic Literature Review
by Luca Simione, Alessandro Frolli, Francesca Sciattella and Salvatore Gaetano Chiarella
Brain Sci. 2024, 14(10), 1001; https://doi.org/10.3390/brainsci14101001 - 30 Sep 2024
Viewed by 1734
Abstract
Background/Objectives: Mindfulness-based interventions (MBIs) have emerged in recent years as a strong candidate for the treatment of a range of difficulties faced by individuals with autism spectrum disorder (ASD), including cognitive, emotional, and social aspects. Therefore, we aimed to conduct a review that [...] Read more.
Background/Objectives: Mindfulness-based interventions (MBIs) have emerged in recent years as a strong candidate for the treatment of a range of difficulties faced by individuals with autism spectrum disorder (ASD), including cognitive, emotional, and social aspects. Therefore, we aimed to conduct a review that systematically examined the efficacy of MBIs for individuals with ASD and their caregivers. Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our literature search was conducted within the MEDLINE database. We included in the review only longitudinal or intervention studies focusing mainly on mindfulness principles, while we excluded mixed intervention studies. We only included studies that explicitly utilized quantitative methodologies for evaluating the outcomes of the interventions, including mental health indices (e.g., stress, anxiety, depression) and assessments of cognitive and social skills (e.g., attention, prosociality). We conducted also a risk of bias assessment through the method of the Cochrane risk of bias tool for intervention studies ROBINS-I. Results: Thirty-seven studies were included in the review, and we grouped the studies by the targets of the interventions, i.e., adults (n = 12), children and adolescents (n = 9), caregivers and medical staff (n = 13), and combined intervention for both children/adolescents and their parents/caregivers (n = 5). The reviewed papers seem to support the feasibility and utility of mindfulness interventions for persons with ASD and their caregivers, but any recommendations based on this body of evidence should be made with caution due to the overall low quality of the studies conducted so far. Conclusions: The review reveals a positive outcome, including the alleviation of psychological distress, reduced behavioral problems, and enhanced cognitive and social skills in individuals with ASD. Despite such promising results, the review notes a limitation in the scarcity of MBIs for young patients, emphasizing caution in universally endorsing the existing literature. Moreover, the results underline the urgency of the exploration of tailored interventions for different ASD subgroups, considering varying levels of autism, and expanding support to teachers in educational settings. Full article
(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)
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