Adults with Down syndrome (DS) are predisposed to Alzheimer's disease (AD) and reveal early amyloid beta (Aβ) pathology in the brain. Positron emission tomography (PET) provides an in vivo measure of ...Aβ throughout the AD continuum. Due to the high prevalence of AD in DS, there is need for longitudinal imaging studies of Aβ to better characterize the natural history of Aβ accumulation, which will aid in the staging of this population for clinical trials aimed at AD treatment and prevention.
Adults with DS (N = 79; Mean age (SD) = 42.7 (7.28) years) underwent longitudinal C-11Pittsburgh compound B (PiB) PET. Global Aβ burden was quantified using the amyloid load metric (AβL). Modeled PiB images were generated from the longitudinal AβL data to visualize which regions are most susceptible to Aβ accumulation in DS. AβL change was evaluated across Aβ(-), Aβ-converter, and Aβ(+) groups to assess longitudinal Aβ trajectories during different stages of AD-pathology progression. AβL change values were used to identify Aβ-accumulators within the Aβ(-) group prior to reaching the Aβ(+) threshold (previously reported as 20 AβL) which would have resulted in an Aβ-converter classification. With knowledge of trajectories of Aβ(-) accumulators, a new cutoff of Aβ(+) was derived to better identify subthreshold Aβ accumulation in DS. Estimated sample sizes necessary to detect a 25% reduction in annual Aβ change with 80% power (alpha 0.01) were determined for different groups of Aβ-status.
Modeled PiB images revealed the striatum, parietal cortex and precuneus as the regions with earliest detected Aβ accumulation in DS. The Aβ(-) group had a mean AβL change of 0.38 (0.58) AβL/year, while the Aβ-converter and Aβ(+) groups had change of 2.26 (0.66) and 3.16 (1.34) AβL/year, respectively. Within the Aβ(-) group, Aβ-accumulators showed no significant difference in AβL change values when compared to Aβ-converter and Aβ(+) groups. An Aβ(+) cutoff for subthreshold Aβ accumulation was derived as 13.3 AβL. The estimated sample size necessary to detect a 25% reduction in Aβ was 79 for Aβ(-) accumulators and 59 for the Aβ-converter/Aβ(+) group in DS.
Longitudinal AβL changes were capable of distinguishing Aβ accumulators from non-accumulators in DS. Longitudinal imaging allowed for identification of subthreshold Aβ accumulation in DS during the earliest stages of AD-pathology progression. Detection of active Aβ deposition evidenced by subthreshold accumulation with longitudinal imaging can identify DS individuals at risk for AD development at an earlier stage.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Little research has examined family emotional climate in the context of having a child with autism spectrum disorder (ASD). The goal of the current study was to determine how the emotional quality of ...family subsystems (parent–child and parent couple relationships, for both mothers and fathers) combine to create various classes of family emotional climate and to identify predictors of class membership in 148 families of children with ASD. The emotional quality of family subsystems was assessed using Five Minute Speech Samples from mothers and fathers. In total, 148 families of children with ASD (86% male) aged 6–13 years were included in analyses. About one-third of parents did not have a college degree and more than two-thirds were of non-Hispanic White origin. Latent class analysis revealed that 43% of the sample was characterized by high levels of warmth and low levels of criticism in both the parent–child and parent couple relationships; 12% of the sample was characterized by low warmth and high criticism in both sets of relationships; and the rest of the sample was divided among three additional classes of emotional climate characterized by different configurations of warmth and criticism across both sets of relationships. Parent level of broader autism phenotype and child emotional and behavioral problems were associated with emotional climate class membership. Implications for interventions are discussed.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
We compared the occurrence and timing of divorce in 391 parents of children with an autism spectrum disorder (ASD) and a matched representative sample of parents of children without disabilities ...using a survival analysis. Parents of children with an ASD had a higher rate of divorce than the comparison group (23.5% vs. 13.8%). The rate of divorce remained high throughout the son's or daughter's childhood, adolescence, and early adulthood for parents of children with an ASD, whereas it decreased following the son's or daughter's childhood (after about age 8 years) in the comparison group. Younger maternal age when the child with ASD was born and having the child born later in the birth order were positively predictive of divorce for parents of children with an ASD. Findings have implications for interventions focused on ameliorating ongoing and long-term marital strains for parents of children with an ASD.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Families of youth with autism spectrum disorder (ASD) are vulnerable to maladaptive psychosocial experiences, including elevated youth emotional and behavioral problems (EBPs) and poor parent couple ...relationship outcomes. Yet, the extent to which these family psychosocial experiences are intertwined has been given little research attention. The present study longitudinally investigated the bidirectional associations between parent couple conflict (PCC) and youth EBPs in 188 families of children and adolescents with ASD (initially aged 5 to 12 years) across four time points (T1, T2, T3, T4), each spaced 12 months apart. Mother- and father-report of youth EBPs and PCC were entered into a cross-lagged panel model. After adjusting for youth age and intellectual disability status and parent education and couple relationship length, the results indicated that father-report of PCC predicted increased youth EBPs 12 months later (T1→T2 and T2→T3). In addition, father-report of youth EBPs predicted increased PCC 12 months later (T3→T4). Mother-report did not demonstrate cross-lagged effects. The findings suggest that fathers’ perceptions of PCC and youth emotional and behavioral functioning are transactionally related, highlighting the need for family-wide interventions.
Objective: This study determined whether child and family environment factors are associated with differences in developmental trajectories of emotional and behavioral dysregulation in children with ...autism spectrum disorder (ASD).
Method: Participants included 186 families of a child with ASD (5-12 years old at baseline; 86% male; 83% non-Hispanic Caucasian; 35% comorbid intellectual disability). At each of the four time points (each spaced 12 months apart), mothers and fathers within each family completed well-validated measures on their own mental health, their child's dysregulation, their parent-child relationship, and their parent couple relationship. Longitudinal multi-level modeling was used to describe trajectories of dysregulation across 3 years and test whether parent depression, closeness in the parent-child relationship, and positive parent dyadic coping were associated with differences in child trajectories.
Results: On average, child dysregulation decreased across time. Closer mother-child and father-child relationship quality was associated with lower baseline dysregulation. More severe child restricted and repetitive behaviors, fewer maternal depression symptoms, and more positive parent dyadic coping were associated with declines in child dysregulation over time.
Conclusions: On average, children with ASD become less dysregulated across time. However, there is important variability in dysregulation trajectories of children with ASD. Children with ASD who have a high (versus low) severity of restricted and repetitive behaviors appear to be at risk for greater dysregulation. The family environment, and specifically a closer parent-child relationship, better maternal mental health, and more positive couple coping, may contribute to a pattern of improved child regulation across time in ASD.
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BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Autistic youth are at risk for internalizing mental health problems such as depression and anxiety. Similarly, parents of autistic youth report higher levels of depression than parents of typically ...developing children. The goal of this study was to examine bidirectional associations between parent depression symptoms and the internalizing problems of autistic youth in 188 families across four time points (T1–T4; spaced 12 months apart). A cross-lagged panel model revealed that mother (T1 and T2) and father (T1) depression symptoms positively predicted the youth’s internalizing problems 12 months later. The youth’s internalizing problems at T3 positively predicted maternal depression symptoms at T4. Future research should explore genetic and environmental pathways that link parent depression and internalizing problems in autistic youth.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
Objectives: Individuals with Down syndrome (DS) have a higher incidence of hearing loss (HL) compared with their peers without developmental disabilities. Little is known about the associations ...between HL and functional hearing for individuals with DS. This study investigated two aspects of auditory functions, “what” (understanding the content of sound) and “where” (localizing the source of sound), in young adults with DS. Speech reception thresholds in quiet and in the presence of interferers provided insight into speech recognition, that is, the “what” aspect of auditory maturation. Insights into “where” aspect of auditory maturation were gained from evaluating speech reception thresholds in colocated versus separated conditions (quantifying spatial release from masking) as well as right versus left discrimination and sound location identification. Auditory functions in the “where” domain develop during earlier stages of cognitive development in contrast with the later developing “what” functions. We hypothesized that young adults with DS would exhibit stronger “where” than “what” auditory functioning, albeit with the potential impact of HL. Considering the importance of auditory working memory and receptive vocabulary for speech recognition, we hypothesized that better speech recognition in young adults with DS, in quiet and with speech interferers, would be associated with better auditory working memory ability and receptive vocabulary. Design: Nineteen young adults with DS (aged 19 to 24 years) participated in the study and completed assessments on pure-tone audiometry, right versus left discrimination, sound location identification, and speech recognition in quiet and with speech interferers that were colocated or spatially separated. Results were compared with published data from children and adults without DS and HL, tested using similar protocols and stimuli. Digit Span tests assessed auditory working memory. Receptive vocabulary was examined using the Peabody Picture Vocabulary Test Fifth Edition. Results: Seven participants (37%) had HL in at least 1 ear; 4 individuals had mild HL, and 3 had moderate HL or worse. Participants with mild or no HL had ≥75% correct at 5° separation on the discrimination task and sound localization root mean square errors (mean ± SD: 8.73° ± 2.63°) within the range of adults in the comparison group. Speech reception thresholds in young adults with DS were higher than all comparison groups. However, spatial release from masking did not differ between young adults with DS and comparison groups. Better (lower) speech reception thresholds were associated with better hearing and better auditory working memory ability. Receptive vocabulary did not predict speech recognition. Conclusions: In the absence of HL, young adults with DS exhibited higher accuracy during spatial hearing tasks as compared with speech recognition tasks. Thus, auditory processes associated with the “where” pathways appear to be a relative strength than those associated with “what” pathways in young adults with DS. Further, both HL and auditory working memory impairments contributed to difficulties in speech recognition in the presence of speech interferers. Future larger-sized samples are needed to replicate and extend our findings.
Parents of children with autism spectrum disorder (ASD) are at increased risk for unsatisfying and conflict‐ridden couple relationships (i.e., marital or romantic partner relationships). There is a ...critical need to identify the couple‐level processes that contribute to this risk. The current study examined the use of dyadic coping, defined as the appraisals and behaviors that partners in relationships use and receive to manage stressors, and to examine whether dyadic coping mediated the association between parenting stress and couple relationship satisfaction in parents who have a child with ASD and in parents who do not have a child with ASD. In total, 184 couples that had a child with ASD (aged 5–12 years) and comparison group of 183 couples who have a child without a neurodevelopmental condition participated in the study. A multivariate analysis of covariance indicated that parents of children with ASD reported less positive and more negative dyadic coping than did parents in the comparison group. Hierarchical linear modeling indicated that dyadic coping mediated the association between parenting stress and couple relationship satisfaction. Findings have important implications for programs aimed at enhancing parent couple relationship in families of children with ASD.
Resumen
Los padres de niños con trastorno del espectro autista (TEA) corren mayor riesgo de tener relaciones de pareja insatisfactorias y conflictivas (p. ej.: relaciones de pareja o conyugales). Existe una necesidad imperiosa de reconocer los procesos a nivel de la pareja que contribuyen a este riesgo. El presente estudio analizó el uso del afrontamiento diádico, definido como las evaluaciones y las conductas que los integrantes de la pareja usan y reciben para manejar los factores desencadenantes de estrés, y si este afrontamiento sirvió como mediador de la asociación entre el estrés por la crianza y la satisfacción con la relación de pareja en los padres que tienen un niño con TEA y en los padres que no tienen un niño con TEA. Participaron en el estudio un total de 184 parejas que tenían un hijo con TEA (de entre 5 y 12 años) y un grupo comparativo de 183 parejas que tenían un hijo sin un trastorno del desarrollo neurológico. Un análisis multifactorial de la covarianza indicó que los padres de los niños con TEA informaron un afrontamiento diádico menos positivo y más negativo que los padres en el grupo de comparación. Los modelos lineales jerárquicos indicaron que el afrontamiento diádico sirvió como mediador de la asociación entre el estrés por la crianza y la satisfacción con la relación de pareja. Los resultados tienen consecuencias importantes para los programas orientados a mejorar la relación de los padres como pareja en las familias de niños con TEA.
摘要
有自闭症谱系障碍(ASD)孩子的父母在不满意的伴侣关系和充满冲突的关系(即婚姻或浪漫伴侣关系)上的风险会增加。确定在伴侣双方的层面导致此风险的过程是非常必要的。本研究考察了对偶应对的使用情况，对偶应对被定义为关系中的一方使用和接受的管理压力源的评价和行为，考察对偶应对是否介导了有ASD孩子的父母和没有ASD孩子的父母在养育压力和夫妻关系满意度之间的关联。参加研究的共有184对夫妇其孩子患有自闭症(5 ‐ 12岁)和183对夫妇其孩子没有神经发育障碍。多变量协方差分析表明，与对照组的父母相比，ASD患儿的父母报告的积极和消极的应对方式较少。层次线性模型研究表明，对偶应对在父母养育压力与夫妻关系满意度之间起着调和作用。研究结果对旨在加强自闭症患儿家庭的父母‐伴侣关系的项目具有重要的意义。
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
We examined daily couple experiences in 174 couples who had a child with autism spectrum disorder (ASD) relative to 179 couples who had a child without disabilities and their same-day association ...with parent affect. Parents completed a 14-day daily diary in which they reported time with partner, partner support, partner closeness, and positive and negative couple interactions and level of positive and negative affect. One-way multivariate analyses of covariance and dyadic multilevel models were conducted. Parents of children with ASD reported less time with partner, lower partner closeness, and fewer positive couple interactions than the comparison group. Daily couple experiences were more strongly associated with parent affect in the ASD than comparison group. Findings have implications for programs and supports.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
Within two-parent households, the parent-couple subsystem (marital or romantic partner relationship) is posited to shape the mental health of both parents and children. Autistic children and their ...parents have an elevated-risk for mental health problems. The present study longitudinally examined the mediating role of the quality of the parent-couple relationship in time-ordered pathways between changes in the mental health problems of autistic children and in parent depression symptoms at a within-family level.
Using four time points of data collected on 188 families of autistic children (aged 5-12 years) across 3 years, the bidirectional associations between parent-couple relationship satisfaction, parent depressive symptoms, and child internalizing and externalizing mental health problems were investigated. Two multi-group (grouped by parent gender) complete longitudinal mediation models in structural equation modeling using Mplus software were conducted.
Parent-couple relationship satisfaction mediated: (1) the association between higher parent depressive symptoms and higher child internalizing mental health problems 12 months later for both mothers and fathers, and (2) the association between higher child externalizing mental health problems and higher father depression symptoms 12 months later. Father depression symptoms mediated a pathway from lower parent-couple satisfaction to higher child internalizing mental health problems 12 months later, and mother depression symptoms mediated the pathway from higher child externalizing mental health problems to lower parent-couple satisfaction 12 months later.
Findings highlight the bidirectional and complex ways that parent and child mental health and the quality of the parent-couple relationship are entwined across time in families of autistic children. Family-wide interventions that address the needs of multiple family members and family systems are best suited to improve the mental health of parents and autistic children.
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