Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-23T08:11:20.339Z Has data issue: false hasContentIssue false
  • English
  • Français

Autism spectrum in patients with schizophrenia: correlations with real-life functioning, resilience, and coping styles

Published online by Cambridge University Press:  12 April 2021

Liliana Dell’Osso ,
Barbara Carpita Open the ORCID record for Barbara Carpita [Opens in a new window] ,
Ivan Mirko Cremone ,
Camilla Gesi ,
Arcangelo D’Ermo ,
Giovanni De Iorio ,
Gabriele Massimetti ,
Eugenio Aguglia ,
Paola Bucci  and
Bernardo Carpiniello
...Show all authors
Liliana Dell’Osso
Affiliation:
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Barbara Carpita*
Affiliation:
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Ivan Mirko Cremone
Affiliation:
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Camilla Gesi
Affiliation:
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Arcangelo D’Ermo
Affiliation:
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Giovanni De Iorio
Affiliation:
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Gabriele Massimetti
Affiliation:
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Eugenio Aguglia
Affiliation:
Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
Paola Bucci
Affiliation:
Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
Bernardo Carpiniello
Affiliation:
Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
Andrea Fagiolini
Affiliation:
Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy
Rita Roncone
Affiliation:
Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
Alberto Siracusano
Affiliation:
Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, Tor Vergata University of Rome, Rome, Italy
Antonio Vita
Affiliation:
Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
Claudia Carmassi
Affiliation:
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
Mario Maj
Affiliation:
Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
*
*Author for correspondence: Barbara Carpita, Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Previous researches highlighted among patients with schizophrenia spectrum disorders (SSD) a significant presence of autistic traits, which seem to influence clinical and functional outcomes. The aim of this study was to further deepen the investigation, evaluating how patients with SSD with or without autistic traits may differ with respect to levels of functioning, self-esteem, resilience, and coping profiles.

Methods

As part of the add-on autism spectrum study of the Italian Network for Research on Psychoses, 164 outpatients with schizophrenia (SCZ) were recruited at eight Italian University psychiatric clinics. Subjects were grouped depending on the presence of significant autistic traits according to the Adult Autism Subthreshold Spectrum (AdAS Spectrum) instrument (“AT group” vs “No AT group”). Other instruments employed were: Autism Spectrum Quotient (AQ), Specific Levels of Functioning (SLOF), Self-Esteem Rating scale (SERS), Resilience Scale for Adults (RSA), and brief-COPE.

Results

The “AT group” reported significantly higher scores than the “No AT group” on SLOF activities of community living but significantly lower scores on work skills subscale. The same group scored significantly lower also on SERS total score and RSA perception of the self subscale. Higher scores were reported on COPE self-blame, use of emotional support and humor domains in the AT group. Several correlations were found between specific dimensions of the instruments.

Conclusion

Our findings suggest the presence of specific patterns of functioning, resilience, and coping abilities among SSD patients with autistic traits.

Keywords

Schizophreniaautism spectrumresiliencecopingglobal functioning
Type
Original Research
Information
CNS Spectrums , Volume 27 , Issue 4 , August 2022 , pp. 457 - 467
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Liliana Dell’Osso and Barbara Carpita equally contributed to the work.

The members of the Italian Network for Research on Psychoses involved in this study are listed in the Appendix.

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. . Arlington, VA: American Psychiatric Association; 2013.Google Scholar
Hamlyn, J, Duhig, M, McGrath, J, et al. Modifiable risk factors for schizophrenia and autism—shared risk factors impacting on brain development. Neurobiol Dis. 2013;53:3–9.CrossRefGoogle ScholarPubMed
Spek, A, Wouters, SGM. Autism and schizophrenia in high functioning adults: behavioral differences and overlap. Res Autism Spectr Disord. 2010;4(4):709–717.CrossRefGoogle Scholar
King, BH, Lord, C. Is schizophrenia on the autism spectrum? Brain Res. 2011;1380:34–41.CrossRefGoogle ScholarPubMed
Chisholm, K, Lin, A, Abu-Akel, A, et al. The association between autism and schizophrenia spectrum disorders: a review of eight alternate models of co-occurrence. Neurosci Biobehav Rev. 2015;55:173–183.CrossRefGoogle ScholarPubMed
Bleuler, E. Dementia Praecox oder Gruppe der Schizophrenien. Leipzig: Deuticke; 1911.Google Scholar
Kolvin, I. Studies in the childhood psychoses. I. Diagnostic criteria and classification. Br J Psychiatry. 1971;118(545):381–384.CrossRefGoogle ScholarPubMed
Rutter, M. Childhood schizophrenia reconsidered. J Autism Child Schizophr. 1972;2(4):315–337.CrossRefGoogle ScholarPubMed
Stahlberg, O, Soderstrom, H, Rastam, M, et al. Bipolar disorder, schizophrenia, and other psychotic disorders in adults with childhood onset AD/HD and/or autism spectrum disorders. J Neural Transm. 2004;111(7):891–902.CrossRefGoogle ScholarPubMed
Mouridsen, SE, Rich, B, Isager, T. Psychiatric disorders in adults diagnosed as children with atypical autism. A case control study. J Neural Transm. 2008;115(1):135–138.CrossRefGoogle ScholarPubMed
Rapoport, J, Chavez, A, Greenstein, D, et al. Autism spectrum disorders and childhood-onset schizophrenia: clinical and biological contributions to a relation revisited. J Am Acad Child Adolesc Psychiatry. 2009;48(1):10–18.CrossRefGoogle ScholarPubMed
Solomon, M, Olsen, E, Niendam, T, et al. From lumping to splitting and back again: atypical social and language development in individuals with clinical-high-risk for psychosis, first episode schizophrenia, and autism spectrum disorders. Schizophr Res. 2011;131(1–3):146–151.CrossRefGoogle ScholarPubMed
Goldstein, G, Minshew, NJ, Allen, DN, et al. High-functioning autism and schizophrenia: a comparison of an early and late onset neurodevelopmental disorder. Arch Clin Neuropsychol. 2002;17(5):461–475.CrossRefGoogle ScholarPubMed
Ursini, G, Punzi, G, Chen, Q, et al. Convergence of placenta biology and genetic risk for schizophrenia. Nat Med. 2018;24(6):792–801.CrossRefGoogle ScholarPubMed
Burbach, JP, van der Zwaag, B. Contact in the genetics of autism and schizophrenia. Trends Neurosci. 2009;32(2):69–72.CrossRefGoogle ScholarPubMed
Kushima, I, Aleksic, B, Nakatochi, M, et al. Comparative analyses of copy-number variation in autism spectrum disorder and schizophrenia reveal etiological overlap and biological insights. Cell Rep. 2018;24(11):2838–2856.CrossRefGoogle ScholarPubMed
Chao, HT, Chen, H, Samaco, RC, et al. Dysfunction in GABA signalling mediates autism-like stereotypies and Rett syndrome phenotypes. Nature. 2010;468(7321):263–269.CrossRefGoogle ScholarPubMed
Zheng, Z, Zheng, P, Zou, X. Association between schizophrenia and autism spectrum disorder: a systematic review and meta-analysis. Autism Res. 2018;11(8):1110–1119.CrossRefGoogle ScholarPubMed
Folstein, S, Rutter, M. Infantile autism: a genetic study of 21 twin pairs. J Child Psychol Psychiatry. 1977;18(4):297–321.CrossRefGoogle ScholarPubMed
van Os, J, Hanssen, M, Bijl, RV, et al. Strauss (1969) revisited: a psychosis continuum in the general population? Schizophr Res. 2000;45(1–2):11–20.CrossRefGoogle ScholarPubMed
Gadow, KD. Association of schizophrenia spectrum and autism spectrum disorder (ASD) symptoms in children with ASD and clinic controls. Res Dev Disabil. 2013;34(4):1289–1299.CrossRefGoogle ScholarPubMed
Cochran, DM, Dvir, Y, Frazier, JA. "Autism-plus" spectrum disorders: intersection with psychosis and the schizophrenia spectrum. Child Adolesc Psychiatr Clin N Am. 2013;22(4):609–627.CrossRefGoogle ScholarPubMed
Cooper, K, Smith, L, Russell, A. Social identity, self-esteem, and mental health in autism. Eur J Soc Psychol. 2017;47(7):844–854.CrossRefGoogle Scholar
Owen, MJ, O’Donovan, MC. Schizophrenia and the neurodevelopmental continuum: evidence from genomics. World Psychiatry. 2017;16:227–235.CrossRefGoogle ScholarPubMed
Dell’Osso, L, Lorenzi, P, Carpita, B. Autistic traits and illness trajectories. Clin Pract Epidemiol Ment Health. 2019;15:94–98.CrossRefGoogle ScholarPubMed
Baron-Cohen, S, Wheelwright, S, Skinner, R, et al. The autism-spectrum quotient (AQ): evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. J Autism Dev Disord. 2001;31(1):5–17.CrossRefGoogle ScholarPubMed
Dell’Osso, L, Dalle, LR, Maj, M. Adult autism spectrum as a transnosographic dimension. CNS Spectr. 2016;21(2):131–133.CrossRefGoogle ScholarPubMed
Skylark, WJ, Baron-Cohen, S. Initial evidence that non-clinical autistic traits are associated with lower income. Mol Autism. 2017;8:61CrossRefGoogle ScholarPubMed
Carpita, B, Carmassi, C, Calderoni, S, et al. The broad autism phenotype in real-life: clinical and functional correlates of autism spectrum symptoms and rumination among parents of patients with autism spectrum disorder. CNS Spectr. 2020;25:1–9.CrossRefGoogle ScholarPubMed
Dell’Osso, L, Cremone, IM, Carpita, B, et al. Correlates of autistic traits among patients with borderline personality disorder. Compr Psychiatry. 2018;83:7–11.CrossRefGoogle ScholarPubMed
Dell’Osso, L, Carpita, B, Gesi, C, et al. Subthreshold autism spectrum disorder in patients with eating disorders. Compr Psychiatry. 2018;81:66–72.CrossRefGoogle ScholarPubMed
Dell’Osso, L, Muti, D, Carpita, B, et al. The Adult Autism Subthreshold Spectrum (AdAS) model: a neurodevelopmental approach to mental disorders. J Psychopathol. 2018;24(3):118–124.Google Scholar
Carpita, B, Muti, D, Dell’Osso, L. Oxidative stress, maternal diabetes, and autism spectrum disorders. Oxid Med Cell Longev. 2018;2018:3717215.CrossRefGoogle ScholarPubMed
Dell’Osso, L, Conversano, C, Corsi, M, et al. Polysubstance and behavioral addictions in a patient with bipolar disorder: Role of lifetime subthreshold autism spectrum. Case Rep Psychiatry. 2018;2018:1547975.Google Scholar
Dell’Osso, L, Carpita, B, Cremone, IM, et al. The mediating effect of trauma and stressor related symptoms and ruminations on the relationship between autistic traits and mood spectrum. Psychiatry Res. 2019;279:123–129.CrossRefGoogle ScholarPubMed
Dell’Osso, L, Carpita, B, Muti, D, et al. Mood symptoms and suicidality across the autism spectrum. Compr Psychiatry. 2019;91:34–38.CrossRefGoogle ScholarPubMed
Carpita, B, Muti, D, Muscarella, A, et al. Sex differences in the relationship between ptsd spectrum symptoms and autistic traits in a sample of university students. Clin Pract Epidemiol Ment Health. 2019;15(1):110–119.CrossRefGoogle Scholar
Dell’Osso, L, Carpita, B, Bertelloni, CA, et al. Subthreshold autism spectrum in bipolar disorder: prevalence and clinical correlates. Psychiatry Res. 2019;281:112605CrossRefGoogle ScholarPubMed
Dell’Osso, L, Muti, D, Lorenzi, P, et al. Autistic traits and rumination as vulnerability factors towards post-traumatic stress symptoms: shaping psychopathological trajectories. J Psychopathol. 2020;26(1):12–20.Google Scholar
Dell’osso, L, Lorenzi, P, Carpita, B. Camouflaging: psychopathological meanings and clinical relevance in autism spectrum conditions. CNS Spectr. 2020;26:1–3.Google ScholarPubMed
Dell’Osso, L, Lorenzi, P, Carpita, B. The neurodevelopmental continuum towards a neurodevelopmental gradient hypothesis. J Psychopathol. 2019;25(4):179–182.Google Scholar
De Crescenzo, F, Postorino, V, Siracusano, M, et al. Autistic symptoms in schizophrenia spectrum disorders: a systematic review and meta-analysis. Front Psychiatry. 2019;10:78.CrossRefGoogle ScholarPubMed
Cannon, M, Caspi, A, Moffitt, TE, et al. Evidence for earlychildhood, pan-developmental impairment specific to schizophreniform disorder: results from a longitudinal birth cohort. Arch Gen Psychiatry. 2002;59(5):449–456.CrossRefGoogle Scholar
Addington, J, Addington, D. Patterns of premorbid functioning in first episode psychosis: relationship to 2-year outcome. Acta Psychiatr Scand. 2005;112(1):40–46.CrossRefGoogle ScholarPubMed
Reichenberg, A, Caspi, A, Harrington, H, et al. Static and dynamic cognitive deficits in childhood preceding adult schizophrenia: a 30-year study. Am J Psychiatry. 2010;167(2):160–169.CrossRefGoogle ScholarPubMed
Strauss, GP, Allen, DN, Miski, P, et al. Differential patterns of premorbid social and academic deterioration in deficit and nondeficit schizophrenia. Schizophr Res. 2012;135(1–3):134–138.CrossRefGoogle ScholarPubMed
Ayesa-Arriola, R, Rodriguez-Sanchez, JM, Perez-Iglesias, R, et al. The relevance of cognitive, clinical and premorbid variables in predicting functional outcome for individuals with first-episode psychosis: a 3 year longitudinal study. Psychiatry Res. 2013;209(3):302–308.CrossRefGoogle ScholarPubMed
Rocca, P, Galderisi, S, Rossi, A, et al. Disorganization and real-world functioning in schizophrenia: results from the multicenter study of the Italian Network for Research on Psychoses. Schizophr Res. 2018;201:105–112.CrossRefGoogle ScholarPubMed
Buonocore, M, Bechi, M, Uberti, P, et al. Cognitive reserve profiles in chronic schizophrenia: effects on theory of mind performance and improvement after training. J Int Neuropsych Soc. 2018;24(6):563–571.CrossRefGoogle ScholarPubMed
Bucci, P, Galderisi, S, Mucci, A, et al. Premorbid academic and social functioning in patients with schizophrenia and its associations with negative symptoms and cognition. Acta Psychiatr Scand. 2018;138(3):253–266.CrossRefGoogle ScholarPubMed
Galderisi, S, Rucci, P, Mucci, A, et al. The interplay among psychopathology, personal resources, context-related factors and real-life functioning in schizophrenia: stability in relationships after 4 years and differences in network structure between recovered and non-recovered patients. World Psychiatry. 2020;19(1):81–91.CrossRefGoogle ScholarPubMed
Bechi, M, Agostoni, G, Buonocore, M, et al. The influence of premorbid adjustment and autistic traits on social cognitive dysfunction in schizophrenia. J Int Neuropsych Soc. 2020;26(3):276–285.CrossRefGoogle Scholar
Bastiaansen, JA, Meffert, H, Hein, S, et al. Diagnosing autism spectrum disorders in adults: the use of Autism Diagnostic Observation Schedule (ADOS) module 4. J Autism Dev Disord. 2011;41(9):1256–1266.CrossRefGoogle ScholarPubMed
Chisholm, K, Pelton, M, Duncan, N, et al. A cross-sectional examination of the clinical significance of autistic traits in individuals experiencing a first episode of psychosis. Psychiatry Res. 2019;282:112623CrossRefGoogle ScholarPubMed
Vita, A, Barlati, S, Deste, G, et al. The influence of autistic symptoms on social and non-social cognition and on real-life functioning in people with schizophrenia: evidence from the Italian Network for Research on Psychoses multicenter study. Eur Psychiatry. 2020;10:1–24.Google Scholar
Vaskinn, A, Abu-Akel, A. The interactive effect of autism and psychosis severity on theory of mind and functioning in schizophrenia. Neuropsychology. 2019;33(2):195–202.CrossRefGoogle Scholar
Lai, MC, Szatmari, P. Resilience in autism: research and practice prospects. Autism. 2019;23(3):539–541.CrossRefGoogle ScholarPubMed
Suzuki, T, Miyaki, K, Eguchi, H, et al. Distribution of autistic traits and their association with sociodemographic characteristics in Japanese workers. Autism. 2018;22(8):907–914.CrossRefGoogle ScholarPubMed
Hirvikoski, T, Blomqvist, M. High self-perceived stress and poor coping in intellectually able adults with autism spectrum disorder. Autism. 2014;19(6):752–757.CrossRefGoogle ScholarPubMed
Abu-Akel, A, Clark, J, Perry, A, et al. Autistic and schizotypal traits and global functioning in bipolar I disorder. J Affect Disord. 2017;207:268–275.CrossRefGoogle ScholarPubMed
Kronenberg, LM, Goossens, PJ, van Busschbach, J, et al. Coping styles in substance use disorder (SUD) patients with and without cooccurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). BMC Psychiatry. 2015;15:159.CrossRefGoogle Scholar
Karakaş, SA, Okanli, A, Yilmaz, E. The effect of internalized stigma on the self esteem in patients with schizophrenia. Arch Psychiatr Nurs. 2016;30(6):648–665.CrossRefGoogle ScholarPubMed
Torgalsbøen, AK. Sustaining full recovery in schizophrenia after 15 years: does resilience matter? Clin Schizophr Relat Psychoses. 2012;5(4):193–200.CrossRefGoogle ScholarPubMed
Eklund, M, Backstrom, M, Hansson, L. Personality and self-variables: important determinants of subjective quality of life in schizophrenia out-patients. Acta Psychiatr Scand. 2003;108(2):134–143.CrossRefGoogle ScholarPubMed
Roe, D. A prospective study on the relationship between self-esteem and functioning during the first year after being hospitalized for psychosis. J Nerv Ment Dis. 2003;191(1):45–49.CrossRefGoogle Scholar
Kim, KR, Song, YY, Park, JY, et al. The relationship between psychosocial functioning and resilience and negative symptoms in individuals at ultra-high risk for psychosis. Aust N Z J Psychiatry. 2013;47(8):762–771.CrossRefGoogle ScholarPubMed
Brekke, JS, Kohrt, B, Green, MF. Neuropsychological functioning as a moderator of the relationship between psychosocial functioning and the subjective experience of self and life in schizophrenia. Schizophr Bull. 2001;27(4):697–708.CrossRefGoogle Scholar
Kim, EY, Jang, MH. The mediating effects of self-esteem and resilience on the relationship between internalized stigma and quality of life in people with schizophrenia. Asian Nurs Res. 2019;13(4):257–263.CrossRefGoogle ScholarPubMed
Cotton, SM, McCann, TV, Gleeson, JF, et al. Coping strategies in carers of young people with a first episode of psychosis. Schizophr Res. 2013;146(1–3):118–124.CrossRefGoogle ScholarPubMed
Marquez-Arrico, JE, Benaiges, I, Adan, A. Strategies to cope with treatment in substance use disorder male patients with and without schizophrenia. Psychiatry Res. 2015;228(3):752–759.CrossRefGoogle ScholarPubMed
Zappia, S, Montemagni, C, Macrì, A, et al. Coping styles in schizophrenia: a study of clinical and functional variables as determinants of strategies to cope with stress. Riv Psichiatr. 2012;47(3):238–245.Google ScholarPubMed
Holubova, M, Prasko, J, Hruby, R, et al. Coping strategies and quality of life in schizophrenia: a cross-sectional study. Neuropsychiatr Dis Treat. 2015;11:3041–3048.Google Scholar
Holubova, M, Prasko, J, Hruby, R, et al. Coping strategies and self-stigma in patients with schizophrenia- spectrum disorders. Patient Prefer Adherence. 2016;10:1151–1158.Google ScholarPubMed
Chen, H, Xu, J, Mao, Y, et al. Positive coping and resilience as mediators between negative symptoms and disability among patients with schizophrenia. Front Psychiatry. 2019;10:641.CrossRefGoogle ScholarPubMed
Dell’Osso, L, Gesi, C, Massimetti, E, et al. Adult Autism Subthreshold Spectrum (AdAS Spectrum): validation of a questionnaire investigating subthreshold autism spectrum. Compr Psychiatry. 2017;73:61–83.CrossRefGoogle ScholarPubMed
Donati, MA, Berrocal, C, Primi C,et al. Measuring subthreshold autistic traits in the general population: psychometric properties of the Adult Autism Subthreshold Spectrum (AdAS Spectrum) scale. Psychiatry Res. 2019;281:112576.CrossRefGoogle ScholarPubMed
Dell’Osso, L, Carmassi, C, Cremone, IM, et al. Defining the optimal threshold scores for Adult Autism Subthreshold Spectrum (AdAS Spectrum) in clinical and general population. Clin Pract Epidemiol Ment Health. 2020;16:204–211.CrossRefGoogle ScholarPubMed
Wheelwright, S, Auyeung, B, Allison, C, et al. Defining the broader, medium and narrow autism phenotype among parents using the Autism Spectrum Quotient (AQ). Mol Autism. 2010;1(1):10CrossRefGoogle Scholar
Mucci, A, Rucci, P, Rocca, P, et al. The Specific Level of Functioning Scale: construct validity, internal consistency and factor structure in a large Italian sample of people with schizophrenia living in the community. Schizophr Res. 2014;159(1):144–150.CrossRefGoogle Scholar
Nugent, WR, Thomas, JW. Validation of a clinical measure of self-esteem. Res Soc Work Pract. 1993;3(2):191–207.CrossRefGoogle Scholar
Friborg, O, Hjemdal, O, Rosenvinge, JH, et al. A new rating scale for adult resilience: what are the central protective resources behind healthy adjustment? Int J Methods Psychiatr Res. 2003;12(2):65–76.CrossRefGoogle ScholarPubMed
Carver, CS. You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behavioral Med. 1997;4(1):92–100.CrossRefGoogle ScholarPubMed
Matsuo, J, Kamio, Y, Takahashi, H, et al. Autistic-like traits in adult patients with mood disorders and schizophrenia. PLoS One. 2015;10(4):e0122711.CrossRefGoogle ScholarPubMed
Trevisan, D, Birmingham, E. Examining the relationship between autistic traits and college adjustment. Autism. 2016;20(6):719–729.CrossRefGoogle ScholarPubMed
Wallace, GL, Budgett, J, Charlton, RA. Aging and autism spectrum disorder: evidence from the broad autism phenotype. Autism Res. 2016;9(12):1294–1303.CrossRefGoogle ScholarPubMed
Bejerot, S, Edgar, J, Humble, MB. Poor performance in physical education—a risk factor for bully victimization. A case-control study. Acta Paediatr. 2011;100(3):413–419.CrossRefGoogle ScholarPubMed
Gillberg, C, Kadesjö, B. Why bother about clumsiness? The implications of having developmental coordination disorder (DCD). Neural Plast. 2003;10(1–2):59–68.CrossRefGoogle Scholar
McChesney, G, Toseeb, U. Happiness, self-esteem, and prosociality in children with and without autism spectrum disorder: Evidence from a UK population cohort study. Autism Res. 2018;11(7):1011–1023.CrossRefGoogle ScholarPubMed
Zhou, T, Wang, Y, Yi, C. Affiliate stigma and depression in caregivers of children with autism spectrum disorders in China: effects of self-esteem, shame and family functioning. Psychiatry Res. 2018;264:260–265.CrossRefGoogle ScholarPubMed
Arwert, TG, Sizoo, BB. Self-reported suicidality in male and female adults with autism spectrum disorders: rumination and self-esteem. J Autism Dev Disord. 2020;50(10):3598–3605.CrossRefGoogle ScholarPubMed
Hillier, A, Goldstein, J, Murphy, D, et al. Supporting university students with autism spectrum disorder. Autism. 2018;22(1):20–28.CrossRefGoogle ScholarPubMed
Capps, L, Sigman, M, Yirmiya, N. Self-competence and emotional understanding in high functioning children with autism. Dev Psychopathol. 1995;7(1):137–149.CrossRefGoogle Scholar
Williamson, S, Craig, J, Slinger, R. Exploring the relationship between measures of self-esteem and psychological adjustment among adolescents with Asperger syndrome. Autism. 2008;12(4):391–402.CrossRefGoogle ScholarPubMed
Pelton, MK, Cassidy, SA. Are autistic traits associated with suicidality? A test of the interpersonal-psychological theory of suicide in a non-clinical young adult sample. Autism Res. 2017;10(11):1891–1904.CrossRefGoogle Scholar
Eisenberg, SA, Shen, BJ, Schwarz, ER, et al. Avoidant coping moderates the association between anxiety and patient-rated physical functioning in heart failure patients. J Behav Med. 2012;35(3):253–261.CrossRefGoogle ScholarPubMed
Meyer, NA, Helle, AC, Tucker, RP, et al. Humor styles moderate borderline personality traits and suicide ideation. Psychiatry Res. 2017;249:337–342.CrossRefGoogle ScholarPubMed
Groden, J, Cautela, J, Prince, S, Berryman, J. The impact of stress and anxiety on individuals with autism and developmental disabilities. In: Schopler, E, Mesibov, GB, eds. Behavioral Issues in Autism. Current Issues in Autism. Boston, MA: Springer; 1994:177–194.CrossRefGoogle Scholar
Pisula, E, Danielewicz, D, Kawa, R, Pisula, W. Autism spectrum quotient, coping with stress and quality of life in a non-clinical sample—an exploratory report. Health Qual Life Outcomes. 2015;13:173CrossRefGoogle Scholar
Dell’Osso, L, Cremone, IM, Carpita, B, et al. Rumination, posttraumatic stress disorder, and mood symptoms in borderline personality disorder. Neuropsychiatr Dis Treat. 2019;15:1231–1238.CrossRefGoogle ScholarPubMed
Fusar-Poli, P, Rutigliano, G, Stahl, D, et al. Development and validation of a clinically based risk calculator for the transdiagnostic prediction of psychosis. JAMA Psychiatry. 2017;74(5):493–500.CrossRefGoogle ScholarPubMed
Harvey, PD, Deckler, E, Jones, MT, et al. Autism symptoms, depression, and active social avoidance in schizophrenia: association with self-reports and informant assessments of everyday functioning. J Psychiatr Res. 2019;115:36–42.CrossRefGoogle ScholarPubMed