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Published in: BMC Psychiatry 1/2023

Open Access 01-12-2023 | Autism Spectrum Disorder | Research

Likelihood of identifying autistic traits with the autism spectrum quotient (AQ) in male juveniles with autism spectrum disorder (ASD) and severe behavioral problems (SBPs)

Authors: Alexa X. Rutten, Robert R. J. M. Vermeiren, Ilja L. Bongers, Chijs Van Nieuwenhuizen

Published in: BMC Psychiatry | Issue 1/2023

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Abstract

Background

When screening for autism spectrum disorders (ASD), the Autism Spectrum Quotient (AQ) is generally considered to be useful. Whether the AQ is also a suitable screener for ASD in juveniles with severe behavioral problems (SBPs) is unknown. Due to the overlap of symptoms between ASD and SBPs, particularly in juveniles low on empathy, the screening capacity of the AQ might be constrained. The aim of the present study was to investigate whether (comorbid) SBPs affect the screening capacity of the AQ. The hypothesis is that male juveniles with SBPs - but without a diagnosis of ASD - will score higher than male juveniles without both SBPs and ASD.

Method

The AQ was completed by 216 male juveniles aged 15–18 years treated at an outpatient department of child and adolescent psychiatry. The 216 participants were categorized into four groups according to a clinical diagnosis of ASD and SBPs (defined as disruptive behavior disorder and/or delinquent behavior). Using multinomial logistic regression, we investigated whether the four identified groups, based on a diagnosis of ASD and SBPs, scored differently for the total score and subscales of the AQ.

Results

Participants in the group with ASD (ASD+) but without SBPs (SBP-) were more likely to report higher levels of autistic traits than the reference group without both ASD and SBPs (ASD-SBP-), except for the subscale on attention to detail (ASD+SBP- OR = 1.04; 95%CI = 0.98–1.11). Participants in the group with both ASD and SBPs were more likely to report higher levels for the total AQ score (ASD+SBP+ OR = 1.03; 95%CI = 1.00–1.05) and the communication subscale of the AQ (ASD+SBP+ OR = 1.18; 95%CI = 1.07–1.31) than the reference group without both ASD and SBPs.

Conclusion

In outpatient male juveniles, SBPs do not affect the screening capacity of the AQ for autistic traits. In spite of the well-known overlap of symptoms between ASD and SBPs, male juveniles with SBPs but without a diagnosis of ASD do not score higher on the AQ than male juveniles without SBPs and without a diagnosis of ASD.
Literature
go back to reference 1. Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, Yusuf A, Shih A, Elsabbagh M: Global prevalence of autism: a systematic review update. Autism Res 2022, 15(5):778–790. https://doi.org/10:1002/aur.2696 1. Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, Yusuf A, Shih A, Elsabbagh M: Global prevalence of autism: a systematic review update. Autism Res 2022, 15(5):778–790. https://​doi.​org/​10:1002/aur.2696
go back to reference 2. Huerta M, Lord C: Diagnostic evaluation of autism spectrum disorders. Pediatr Clin North Am 2012, 59(1):103–111. https://doi.org/10.1016/j.pcl.2011.10.018 2. Huerta M, Lord C: Diagnostic evaluation of autism spectrum disorders. Pediatr Clin North Am 2012, 59(1):103–111. https://​doi.​org/​10.​1016/​j.​pcl.​2011.​10.​018
go back to reference 3. Garcia-Primo P, Hellendoorn A, Charman T, Roeyers H, Dereu M, Roge B, Baduel S, Muratori F, Narzisi A, Van Daalen E et al: Screening for autism spectrum disorders: State of the art in Europe. Eur Child Adolesc Psychiatry 2014, 23(11):1005–1021. https://doi.org/10.1007/s00787-014-0555-6 3. Garcia-Primo P, Hellendoorn A, Charman T, Roeyers H, Dereu M, Roge B, Baduel S, Muratori F, Narzisi A, Van Daalen E et al: Screening for autism spectrum disorders: State of the art in Europe. Eur Child Adolesc Psychiatry 2014, 23(11):1005–1021. https://​doi.​org/​10.​1007/​s00787-014-0555-6
go back to reference 4. Baron-Cohen S, Wheelwright S, Skinner R, Martin J, Clubley E: The Autism-Spectrum Qotient (AQ): Evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematics. J Aut Devel Disord 2001, 31(1):5–17. https://doi.org/10.1023/a:1005653411471 4. Baron-Cohen S, Wheelwright S, Skinner R, Martin J, Clubley E: The Autism-Spectrum Qotient (AQ): Evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematics. J Aut Devel Disord 2001, 31(1):5–17. https://​doi.​org/​10.​1023/​a:1005653411471
go back to reference 5. Baron-Cohen S, Hoekstra RA, Knickmeyer R, Wheelwright S: The Autism-Spectrum Quotient (AQ)-Adolescent version. J Aut Devel Disord 2006, 36(3):343–350. https://doi.org/10.1007/s10803-006-0073-6 5. Baron-Cohen S, Hoekstra RA, Knickmeyer R, Wheelwright S: The Autism-Spectrum Quotient (AQ)-Adolescent version. J Aut Devel Disord 2006, 36(3):343–350. https://​doi.​org/​10.​1007/​s10803-006-0073-6
go back to reference 6. Hoekstra RA, Bartels M, Cath DC, Boomsma DI: Factor, structure, reliability and criterion validity of the Autism-Spectrum Quotient (AQ): A study in Dutch population and patient groups. J Aut Devel Disord 2008, 38(8):1555–1566. https://doi.org/10.1007/s10803-008-0538-x 6. Hoekstra RA, Bartels M, Cath DC, Boomsma DI: Factor, structure, reliability and criterion validity of the Autism-Spectrum Quotient (AQ): A study in Dutch population and patient groups. J Aut Devel Disord 2008, 38(8):1555–1566. https://​doi.​org/​10.​1007/​s10803-008-0538-x
go back to reference 7. Sizoo BB, Horwitz EH, Teunisse JP, Kan CC, Vissers CTWM, Forceville E.J.M., Van Voorst AJP, Geurts HM: Predictive validity of self-report questionnaires in the assessment of autism spectrum disorders in adults. Autism 2015, 19(8):842–849. https://doi.org/10.1177/1362361315589869 7. Sizoo BB, Horwitz EH, Teunisse JP, Kan CC, Vissers CTWM, Forceville E.J.M., Van Voorst AJP, Geurts HM: Predictive validity of self-report questionnaires in the assessment of autism spectrum disorders in adults. Autism 2015, 19(8):842–849. https://​doi.​org/​10.​1177/​1362361315589869​
go back to reference 8. Auyeung B, Baron-Cohen S, Wheelwright S, Allison C: The Autism Spectrum Quotient: Children’s version (AQ-Child). J Aut Devel Disord 2008, 38(7):1230–1240. https://doi.org/10.1007/s10803-007-0504-z 8. Auyeung B, Baron-Cohen S, Wheelwright S, Allison C: The Autism Spectrum Quotient: Children’s version (AQ-Child). J Aut Devel Disord 2008, 38(7):1230–1240. https://​doi.​org/​10.​1007/​s10803-007-0504-z
go back to reference 9. Sizoo BB, Van den Brink W, Gorissen-van Eenige M, Koeter MW, Van Wijngaarden-Cremers PJM, Van der Gaag RJ: Using the Autism-Spectrum Quotient to discriminate autism spectrum disorder from ADHD in adult patients with and without comorbid substance use disorder. J Aut Devel Disord 2009, 39(9):1291–1297. https://doi.org/10.1007/s10803-009-0743-2 9. Sizoo BB, Van den Brink W, Gorissen-van Eenige M, Koeter MW, Van Wijngaarden-Cremers PJM, Van der Gaag RJ: Using the Autism-Spectrum Quotient to discriminate autism spectrum disorder from ADHD in adult patients with and without comorbid substance use disorder. J Aut Devel Disord 2009, 39(9):1291–1297. https://​doi.​org/​10.​1007/​s10803-009-0743-2
go back to reference 10. Ashwood KL, Gillan N, Horder J, Hayward H, Woodhouse E, McEwen FS, Findon J, Eklund H, Spain D, Wilson CE et al: Predicting the diagnosis of autism in adults using the Autism-Spectrum Quotient (AQ) questionnaire. Psychol Med 2016, 46(12):2595–2604. https://doi.org/10.1017/S0033291716001082 10. Ashwood KL, Gillan N, Horder J, Hayward H, Woodhouse E, McEwen FS, Findon J, Eklund H, Spain D, Wilson CE et al: Predicting the diagnosis of autism in adults using the Autism-Spectrum Quotient (AQ) questionnaire. Psychol Med 2016, 46(12):2595–2604. https://​doi.​org/​10.​1017/​S003329171600108​2
go back to reference 11. Agelink van Rentergem JA, Lever AG, Geurts HM: Negatively phrased items of the Autism Spectrum Quotient function differently for groups with and without autism. Autism 2019, 23(7):1752–1764. https://doi.org/10.1177/1362361319828361 11. Agelink van Rentergem JA, Lever AG, Geurts HM: Negatively phrased items of the Autism Spectrum Quotient function differently for groups with and without autism. Autism 2019, 23(7):1752–1764. https://​doi.​org/​10.​1177/​1362361319828361​
go back to reference 12. De Wied M, Gispen-De Wied C, Van Boxtel A: Empathy dysfunction in children and adolescents with disruptive behavior disorders. Eur J Pharmacol 2010, 626(1):97–103. https://doi.org/10.1016/j.ejphar.2009.10.016 12. De Wied M, Gispen-De Wied C, Van Boxtel A: Empathy dysfunction in children and adolescents with disruptive behavior disorders. Eur J Pharmacol 2010, 626(1):97–103. https://​doi.​org/​10.​1016/​j.​ejphar.​2009.​10.​016
go back to reference 13. Merikangas KR, Nakamura BA, Kessler RC: Epidemiology of mental disorders in children and adolescents. Diaglogues Clin Neurosci 2009, 11(1):7–20. https://doi.org/10.31887/DCNS.2009.11.1/krmerikangas 13. Merikangas KR, Nakamura BA, Kessler RC: Epidemiology of mental disorders in children and adolescents. Diaglogues Clin Neurosci 2009, 11(1):7–20. https://​doi.​org/​10.​31887/​DCNS.​2009.​11.​1/​krmerikangas
go back to reference 14. Fernández-Molina E, Bartolomé Gutiérrez R: Juvenile crime drop: What is happening with youth in Spain and why? Eur J Criminol 2018, 17(3):1–26. https://doi.org/10.1177/1477370818792383 14. Fernández-Molina E, Bartolomé Gutiérrez R: Juvenile crime drop: What is happening with youth in Spain and why? Eur J Criminol 2018, 17(3):1–26. https://​doi.​org/​10.​1177/​1477370818792383​
go back to reference 15. Young S, Greer B, Church R: Juvenile delinquency, welfare, justice and therapeutic interventions: a global perspective. BJPsych Bull 2017, 41(1):21–29. https://doi.org/10.1192/pb.bp.115.052274 15. Young S, Greer B, Church R: Juvenile delinquency, welfare, justice and therapeutic interventions: a global perspective. BJPsych Bull 2017, 41(1):21–29. https://​doi.​org/​10.​1192/​pb.​bp.​115.​052274
go back to reference 16. Jones AP, Happé FG, Gilbert F, Burnett S, Viding E: Feeling, caring, knowing: Different types of empathy deficit in boys with psychopathic tendencies and autism spectrum disorder. J Child Psychol Psychiat 2010, 51(11):1188–1197. https://doi.org/10.1111/j.1469-7610.2010.02280.x 16. Jones AP, Happé FG, Gilbert F, Burnett S, Viding E: Feeling, caring, knowing: Different types of empathy deficit in boys with psychopathic tendencies and autism spectrum disorder. J Child Psychol Psychiat 2010, 51(11):1188–1197. https://​doi.​org/​10.​1111/​j.​1469-7610.​2010.​02280.​x
go back to reference 17. Leno V, Charman T, Pickles A, Jones C, Baird G, Happé F, Simonoff E: Callous-unemotional traits in adolescents with autism spectrum disorder. BJPsych 2015, 207(5):392–399. https://doi.org/10.1192/bjp.bp.114.159863 17. Leno V, Charman T, Pickles A, Jones C, Baird G, Happé F, Simonoff E: Callous-unemotional traits in adolescents with autism spectrum disorder. BJPsych 2015, 207(5):392–399. https://​doi.​org/​10.​1192/​bjp.​bp.​114.​159863
go back to reference 18. Pasalich DS, Dadds MR, Hawes DJ: Cognitive and affective empathy in children with conduct problems: Additive and interactive effects of callous-unemotional traits and autism spectrum disorders symptoms. Psychiatry Res 2014, 219(3):625–630. https://doi.org/10.1016/j.psychres.2014.06.025 18. Pasalich DS, Dadds MR, Hawes DJ: Cognitive and affective empathy in children with conduct problems: Additive and interactive effects of callous-unemotional traits and autism spectrum disorders symptoms. Psychiatry Res 2014, 219(3):625–630. https://​doi.​org/​10.​1016/​j.​psychres.​2014.​06.​025
go back to reference 19. Bishop SL, Mailick Seltzer M: Self-reported autism symptoms in adults with autism spectrum disorders. J Aut Devel Disord 2012, 42(11):2354–2363. https://doi.org/10.1007/s10803-012-1483-2 19. Bishop SL, Mailick Seltzer M: Self-reported autism symptoms in adults with autism spectrum disorders. J Aut Devel Disord 2012, 42(11):2354–2363. https://​doi.​org/​10.​1007/​s10803-012-1483-2
go back to reference 20. Johnson SA, Filliter JH, Murphy RR: Discrepancies between self- and parent-perceptions of autistic traits and empathy in high functioning children and adolescents on the autism spectrum. J Aut Devel Disord 2009, 39(12):1706–1714. https://doi.org/10.1007/s10803-009-0809-1 20. Johnson SA, Filliter JH, Murphy RR: Discrepancies between self- and parent-perceptions of autistic traits and empathy in high functioning children and adolescents on the autism spectrum. J Aut Devel Disord 2009, 39(12):1706–1714. https://​doi.​org/​10.​1007/​s10803-009-0809-1
go back to reference 21. Hull L, Petrides KV, Mandy W: The female autism phenotype and camouflage: a narrative review. Rev J Autism and Dev Disord 2020, 7(2). https://doi.org/10.1007/s40489-020-00197-9 21. Hull L, Petrides KV, Mandy W: The female autism phenotype and camouflage: a narrative review. Rev J Autism and Dev Disord 2020, 7(2). https://​doi.​org/​10.​1007/​s40489-020-00197-9
go back to reference 22. Rubinstein E, Wiggins LD, Lee L-C: A Review of the differences in developmental, psychiatric, and medical endophenotypes between males and females with autism spectrum disorder. J Dev Phys Disabil 2015, 27(1):119–139. 22. Rubinstein E, Wiggins LD, Lee L-C: A Review of the differences in developmental, psychiatric, and medical endophenotypes between males and females with autism spectrum disorder. J Dev Phys Disabil 2015, 27(1):119–139.
go back to reference 23. Van Wijngaarden-Cremers PJM, Van Eeten E, Groen WB, Van Deurzen PA, Oosterling IJ, Van der Gaag RJ: Gender and age differences in the core triad of impairments in autism spectrum disorders: a systematic review and meta-analysis. J Aut Devel Disord 2013, 44(3):627–635. https://doi.org/10.1007/s10803-013-1913-9 23. Van Wijngaarden-Cremers PJM, Van Eeten E, Groen WB, Van Deurzen PA, Oosterling IJ, Van der Gaag RJ: Gender and age differences in the core triad of impairments in autism spectrum disorders: a systematic review and meta-analysis. J Aut Devel Disord 2013, 44(3):627–635. https://​doi.​org/​10.​1007/​s10803-013-1913-9
Metadata
Title
Likelihood of identifying autistic traits with the autism spectrum quotient (AQ) in male juveniles with autism spectrum disorder (ASD) and severe behavioral problems (SBPs)
Authors
Alexa X. Rutten
Robert R. J. M. Vermeiren
Ilja L. Bongers
Chijs Van Nieuwenhuizen
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2023
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-023-05200-1

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