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Research has shown that individuals with autism spectrum disorder have higher rates of health problems throughout childhood, adolescence, and adulthood, and that this may result in elevated risk of early mortality. This study reported the rate, timing, and causes of death in a large community-based cohort of adolescents and adults with autism spectrum disorder (n = 406) over a 20-year period (1998-2018) and identified predictors of mortality. Over this period, 6.4% of individuals died at an average age of 39 years. Causes of death included chronic conditions (such as cancer and heart disease), accidents (such as choking on food and accidental poisoning), and health complications due to medication side effects. Even after controlling for age and health status, significant predictors of mortality were early childhood levels of impairments in social reciprocity and high levels of functional impairments at the start of the study period. The results suggest the importance of social engagement and functional self-sufficiency across the life course, as well as adequate access to health care for individuals with autism spectrum disorder.

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This article examines difference in caregiving experiences between fathers and mothers who have a son or a daughter with schizophrenia. We assess differences in predictors of burden, depressive symptoms, and positive psychological well-being and the stress-buffering effects of social participation and marital satisfaction. To test the hypothesized relationships, we sampled a hundred caregiving couples who were drawn from a study of aging families of adults with schizophrenia. Results show men and women to be equally vulnerable to caregiving stressors. While neither marital satisfaction nor social participation buffered the effects of stress on well-being, they each predicted positive well-being outcomes for both parents. [ABSTRACT FROM PUBLISHER]

Abstract: Developmental disabilities and severe mental illness are costly to the affected individual and frequently to their family as well. Little studied are their nondisabled siblings. Here we examine major life course outcomes (education, employment, and marriage) of these siblings in adulthood using data from the Wisconsin Longitudinal Study. Our sample comprises 113 individuals with developmental disabilities and 337 of their nondisabled siblings; 97 individuals with mental illness and 235 of their nondisabled siblings; and 17,126 unaffected comparison group members. We find that siblings of individuals with mental illness have less education and less employment than the unaffected comparison group, whereas those who have a sibling with developmental disabilities had normative patterns of education and employment, but less marriage and more divorce. Robustness tests incorporating genetic data do not change the conclusions based on the nongenetic analyses. [Copyright &y& Elsevier]

The present longitudinal study investigated changes in service receipt and unmet service needs spanning 14 years before and after high school exit in a large community-based sample of individuals with autism spectrum disorder (ASD) (n = 204), of whom 59% had co-occurring intellectual disability (ID). Using multilevel models, potential discontinuity of service patterns at the point of high school exit was examined, as well as the rate of change in services received and needed during the high school years and into the post-high school period. Differences between those with and without ID were probed. Study findings indicated that overall, sample members experienced a reduction in receipt of services during high school, particularly for those without co-occurring ID. After high school exit, sample members experienced a decline in services received; for those without ID, there was a continuous rate of loss of services after leaving high school but for those with ID, there was a sharp decline in services received. Unmet service needs increased right after high school exit for both those with and without ID. These patterns reflect loss of entitlement for services that accompanies high school exit, and the limited availability of adult services for individuals with ASD. This study documented not only the post-high school service cliff that has been the subject of much concern, but also that the loss of services begins long before high school exit and that subgroups of the population with ASD are particularly vulnerable. Autism Res 2019, 12: 911-921. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In this research, we studied changes in the number of services received before and after high school exit in a large sample of individuals with autism spectrum disorder (ASD). With each passing year during high school, individuals with ASD received fewer services. At the time of high school exit, there was a sharp drop in the number of services received, particularly for those with co-occurring intellectual disability. This study found not only that there is a post-high school service cliff, but also that the loss of services begins long before high school exit., (© 2019 International Society for Autism Research, Wiley Periodicals, Inc.)

Neuroticism is a stable and heritable personality trait that is strongly linked to depression. Yet, little is known about its association with late life depression, as well as how neuroticism eventuates into depression. This study used data from the Wisconsin Longitudinal Study (WLS; N = 4,877) to examine the direct and indirect effects of neuroticism on late life depression at 3 points in the life course-ages 53, 64, and 71-via stressful life events (i.e., independent and dependent) and social supports measured across adulthood and into later life. Neuroticism was assayed using multiple methods, including self-report measures (phenotypic model) and a polygenic score (polygenic model) informed by a meta-analytic genome-wide association study. Results indicated that the phenotypic model of neuroticism and late life depression was partially mediated via dependent stressful life events experienced after the age of 53 and by age 64 social support. This association was replicated in the polygenic model of neuroticism, providing key evidence that the findings are robust. No indirect effects emerged with respect to age 53 social support, age 71 social support, adult dependent stressful life events (experienced between age 19 and 52), and adult and late life independent stressful life events in either the phenotypic or polygenic models as they pertained to late life depression. Results are consistent with previous findings that individuals with high neuroticism may be vulnerable to late life depression through psychosocial risk factors that are, in part, attributable to their own personality. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Sustaining community employment is a challenge for adults with autism spectrum disorders, especially for those who have co-occurring intellectual disability, but factors contributing to this employment outcome have not been fully evaluated. This study utilized longitudinal data to explore the impact of contextual influences, family factors, and individual characteristics on sustained employment over approximately 18 months ( N = 105). Very few adults with autism spectrum disorder and intellectual disability achieved sustained employment (14.3%). The results indicated that more independent daily living skills, a higher family income, a larger maternal social network, an inclusive school environment in early childhood, and currently living in an area with a larger population size were associated with significantly greater odds of sustaining employment. Follow-up analyses suggested that managing personal care is particularly important for employment.

We prospectively examined the risk of divorce in 190 parents of children with developmental disabilities compared to 7,251 parents of children without disabilities based on a random sample drawn from the community and followed longitudinally for over 50 years. A significant interaction between the parental group status and number of children was found: In the comparison group, having a larger number of children was related to an increased risk of divorce, whereas the number of children did not increase divorce risk among parents of children with developmental disabilities.

We examined how the educational expectations that parents with mild intellectual deficits had for their children shaped their children's attainment, and how parents' own intellectual limitations affected this process. We identified 612 parents with mild intellectual deficits and 2,712 comparison parents from the Wisconsin Longitudinal Study, a prospective longitudinal study in which participants were followed from ages 18 to 64. Compared to the norm, parents with mild intellectual deficits expected their children to complete less education, even after controlling for sociodemographic background variables, and children of parents with mild intellectual deficits did, in fact, complete fewer years of education. For both groups, parental expectations were the strongest predictor of attainment. Results suggest that disparities in education are shaped in part by parents' beliefs about educational opportunities.

Objective: Whereas many studies have examined the long-term toll of coping with an adult child's serious mental illness, relatively few have examined both the subjective burden and personal gains associated with this parenting role. This study investigated the stressors and resources related to burden and gains among older parents of adults with serious mental illness., Methods: The study was a secondary analysis of data collected in the Wisconsin Longitudinal Study. Regression analysis of telephone and mailed responses of 111 parents of adults with serious mental illness was used to examine the stressors and resources associated with parental burden and gains., Results: Stressors that were positively associated with subjective burden included the amount of care provided to a child with serious mental illness; parents and children living in the same household was also positively associated, although it was not statistically significant (p=.07). Parents who received more assistance from an adult child with serious mental illness and those who were support group members reported less subjective burden and more gains. A higher number of confidants were also positively associated with gains. Parents who provided more assistance with activities of daily living to their adult child reported higher levels of gains., Conclusions: Findings suggest that recovery-oriented approaches to supporting families in later stages of life may involve creating opportunities for adults with serious mental illness to play positive roles in the lives of aging parents and in helping older parents recognize ways in which successfully coping with caregiving challenges may lead to personal gains.

Medication use was examined in 286 adolescents and adults with ASD over a 4.5 year period. A total of 70% were taking a psychotropic or non-psychotropic medication at the beginning of the study. Both the number of psychotropic and non-psychotropic medications taken, and the proportion of individuals taking these medications, increased significantly over the study period, with 81% taking at least one medication 4.5 years later. Our findings suggested a high likelihood of staying medicated over time. Thus, adolescents and adults with ASD are a highly and increasingly medicated population.

Objective: In a multisite study, the authors examined the construct validity and utility of a brief self-report Satisfaction With Life scale, an expanded 21-item version of one of the earliest measures of subjective satisfaction with life used with individuals with serious and persistent mental illness. The Satisfaction With Life scale measures satisfaction in four domains: living situation, social relationships, work, and self and present life., Methods: Satisfaction With Life scale data were gathered from consumers receiving community treatment at two sites in Los Angeles (N=166 and N=172, respectively) and one in Wisconsin (N=146). A confirmatory factor analysis of a hypothesized four-factor structure using data from the pooled Los Angeles samples revealed that several items were less than optimal indicators of the underlying domain. On the basis of an analysis of each item, the Satisfaction With Life scale was reduced to 18 items, and the factor structure and factor loadings of the revised scale were cross-validated with data from the Wisconsin sample. The 18-item scale was further validated by testing hypotheses regarding the relationship between the instrument's four domains, or subscales, and clinically important life conditions of clients in the areas of symptoms, living and employment situations, and social relationships., Results: The findings provided excellent support for the construct validity of the 18-item Satisfaction With Life scale, which assesses an individual's subjective satisfaction with his or her current life in the four domains: living situation, social relationships, work, and self and present life., Conclusions: The brief, easily completed 18-item Satisfaction With Life scale is a useful tool in evaluation research for assessing the subjective satisfaction with life of adults with serious mental illness.

This study compared the mental and physical health of two groups of black mothers aged 55 years and older: those who were providing care for their adult child with schizophrenia or schizoaffective disorder (N=30) and those who did not have a child with mental illness (N=263). The only demographic variable that was found to differ between the two groups was that the women who were providing care for their adult child with mental illness had more children than the women in the comparison group. Both groups of women had similar mental health status. However, the mothers who were providing care for their adult children with mental illness had higher rates of chronic health conditions, such as high blood pressure, arthritis, and eye problems.