Objectives: Psychiatric problems are common in autism spectrum disorders (ASDs) but the reasons for this are poorly understood. We use a longitudinal population-representative cohort s to examine the four-year persistence of psychiatric problems and to identify risk factors for their occurrence and stability.
Methods: Eighty-one 16 year old adolescents, initially seen at 12 years, were re-assessed using the parent-report Strengths and Difficulties Questionnaire (SDQ). Child, family and contextual characteristics from age 12 were tested as risk factors for psychopathology.
Results: Prevalence rates varied depending on whether general population or ASD-specific SDQ cut-offs were used; while the former suggested a decrease in psychiatric problems over time, the ASD-specific cut-offs showed no significant rate differences between 12 and 16 years. There was strong longitudinal domain-specificity, with parent correlations ranging from 0.44-0.58 and teacher SDQ reports at age 12 showing correlations of 0.31-0.58 with parent reports at 16. Among the few significant risk factors, lower IQ and adaptive functioning predicted hyperactivity problems and total difficulties. Emotional problems at 16 were predicted by poorer maternal mental health, family-based deprivation and lower social class. Improvement from 12 to 16 in conduct problems was predicted by greater neighborhood deprivation and special school attendance.
Conclusions: Additional psychiatric problems in ASD are persistent and domain-specific from childhood to adolescence. Using norms generated for general population samples may be inappropriate and give misleading results. There was a striking lack of effect for risk factors associated with psychopathology in the general child population, although a few expected associations were found.
See more of: Psychiatric/Behavioral Comorbidities
See more of: Symptoms, Diagnosis & Phenotype