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This study examined the development of decision-making and its association with psychological wellbeing and risky behaviours in adolescents with and without autism. Participants included 270 autistic and 9,713 typically developing adolescents. In both samples, those with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) were excluded. Data came from the Millennium Cohort Study, a nationally representative population-based birth cohort. Decision-making was assessed using the Cambridge Gambling Task at ages 11 and 14. Psychological wellbeing (happiness, self-esteem, depressive symptoms and self-harm) and risky/antisocial behaviours were self-reported at age 14. After adjusting for sex, cognitive ability, spatial working memory, socioeconomic status and pubertal status, autistic adolescents showed comparable quality of decision-making to that of their peers at both ages but also a more deliberative decision-making style as they aged. Only in autistic adolescents was this decision-making style associated with positive outcomes.

This exploratory study aimed to explore the association between depression and self-harming behaviour in adolescence and the timing of diagnosis for autism spectrum disorder. We analysed data on 11,320 14 year olds, including 396 children with autism spectrum disorder, from the UK Millennium Cohort Study. Exposures were the timing of diagnosis for autism spectrum disorder confirmed by parental report at ages 5, 7, 11 and 14. Outcomes were depression measured by the Short Mood and Feelings Questionnaire (scores [greater than or equal to] 12) and self-report of self-harming behaviour, both assessed at age 14. Data were analysed using multivariable regression analysis. 91% of the autism spectrum disorder group had within-typical-range cognitive ability. After adjusting for child and family confounders, there was a positive linear trend between diagnostic age and depression, with children diagnosed between ages 7 and 11 and children diagnosed after age 11 showing increased symptoms (odds ratio=2.21 and 3.58, respectively). A similar trend was observed for self-harming behaviour, with children diagnosed after age 11 showing the strongest association (odds ratio=3.16). These results suggest the importance of earlier diagnosis in preventing secondary mental health problems in this population, particularly among those without cognitive delays. Further studies replicating across a wider intellectual spectrum and clarifying the underlying mechanism are warranted.

This study aimed to identify determinants of a late autism spectrum disorder diagnosis, including diagnoses made 'very late' (i.e., in adolescence), using the Millennium Cohort Study, a nationally representative population-based cohort in the United Kingdom. Children diagnosed with autism spectrum disorder by age 14 (N = 581) were included and grouped by the parent-reported timing of diagnosis: before school (up to age 5), during primary school (age 5-11) and during secondary school (age 11-14). Predictors of diagnostic timing, at the child, family and school levels, were investigated using multinomial logistic regression. Most (79%) children with autism spectrum disorder were diagnosed after school entry, and 28% were not diagnosed until secondary school. Among those not diagnosed until secondary school, 75% had been identified at age 5 years by a parent and/or teacher as having socio-behavioural difficulties. Being diagnosed after starting school was predicted by living in poverty (adjusted relative risk ratio: primary = 1.90, 95% confidence interval: 1.03-3.53; secondary = 2.15, 1.05-4.42) and/or having no initial parental concerns (primary = 0.32, 0.15-0.70; secondary = 0.19, 0.09-0.43). Having typical-range intelligence also predicted diagnosis during secondary school. The result indicates that those without cognitive delays and poorer children were at risk of 'very late' (i.e. adolescent) diagnosis. Strategies to promote earlier identification, targeting age at primary school entry, could help those more likely to be diagnosed late.

Background: Understanding the etiology of psychosis is essential to the development of preventive interventions. The COVID‐19 pandemic provides a rare natural experiment that can expand our understanding of the role of social factors in the trajectories and etiology of psychosis across adolescence, particularly in Tokyo where the prevalence of actual COVID‐19 infection remained low. We hypothesized that the likelihood of self‐reporting psychotic experiences (PEs) would increase following the onset of the COVID‐19 pandemic. Methods: The Tokyo Teen Cohort (TTC) is a prospective cohort study of adolescents in the general population of the Tokyo metropolitan area, followed from age 10 to 16 years. We used multi‐level linear regression models to test the associations between the phase of the COVID‐19 pandemic and self‐reported PEs. Results: Among 1935 adolescents included in the analysis, a rapid increase in PEs occurred at the onset of the COVID‐19 pandemic, following approximately 6 years of steady decline across prior waves. This association was more pronounced for boys compared to girls. This increase became more pronounced as the pandemic moved into later phases, defined based on contemporaneous sociopolitical changes in Tokyo (i.e. changes to school closure, social distancing guidelines, and the state of emergency status). Conclusions: The steady decline in PEs across adolescence was halted and reversed concurrent with the COVID‐19 pandemic onset, despite very low rates of COVID‐19 infection. This implicates COVID‐19 related socioenvironmental factors as contributory etiological factors in the development of PEs in this adolescent cohort. [ABSTRACT FROM AUTHOR]

This study examined the development of decision-making and its association with psychological wellbeing and risky behaviours in adolescents with and without autism. Participants included 270 autistic and 9,713 typically developing adolescents. In both samples, those with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) were excluded. Data came from the Millennium Cohort Study, a nationally representative population-based birth cohort. Decision-making was assessed using the Cambridge Gambling Task at ages 11 and 14. Psychological wellbeing (happiness, self-esteem, depressive symptoms and self-harm) and risky/antisocial behaviours were self-reported at age 14. After adjusting for sex, cognitive ability, spatial working memory, socioeconomic status and pubertal status, autistic adolescents showed comparable quality of decision-making to that of their peers at both ages but also a more deliberative decision-making style as they aged. Only in autistic adolescents was this decision-making style associated with positive outcomes., Author(s): Mariko Hosozawa [sup.1] [sup.2] , William Mandy [sup.3] , Noriko Cable [sup.1] , Eirini Flouri [sup.4] Author Affiliations: (1) grid.83440.3b, 0000000121901201, Department of Epidemiology and Public Health, University College [...]

Subclinical traits of autism were measured in children with somatic symptom disorder (SSD, n = 28) and compared with age-matched controls (n = 26) using the Autism Spectrum Quotient (AQ) children's version. The KINDL[superscript R] quality of life questionnaire was used to assess functional disability. Although there was no significant group difference in total traits of autism, SSD group had significantly greater difficulty in attention switching domain. Logistic regression analysis confirmed attention switching and age were associated with increased likelihood of SSD. In SSD group, difficulty in attention switching significantly negatively correlated with total, family, and friends quality of life scores. In conclusion, assessment and treatment targeting difficulties in attention switching could be useful when dealing with children with SSD.

Subclinical traits of autism were measured in children with somatic symptom disorder (SSD, n = 28) and compared with age-matched controls (n = 26) using the Autism Spectrum Quotient (AQ) children's version. The KINDL.sup.R quality of life questionnaire was used to assess functional disability. Although there was no significant group difference in total traits of autism, SSD group had significantly greater difficulty in attention switching domain. Logistic regression analysis confirmed attention switching and age were associated with increased likelihood of SSD. In SSD group, difficulty in attention switching significantly negatively correlated with total, family, and friends quality of life scores. In conclusion, assessment and treatment targeting difficulties in attention switching could be useful when dealing with children with SSD., Author(s): Kyoko Hatta [sup.1] , Mariko Hosozawa [sup.1] , Kyoko Tanaka [sup.2] , Toshiaki Shimizu [sup.1] Author Affiliations: (Aff1) 0000 0004 1762 2738, grid.258269.2, Department of Pediatrics and Adolescent Medicine, [...]

Background and Hypotheses A wealth of evidence suggests that adolescent psychotic experiences (PEs), and especially auditory hallucinations (AHs), are associated with an increased risk for self-injurious behavior (SIB). However, the directionality and specificity of this association are not well understood, and there are no published studies investigating within-person effects over time. The present study aimed to test whether AHs and SIB prospectively increase reciprocal risk at the individual level during early-to-middle adolescence. Study Design Three waves (12y, 14y, and 16y) of self-reported AHs and SIB data from a large Tokyo-based adolescent birth cohort (N = 2825) were used. Random Intercept Cross-Lagged Panel Model (RI-CLPM) analysis was conducted to test the within-person prospective associations between AHs and SIB. Study Results At the within-person level, AHs were associated with subsequent SIB over the observation period (12y–14y: β =.118, P <.001; 14–16y: β =.086, P =.012). The reverse SIB->AHs relationship was non-significant at 12–14y (β =.047, P =.112) but emerged from 14y to 16y as the primary direction of influence (β =.243, P <.001). Incorporating depression as a time-varying covariate did not meaningfully alter model estimates. Conclusions A complex bi-directional pattern of relationships was observed between AHs and SIB over the measurement period, and these relationships were independent of depressive symptoms. Adolescent AHs may be both a predictor of later SIB and also a manifestation of SIB-induced psychological distress. [ABSTRACT FROM AUTHOR]

Objectives: To examine if gestational age groups predict the development of social competence difficulties (SCDs) from childhood into mid-adolescence and to assess the mediation by maternal psychological distress during infancy on these trajectories.Design: Nationally representative population-based birth cohort (UK Millennium Cohort Study).Participants: 15 821 children born in 2000-2002.Outcome Measures: SCDs (derived from peer and prosocial subscales of Strengths and Difficulties Questionnaire) were assessed by parent report when the participants were aged 3, 5, 7, 11 and 14 years. Maternal psychological distress was self-rated using Rutter Malaise Inventory when the children were 9 months of age. Data were modelled using latent growth curve analysis.Results: Developmental trajectories of SCDs were U-shaped in all groups. Very preterm (VP) children (<32 weeks, n=173) showed pronounced difficulties throughout, with the coefficient difference from the full term at age 14 being 0.94 (95% CI 0.23 to 1.66, equivalent to 0.32 SD of the population average SCDs). Moderate-to-late preterm children (32-36 weeks, n=1130) and early-term children (37-38 weeks, n=3232) showed greater difficulties compared with the full-term peers around age 7 years, which resolved by age 14 years (b=0.20, 95% CI -0.05 to 0.44; b=0.03, 95% CI -0.12 to 0.17, respectively). Maternal psychological distress during infancy mediated 20% of the aforementioned association at age 14 years for the VP.Conclusion: There was a dose-response association between gestational age and the trajectories of SCDs. Monitoring and providing support on social development throughout childhood and adolescence and treating early maternal psychological distress may help children who were born earlier than ideal, particularly those born VP. [ABSTRACT FROM AUTHOR]