̽��ֱ�� of Cambridge - Carrie Allison

Sex differences in brain structure present at birth

Anonymous — Tue, 07 Jan 2025 08:00:33 +0000

While male brains tended to be greater in volume than female brains, when adjusted for total brain volume, female infants on average had significantly more grey matter, while male infants on average had significantly more white matter in their brains.

Grey matter is made up of neuron cell bodies and dendrites and is responsible for processing and interpreting information, such as sensation, perception, learning, speech, and cognition. White matter is made up of axons, which are long nerve fibres that connect neurons together from different parts of the brain.

Yumnah Khan, a PhD student at the Autism Research Centre, who led the study, said: “Our study settles an age-old question of whether male and female brains differ at birth. We know there are differences in the brains of older children and adults, but our findings show that they are already present in the earliest days of life.

“Because these sex differences are evident so soon after birth, they might in part reflect biological sex differences during prenatal brain development, which then interact with environmental experiences over time to shape further sex differences in the brain.”

One problem that has plagued past research in this area is sample size. ̽��ֱ��Cambridge team tackled this by analysing data from the Developing Human Connectome Project, where infants receive an MRI brain scan soon after birth. Having over 500 newborn babies in the study means that, statistically, the sample is ideal for detecting sex differences if they are present.

A second problem is whether any observed sex differences could be due to other factors, such as differences in body size. ̽��ֱ��Cambridge team found that, on average, male infants had significantly larger brain volumes than did females, and this was true even after sex differences in birth weight were taken into account.

After taking this difference in total brain volume into account, at a regional level, females on average showed larger volumes in grey matter areas related to memory and emotional regulation, while males on average had larger volumes in grey matter areas involved in sensory processing and motor control.

̽��ֱ��findings of the study, the largest to date to investigate this question, are published in the journal Biology of Sex Differences.

Dr Alex Tsompanidis who supervised the study, said: “This is the largest such study to date, and we took additional factors into account, such as birth weight, to ensure that these differences are specific to the brain and not due to general size differences between the sexes.

“To understand why males and females show differences in their relative grey and white matter volume, we are now studying the conditions of the prenatal environment, using population birth records, as well as in vitro cellular models of the developing brain. This will help us compare the progression of male and female pregnancies and determine if specific biological factors, such as hormones or the placenta, contribute to the differences we see in the brain.”

̽��ֱ��researchers stress that the differences between males and females are average differences.

Dr Carrie Allison, Deputy Director of the Autism Research Centre, said: “ ̽��ֱ��differences we see do not apply to all males or all females, but are only seen when you compare groups of males and females together. There is a lot a variation within, and a lot of overlap between, each group.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre, added: “These differences do not imply the brains of males and females are better or worse. It’s just one example of neurodiversity. This research may be helpful in understanding other kinds of neurodiversity, such as the brain in children who are later diagnosed as autistic, since this is diagnosed more often in males.”

̽��ֱ��research was funded by Cambridge ̽��ֱ�� Development and Research, Trinity College, Cambridge, the Cambridge Trust, and the Simons Foundation Autism Research Initiative.

Reference
Khan, Y T, Tsompanidis, A, Radecki, M A, et al. Sex differences in human brain structure at birth. Biol Sex Differ; 17 Oct 2024; DOI: 10.1186/s13293-024-00657-5

Sex differences in brain structure are present from birth, research from the Autism Research Centre at the ̽��ֱ�� of Cambridge has shown.

We know there are differences in the brains of older children and adults, but our findings show that they are already present in the earliest days of life

Yumnah Khan

Chayene Rafaela

Photograph of a young girl hugging a baby boy

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Autistic individuals have increased risk of chronic physical health conditions across the whole body

Anonymous — Fri, 29 Sep 2023 12:38:16 +0000

Previous studies have shown that autistic people are dying far younger than others and that they are more likely to experience a range of physical health conditions. Until now, it was believed that autistic people were more likely to have specific conditions, such as gastrointestinal pain, sleep problems, and epilepsy/seizure disorders.

̽��ֱ��new study is different in that it investigated a much wider range of health risks than has been done before and shows that autistic people experience a much broader range of health vulnerabilities than was previously thought.

Specifically, autistic people are more likely to have physical health conditions across all organ systems, including the brain (such as migraine), the gastrointestinal system (for example coeliac disease), and the endocrine system (for example endometriosis), compared to non-autistic people.

Dr Elizabeth Weir, a Research Associate at the Autism Research Centre in Cambridge, who led the team, said: “This study emphasizes the increased health vulnerability of autistic people both in the types and number of conditions they may have. We now need to understand the causes of these increased risks, which are likely multifactorial in nature.”

This is the first study to show that autistic people are more likely than non-autistic people to experience ‘physical health multimorbidity’, meaning that they have at least two or more physical health conditions. These include co-occurring fibromyalgia (which causes chronic pain throughout the body) and polycystic ovarian syndrome (which causes irregular menstrual cycles, infertility, excess hair growth, and acne in women) across different organ systems.

̽��ֱ��study was conducted by a team at the ARC and used an anonymized, self-report survey to compare the experiences of 1,129 autistic people with 1,176 non-autistic people aged 16-90 years. ̽��ֱ��participants were international, although 67% of participants were from the UK.

̽��ֱ��survey assessed risk of 60 physical health conditions across nine different organ systems (gastrointestinal, endocrine, rheumatological, neurological, ocular, renal/hepatic, otolaryngological, haematological, and dermatological). ̽��ֱ��analysis took into account other factors such as age, sex assigned at birth, country of residence, ethnicity, education-level, alcohol use, smoking, body mass index, and family medical history.

̽��ֱ��team found that autistic people were more likely to have diagnosed medical conditions across all nine organ systems tested, compared to non-autistic people. Regarding specific conditions, autistic people had higher rates of 33 specific conditions compared to non-autistic peers. These included coeliac disease, gallbladder disease, endometriosis, syncope (fainting or passing out), vertigo, urinary incontinence, eczema, and iron deficiency anaemia.

Dr John Ward, a visiting research scientist at the ARC in Cambridge, who conducted the analysis, said: “This research adds to the body of evidence that the healthcare needs of autistic people are greater than those of non-autistic people. More research is required, particularly surrounding the early identification, and monitoring of chronic conditions.”

This is also the first epidemiological study to show that Ehlers-Danlos Syndrome (EDS) – a group of disorders that affects connective tissues and which cause symptoms such as joint hypermobility, loose joints that dislocate easily, joint pain and clicking joints, skin that bruises easily, extreme tiredness, digestive problems, dizziness, stretchy skin, wounds that are slow to heal, organ prolapse, and hernias – may be more common among autistic women than non-autistic women.

̽��ֱ��new research also replicates previous findings to show that autistic people have higher rates of all central sensitivity syndromes, which are a varied group of conditions that are related to dysregulation of the central nervous system, compared to non-autistic people. Central sensitivity syndromes include irritable bowel syndrome (IBS), temporomandibular joint syndrome (TMJ), migraine, tinnitus, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and fibromyalgia.

̽��ֱ��new study also investigated risks of physical health multimorbidity with a novel application of ‘network analysis’, a technique used to understand relationships between different parts of a system. This analysis method is regularly used in neuroscience to understand how different regions of the brain interact with each other. In this study, the analysis assessed how often conditions from different organ systems occurred together in the same person. In addition to highlighting complex health needs, this analysis established for the first time that the combinations of medical conditions that frequently co-occur may be different between autistic and non-autistic adults.

These results are preliminary evidence that healthcare providers such as GPs or family physicians need to be monitoring the health care needs of autistic people much more closely.

Dr Carrie Allison, Director of Strategy at the ARC and a member of the team, added: “These findings highlight the acute need to adapt the healthcare system to better meet the needs of autistic people. These results must be confirmed in larger, population-based samples.”

Professor Sir Simon Baron-Cohen, Director of the ARC and another member of the team, said: “We are aware of the risks of mental health conditions in autistic people, but this new research identifies their risks of physical health conditions too. We need to urgently re-evaluate current health care systems to improve support for autistic people.”

Funding for this project was provided by the Autism Centre of Excellence at Cambridge, the Rosetrees Trust, the Cambridge and Peterborough NHS Foundation Trust, the Corbin Charitable Trust, the Queen Anne’s Gate Foundation, the MRC, the Wellcome Trust and the Innovative Medicines Initiative.

Reference

Ward, J & Weir, E, Allison, C, Baron-Cohen, S. Increased rates of chronic physical health conditions across all organ systems in autistic adolescents and adults. Molecular Autism (2023).

Autistic people have higher rates of chronic physical health conditions across the whole body and are more likely to have complex health needs, according to a study led by researchers at the ̽��ֱ�� of Cambridge. Their findings, published in the journal Molecular Autism, have important implications for the clinical care of autistic people.

This study emphasizes the increased health vulnerability of autistic people both in the types and number of conditions they may have

Elizabeth Weir

HikiApp

Two autistic friends sitting outside using stim toys and laughing at their phones

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Search is on for ‘super memorisers’ to help scientists unlock the secrets of memory

cjb250 — Wed, 03 May 2023 06:00:04 +0000

Anyone who believes they have an exceptional memory is invited to take an online survey and memory test. Based on their performance, some people will be invited to Cambridge to have a brain scan so that the origins of exceptional memory can be explored in detail.

̽��ֱ��team will also be exploring whether people who are autistic or neurodiverse are more likely to have an exceptional memory.

It’s long been known that people differ in their memory ability, with some having seemingly infinite memory. For example, essayist and writer Daniel Tammet, who the Cambridge team have worked with previously, set the European record in 2004 for reciting the number pi from memory after recalling it to 22,514 digits. He is both autistic and has synaesthesia, where the senses are interconnected, which may go some way to explaining his talents.

Professor Jon Simons from the Department of Psychology at the ̽��ֱ�� of Cambridge said: “Memory is one of the best understood psychological processes in terms of brain networks and yet we still don’t really know why some people have exceptional memories. That’s why we’re inviting people to take part in our study.”

Professor Sir Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge ̽��ֱ��, and lead investigator of the study, said: “You don’t need to have won any competitions to take part or to consider yourself neurodiverse – and you certainly don’t need to be able to recite pi to 22,000 digits! We’re looking for anyone who thinks they might be a ‘super memoriser’ to try out our memory tests.”

Anyone who wants to take part will need to take three brief online memory tests, such as memorising a phone number or patterns on a chess board. Anyone who scores highly on one or more of these tests could be invited to come to Cambridge for a brain scan using an MRI scanner. All expenses will be paid.

̽��ֱ��Cambridge scientists want to know whether the brains of people who have exceptional memory show differences in how they are structured or how they function compared to those who do not: in short, how do they achieve their remarkable feats of memory? ̽��ֱ��team also want to investigate if autism gives rise to a greater likelihood of exceptional memory.

Dr Carrie Allison, also from the Autism Research Centre, added: “We hope that people will enjoy taking part in this study, and in the process contribute to helping us understand more about memory and whether exceptional memory is related to autism. For decades, autism research has focused on disability, but this study is a wonderful opportunity to focus on strengths.”

To take part you must be between the ages of 16 and 60 years old.

Take the survey and memory tests here

Cambridge scientists are today launching a search to find people who have exceptional memory, as they attempt to understand why some people are much better at remembering than others.

Memory is one of the best understood psychological processes in terms of brain networks and yet we still don’t really know why some people have exceptional memories

Jon Simons

geralt

Pi on a blackboard

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Autistic people are more likely to experience depression and anxiety during pregnancy

cjb250 — Wed, 26 Oct 2022 07:00:17 +0000

In the study, led by researchers at the Autism Research Centre, 524 non-autistic people and 417 autistic people completed an online survey about their experience of pregnancy. Anyone who was pregnant at the time of responding or had previously given birth was eligible to take part.

̽��ֱ��study revealed that autistic parents were around three times more likely than non-autistic parents to report having experienced prenatal depression (9% of non-autistic parents and 24% of autistic parents) and anxiety (14% of non-autistic parents and 48% of autistic parents).

Autistic respondents also experienced lower satisfaction with pregnancy healthcare. Autistic respondents were less likely to trust professionals, feel that professionals took their questions and concerns seriously, feel that professionals treated them respectfully, and be satisfied with how information was presented to them in appointments. Furthermore, autistic respondents were more likely to experience sensory issues during pregnancy and more likely to feel overwhelmed by the sensory environment of prenatal appointments.

Dr Sarah Hampton, lead researcher on the study, said: “This study suggests that autistic people are more vulnerable to mental-health difficulties during pregnancy. It is imperative that effective mental-health screening and support is available for autistic people during pregnancy.”

Dr Rosie Holt, a member of the research team, added: “ ̽��ֱ��results also suggest that autistic people may benefit from accommodations to prenatal healthcare. These may include adjustments to the sensory environment of healthcare settings, as well as adjustments to how information is communicated during prenatal appointments.”

Dr Carrie Allison, Deputy Director of the Autism Research Centre and a member of the team, said: “We are grateful to members of the autistic community for providing feedback when we designed this research. It is vital that autistic people with lived experience help shape the research we do, and we keep their priorities as a clear focus.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre and a member of the research team, said: “It is important that more research is conducted looking at the experiences of autistic new parents, who have been neglected in research. It is also important that this research is translated into health and social care policy and practice to ensure these parents receive the support and adaptations they need in a timely manner.”

Reference
Hampton, S, Allison, C, Baron-Cohen, S, & Holt, R (2022). Autistic People’s Perinatal Experiences I: A Survey of Pregnancy Experiences. Journal of Autism and Developmental Disorders

Autistic people are more vulnerable to depression and anxiety during pregnancy, according to new research from the ̽��ֱ�� of Cambridge. ̽��ֱ��results are published in the Journal of Autism and Developmental Disorders and have important implications for supporting autistic people during pregnancy.

This study suggests that autistic people are more vulnerable to mental health difficulties during pregnancy. It is imperative that effective mental health screening and support is available for autistic people during pregnancy

Sarah Hampton

PetraSolajova

Pregant woman

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Autistic individuals have poorer health and healthcare

Anonymous — Fri, 27 May 2022 07:52:21 +0000

These findings, published in Molecular Autism, have important implications for the healthcare and support of autistic individuals.

Many studies indicate that autistic people are dying far younger than others, but there is a paucity of research on the health and healthcare of autistic people across the adult lifespan. While some studies have previously suggested that autistic people may have significant barriers to accessing healthcare, only a few, small studies have compared the healthcare experiences of autistic people to others.

In the largest study to date on this topic, the team at the Autism Research Centre (ARC) in Cambridge used an anonymous, self-report survey to compare the experiences of 1,285 autistic individuals to 1,364 non-autistic individuals, aged 16-96 years, from 79 different countries. 54% of participants were from the UK. ̽��ֱ��survey assessed rates of mental and physical health conditions, and the quality of healthcare experiences.

̽��ֱ��team found that autistic people self-reported lower quality healthcare than others across 50 out of 51 items on the survey. Autistic people were far less likely to say that they could describe how their symptoms feel in their body, describe how bad their pain feels, explain what their symptoms are, and understand what their healthcare professional means when they discuss their health. Autistic people were also less likely to know what is expected of them when they go to see their healthcare professional, and to feel they are provided with appropriate support after receiving a diagnosis, of any kind.

Autistic people were over seven times more likely to report that their senses frequently overwhelm them so that they have trouble focusing on conversations with healthcare professionals. In addition, they were over three times more likely to say they frequently leave their healthcare professional’s office feeling as though they did not receive any help at all. Autistic people were also four times more likely to report experiencing shutdowns or meltdowns due to a common healthcare scenario (e.g., setting up an appointment to see a healthcare professional).

̽��ֱ��team then created an overall ‘health inequality score’ and employed novel data analytic methods, including machine learning. Differences in healthcare experiences were stark: the models could predict whether or not a participant was autistic with 72% accuracy based only on their ‘health inequality score’. ̽��ֱ��study also found worryingly high rates of chronic physical and mental health conditions, including arthritis, breathing concerns, neurological conditions, anorexia, anxiety, ADHD, bipolar disorder, depression, insomnia, OCD, panic disorders, personality disorders, PTSD, SAD, and self-harm.

Dr Elizabeth Weir, a postdoctoral scientist at the ARC in Cambridge, and the lead researcher of the study, said: “This study should sound the alarm to healthcare professionals that their autistic patients are experiencing high rates of chronic conditions alongside difficulties with accessing healthcare. Current healthcare systems are failing to meet very fundamental needs of autistic people.”

Dr Carrie Allison, Director of Strategy at the ARC and another member of the team, added: “Healthcare systems must adapt to provide appropriate reasonable adjustments to autistic and all neurodiverse patients to ensure that they have equal access to high quality healthcare.”

Professor Sir Simon Baron-Cohen, Director of the ARC and a member of the team, said: “This study is an important step forward in understanding the issues that autistic adults are facing in relation to their health and health care, but much more research is needed. We need more research on long term outcomes of autistic people and how their health and healthcare can be improved. Clinical service providers need to ask autistic people what they need and then meet these needs.”

̽��ֱ��research was funded by the Autism Centre of Excellence, the Rosetrees Trust, the Cambridge and Peterborough NHS Foundation Trust, the Corbin Charitable Trust, the Queen Anne’s Gate Foundation, the MRC, the Wellcome Trust and the Innovative Medicines Initiative.

Reference
Weir, E, Allison, C, & Baron-Cohen, S. Autistic adults have poorer quality healthcare and worse health based on self-report data. Molecular Autism (2022).

Autistic individuals are more likely to have chronic mental and physical health conditions, suggests new research from the ̽��ֱ�� of Cambridge. Autistic individuals also report lower quality healthcare than others.

This study should sound the alarm to healthcare professionals that their autistic patients are experiencing high rates of chronic conditions alongside difficulties with accessing healthcare

Elizabeth Weir

NicolasMcComber

Autistic trans man at home looking out of a window

Yes

Autistic defendants are being failed by the criminal justice system

cjb250 — Tue, 15 Mar 2022 01:01:03 +0000

This comes on the back of an Equality and Human Rights Commission report in June 2020 that warned that the CJS is failing those with learning disabilities and autistic people. However, there is almost no research investigating how autistic defendants are being treated within the CJS.

̽��ֱ��team set out to fill this gap by conducting a survey of 93 defence lawyers about autistic people they have represented in the last five years to find out about their defendants’ experiences of navigating the CJS. In their study, published today in Autism Research, the researchers found the CJS is failing autistic people.

̽��ֱ��study found that only half of autistic people (52%) were considered by the police to be vulnerable adults, even though the law recognises all autistic people as vulnerable.

Over a third (35%) of autistic defendants were not given an ‘appropriate adult’ during police investigations, even though their diagnosis was known to police, and despite all autistic people being entitled under the law to have an appropriate adult present when being interviewed by the police. A further 18% did not have an ‘appropriate adult’ present because their diagnosis was not known to the police.

Appropriate adults act to safeguard the interests and rights of vulnerable defendants by ensuring that they are treated in a just manner and are able to participate effectively during an investigation.

Only a quarter (25%) of autistic people were given ‘reasonable adjustments’, with 38% not given any even though lawyers stated that this would have been beneficial. This is despite all autistic people being entitled to reasonable adjustments under the law. A further 33% did not receive any adjustments because their autism diagnosis was unknown at the time. Of the autistic people whose case went to trial, more than one in five (22%) were not given any reasonable adjustments even though their lawyers stated that this would have been helpful.

Reasonable adjustments, such as using visual aids to assist with communication and allowing extra time to process information, can be made by the police to assist the detainee.

Dr Rachel Slavny-Cross, who led the study, said: “Our research shows quite clearly that autistic adults are not receiving fair treatment within the criminal justice system. Without reasonable adjustments or support, this could place them at a significant disadvantage.”

In just under half of the cases that included a trial by jury (47%), the jury was not informed that the defendant was autistic. 59% of prosecution barristers and 46% of judges or magistrates said or did something during the trial that made them concerned that they did not have an adequate understanding of autism.

Dr Carrie Allison, a member of the research team, said: “It’s vital that jurors are provided with information about a defendant’s autism and its implications, otherwise they are likely to misinterpret atypical behaviour exhibited by the defendant in court. Similarly, judges may fail to take into consideration mitigating factors that might otherwise influence sentencing.”

̽��ֱ��study found that lawyers were more likely to be concerned that their autistic clients would engage in self-harm behaviours, compared with their non-autistic clients, and were more likely to report that their autistic clients experienced ‘meltdowns’ as a result of their involvement in the CJS.

Dr Sarah Griffiths. another member of the research team, said: “Autistic adults are particularly vulnerable to mental health problems, such as stress and heightened anxiety, with many autistic people experiencing meltdown and shutdown as a result. This is likely to have shaped their interactions with the criminal justice system and their ability to cope with the stress of being subject to criminal proceedings.”

̽��ֱ��study also found that those working within the CJS may be unaware that an individual is autistic, or of the implications of an autism diagnosis. They found that many autistic people do not disclose their diagnosis at the point of police contact or are themselves unaware they are autistic. However, as the study shows, even autistic defendants who disclose their diagnosis are failing to receive reasonable adjustments.

However, a positive finding was that, in cases where their client was found to have committed a crime, 60% of judges saw the defendant’s autism as a mitigating factor, and in these cases the majority of autistic people were given a suspended or reduced sentence.

Professor Sir Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge and a member of the research team, added: “There’s an urgent need across the criminal justice system for increased awareness about autism. ̽��ֱ��police, lawyers, judges and jurors should be given mandatory training to be aware of how autism affects an individual’s behaviour, so that autistic defendants are treated fairly within the criminal justice system.”

Funding for this project was provided by the Autism Centre of Excellence.

Reference
Slavny-Cross, R et al. Autism and the criminal justice system: An analysis of 93 cases. Autism Research; 15 March 2022; DOI: 10.1002/aur.2690

̽��ֱ��criminal justice system (CJS) is failing autistic people, argue researchers at the Autism Research Centre, ̽��ֱ�� of Cambridge, after a survey of lawyers found that an overwhelming majority of their clients were not provided with adequate support or adjustments.

Our research shows quite clearly that autistic adults are not receiving fair treatment within the criminal justice system. Without reasonable adjustments or support, this could place them at a significant disadvantage

Rachel Slavny-Cross

feedough (Getty Images)

Law books and justice statue

Yes

Autistic individuals are more likely to be LGBTQ+

cjb250 — Mon, 20 Sep 2021 14:32:56 +0000

̽��ֱ��findings have important implications for the healthcare and support of autistic individuals. ̽��ֱ��results are published in the journal Autism Research.

For many years it was wrongly assumed that autistic individuals are uninterested in sexual or romantic relationships, but this is not the case. In recent years, small studies have suggested that autistic individuals are more likely to experience a wider diversity of sexual orientations and are less likely to have sexually transmitted infections (STIs). However, the existing evidence has been limited in size and scope.

In the largest study to date on these topics, the team at the Autism Research Centre used an anonymous, self-report survey to study the sexual activity, sexual orientation, and sexual health of autistic adults. Overall, 1,183 autistic and 1,203 non-autistic adolescents and adults (aged 16-90 years) provided information about their sexual activity, sexual orientation, and medical history of STIs.

̽��ֱ��results showed that the majority of autistic adults (70% of autistic males and 76% of autistic females) engage in sexual activity—although they do so to a lesser degree than their non-autistic peers (89% of both non-autistic males and females report engaging in sexual activity). In contrast to previous findings, the results also found that there were no differences in likelihood of ever contracting an STI, or the age at which participants first engaged in sexual activity, between autistic and non-autistic individuals.

In addition, the study found that autistic adults and adolescents are approximately eight times more likely to identify as asexual and ‘other’ sexuality than their non-autistic peers. And there were sex differences in sexual orientation: autistic males are 3.5 times more likely to identify as bisexual than non-autistic males, whereas autistic females are three times more likely to identify as homosexual than non-autistic females.

When comparing autistic females and males directly, autistic females were more likely to be sexually active; more likely to identify as asexual, bisexual, and ‘other’ sexuality; and were less likely to identify as heterosexual.

Elizabeth Weir, a PhD candidate at the Autism Research Centre in Cambridge, and the lead researcher of the study, said: “Understanding the intersectional identities of autistic individuals who are asexual, bisexual, homosexual, or ‘other’ sexuality is key. It is particularly important that healthcare providers and educators use language that is affirming and accepting of all sexual orientations and gender identities when providing sexual education and sexual health screening checks to autistic and non-autistic people alike.”

Dr Carrie Allison, Director of Strategy at the Autism Research Centre and a member of the team, said: “We must ensure that autistic individuals are receiving equal access to healthcare and support in their choices in their personal lives, to enjoy fulfilling lives and good mental health.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre and a member of the team, said: “This new study is an important example of applied health research with policy relevance for health and social care services.”

Reference
Weir, E., Allison, C., & Baron-Cohen, S. ̽��ֱ��sexual health, orientation, and activity of autistic adolescents and adults. Autism Research (2021). DOI: 10.1002/aur.2604

New research from the ̽��ֱ�� of Cambridge suggests that autistic individuals are less likely to identify as heterosexual and more likely to identify with a diverse range of sexual orientations than non-autistic individuals.

Cecilie Johnsen via Unsplash

Pride flag

Yes

Autistic individuals may be more likely to use recreational drugs to self-medicate their mental health

cjb250 — Thu, 01 Jul 2021 22:30:48 +0000

There is significant debate about substance use of autistic adolescents and adults. Some studies indicate that autistic individuals are less likely to use substances, whereas others suggest that autistic individuals are at greater risk of substance misuse or abuse. ̽��ֱ��team at the Autism Research Centre in Cambridge used a ‘mixed methods’ design to consider both the frequency of substance use among autistic individuals, as well as their self-reported experiences of substance use.

Overall, 1,183 autistic and 1,203 non-autistic adolescents and adults (aged 16-90 years) provided information about the frequency of their substance use via an anonymous, online survey; of this group, 919 individuals also gave more in-depth responses about their experiences of substance use.

Autistic adults were less likely than non-autistic peers to use substances. Only 16% of autistic adults, compared to 22% of non-autistic adults, reported drinking on three or more days per week on average. Similarly, only 4% of autistic adults reported binge-drinking compared to 8% of non-autistic adults.

There were also some sex differences in patterns of substance use: autistic males were less likely than non-autistic males to report ever having smoked or used drugs. In contrast, the team did not find differences in the patterns of frequency of smoking or drug use between autistic and non-autistic females.

However, despite lower rates of substance use overall, the qualitative findings of the study provide a much less hopeful picture: autistic adults were nearly nine times more likely than non-autistic peers to report using recreational drugs (such as marijuana, cocaine and amphetamines) to manage unwanted symptoms, including autism-related symptoms.

Drugs were used to reduce sensory overload, help with mental focus, and provide routine, among other reasons. Several autistic participants also indirectly referenced using substances to mask their autism. Past research has shown that this behavioural management (also known as ‘camouflaging’ or ‘compensating’) has been linked to emotional exhaustion, worse mental health, and even increased risk of suicide among autistic adults.

Autistic adolescents and adults were also over three times more likely than others to report using substances to manage mental health symptoms, including anxiety, depression, and suicidal thoughts. Several participants specifically noted that they used drugs for self-medication. However, this self-medication was not always viewed as negative by participants, and several noted that using recreational drugs allowed them to reduce the doses of prescribed medications for mental health conditions, which was a welcome change due to the sometimes significant side effects from their prescribed medications.

Another area of concern was the strong association between vulnerability and substance use among autistic teenagers and adults. Previous work from the Cambridge team suggests that autistic adults may be much more likely to have adverse life experiences and be at greater risk of suicide than others. ̽��ֱ��findings of the new study indicate that autistic individuals are over four times more likely to report vulnerability associated with substance use compared to their non-autistic peers, including dependence/addiction, using drugs to deal with past trauma, and substance use associated with suicide.

In addition, the study identified two new areas of vulnerability not been previously reported: being forced, tricked, or accidentally taking drugs; and childhood use of substances (at the age of 12 years or younger).

Elizabeth Weir, a PhD student at the Autism Research Centre in Cambridge, and the lead researcher of the study, said: “Whether or not the substances currently classed as ‘recreational’ could be used medically remains an open question. It is evident that the current systems of health and social care support are not meeting the needs of many autistic teenagers and adults.

“No one should feel that they need to self-medicate for these issues without guidance from a healthcare professional. Identifying new forms of effective support is urgent considering the complex associations between substance use, mental health, and behaviour management—particularly as camouflaging and compensating behaviours are associated with suicide risk among autistic individuals.”

Dr Carrie Allison, Director of Research Strategy at the Autism Research Centre and a member of the research team, said: “While some of our results suggest lower likelihood of substance use overall, physicians should not assume that their autistic patients aren’t using drugs. Drug use can be harmful so healthcare providers should aim to establish trusting relationships with autistic and non-autistic patients alike to foster frank and honest conversations about substance use.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre and a member of the team, said: “We continue to see new areas in which autistic adults experience vulnerability: mental health, physical health, suicide risk, lifestyle patterns, the criminal justice system, and so on. Substance use is now another area that we need to consider when developing new forms of support for autistic individuals. It is essential that we ensure that autistic people have equal access to high quality social and healthcare that can appropriately support their specific needs; and, unfortunately, it seems clear that our current systems are still not meeting this mark.”

̽��ֱ��research was funded by the Autism Research Trust, Rosetrees Trust, Cambridge and Peterborough NHS Foundation Trust, Corbin Charitable Trust, Medical Research Council, Wellcome and the Innovative Medicines Initiative.

Reference
Weir, E, Allison, C, & Baron-Cohen, S. Understanding the substance use of autistic adolescents and adults: a mixed methods approach. ̽��ֱ��Lancet Psychiatry (2021).

While autistic individuals are less likely to use substances, those who do so are more likely to self-medicate for their mental health symptoms, according to new research from the ̽��ֱ�� of Cambridge and published today in ̽��ֱ��Lancet Psychiatry.

It is essential that we ensure that autistic people have equal access to high quality social and healthcare that can appropriately support their specific needs; and, unfortunately, it seems clear that our current systems are still not meeting this mark

Simon Baron-Cohen

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