Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
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Clinical Characteristics of Aggressive Behavior Problems in Children with Autism Spectrum Disorder: Preliminary Study

공격적 문제행동을 보이는 자폐스펙트럼장애 아동청소년의 임상적 특징: 예비연구

  • Yang, Young-Hui (Department of Child and Adolescent Psychiatry, National Center for Mental Health) ;
  • Kim, Hyen-Jung (Center for Behavior Development, National Center for Mental Health) ;
  • Lee, Won-Hye (Department of Clinical Psychology, National Center for Mental Health)
  • 양영희 (국립정신건강센터 소아청소년정신과) ;
  • 김현정 (국립정신건강센터 행동발달증진센터) ;
  • 이원혜 (국립정신건강센터 심리건강과)
  • Received : 2017.05.16
  • Accepted : 2017.07.06
  • Published : 2017.10.01
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Abstract

Objectives: The aim of this study was to investigate the clinical characteristics of aggressive behavior problems in children and adolescents with autism spectrum disorder (ASD). Methods: Children and adolescents with ASD, aged 6-18 years, were included in this study. We divided them into two groups according to the presence or absence of aggressive behavior. They were assessed using three scales, the Korean-Child Behavior Checklist (K-CBCL), Behavior Problem Inventory, and Social Communication Questionnaire, which were completed by their parents, who conducted a continuous performance test to evaluate their attention function. The statistical analysis was done using the Mann-Whitney U-test between the two groups at a p-value of 0.05. Results: A total of 17 children participated in this study. Ten children (7 boys, $12.4{\pm}4.27years$) were included in the group with aggressive behavior problems and 7 children (6 boys, $13.8{\pm}3.53years$) in the group without aggressive behavior problems. There were no significant differences in the age, gender or intelligence quotient of the two groups. The children with aggressive behavior problems showed a trend of higher T-scores in the attention problems and anxiety/depressed subscale of the CBLC (p<0.1). Conclusion: The results suggest that aggressive behavior problems in children with ASD may be related to their attention problems, anxiety and depression.

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References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Arlington, VA: American Psychiatric Association;2013
  2. Matson JL, Nebel-Schwalm MS. Comorbid psychopathology with autism spectrum disorder in children: an overview. Res Dev Disabil 2007;28:341-352. https://doi.org/10.1016/j.ridd.2005.12.004
  3. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry 2008;47:921-929. https://doi.org/10.1097/CHI.0b013e318179964f
  4. Farmer C, Butter E, Mazurek MO, Cowan C, Lainhart J, Cook EH, et al. Aggression in children with autism spectrum disorders and a clinic-referred comparison group. Autism 2015;19:281-291. https://doi.org/10.1177/1362361313518995
  5. Kanne SM, Mazurek MO. Aggression in children and adolescents with ASD: prevalence and risk factors. J Autism Dev Disord 2011; 41:926-937. https://doi.org/10.1007/s10803-010-1118-4
  6. Dominick KC, Davis NO, Lainhart J, Tager-Flusberg H, Folstein S. Atypical behaviors in children with autism and children with a history of language impairment. Res Dev Disabil 2007;28:145-162. https://doi.org/10.1016/j.ridd.2006.02.003
  7. Estes AM, Dawson G, Sterling L, Munson J. Level of intellectual functioning predicts patterns of associated symptoms in school-age children with autism spectrum disorder. Am J Ment Retard 2007; 112:439-449. https://doi.org/10.1352/0895-8017(2007)112[439:LOIFPP]2.0.CO;2
  8. Hill AP, Zuckerman KE, Hagen AD, Kriz DJ, Duvall SW, van Santen J, et al. Aggressive Behavior Problems in Children with Autism Spectrum Disorders: prevalence and correlates in a large clinical sample. Res Autism Spectr Disord 2014;8:1121-1133. https://doi.org/10.1016/j.rasd.2014.05.006
  9. De Giacomo A, Craig F, Terenzio V, Coppola A, Campa MG, Passeri G. Aggressive behaviors and verbal communication skills in autism spectrum disorders. Glob Pediatr Health. 2016;3:2333794X16644360.
  10. Matson JL, Cervantes PE. Assessing aggression in persons with autism spectrum disorders: an overview. Res Dev Disabil 2014;35: 3269-3275. https://doi.org/10.1016/j.ridd.2014.08.004
  11. Bronsard G, Botbol M, Tordjman S. Aggression in low functioning children and adolescents with autistic disorder. PLoS One 2010;5: e14358. https://doi.org/10.1371/journal.pone.0014358
  12. Mulligan CK, Trauner DA. Incidence and behavioral correlates of epileptiform abnormalities in autism spectrum disorders. J Autism Dev Disord 2014;44:452-458. https://doi.org/10.1007/s10803-013-1888-6
  13. Burrows EL, Laskaris L, Koyama L, Churilov L, Bornstein JC, Hill-Yardin EL, et al. A neuroligin-3 mutation implicated in autism causes abnormal aggression and increases repetitive behavior in mice. Mol Autism 2015;6:62. https://doi.org/10.1186/s13229-015-0055-7
  14. Sala M, Braida D, Lentini D, Busnelli M, Bulgheroni E, Capurro V, et al. Pharmacologic rescue of impaired cognitive flexibility, social deficits, increased aggression, and seizure susceptibility in oxytocin receptor null mice: a neurobehavioral model of autism. Biol Psychiatry 2011;69:875-882. https://doi.org/10.1016/j.biopsych.2010.12.022
  15. Shea S, Turgay A, Carroll A, Schulz M, Orlik H, Smith I, et al. Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Pediatrics 2004;114:e634-641. https://doi.org/10.1542/peds.2003-0264-F
  16. Parikh MS, Kolevzon A, Hollander E. Psychopharmacology of aggression in children and adolescents with autism: a critical review of efficacy and tolerability. J Child Adolesc Psychopharmacol 2008; 18:157-178. https://doi.org/10.1089/cap.2007.0041
  17. McDougle CJ, Stigler KA, Erickson CA, Posey DJ. Atypical antipsychotics in children and adolescents with autistic and other pervasive developmental disorders. J Clin Psychiatry 2008;69 Suppl 4: 15-20. https://doi.org/10.4088/JCP.0508e15
  18. Fitzpatrick SE, Srivorakiat L, Wink LK, Pedapati EV, Erickson CA. Aggression in autism spectrum disorder: presentation and treatment options. Neuropsychiatr Dis Treat 2016;12:1525-1538.
  19. Rojahn J, Matson JL, Lott D, Esbensen AJ, Smalls Y. The Behavior Problems Inventory: an instrument for the assessment of self-injury, stereotyped behavior, and aggression/destruction in individuals with developmental disabilities. J Autism Dev Disord 2001;31: 577-588. https://doi.org/10.1023/A:1013299028321
  20. Bang SY, Lee JW, Hwang SH, Hong EJ, Park JH. Development of tools and protocols assessing problematic behaviors in children with developmental disorders. Seoul: National Center for Mental Health;2013.
  21. Achenbach TM. Manual for the child: behavior checklist and revised child behavior profile. Burlington, VT: University Vermont, Dept. Psychiatry;1983.
  22. Berument SK, Rutter M, Lord C, Pickles A, Bailey A. Autism screening questionnaire: diagnostic validity. Br J Psychiatry 1999;175: 444-451. https://doi.org/10.1192/bjp.175.5.444
  23. Kim JH, Sunwoo HJ, Park SB, Noh DH, Jung YK, Cho IH, et al. A validation study of the Korean version of Social Communication Questionnaire. J Korean Acad Child Adolesc Psychiatry 2015;26: 197-208. https://doi.org/10.5765/jkacap.2015.26.3.197
  24. Yoo HK, Lee J, Kang SH, Park EH, Jung J, Kim BN, et al. Standardization of the Comprehensive Attention Test for the Korean children and adolescents. J Korean Acad Child Adolesc Psychiatry 2009; 20:68-75.
  25. Matson JL, Mahan S, Fodstad JC, Worley JA, Neal D, Sipes M. Effects of symptoms of co-morbid psychopathology on challenging behaviours among infants and toddlers with autistic disorder and PDD-NOS as assessed with the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT). Dev Neurorehabil 2011;14:129-139. https://doi.org/10.3109/17518423.2011.557029
  26. Cervantes P, Matson JL, Tureck K, Adams HL. The relationship of comorbid anxiety symptom severity and challenging behaviors in infants and toddlers with autism spectrum disorder. Res Autism Spectr Disord 2013;7:1528-1534. https://doi.org/10.1016/j.rasd.2013.09.005
  27. Niditch LA, Varela RE, Kamps JL, Hill T. Exploring the association between cognitive functioning and anxiety in children with autism spectrum disorders: the role of social understanding and aggression. J Clin Child Adolesc Psychol 2012;41:127-137. https://doi.org/10.1080/15374416.2012.651994
  28. Patel S, Day TN, Jones N, Mazefsky CA. Association between anger rumination and autism symptom severity, depression symptoms, aggression, and general dysregulation in adolescents with autism spectrum disorder. Autism 2017;21:181-189. https://doi.org/10.1177/1362361316633566
  29. Chen C, Shen YD, Xun GL, Cai WX, Shi LJ, Xiao L, et al. Aggressive behaviors and treatable risk factors of preschool children with autism spectrum disorder. Autism Res 2017;10:1155-1162. https://doi.org/10.1002/aur.1751
  30. Carroll D, Hallett V, McDougle CJ, Aman MG, McCracken JT, Tierney E, et al. Examination of aggression and self-injury in children with autism spectrum disorders and serious behavioral problems. Child Adolesc Psychiatr Clin N Am 2014;23:57-72. https://doi.org/10.1016/j.chc.2013.08.002