![]() ![]() Although the hypothesis is interesting for scientific reasons, discussed below, it also draws attention to the fact that, even in severely disabled children who sustain trauma, although they may not be able to describe it, the traumatic experience may have negative outcomes. Combining these, he theorizes that trauma may heighten the risk of aggressive behavior in ASD. He then describes what links trauma histories with violence. He bases this suggestion on similarities in the neuropathophysiology of ASD and the long-term neurobiological effects of trauma exposure. Im suggests the possibility that people with ASD are particularly vulnerable to the negative effects of trauma. ![]() “Trauma as a Contributor to Violence in Autism Spectrum Disorder” 1 is interesting from the start as a consideration of the effects that traumatic experiences may have on ASD. Above all, it is important to recognize that people with ASD experience the full array of psychiatric disorders that typical people experience and that having ASD does not confer protection against any other disorder. Furthermore, they illustrate that psychiatric behaviors that co-occur with ASD should be assessed through the lens of ASD and that ASD can alter or distort them. They also illustrate that ASD should be thought of as a pervasive disorder, with broad effects on all domains of behavior. These examples highlight the importance of a careful clinical examination as fundamental to any attempt to determine the source of problematic behavior. The social disability in ASD can manifest as flat affect, social withdrawal, and reluctance to engage in group activities, all things that could also be attributable to depression. Another example of the way in which ASD can mimic another disorder is depression. Selective serotonin reuptake inhibitors, which can be effective for obsessive-compulsive disorder, rarely have any impact on primary repetitive behaviors rooted in ASD. Repetitive behaviors can be conceptualized as representing an aspect of the primary diagnosis, or, on the other hand, comorbid obsessive-compulsive disorder. Consider repetitive behaviors, for example, one of the hallmark symptoms of ASD. In some cases, ASD can mimic other disorders. If an inappropriate focus were driving inattention, rather than true attention-deficit/hyperactivity disorder, a standard treatment such as a stimulant, may exacerbate the problem. ASD can also be associated with hyperfocus on details in the environment, which may present as inattention, and in fact reflects attention focused on aspects of the environment that are not salient to others. Untangling the contributing factors to define treatment targets must be done with an understanding that ASD itself can distort the way in which psychiatric disorders present themselves.įor example, when a child with ASD is inattentive in a school setting, it raises the question of comorbid attention-deficit/hyperactivity disorder. On the other hand, many of the problematic behaviors associated with ASD, including aggression, are treatable. The core symptoms that define ASD, social disability, and restrictive patterns of behavior are thought to be the consequences of a distinct developmental trajectory rather than a reversible psychiatric illness, thus not easily treatable. From a clinical perspective, managing autism can be challenging. ASD is more often than not associated with psychiatric comorbidities, including anxiety disorders, mood disorders, and psychotic disorders. CDD is a rare form of ASD that is defined by late onset, a traumatic prodrome, onset of behaviors including some with similarities to PTSD, and aggression.Īutism spectrum disorder (ASD) encompasses a variety of presentations, differing from one another along several spectra, including intellectual and language ability. Im's hypotheses are discussed, and a case example of childhood disintegrative disorder (CDD) is raised to give clinical support to his hypotheses. ![]() Comorbidities of autism spectrum disorder are discussed as an introduction to the argument that, although ASD may modify presentation, it does not confer any protection against other disorder, including the negative effects of trauma (e.g., posttraumatic stress disorder). ![]()
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