Category: mental health

Human Brain Protein Associated with Autism

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The human dopamine transporter protein is missing a single amino acid.

Credit: UAB
Aurelio Galli
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A mutant gene that encodes a brain protein in a child with autism has been placed into the brains of fruit flies. Fruit flies hosting that gene produce the variant human brain protein and show abnormal behaviors of fear, repetitive activity and altered social interaction, reminiscent of autism impairments.

The genetic variant was found in the Simon Simplex Collection, which has collected genetic samples from 2,600 simplex families with autism spectrum disorder, or ASD. The brain protein is the dopamine transporter, or DAT, whose job is to pump the neurotransmitter dopamine back into nerve cells once the neurotransmitter has been released. The mutant protein is missing a single amino acid.

A study of this variant DAT — from its impaired molecular mechanism to its effect on fruit fly behavior — has been published in Proceedings of the National Academy of Sciences by co-corresponding authors Aurelio Galli, Ph.D., and Eric Gouaux, Ph.D.

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Galli is professor in the Department of Surgery at the University of Alabama at Birmingham, and Gouaux is professor in the Vollum Institute at the Oregon Health & Science University and Howard Hughes Medical Institute.

Researchers found that fruit flies with the human variant DAT, or vDAT, are hyperactive. They had increased locomotor activity in both day and night, as compared with normal fruit flies. They also showed repetitive behavior — the vDAT fruit flies groomed themselves 23 percent of the time, versus 6 percent of the time for normal fruit flies. Repetitive behavior like self-grooming has been observed in animal models of neuropsychiatric disorders.

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The vDAT fruit flies were also more fearful than normal fruit flies. In response to the sound of a predatory wasp, normal flies froze for about 150 milliseconds, and then they fled, as shown by a distinctive and rapid increase in average velocity that was captured by a 1,000-frame per second camera. In contrast, the vDAT fruit flies froze at the sound of the predator and showed little signs of fleeing during 600 milliseconds.

The vDAT fruit flies had impaired social interaction, as measured by changes in grouping. Many animal populations form temporary or permanent groups, such as flocks, schools or herds, that aid survival in the face of predators. Fleeing, in response to a threat, is an escape behavior where the flock size may compress or expand. The researchers found that normal fruit flies expanded their flock size in response to a threat — the sound of the predator wasp. The vDAT fruit flies, in contrast, compressed their flock size.

Besides the fruit fly behavior, the PNAS study is a comprehensive multidisciplinary approach that gets at some root causes of autism to a degree of detail that could make potential therapeutic treatments more realizable in the future.

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Besides vDAT, the labs of Galli and Heinrich Matthies, Ph.D., assistant professor in the UAB Department of Surgery, have identified several other mutations in the human DAT gene that affect DAT function in individuals with ASD. For these people, disruption of dopamine transport appears to be a risk factor that promotes complications associated with ASD.

“The experimental paradigms we describe here,” Galli said, “provide a framework for molecular and behavioral analysis of novel DAT variants that are discovered by genetic analyses of individuals with ASD or related neuropsychiatric illness, as well as other disease-linked mutants that are emerging from precision medicine initiatives.”

Galli and Gouaux’s PNAS research went from human genetics to a basic animal model with simplified behavior, as detected by a new high-powered analysis. It investigated the underlying molecular mechanisms and basic biological functions with ever greater resolution, through studies at the cell level and all the way down to a bacterial system. Each added system was more fundamental with regard to biological complexity and phylogenetic level.

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Details of vDAT structure and function
Besides altered fly behavior caused by the mutant protein, the PNAS study probed the molecular structure and function of vDAT using mutation of a related transporter protein from a thermophilic bacterium as a model. Experiments included X-ray crystallography, spin resonance spectroscopy, molecular modeling, cell culture studies and electrophysiology studies of fruit fly brains expressing the mutant.

The researchers showed that vDAT cells have impaired dopamine transport and impaired DAT-mediated electrical currents. Also, expression of the human vDAT reduced dopamine uptake in the whole brain of fruit flies. These findings support the idea that human DAT dysfunction in ASD stems from specific and yet distinct mechanisms.

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To probe the mechanism of impaired transporter function, researchers used the related bacterial transporter as a model. They removed the single amino acid from the related bacterial transporter that correlates with the single amino acid missing in vDAT. Like DAT, the bacterial transporter protein embeds across the cell membrane and has domains called the extracellular gate and the intracellular gate to receive and release the molecule being transported from outside the cell to inside.

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Deletion of the single amino acid altered conformation of the bacterial protein and appeared to lock its extracellular gate, apparently through disrupted hydrogen bonds between amino acids of the protein that abnormally left the intracellular gate in a conformation called “half-open and inward facing.” Molecular dynamics simulation of vDAT showed similar conformational changes and altered hydrogen bonding.

Co-authors with Galli, Gouaux and Matthies for the paper, “Structural, functional, and behavioral insights of dopamine dysfunction revealed by a deletion in SLC6A3,” are Nicholas G. Campbell, Aparna Shekar, Dungeng Peng, Amanda M. Duran, Brian O’Grady, Ramnarayan Ramachandran, James S. Sutcliffe, Jens Meiler, Leon M. Bellan and Hassane S. Mchaourab, Vanderbilt University; Jenny I. Aguilar and Kevin Erreger, Department of Surgery, UAB School of Medicine; Vikas Navratna and Dongxue Yang, Vollum Institute, Oregon Health and Science University; Alexander N. Morley, Harald H. Sitte and Thomas Stockner, Medical University of Vienna, Austria; and Greta Galli, University School of Nashville, Tennessee.

Mchaourab is co-senior author with Galli, and Greta Galli is daughter of Aurelio Galli.

Support for this work came from National Institutes of Health grants MH070039, GM080403, HL122010, DA35263, DA38058 and NS007491-14.

'Financial infidelity'

What defines it, who is at risk, and what are the consequences?

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Romantic partners aren’t always honest about money in their relationships, but when does hiding purchases, debt and savings constitute “financial infidelity”? Research by professors at four universities, including Indiana University, defines the concept and provides a means for predicting its occurrence within relationships.

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Love, Lies and Money: Financial Infidelity in Romantic Relationships,” in the Journal of Consumer Research, is the first systematic investigation of financial infidelity in committed romantic relationships.

The professors define financial infidelity as “engaging in any financial behavior that is expected to be disapproved of by one’s romantic partner and intentionally failing to disclose this behavior to them.” It involves both the financial “act” and the subsequent concealment.

It differs from secret consumption and merely hiding spending because it involves a broader set of financial behaviors, including seemingly “positive” actions such as saving extra income in a personal bank account.

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“Financial infidelity has the potential to be as harmful for relationship health and longevity as sexual infidelity, as conflicts over money are also a primary reason for divorce,” said co-author Jenny Olson, assistant professor of marketing at the IU Kelley School of Business. “Given the role that finances play in the health of relationships, consumers benefit from being aware of financial infidelity and its consequences.”

Growing in popularity is financial therapy, which combines finance with emotional support to help individuals and couples think, feel and behave with money to improve their overall well-being, make logical spending decisions and face financial challenges.

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“An understanding of financial infidelity can benefit financial services companies and advisors, clinical therapists and relationship counselors, all of whom play a role in promoting consumer well-being,” Olson said. “If couples seek professional financial advice, they must be willing to openly discuss their spending and savings habits, debts and financial goals. It is clear that financial infidelity is a barrier to effective planning, as well as to a healthy relationship.”

The researchers developed a “financial infidelity scale (FI-Scale)” using a dozen lab and field tests. Key findings included:

  • Whether the financial act is expected to elicit any level of disapproval was more important than the degree of disapproval.
  • Consumers more prone to financial infidelity exhibited a stronger preference for secretive purchase options, such as using a personal credit card versus a jointly held card, and cash over credit.
  • A preference for ambiguous packaging and shopping at inconspicuous stores.
  • A greater likelihood of concealing financial information from their partner in a mobile banking app.

Each choice is relevant to marketers. The prevalence of financial infidelity among consumers and variations along the FI-Scale affect purchasing decisions. It is important that companies be aware of certain consumer segments that may be prone to financial infidelity and thus affect their bottom lines.

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For example, the trend of businesses going “cash-free” may affect retailers such as beauty salons and gift shops because of the use of cash to disguise purchases. Consumers strategically using cash may be less willing to make purchases only for their pleasure or personal wants.

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Other authors on the study are Emily Garbinsky, assistant professor of marketing at the Mendoza College of Business at the University of Notre Dame; Joe J. Gladstone, assistant professor of consumer behavior at the School of Management at University College London; and Hristina Nikolova, the Diane Harkins Coughlin and Christopher J. Coughlin Sesquicentennial assistant professor at the Carroll School of Management at Boston College.

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Black Children Tend to be Diagnosed with Autism Later than White Children

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Photo by Zach Vessels
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The rate of diagnosis for autism spectrum disorders (ASD) is the same among all racial groups — one in 110, according to current estimates. However, a study by a Florida State University researcher has found that African-American children tend to be diagnosed later than white children, which results in a longer and more intensive intervention. The reasons for later diagnoses include a lack of access to quality, affordable, culturally competent health care, according to Martell Teasley, an associate professor in Florida State’s College of Social Work who has conducted a comprehensive review of researchliterature on autism and African-American children. In addition, the stigmaattached to mental health conditions within the black community contribute to misdiagnoses of autism, and underuse of available treatment services.

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“There are no subjective criteria for diagnosing autism. Only brain scans can truly provide appropriate diagnoses, because we are dealing with biological and chemical imbalances in the brain,” Teasley said. “Not every child is going to have access to this kind of medical evaluation, particularly those who are indigent and don’t have health care funding.”

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Teasley examined ASD diagnosis and treatment strategies, and their effect on African-American families, in “Autism and the African-American Community,” a paper published in a special issue of the journal Social Work in Public Health (Vol. 26, Issue 4, 2011) that dealt with health-care policy issues in the black community related to the human genome.

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Associate Professor in Florida State’s College of Social Work

Teasley co-wrote the paper with Ruby Gourdine, a professor of social work at Howard University in Washington, D.C., and Tiffany Baffour, an associate professor of social work at Winston-Salem State University in North Carolina. Because of the social stigma, Teasley says that some African-American families might be resistant to accept a diagnosis and treatment. “Less discussion about autism among African-Americans or between African-Americans and health care providers leads to misdiagnoses, a lack of treatment and a lack of services,” Teasley said.

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“This will lead to greater challenges for families — more stress and anxiety, and poorer developmental outcomes.” African-Americans also might resist a diagnosis and treatment because of a mistrust of mainstream health care providers over past discrimination. “African-Americans are well versed in going to a doctor who might have biases or discriminatory practices, so they may not readily accept what a doctor says,” Teasley said. In addition, a cultural divide between African-Americans and mainstream health care providers can hinder a timely and correct diagnosis.

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“There are not enough health care professionals who understand the cultural norms and attributes of the African-American community,” Teasley said. African-Americans live in all types of settings, but the majority live in urban areas, which have seen a decline in the number of mental-health care agencies since the 1980s. “This lack of accessibility causes a problem for some African-Americans,” Teasley said. Once a child is diagnosed with ASD, Teasley says both the child and the members of his or her family needs to receive appropriate training and counseling. “The children need behavioral counseling so they can develop the skills to live as independently as possible,” he said. “The families need to learn how to work with children who are autistic. “Intervention for any autistic child needs to start around age 3, so we can get the child to begin to learn how to eat right and develop normal, healthy routines, which will result in a better developmental outcome,” Teasley said. “Later intervention will result in a poorer developmental outcome that can have a lasting impact on the child’s and family’s quality of life.”

Martell Teasley, College of Social Work(850) 644-9595; mteasley@fsu.edu

“Could My Child Have Autism?”

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Ten Signs of Possible Autism-Related Delays in 6- to 12-Month-Old Children

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Though autism is often not diagnosed until the age of three, some children begin to show signs of developmental delay before they turn a year old. While not all infants and toddlers with delays will develop autism spectrum disorders (ASD), experts point to early detection of these signs as key to capitalizing on early diagnosis and intervention, which is believed to improve developmental outcomes.

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According to Dr. Rebecca Landa, director of the Center for Autism and Related Disorders at the Kennedy Krieger Institute in Baltimore, Md., parents need to be empowered to identify the warning signs of ASD and other communication delays. “We want to encourage parents to become good observers of their children’s development so that they can see the earliest indicators of delays in a baby’s communication, social and motor skills,” says Dr. Landa, who also cautions that some children who develop ASD don’t show signs until after the second birthday or regress after appearing to develop typically.

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For the past decade, Dr. Landa has followed infant siblings of children with autism to identify red flags of the disorder in their earliest form. Her research has shown that diagnosis is possible in some children as young as 14 months and sparked the development of early intervention models that have been shown to improve outcomes for toddlers showing signs of ASD as young as one and two years old. Dr. Landa recommends that as parents play with their infant (6 – 12 months), they look for the following signs that have been linked to later diagnosis of ASD or other communication disorders: 1. Rarely smiles when approached by caregivers2. Rarely tries to imitate sounds and movements others make, such as smiling and laughing, during simple social exchanges3. Delayed or infrequent babbling4. Does not respond to his or her name with increasing consistency from 6 – 12 months 5. Does not gesture to communicate by 10 months6. Poor eye contact7. Seeks your attention infrequently8. Repeatedly stiffens arms, hands, legs or displays unusual body movements such as rotating the hands on the wrists, uncommon postures or other repetitive behaviors9. Does not reach up toward you when you reach to pick him or her up10. Delays in motor development, including delayed rolling over, pushing up and crawling

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“If parents suspect something is wrong with their child’s development, or that their child is losing skills, they should talk to their pediatrician or another developmental expert,” says Dr. Landa. “Don’t adopt a ‘wait and see’ perspective. We want to identify delays early in development so that intervention can begin when children’s brains are more malleable and still developing their circuitry.”

About the Kennedy Krieger Institute Internationally recognized for improving the lives of children and adolescents with disorders and injuries of the brain and spinal cord, the Kennedy Krieger Institute in Baltimore, MD serves more than 16,000 individuals each year through inpatient and outpatient clinics, home and community services and school-based programs. Kennedy Krieger provides a wide range of services for children with developmental concerns mild to severe, and is home to a team of investigators who are contributing to the understanding of how disorders develop while pioneering new interventions and earlier diagnosis. For more information on Kennedy Krieger Institute, visit: www.kennedykrieger.org.

Sugar changes the chemistry of your brain

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Anyone who has desperately searched their kitchen cabinets for a piece of forgotten chocolate knows that the desire for palatable food can be hard to control. But is it really addiction?

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The idea of food addiction is a very controversial topic among scientists. Researchers from Aarhus University have delved into this topic and examined what happens in the brains of pigs when they drink sugar water. The conclusion is clear: sugar influences brain reward circuitry in ways similar to those observed when addictive drugs are consumed. The results have just been published in the journal Scientific Reports.

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“There is no doubt that sugar has several physiological effects, and there are many reasons why it is not healthy. But I have been in doubt of the effects sugar has on our brain and behaviour, I had hoped to be able to kill a myth. ” says Michael Winterdahl, Associate Professor at the Department of Clinical Medicine at Aarhus University and one of the main authors of the work.

The publication is based on experiments done using seven pigs receiving two liters of sugar water daily over a 12-day period. To map the consequences of the sugar intake, the researchers imaged the brains of the pigs at the beginning of the experiment, after the first day, and after the 12th day of sugar.

“After just 12 days of sugar intake, we could see major changes in the brain’s dopamine and opioid systems. In fact, the opioid system, which is that part of the brain’s chemistry that is associated with well-being and pleasure, was already activated after the very first intake,” says Winterdahl.

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When we experience something meaningful, the brain rewards us with a sense of enjoyment, happiness and well-being. It can happen as a result of natural stimuli, such as sex or socializing, or from learning something new. Both “natural” and “artificial” stimuli, like drugs, activate the brain’s reward system, where neurotransmitters like dopamine and opioids are released, Winterdahl explains.

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We chase the rush

“If sugar can change the brain’s reward system after only twelve days, as we saw in the case of the pigs, you can imagine that natural stimuli such as learning or social interaction are pushed into the background and replaced by sugar and/or other ‘artificial’ stimuli. We’re all looking for the rush from dopamine, and if something gives us a better or bigger kick, then that’s what we choose” explains the researcher.

When examining whether a substance like sugar is addictive, one typically studies the effects on the rodent brain. ¨It would, of course, be ideal if the studies could be done in humans themselves, but humans are hard to control and dopamine levels can be modulated by a number of different factors. They are influenced by what we eat, whether we play games on our phones or if we enter a new romantic relationship in the middle of the trial, with potential for great variation in the data. The pig is a good alternative because its brain is more complex than a rodent and gyrated like human and large enough for imaging deep brain structures using human brain scanners. The current study in minipigs introduced a well-controlled set-up with the only variable being the absence or presence of sugar in the diet.

Background for the results:

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  • The study involved imaging the pig brain before and after sugar intake.
  • Partners involved in the study: Michael Winterdahl, Ove Noer, Dariusz Orlowski, Anna C. Schacht, Steen Jakobsen, Aage K. O. Alstrup, Albert Gjedde and Anne M. Landau.
  • The study was financed by a grant from AUFF to Anne Landau.
  • The scientific article has been published in Scientific Reports and is freely available online: doi: https://doi.org/10.1038/s41598-019-53430-9

The 69 genes that increase the risk for autism

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UCLA-led team compares DNA of children with the disorder to that of their siblings and parents

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A UCLA-led research team has identified dozens of genes, including 16 new genes, that increase the risk of autism spectrum disorder. The findings, published in the journal Cell, were based on a study of families with at least two children with autism.

Researchers from UCLA, Stanford University and three other institutions used a technique called whole genome sequencing to map the DNA of 2,300 people from nearly 500 families. They found 69 genes that increase the risk for autism spectrum disorder; 16 of those genes were not previously suspected to be associated with a risk for autism.

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Researchers also identified several hundred genes they suspect may increase the risk of autism based on their proximity to genes previously identified to carry an increased risk.  The study analyses further revealed several new biological pathways not previously identified in studies of autism.

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The findings shed light on how genetic variants or mutations — the differences that make each person’s genome unique — are passed from parents to children affected with autism, said the study’s co-lead author Elizabeth Ruzzo, a UCLA postdoctoral scholar. Former UCLA postdoctoral scholar Laura Pérez-Cano is the study’s other co-lead author.

“When we look at parents of autistic children and compare them to individuals without autism, we find that those parents carry significantly more, rare and highly damaging gene variants,” Ruzzo said. “Interestingly, these variants are frequently passed from the parents to all of the affected children but none of the unaffected children, which tells us that they are significantly increasing the risk of autism.”

Of the children in the study, 960 have autism and 217 children do not. That enabled researchers to analyze the genetic differences between children with and without autism across different families.

“Studying families with multiple children affected with autism increased our ability to detect inherited mutations in autism spectrum disorder,” said Dr. Daniel Geschwind, senior, corresponding author of the study and the Gordon and Virginia MacDonald Distinguished Professor of Human Genetics, Neurology and Psychiatry at the David Geffen School of Medicine of UCLA.

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“We show a substantial difference between the types of mutations that occur in different types of families, such as those that have more than one affected child versus those having only one child with ASD,” said Geschwind, who also was the study’s co-principal investigator and director of the UCLA Center for Autism Research and Treatment and director of the Institute of Precision Health at UCLA.

The research also found that the 16 genes newly determined to be associated with an increased risk for autism form a network with previously identified ASD risk genes. The way they interact with one another further heightens the risk, said the study’s co-senior author and co-principal investigator Dennis Wall, a Stanford University School of Medicine associate professor of pediatrics and of biomedical data science.

“They associate with each other more tightly than we’d expect by chance,” he said. “These genes are talking to each other, and those interactions appear to be an important link to autism spectrum disorder.”

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The nearly 600 genes researchers suspect as carrying an increased risk of autism were identified through “guilt by association,” or through their interactions with other genes that already have been shown to carry an increased autism risk, Ruzzo said.

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“And although not all of those genes will be found to increase the risk for autism, our analysis indicates that future studies will provide support for many of these genes,” she said.

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The families studied are part of the Autism Genetic Resource Exchange (AGRE), which was originally developed nearly two decades ago by researchers and the National Institutes of Health in collaboration with Cure Autism Now, which is now a program of Autism Speaks.

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Autism is a spectrum of neurological disorders characterized by difficulties with communication and social interaction. Geschwind has been working to identify the genetic causes and biological mechanisms of the disorder for more than a decade, and led the original development of the AGRE resource that was used in this study in the late 1990s. In 2018, he and colleagues at UCLA received their second, five-year grant from the NIH to expand autism research by studying genetic causes of autism in African American families.

Higher rates of post-natal depression among autistic mothers

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Autistic mothers are more likely to report post-natal depression compared to non-autistic mothers, according to a new study of mothers of autistic children carried out by researchers at the University of Cambridge

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A better understanding of the experiences of autistic mothers during pregnancy and the post-natal period is critical to improving wellbeing. The results are published in Molecular Autism.

The team recruited an advisory panel of autistic mothers with whom they co-developed an anonymous, online survey. After matching, this was completed by 355 autistic and 132 non-autistic mothers, each of whom had at least one autistic child.

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Sixty percent of autistic mothers in the study reported they had experienced post-natal depression. By comparison, only 12% of women in the general population experience post-natal depression. In addition, autistic mothers had more difficulties in multi-tasking, coping with domestic responsibilities, and creating social opportunities for their child.

The study also found that when autistic mothers disclosed their autism diagnosis to a professional, they were not believed the majority of the time. Autistic women felt misunderstood by professionals more frequently during pre- and post-natal appointments and found motherhood an isolating experience. Despite these challenges, autistic mothers reported they were able to act in the best interest of their child, putting their child’s needs first and seeking opportunities to boost their child’s self-confidence.

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Dr Alexa Pohl, who led the study, said: “Autistic mothers face unique challenges during the perinatal period and parenthood. Despite these challenges, an overwhelming majority of autistic mothers reported that parenting overall was a rewarding experience. This research highlights the need for increased awareness of the experiences of motherhood for autistic women and the need for more tailored support.”

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Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge, and part of the team, said: “This worryingly high number of autistic mothers who experience post-natal depression means we are failing them and their infants at a critical point in their lives. We now need more research into why the rates are so much higher, whether they are seeking help and not getting it, or if they are not seeking help and for what reasons. A new research priority is to develop autism-relevant screening tools and interventions for post-natal depression in these mothers.”

Monique Blakemore, an autistic advocate and member of the team, said: “This vital study was initiated by the autistic community, who collaborated as equal partners with researchers in the design, dissemination and interpretation of the survey. This is an excellent example of what can be achieved through such partnership.”

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The study was supported by the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC), East of England, at Cambridgeshire and Peterborough NHS Foundation Trust, the Autism Research Trust, the MRC, the NIHR Cambridge Biomedical Research Centre, and Autistica.

Reference

A comparative study of autistic and nonautistic women’s experience of motherhood by Alexa Pohl, Sarah Crockford, Monique Blakemore, Carrie Allison and Simon Baron-Cohen. Molecular Autism. DOI: 10.1186/s13229-019-0304-2

When should a young girl visit a gynecologist?

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According to the American College of Obstetricians and Gynecologist, girls should have their first gynecologic visit between the ages of 13 and 15 years old.

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Parents of young teenage girls are probably thinking about how to help them navigate social media, classwork, and their social lives. However, as young teenagers begin to go through puberty, it is also important to help them understand how to manage their changing bodies. Scheduling an appointment with a pediatric and adolescent gynecologist is one way to do this.

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According to the American College of Obstetricians and Gynecologist, girls should have their first gynecologic visit between the ages of 13 and 15 years old. Pediatric and adolescent gynecology is a subspecialty of gynecology that provides comprehensive care for girls from birth to early adulthood. Pediatric and adolescent gynecologists take special care of the emotional needs of their patients and families while providing the unique care that’s necessary to foster the child’s transition from pediatrics to adult gynecology.

We spoke with pediatric gynecologist Amber Truehart, MD, about other reasons a girl should visit a gynecologist before she becomes an adult.

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Education and Examinations

Patient education is one highlight of building a relationship with a pediatric and adolescent gynecologist. During the first visit, the doctor will help reinforce an understanding of healthy body weight and good habits for healthy bones. This is also an opportunity for young patients to learn about basic female hygiene, normal versus abnormal vaginal discharge, and puberty. Additionally, depending on the patient’s individual needs, their physical and emotional development, and medical history, the doctor may perform a basic physical exam, possibly including a breast exam.

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Menstrual Cycle

Most girls get their first period when they are between 10 and 15 years old. So, it’s likely that a young girl is beginning to think about her period around this time. A visit with a pediatric and adolescent gynecologist will help her learn about the menstrual cycle and what is considered normal or abnormal. She can also learn how to manage her cycle, pain relief, and how to deal with premenstrual syndrome (PMS).

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Vaccinations

Young girls are able to get the HPV vaccine at their gynecologist’s office. The HPV vaccine helps protect children from developing the human papillomavirus, which can lead to six types of cancers later in life. The Centers for Disease Control and Prevention recommends two doses of the HPV vaccine, the first at age 11 and then six months later. If the child waits until age 15, they’ll need three doses of the vaccine.

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Sex Talks

Let’s face it — it may be difficult for a young girl to talk to a parent about sex. Yet, it’s important that she have an avenue for these conversations. Getting her in front of an expert she trusts will help her get accurate information and learn about sexually transmitted infections, HIV, and pregnancy prevention. She can also talk with her gynecologist about safe and healthy intimate relationships, LGBTQ topics and having sex for the first time.

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Special Assessments

For girls and young women who need complex gynecologic care, forming a doctor-patient relationship connects them with an expert who is poised to provide a full range of specialized services. Pediatric and adolescent gynecologists are trained to care for the intricate needs of children and teens who have physical or mental disabilities, congenital gynecologic abnormalities (present since birth), and underlying chronic health problems.

Exercise and Anxiety Reduction in Children with Autism

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An Autism Intervention Research Network on Physical Health grant supports the research

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The Center for Autism & Neurodevelopmental Disorders will begin a research study using physical exercise to reduce anxiety in children with Autism Spectrum Disorder (ASD) among underserved populations.

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This initiative is made possible through a grant from the Autism Intervention Research Network on Physical Health (AIR-P). Jean Gehricke, Ph.D., associate professor of pediatrics at UC Irvine and a licensed clinical psychologist with The Center for Autism & Neurodevelopmental Disorders, is the principal investigator of the study. The four-year study is receiving $103,125 for its initial year, with the potential overall total of $790,625. Gehricke expects to enroll participants by early fall.

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“We are excited to be chosen as the only site nationwide to receive this AIR-P grant to study the impact of exercise on anxiety, which is very common and can lead to poor outcomes in children with autism,” Gehricke said. “The grant will allow us to collect valuable data that could significantly improve long-term physical and mental health, particularly in underserved communities.”

A growing international body of research is confirming the wide-ranging benefits of exercise in reducing stress and improving the long-term health of children and adults alike. This study will determine the potential benefits of exercise in underserved children with ASD.

“We often tell our families to encourage their children with autism to get out and exercise,” said Kelly McKinnon, M.A., BCBA, co-investigator on the project. “It’s exciting to be able to study its impact and share the results with our families.”

The physical exercise research program is being designed to incorporate comprehensive new guidelines for physical exercise in children developed by the Centers for Disease Control and Prevention. Researchers will measure impact based on several key factors, including compliance, anxiety and salivary cortisol levels measured before and after completion of the exercise and control group interventions. Cortisol is a frequently used biomarker for stress, Gehricke explained.

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Collecting this data will aid in the development of an evidence-based physical exercise intervention toolkit for the treatment of anxiety as well as other behaviors and improvement of physical health in children with ASD from underserved populations.

“Research is one of the core pillars of our mission,” said Catherine Brock, M.A., executive director of The Center for Autism & Neurodevelopmental Disorders. “With this grant and Jean Gehricke’s pioneering research efforts, we will be better able to help parents and families overcome obstacles they face and assist children in reaching their optimal potential.”

For more information, please visit http://www.thecenter4autism.org.

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About The Center for Autism & Neurodevelopmental DisordersFounded in 2001 (originally as For OC Kids), The Center is home to a team of experts in the field of autism and neurodevelopmental disorders. Since its opening, The Center has been a leader in clinical services, research, education, and outreach, serving clients from birth through 22 years old.

In late 2012, a catalytic investment by the Thompson Family Foundation and the Children and Families Commission of Orange County provided $14.8 million to expand The Center for Autism & Neurodevelopmental Disorders.

The Center was established to provide help and hope to children, adolescents, young adults and their families challenged by autism spectrum and other neurodevelopmental disorders through excellent clinical care, innovative research, quality education, and community engagement. For more information, please visit http://www.thecenter4autism.org.

Taking Antidepressants During Pregnancy Increases Risk of Autism by 87%

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Ground breaking study published in JAMA Pediatrics looks at outcomes of 145,456 pregnancies after antidepressant use

Credit: Hepingting, CC BY SA 2.0, https://flic.kr/p/95h8gu
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Using antidepressants during pregnancy greatly increases the risk of autism, Professor Anick Bérard of the University of Montreal and its affiliated CHU Sainte-Justine children’s hospital revealed today. Prof. Bérard, an internationally renowned expert in the fields of pharmaceutical safety during pregnancy, came to her conclusions after reviewing data covering 145,456 pregnancies. “The variety of causes of autism remain unclear, but studies have shown that both genetics and environment can play a role,” she explained. “Our study has established that taking antidepressants during the second or third trimester of pregnancy almost doubles the risk that the child will be diagnosed with autism by age 7, especially if the mother takes selective serotonin reuptake inhibitors, often known by its acronym SSRIs.” Her findings were published today in JAMA Pediatrics.

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Using antidepressants during pregnancy greatly increases the risk of autism, Professor Anick Bérard of the University of Montreal and its affiliated CHU Sainte-Justine children’s hospital revealed today. Prof. Bérard, an internationally renowned expert in the fields of pharmaceutical safety during pregnancy, came to her conclusions after reviewing data covering 145,456 pregnancies. “The variety of causes of autism remain unclear, but studies have shown that both genetics and environment can play a role,” she explained. “Our study has established that taking antidepressants during the second or third trimester of pregnancy almost doubles the risk that the child will be diagnosed with autism by age 7, especially if the mother takes selective serotonin reuptake inhibitors, often known by its acronym SSRIs.” Her findings were published today in JAMA Pediatrics.

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Bérard and her colleagues worked with data from the Quebec Pregnancy Cohort and studied 145,456 children between the time of their conception up to age ten. In addition to information about the mother’s use of antidepressants and the child’s eventual diagnosis of autism, the data included a wealth of details that enabled the team to tease out the specific impact of the antidepressant drugs. For example, some people are genetically predisposed to autism (i.e., a family history of it.) Maternal age, and depression are known to be associated with the development of autism, as are certain socio-economic factors such as being exposed to poverty, and the team was able to take all of these into consideration. “We defined exposure to antidepressants as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy. This period was chosen as the infant’s critical brain development occurs during this time,” Prof. Bérard said. “Amongst all the children in the study, we then identified which children had been diagnosed with a form of autism by looking at hospital records indicating diagnosed childhood autism, atypical autism, Asperger’s syndrome, or a pervasive developmental disorder. Finally, we looked for a statistical association between the two groups, and found a very significant one: an 87% increased risk.” The results remained unchanged when only considering children who had been diagnosed by specialists such as psychiatrists and neurologists.

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The findings are hugely important as six to ten percent of pregnant women are currently being treated for depression with antidepressants. In the current study, 1,054 children were diagnosed with autism (0.72% of the children in the study), on average at 4.5 years of age. Moreover, the prevalence of autism amongst children has increased from 4 in 10,000 children in 1966 to 100 in 10,000 today. While that increase can be attributed to both better detection and widening criteria for diagnosis, researchers believe that environmental factors are also playing a part. “It is biologically plausible that anti-depressants are causing autism if used at the time of brain development in the womb, as serotonin is involved in numerous pre- and postnatal developmental processes, including cell division, the migration of neuros, cell differentiation and synaptogenesis – the creation of links between brain cells,” Prof. Bérard explained. “Some classes of anti-depressants work by inhibiting serotonin (SSRIs and some other antidepressant classes), which will have a negative impact on the ability of the brain to fully develop and adapt in-utero”

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The World Health Organization indicates that depression will be the second leading cause of death by 2020, which leads the researchers to believe that antidepressants will likely to remain widely prescribed, including during pregnancy. “Our work contributes to a better understanding of the long-term neurodevelopmental effects of anti-depressants on children when they are used during gestation. Uncovering the outcomes of these drugs is a public health priority, given their widespread use,” Prof. Bérard said.

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About this study:Takoua Boukhris, Odile Sheehy, Laurent Mottron, MD, PhD, and Anick Bérard, PhD, published “Antidepressant use during pregnancy and the risk of autism spectrum disorder in children” in JAMA Pediatrics on December 14, 2015.

Anick Bérard, PhD, is a professor at the University of Montreal’s Faculty of Pharmacy and a researcher at the CHU Sainte-Justine Research Centre.

This study was supported by the Canadian Institutes of Health Reseach (CIHR) “Quebec Training Network in Perinatal Research”, and the Fonds de la recherche du Québec – Santé (FRQ-S).,

Dr. Bérard is the recipient of a FRQ-S research Chair on Medications and Pregnancy. Dr Bérard is a consultant for plaintiffs in litigations involving antidepressants and birth defects.

The University of Montreal is officially known as Université de Montréal.