Kandice J. Varcin

Empathic deficits in schizophrenia: The potential role of rapid facial mimicry

Emotional facial expressions evoke rapid, involuntary, and covert facial reactions in the perceiver that are consistent with the emotional valence of the observed expression. These responses are believed to be an important low-level mechanism contributing to the experience of empathy, which some have argued rely on a simulation mechanism subserved by the human mirror neuron system (MNS). Because schizophrenia is associated with pervasive social cognitive difficulties which have been linked to structural abnormalities in the MNS network, the aim of the present study was to provide the first assessment of how rapid facial mimicry reactions (within 1000 ms poststimulus onset) are affected in schizophrenia. Activity in the corrugator supercilii and zygomaticus major muscle regions was quantified using electromyography while individuals with schizophrenia (n = 25) and controls (n = 25) viewed images of happy and angry facial expressions. In contrast to controls, individuals with schizophrenia demonstrated atypical facial mimicry reactions which were not associated with any clinical features of the disorder. These data provide evidence for a low-level disruption that may be contributing to empathizing deficits in schizophrenia and are discussed in relation to neuropsychological models of empathy and schizophrenia.

Early developmental trajectories associated with ASD in infants with tuberous sclerosis complex

Objective: We performed a longitudinal cohort study of infants with tuberous sclerosis complex (TSC), with the overarching goal of defining early clinical, behavioral, and biological markers of autism spectrum disorder (ASD) in this high-risk population. Methods: Infants with TSC and typically developing controls were recruited as early as 3 months of age and followed longitudinally until 36 months of age. Data gathered at each time point included detailed seizure history, developmental testing using the Mullen Scales of Early Learning, and social-communication assessments using the Autism Observation Scale for Infants. At 18 to 36 months, a diagnostic evaluation for ASD was performed using the Autism Diagnostic Observation Schedule. Results: Infants with TSC demonstrated delays confined to nonverbal abilities, particularly in the visual domain, which then generalized to more global delays by age 9 months. Twenty-two of 40 infants with TSC were diagnosed with ASD. Both 12-month cognitive ability and developmental trajectories over the second and third years of life differentiated the groups. By 12 months of age, the ASD group demonstrated significantly greater cognitive delays and a significant decline in nonverbal IQ from 12 to 36 months. Conclusions: This prospective study characterizes early developmental markers of ASD in infants with TSC. The early delay in visual reception and fine motor ability in the TSC group as a whole, coupled with the decline in nonverbal ability in infants diagnosed with ASD, suggests a domain-specific pathway to ASD that can inform more targeted interventions for these high-risk infants.

Symptom profiles of autism spectrum disorder in tuberous sclerosis complex

Objective: To determine the extent to which deficits associated with autism spectrum disorder (ASD) in toddlers with tuberous sclerosis complex (TSC) overlap with those in toddlers with nonsyndromic ASD (nsASD) and to examine cognitive function and epilepsy severity in toddlers with TSC and comorbid ASD. This is the endpoint analysis from a longitudinal investigation of ASD risk factors in children with TSC. Methods: Measures included the Autism Diagnostic Observation Schedule (ADOS), the Mullen Scales of Early Learning, and clinical epilepsy variables. A repeated-measures analysis of variance was performed with between-subjects factor of group (typically developing, TSC/no ASD, TSC/ASD, nsASD) and within-subjects factors of individual ADOS item scores in the social communication and repetitive behavior/restricted interest domains. Within the TSC group, comparisons of epilepsy characteristics and cognitive domains were performed using independent-samples t tests. Results: Children with TSC/ASD demonstrated a profile of social communication impairment that had complete convergence with nsASD. Measured social communication impairments included gestures, pointing, eye contact, responsive social smile, and shared enjoyment. This convergence was observed despite the high comorbidity between ASD and cognitive impairment in TSC. Conclusions: This study supports the clinical diagnosis of ASD in young children with TSC and demonstrates remarkable convergence of autism symptoms between TSC/ASD and nsASD. Our results strongly suggest the need for early intervention in toddlers with TSC, with treatment strategies targeting social communication function as well as broader developmental domains, before the onset of autism symptoms.

Graduate attributes of the 4-year Australian undergraduate psychology program

This paper outlines the background, process and outcomes for a project that delineated a set of graduate attributes of the 4-year Australian undergraduate psychology program. The nature of the current undergraduate psychology program and its quality assurance system is described, followed by a consideration of current issues in psychology education and training. The processes involved in delineating the six graduate attributes (i.e., knowledge and understanding, research methods, critical thinking, values, communication, and application) are then described. Some issues and suggestions related to their implementation are then outlined. Finally, the authors summarise what has been accomplished in delineating the graduate attributes, and what still needs to be achieved.

A developmental neuroscience approach to the search for biomarkers in autism spectrum disorder.

PURPOSE OF REVIEW The delineation of biomarkers in autism spectrum disorder (ASD) offers a promising approach to inform precision-medicine-based approaches to ASD diagnosis and treatment and to move toward a mechanistic description of the disorder. However, biomarkers with sufficient sensitivity or specificity for clinical application in ASD are yet to be realized. Here, we review recent evidence for early, low-level alterations in brain and behavior development that may offer promising avenues for biomarker development in ASD. RECENT FINDINGS Accumulating evidence suggests that signs associated with ASD may unfold in a manner that maps onto the hierarchical organization of brain development. Genetic and neuroimaging evidence points towards perturbations in brain development early in life, and emerging evidence indicates that sensorimotor development may be among the earliest emerging signs associated with ASD, preceding social and cognitive impairment. SUMMARY The search for biomarkers of risk, prediction and stratification in ASD may be advanced through a developmental neuroscience approach that looks outside of the core signs of ASD and considers the bottom-up nature of brain development alongside the dynamic nature of development over time. We provide examples of assays that could be incorporated in studies to target low-level circuits.

Putting Technology Into Youth Mental Health Practice: Young People's Perspectives

Although young people aged 16 to 25 are particularly susceptible to mental ill-health, they are difficult to engage in ongoing treatment. Meanwhile, young people are more engaged with digital technologies than ever before, with the Internet and mobile technologies reaching ubiquity in young lives. Despite this, it is unclear from the literature how young people’s high technology use may be harnessed for the better management of youth mental health problems in face-to-face treatment. To explore young people’s opinions on how technology can be used for treatment engagement and as a complement to mental health treatment, a total of 21 participants aged 16 to 25 years were consulted in two focus groups. Transcripts were analyzed using thematic analysis, with consensus coding by two independent raters. Participants were positive about the integration of technology into youth mental health practice, but indicated that identifying the client’s preferred technology was the most reliable means of engagement. They reported already using technology as an informal complement to treatment, and asserted that formal technology integration must have a clear benefit to treatment while not replacing face-to-face time. Technology use to provide support beyond discharge and between sessions was suggested as a useful means for continuity of care and to prevent relapse. While various technologies were described as engaging, easy-to-access, informative, and empowering, their benefits are not yet being harnessed in youth health services to their full potential. More research is required to better understand how to best put technology into youth mental health practice.

The emergence of autism spectrum disorder: insights gained from studies of brain and behaviour in high-risk infants

Purpose of review We review studies of infants at risk for autism spectrum disorder (ASD), proposing that the earliest manifestations of disrupted brain development can shed light on prebehavioural markers of risk and mechanisms underlying the heterogeneity of ASD. Recent findings Prospective, longitudinal studies of infants at risk for ASD have revealed that behavioural signs of ASD are generally not observed until the second year of life. The developmental signs within the first year are often subtle and rooted in processes outside the core diagnostic domains of ASD, such as motor and visual perceptual function. However, studies examining early brain development and function have identified a myriad of atypicalities within the first year that are associated with risk for ASD. Summary Longitudinal studies of high-risk infants provide a unique opportunity to identify and quantify the sources of the atypical development and developmental heterogeneity of ASD. Integration of assays of behaviour and brain in the first year of life, expansion of the definition of high risk, and coordinated efforts in multisite investigations to adequately power integrative studies will lead to new insights into mechanisms of atypical development and, ultimately, the ideal timing and target for interventions that aim to attenuate delays or impairments.

Prenatal maternal stress events and phenotypic outcomes in Autism Spectrum Disorder

There is significant heterogeneity amongst individuals with Autism Spectrum Disorder (ASD) in symptom presentation and severity. An understanding of the factors that contribute to and modulate symptom severity are critical to informing prognosis, stratification, and treatment decisions. Maternal prenatal stress exposure is a nonspecific risk factor for a wide array of neurodevelopmental outcomes in subsequent offspring. Emerging evidence suggests that prenatal maternal stress may increase ASD risk and contribute to variability in autism‐like traits in the general population. In the current study, we aimed to determine whether prenatal maternal exposure to stressful life events is associated with symptom severity amongst individuals with ASD. We performed multiple regression analyses to examine associations between retrospectively recalled maternal prenatal stressful life events and the severity of ASD‐associated symptoms in 174 children with ASD (Mage = 9.09 years; SD = 3.81). ASD‐related symptom severity was measured using the Social Responsiveness Scale and communication abilities were measured using the Childrens Communication Checklist. Exposure to prenatal stressful life events was a significant predictor of ASD‐related symptom severity (t = 2.014; P = .048) and communication abilities (t = −2.925; P = .004) amongst children with ASD, even after controlling for a range of sociodemographic and obstetric variables. Follow‐up analyses demonstrated significant increases in symptom severity only in the context of multiple (two or more) prenatal stressful life events. Together, these findings indicate that ASD, in the context of prenatal maternal stress exposure, may be associated with a more severe phenotype, particularly when there are multiple prenatal exposures. Autism Res 2017, 10: 1866–1877.

Visual Evoked Potentials as a Readout of Cortical Function in Infants With Tuberous Sclerosis Complex

Tuberous sclerosis complex is an autosomal dominant genetic disorder that confers a high risk for neurodevelopmental disorders, such as autism spectrum disorder and intellectual disability. Studies have demonstrated specific delays in visual reception skills that may predict the development of autism spectrum disorder and intellectual disability. Based on evidence for alterations in the retinogeniculate pathway in animal models of tuberous sclerosis complex, we asked whether children with tuberous sclerosis complex demonstrate alterations in early visual processing that may undermine the development of higher-level visual behaviors. Pattern-reversal visual evoked potentials were recorded in infants with tuberous sclerosis complex (n = 16) and typically developing infants (n = 18) at 12 months of age. Infants with tuberous sclerosis complex demonstrated remarkably intact visual evoked potentials even within the context of intellectual disability and epilepsy. Infants with tuberous sclerosis complex show intact visual cortical processing, suggesting that delays in visually mediated behaviors in tuberous sclerosis complex may not be rooted in early visual processing deficits.

Early autism symptoms in infants with tuberous sclerosis complex

Tuberous sclerosis complex (TSC) is a rare, autosomal dominant genetic syndrome that confers significantly increased risk for autism spectrum disorder (ASD), with 50–60% of infants with TSC meeting criteria for ASD by 3 years of age. In a previous study of the current longitudinal cohort, we found that infants with TSC who develop ASD (TSC/ASD) evidence decreased cognitive abilities that diverge from infants with TSC and no ASD (TSC/no ASD). We extended this work by asking whether TSC/ASD infants (n = 13) differed from TSC/no ASD infants (n = 10) and infants with low developmental risk and no ASD (LR; n = 21) in their social communication functioning during the first year of life. We measured early ASD symptoms with the Autism Observation Scale for Infants (AOSI) at 9 and 12 months of age. At both ages, infants in the TSC/ASD group had significantly higher AOSI total scores than infants in the TSC/no ASD and LR groups, which were not fully explained by differences in cognitive abilities. Several items on the AOSI at both ages were predictive of ASD outcome, particularly those representing core social communication deficits (e.g., social referencing). Our findings signal the need for further study of this population within the first year and provide strong justification for early identification and early intervention targeting social communication skills in infants with TSC. Autism Res 2017, 10: 1981–1990.