Browsing by Author "Kreiser, Nicole L."

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    ASD Traits, Social Competence, and Co-Occurring Psychopathology: The Moderating Role of Gender
    Kreiser, Nicole L. (Virginia Tech, 2014-03-26)
    The higher occurrence of autism spectrum disorder (ASD) and sub-threshold autistic traits in males, relative to females, has been consistently documented in the literature (e.g., Fombonne 2003, 2005). In addition to potential biogenetic mechanisms, there is some evidence suggesting that differences in the behavioral manifestation of ASD symptoms and co-occurring psychopathology may play a role in the differential prevalence of ASD in males and females (e.g., Holtmann, Bolte, and Poustka, 2007; Lai et al., 2011; Solomon, Miller, Taylor, Hinshaw, and Carter, 2012). In this two-phase study, we sought to examine potential gender differences in the relationship between behaviorally defined ASD traits and observable social impairment and co-occurring psychopathology, in a non-clinical sample of young adults. It was hypothesized that gender would moderate the relationship between ASD traits and observed social impairment and co-occurring psychopathology, such that ASD traits would be related to greater levels of observed social impairment for males, and that ASD traits would be related to greater levels of co-occurring psychopathology for females. In Phase I, 1039 undergraduate students participated in an online survey on general psychopathology and ASD traits. From this sample, a subgroup (n = 79) completed Phase II, an in-lab study that included a clinical interview and behavioral observation. ASD traits were not predictive of observed social impairment over and above the effects of social anxiety in this sample, regardless of gender. Although males and females in the sample did not differ on severity of ASD traits, when controlling for the effect of social anxiety, females were rated as more socially competent than males. ASD traits more strongly predicted screening positive for mood disorders in females than in males. Implications regarding ASD traits, as related to social impairment and co-occurring psychopathology in females are discussed.
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    Underidentification of Autism Spectrum Disorder in Females: A Case Series Illustrating the Unique Presentation of this Disorder in Young Women
    Trubanova, Andrea; Donlon, Katharine; Kreiser, Nicole L.; Ollendick, Thomas H.; White, Susan W. (Exeley, 2014-05)
    Autism spectrum disorder (ASD) is diagnosed more often in males than females, with the male-to-female gender ratio reported to be around 4.3:1 to 5:1. It is possible that the underrecognition of ASD in females partially contributes to this uneven ratio. Recent attention has been placed on understanding the processes that give rise to this gender difference in ASD prevalence. Socialization may contribute to the unique presentation of ASD in females, which may underlie this condition’s subsequent underidentification in this group. The purpose of this case series is to demonstrate how symptoms of ASD may uniquely manifest in females without co-occurring intellectual impairment. An examination of three case examples of young women diagnosed with ASD will illustrate the processes that contribute to the atypical manifestation and underidentification of ASD in females. Across cases, the females in this study demonstrated shared symptom presentations within three domains: 1) unique core symptom manifestation (insistence on sameness, lack of social engagement, and social processing difficulties); 2) heightened psychiatric comorbidities with internalizing disorders (anxiety, depression, and borderline personality traits); and 3) emotional dysregulation. These three domains reflect specific processes that may help to explain the underidentification of ASD in females via diagnostic overshadowing. Consideration of atypical symptom presentations, heightened comorbidities, and emotion regulation difficulties may help with the understanding of why ASD symptoms in females are commonly underidentified or identified later than they are in males. Social difficulties in combination with internalizing psychiatric disorders and emotional dysregulation may lead to the development of a specific symptom presentation in females that obscures the detection of ASD symptoms. Suggestions for clinical practice are made to promote the accurate identification of ASD and to inform case formulation and treatment planning.