Thread by @SedgewickF

New session, new thread (same seat)

Most excited to hear from @Sarah_NottsUni about her updated work!

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First an overview of mental health in autism, covering:

What do we mean by MH?
What do we know about MH in autistic people?
What are the consequences?
What contributes to MH problems?
What factors protect from MH problems?

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1. What is MH?

Psychological, emotional and social wellbeing.
Affects how we think, feel and act.
Changes over lifespan.
MH problems are common - 25% of nonautistic people will experience difficulty.

But we know less about MH in autistic people.

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MH in autistic children and adolescents...
7.7% clinical depression (+10% subclinical)
40% clinical anxiety disorders
Sleep disorders incredibly common

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MH in autistic adults...

More issues as get older
Anxiety 27% at current moment, 42% lifetime prevalence
25% current depression, 37% lifetime prevalence
80% report sleep disturbance - worsens MH (feedback loop)
12% substance misuse
60% min one psych condition

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10 to 14% of autistic females have attempted suicide at least once. If also ADHD, rises to 20%

6% of autistic males

All higher than general population.

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Completed suicide -

Autistic females 12 to 14 times more likely than non autistic peers

Autistic males 7 to 13 times more likely than non autistic peers

And those numbers are possibly underestimated... 💔

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I appreciate the call to see these deaths as preventable and a societal failure.

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Slightly abrupt move to links between mental and physical health.

14% of CYP with chronic pain had positive screening for autism (not full dx)

Autistic people average lifespan 16 years shorter than matched non autistic peers due to range of health conditions.

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There are individual and environmental factors influencing mental health issues - need broader system intervention to prevent difficulties.

Also awareness that interaction may not be the same as in non autistic people.

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Next work from Newcastle Uni, team including @jacquirodgers on autistic people's experiences of anxiety and anxiety treatments.

Wide ranging impacts in every area of life.

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Common to see autistic people meeting criteria for not just one or two, but three four or five anxiety disorders.

In the UK, talking therapies are the first line of treatment. However, autistic people often unimpressed and find these ineffective.

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Excited to hear about the development of an autism specific anxiety screening questionnaire!

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Found 77% of 500+ autistic adults had an anxiety disorder diagnosis.

Sensory, uncertainty, feeling different and being bullied key causes.

Females sig more anxious than males.

Anx corr with younger adults, more autistic behavs, more dif w/uncertainty, more depression

Anxiety has major impacts on all these areas...

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15% did not complete talking therapy.

39% felt it had no impact or made them feel worse.

Not good enough! I know of work adapting eating disorder treatment for autistic people (@PEACE_Pathway) We need the same for anxiety

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General recommended changes:

Knowledge of autism
Consistent therapist
Sensory considerations
Therapist always available in the moment

The things we know autistic people need across contexts (replace therapist for teacher, for example)

We have answers, they need implementing!

Fascinating to hear about personalised treatment being developed.

Hopefully it happens in good time and can be rolled out widely.

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(Plus the name PAT-A /patė makes me think of toast!)

Yaya, @Sarah_NottsUni now!

New validated suicidality assessment tool for autistic adults, developed with autistic adults.

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For a moment I thought the measure had been called the SPQR and got really excited about a crossover between my passion got ancient history and autism!

It is actually the SBQ-R...

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Autistic adults respond to existing measures differently than non autistic adults

E.g. difference betwn passing thought&plan, impulsive attempts without a plan, current measures not capturing intensity/frequency of thoughts, impossibility of answering future as

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Clear need for adapted questions.

Changes (validated):
Adding in stage between thoughts and plans
Adding in qual follow up qs
More freq options/perseverative thoughts
Giving more concrete options rather than abstract qs
Added visual aids

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Cont.

Simplified response options
Who did you tell if you did?
If haven't told anyone, why?

Recognising value of qual detail to enrich quant data

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Most difference was on intensity and frequency of suicidal thoughts.

Also clear evidence of similarities on other aspects of the questionnaire.

Good tesr-retest validity (implies consistently useful)

Scores associate with anxiety, depression, camouflaging& more

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Sarah @Sarah_NottsUni finishes noting that this is validated for research use, not clinical (yet!)

Cannot predict response to future adverse events, but can be used in research to look at risk factors which may then be useful in clinical work

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Now work on developing a depression screening tool from Naomi Downes.

Focused on children and adolescents, initially found many depression criteria which overlap with autism criteria or recognised behaviours.

Something I'll be covering with students this term!

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Awareness of "atypical' depression presentation in autistic people is really important for clinicians and teachers. Both careers my students are interested in.

If we as academics can build this knowledge in throughout students time with us, it normalises it.

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Really thorough process put in place to develop this measure, with professional and parent input. Wondering if autistic adults were also involved?
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Yep, an expert group has just been mentioned - must have missed it first time around.

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