Happy Tamil New Year

Puthandu /Tamil New Year is believed to be the day God Brahma, began his creation. It falls on the first day of the Tamil month of Chithirai (~Apr 13-15). Tamil calendar was created during the Chola dynasty in the 9th century CE.

Mango Pachadi, is the speciality food of the day, symbolizing the different flavors of life, including sweetness, sourness, bitterness, and tanginess.

Schwartzman 2023: suicidal behaviors in autistic adolescents

No surprise that suicide ideation and NSSI is higher in autistics!

Key Takeaways

• Early adolescent autistics (total sample 239, 138 autistic) at higher risk for suicidal ideation and NSSI (non suicidal self-injurious behaviors) compared to non-autistics.
• 20% autistics reported suicide ideation on self-report questionnaires but not to a study psychiatrist (via the Columbia Suicide Severity Rating Scale)
• No sex based differences seen. 

Questions that arise after reading. 

• What are the underlying factors that contribute to the higher risk of suicidal thoughts / behaviors and NSSI in autistic early adolescents? 
• How can clinicians improve their ability to detect these behaviors given the discrepancies between self-report and clinician-rated measures? 
• What interventions or treatments are effective in reducing the risk of these behaviors in autistic youth? 
• How can parents, caregivers, and educators better support autistic youth who may be at risk ? 
• What are the long-term outcomes for autistic youth with suicidal thoughts/behaviors and NSSI?

References
Schwartzman JM, Muscatello R, Corbett BA. Assessing Suicidal Thoughts and Behaviors and Nonsuicidal Self-Injury in Autistic and Non-Autistic Early Adolescents Using the Columbia Suicide Severity Rating Scale. Journal of Autism and Developmental Disorders 53.2 (2023): 559-570. doi:10.1177/136236132311621. PMID 30938385

April 13 is Autism Adolescence Day

Recognizing the transitions that come with adolescence in autism, along with the current inadequacy of needed supports, care and services. Translatable solutions are needed now. 

April 13 is Autism Adolescence Day

Because being a teenager isn't hard enough already

Compared to Neurotypical Teens, Autistic teens face greater challenges in 

Social Front. 

• Social Isolation/Loneliness, Social Difficulties, fewer friendships/social contacts, lesser time spent on social activities (1,2,3)
• Mental health, suicide ideation  and NSSI 
• Bullying and victimization
• Navigating educational system & workplace due to social and communication difficulties

Health Issues. 

• Seizure onset  15%  (compared to 0.5 - 1% in general population) (4). 
• Higher prevalence of atypical or non-convulsive seizures in autistic teens compared to non-autistic (5). 
• Increased prevalence of epilepsy in autistic teens  (11.4%) compared to 0.5% in general population (6).
• Sleep disturbance at 50-80%- insomnia, nightmares, and irregular sleep-wake cycles (7).
• Sensory sensitivities at 88% (non-autistic teens 58%) (8). 
• GI symptoms in autistic kids compared to non-autistic kids. In a 2014 study (9) figures are 43.5% compared to 18.1%. In a  2010 study (10), figures are 46-85% compared to 9-10%). Which means the prevalence is higher in autistic teens as well. 'Autistic teenagers at increased risk for anxiety, depression, and other mental health conditions.
• Co-occuring condition in 70% of autistics -  anxiety disorders 41%,  ADHD 31% & mood disorders 16% (11).
• Nuero-inflammatory markers in autistic teens
• Obesity 22.4% (general population 15.6%) (14)
• Asthma 22.2% (general population 12.8%) (15) 
• Allergies  23.9% (general population 18.4%) (16)

MAST - The Maastricht Acute Stress Test

[concepts in Sensorimotor Research] 

The Maastricht Acute Stress Test (MAST) is a research laboratory procedure that is used to induce stress in research participants. It is used to study the effects of stress on a variety of physiological and psychological processes, including heart rate, blood pressure, cortisol levels, anxiety, and depression. The MAST combines elements from two of the most common experimental paradigms measuring stress, the Trier Social Stress Test (TSST) and the Cold Pressor Test (CPT).

The Test: 
There is a 5-minute preparation phase, during which the participant is seated in a comfortable chair and is given instructions about the task. The participant is then asked to put their right hand into a bowl of ice water for 60-90 seconds. In between each hand immersion trial, the participant is asked to complete a series of mental arithmetic problems. The participant is given negative feedback if they make a mistake or take too long to answer a question.

The test takes approximately 20 minutes to complete. During the procedure, the participant's heart rate, BP, and salivary cortisol levels are measured. The participant is also asked to rate their subjective feelings of stress on a scale of 1 to 10.

Benefits

• It is a simple and easy-to-use procedure.
• It is non-invasive and does not pose any risk to participants.
• It is effective at inducing stress in participants.
• It can be used to measure a variety of stress-related outcomes.

Limitations

• Laboratory-based procedures may not be representative of real-world stress.
• It can be stressful for participants and may not be suitable for everyone. (will autistics even agree to do this?)
• It is not a diagnostic tool and cannot be used to diagnose any medical conditions.

https://www.frontiersin.org/articles/10.3389/fpsyg.2017.00567/full