Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-17T08:39:41.647Z Has data issue: false hasContentIssue false
  • English
  • Français

Trajectories of internalizing and externalizing symptoms among adults with autism spectrum disorders

Published online by Cambridge University Press:  27 November 2015

Ashley C. Woodman ,
Marsha R. Mailick  and
Jan S. Greenberg
Ashley C. Woodman*
Affiliation:
University of Massachusetts–Amherst
Marsha R. Mailick
Affiliation:
University of Wisconsin–Madison
Jan S. Greenberg
Affiliation:
University of Wisconsin–Madison
*
Address correspondence and reprint requests to: Ashley C. Woodman, University of Massachusetts–Amherst, 135 Hicks Way, Tobin Hall 509, Amherst, MA 01003; E-mail: awoodman@psych.umass.edu.
Get access Rights & Permissions [Opens in a new window]

Abstract

Individuals with autism spectrum disorder (ASD) experience higher rates of psychopathology than their typically developing peers or peers with other intellectual or developmental disabilities. Little is known about the developmental course of psychiatric symptoms such as internalizing and externalizing behaviors in this population. Individual characteristics and aspects of the family environment may explain variability in outcomes for adults with ASD. The present study extends our current understanding of psychopathology among individuals with ASD by examining group-based trajectories of internalizing and externalizing symptoms in adulthood. Overall, the results showed that symptoms became less severe over time. Distinct patterns of change in psychopathology were observed and associated with differential profiles of psychotropic medication use, comorbid mental health diagnoses, and residential placement. The likelihood of following each developmental trajectory was estimated based on characteristics of the adults with ASD (gender, adaptive behavior, and autistic symptoms) and maternal expressed emotion (criticism and warmth). Maternal criticism and warmth were identified as key risk and protective factors, respectively, with important implications for future research and intervention for individuals with ASD.

Type
Regular Articles
Information
Development and Psychopathology , Volume 28 , Issue 2 , May 2016 , pp. 565 - 581
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M., & Edelbrock, C. S. (1981). Behavioral problems and competencies reported by parents of normal and disturbed children aged four through sixteen. Monographs of the Society for Research in Child Development, 46, 1–82.CrossRefGoogle ScholarPubMed
Achenbach, T. M., & Rescorla, L. A. (2003). Manual for the ASEBA Adult Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.Google Scholar
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
Anderson, D. K., Maye, M. P., & Lord, C. (2011). Changes in maladaptive behaviors from midchildhood to young adulthood in autism spectrum disorder. American Journal of Intellectual and Developmental Disabilities, 116, 381–397. doi:10.1352/1944-7558-116.5.381 CrossRefGoogle ScholarPubMed
Baker, B. L., Heller, T. L., & Henker, B. (2000). Expressed emotion, parenting stress, and adjustment in mothers of young children with behavior problems. Journal of Child Psychology and Psychiatry, 41, 907–915.CrossRefGoogle ScholarPubMed
Baker, B. L., Neece, C. L., Fenning, R. M., Crnic, K. A., & Blacher, J. (2010). Mental disorders in five-year-old children with or without developmental delay: Focus on ADHD. Journal of Clinical Child and Adolescent Psychology, 39, 492–505. doi:10.1080/15374416.2010.486321 CrossRefGoogle ScholarPubMed
Baker, J. K., Seltzer, M. M., & Greenberg, J. S. (2011). Longitudinal effects of adaptability on behavior problems and maternal depression in families of adolescents with autism. Journal of Family Psychology, 25, 601–609. doi:10.1037/a0024409 CrossRefGoogle ScholarPubMed
Beck, A., Daley, D., Hastings, R. P., & Stevenson, J. (2004). Mothers’ expressed emotion towards children with and without intellectual disabilities. Journal of Intellectual Disability Research, 48, 628–638. doi:10.1111/j.1365-2788.2003.00564.x CrossRefGoogle ScholarPubMed
Billstedt, E., Gillberg, C., & Gillberg, C. (2005). Autism after adolescence: Population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. Journal of Autism and Developmental Disorders, 35, 351–360. doi:10.1007/s10803-005-3302-5 CrossRefGoogle ScholarPubMed
Borkowski, J. G., Ramey, S. L., & Bristol-Power, M. (2001). Parenting and the child's world: Influences on academic, intellectual, and social–emotional development. Mahwah, NJ: Erlbaum.CrossRefGoogle Scholar
Bradley, E. A., Summers, J. A., Wood, H. L., & Bryson, S. E. (2004). Comparing rates of psychiatric and behavior disorders in adolescents and young adults with severe intellectual disability with and without autism. Journal of Autism and Developmental Disorders, 34, 151–161. doi:10.1023/B:JADD.0000022606.97580.19 CrossRefGoogle Scholar
Brereton, A. V., Tonge, B. J., & Einfeld, S. L. (2006). Psychopathology in children and adolescents with autism compared to young people with intellectual disability. Journal of Autism and Developmental Disorders, 36, 863–870. doi:10.1007/s10803-006-0125-y CrossRefGoogle ScholarPubMed
Centers for Disease Control. (2014). Prevalence of autism spectrum disorders among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2010. Morbidity and Mortality Weekly Report, 63, 1–21.Google Scholar
Chadwick, O., Walker, N., Bernard, S., & Taylor, E. (2000). Factors affecting the risk of behaviour problems in children with severe intellectual disability. Journal of Intellectual Disability Research, 44, 108–123.CrossRefGoogle ScholarPubMed
Cicchetti, D., & Toth, S. L. (Eds.) (1991). Internalizing and externalizing expressions of dysfunction. Hillsdale, NJ: Erlbaum.Google Scholar
Comer, R. J. (2002). PDR [physician's desk reference] drug guide for mental health professionals. Montvale, NJ: Thomson Medical Economics.Google Scholar
Davis, N. O., & Kollins, S. H. (2012). Treatment for co-occurring attention deficit/hyperactivity disorder and autism spectrum disorder. Neurotherapeutics, 9, 518–530. doi:10.1007/s13311-012-0126-9 CrossRefGoogle ScholarPubMed
Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20, 775–803. doi:10.1017/S0954579408000370 CrossRefGoogle ScholarPubMed
de Bildt, A., Sytema, S., Kraijer, D., Sparrow, S., & Minderaa, R. (2005). Adaptive functioning and behaviour problems in relation to level of education in children and adolescents with intellectual disability. Journal of Intellectual Disability Research, 49, 672–681. doi:10.1111/j.1365-2788.2005.00711.x CrossRefGoogle ScholarPubMed
Esbensen, A. J., Greenberg, J. S., Seltzer, M. M., & Aman, M. G. (2009). A longitudinal investigation of psychotropic and non-psychotropic medication use among adolescents and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 1339–1349.CrossRefGoogle ScholarPubMed
Farley, M. A., McMahon, W. M., Fombonne, E., Jenson, W. R., Miller, J., Gardner, M., et al. (2009). Twenty-year outcome for individuals with autism and average or near-average cognitive abilities. Autism Research, 2, 109–118. doi:10.1002/aur.69 CrossRefGoogle ScholarPubMed
Filipek, P. A., Accardo, P. J., Ashwal, S., Baranek, G. T., Cook, E. J., Dawson, G., et al. (2000). Practice parameter: Screening and diagnosis of autism: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology, 55, 468–479.CrossRefGoogle Scholar
Fombonne, E. (2003). The prevalence of autism. Journal of the American Medical Association, 289, 87–89. doi:10.1001/jama.289.1.87 CrossRefGoogle ScholarPubMed
Forster, S., Gray, K. M., Taffe, J., Einfeld, S. L., & Tonge, B. J. (2011). Behavioural and emotional problems in people with severe and profound intellectual disability. Journal of Intellectual Disability Research, 55, 190–198. doi:10.1111/j.1365-2788.2010.01373.x CrossRefGoogle ScholarPubMed
Gerber, F., Baud, M. A., Giroud, M., & Carminati, G. G. (2008). Quality of life of adults with pervasive developmental disorders and intellectual disabilities. Journal of Autism and Developmental Disorders, 38, 1654–1665. doi:10.1007/s10803-008-0547-9 CrossRefGoogle ScholarPubMed
Gillberg, C., & Coleman, M. (1992). The biology of the autistic syndromes (2nd ed.). London: MacKeith Press.Google Scholar
Gray, K., Keating, C., Taffe, J., Brereton, A., Einfeld, S., & Tonge, B. (2012). Trajectory of behavior and emotional problems in autism. American Journal on Intellectual and Developmental Disabilities, 117, 121–133. doi:10.1352/1944-7588-117-2.121 CrossRefGoogle ScholarPubMed
Greenberg, J. S., Seltzer, M. M., Hong, J., & Orsmond, G. I. (2006). Bidirectional effects of expressed emotion and behavior problems and symptoms in adolescents and adults with autism. American Journal on Mental Retardation, 111, 229–249.CrossRefGoogle ScholarPubMed
Hastings, R. P., Daley, D., Burns, C., & Beck, A. (2006). Maternal distress and expressed emotion: Cross-sectional and longitudinal relationships with behavior problems of children with intellectual disabilities. American Journal on Mental Retardation, 111, 48–61. doi:10.1352/0895-8017(2006)111[48:MDAEEC]2.0.CO;2 CrossRefGoogle ScholarPubMed
Hastings, R. P., & Lloyd, T. (2007). Expressed emotion in families of children and adults with intellectual disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 13, 339–345. doi:10.1002/mrdd.20173 CrossRefGoogle ScholarPubMed
Hastings, R. P., & Mount, R. H. (2001). Early correlates of behavioural and emotional problems in children and adolescents with severe intellectual disabilities: A preliminary study. Journal of Applied Research in Intellectual Disabilities, 14, 381–391. doi:10.1046/j.13602322.2001.00079.x CrossRefGoogle Scholar
Hauser-Cram, P., & Woodman, A. C. (2015). Trajectories of internalizing and externalizing behavior problems in children with developmental disabilities. Journal of Abnormal Child Psychology, 1–11. doi:10.1007/s10802-015-0055-2 Google Scholar
Hedley, D., & Young, R. (2006). Social comparison processes and depressive symptoms in children and adolescents with Asperger syndrome. Autism, 10, 139–153.CrossRefGoogle ScholarPubMed
Hill, A., Bölte, S., Petrova, G., Beltcheva, D., Tacheva, S., & Poustka, F. (2001). Stability and interpersonal agreement of the interview-based diagnosis of autism. Psychopathology, 34, 187–191. doi:10.1159/000049305 CrossRefGoogle ScholarPubMed
Hofstra, M. B., van der Ende, J., & Verhulst, F. C. (2000). Continuity and change of psychopathology from childhood into adulthood: A 14-year follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 850–858. doi:10.1097/00004583-200007000-00013 CrossRefGoogle ScholarPubMed
Hooley, J. M., & Gotlib, I. H. (2000). A diathesis-stress conceptualization of expressed emotion and clinical outcome. Applied & Preventive Psychology, 9, 135–151. doi:10.1016/S0962-1849(05)80001-0 CrossRefGoogle Scholar
Huerta, M., Bishop, S. L., Duncan, A., Hus, V., & Lord, C. (2012). Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders. American Journal of Psychiatry, 169, 1056–1064.CrossRefGoogle ScholarPubMed
Hurley, R. S., Losh, M., Parlier, M., Reznick, J. S., & Piven, J. (2007). The broad autism phenotype questionnaire. Journal of Autism and Developmental Disorders, 37, 1679–1690.CrossRefGoogle ScholarPubMed
Hutton, J., Goode, S., Murphy, M., Couteur, A. L., & Rutter, M. (2008). New-onset psychiatric disorders in individuals with autism. Autism, 12, 373–390. doi:10.1177/1362361308091650 CrossRefGoogle ScholarPubMed
Jones, B. L., & Nagin, D. S. (2007). Advances in group-based trajectory modeling and an SAS procedure for estimating them. Sociological Methods & Research, 35, 542–571. doi:10.1177/0049124106292364 CrossRefGoogle Scholar
Jones, B. L., Nagin, D. S., & Roeder, K. (2001). A SAS procedure based on mixture models for estimating developmental trajectories. Sociological Methods & Research, 29, 374–393. doi:10.1177/0049124101029003005 CrossRefGoogle Scholar
Katsuki, F., Takeuchi, H., Konishi, M., Sasaki, M., Murase, Y., Naito, A., et al. (2011). Pre–post changes in psychosocial functioning among relatives of patients with depressive disorders after brief multifamily psychoeducation: A pilot study. BMC Psychiatry, 11, 56. doi:10.1186/1471-244X-11-56 CrossRefGoogle ScholarPubMed
Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism, 4, 117–132. doi:10.1177/1362361300004002002 CrossRefGoogle Scholar
Kraatz Keiley, M., Bates, J. E., Dodge, K. A., & Pettit, G. S. (2000). A cross-domain growth analysis: Externalizing and internalizing behaviors during 8 years of childhood. Journal of Abnormal Child Psychology, 28, 161–179. doi:10.1023/A:1005122814723 CrossRefGoogle Scholar
Landa, R. J., Holman, K. C., & Garrett-Mayer, E. (2007). Social and communication development in toddlers with early and later diagnosis of autism spectrum disorders. Archives of General Psychiatry, 64, 853. doi:10.1001/archpsyc.64.7.853 CrossRefGoogle ScholarPubMed
Larsen, F. W., & Mouridsen, S. E. (1997). The outcome in children with childhood autism and Asperger syndrome originally diagnosed as psychotic. A 30-year follow-up study of subjects hospitalized as children. European Child & Adolescent Psychiatry, 6, 181–190. doi:10.1007/BF00539924 CrossRefGoogle ScholarPubMed
Leadbeater, B. J., Kuperminc, G. P., Blatt, S. J., & Hertzog, C. (1999). A multivariate model of gender differences in adolescents’ internalizing and externalizing problems. Developmental Psychology, 35, 1268–1282. doi:10.1037/0012-1649.35.5.1268 CrossRefGoogle ScholarPubMed
Lenior, M. E., Dingemans, P. M., Schene, A. H., Hart, A. A., & Linszen, D. H. (2002). The course of parental expressed emotion and psychotic episodes after family intervention in recent-onset schizophrenia: A longitudinal study. Schizophrenia Research, 57, 183–190. doi:10.1016/S0920-9964(01)00305-X CrossRefGoogle ScholarPubMed
Lord, C., Pickles, A., McLennan, J., Rutter, M., Bregman, J., Folstein, S., et al. (1997). Diagnosing autism: Analyses of data from the Autism Diagnostic Interview. Journal of Autism and Developmental Disorders, 27, 501–517. doi:10.1023/A:1025873925661 CrossRefGoogle ScholarPubMed
Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview—Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685. doi:10.1007/BF02172145 CrossRefGoogle ScholarPubMed
Maenner, M. J., Smith, L. E., Hong, J., Makuch, R., Greenberg, J. S., & Mailick, M. R. (2013). Evaluation of an activities of daily living scale for adolescents and adults with developmental disabilities. Disability and Health Journal, 6, 8–17. doi:10.1016/j.dhjo.2012.08.005 CrossRefGoogle ScholarPubMed
Magaña, A. B., Goldstein, M. J., Karno, M., Miklowitz, D. J., Jenkins, J., & Falloon, I. R. (1986). A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry Research, 17, 203–212.CrossRefGoogle ScholarPubMed
Masten, A. S., Roisman, G. I., Long, J. D., Burt, K. B., Obradović, J., Riley, J. R., et al. (2005). Developmental cascades: Linking academic achievement and externalizing and internalizing symptoms over 20 years. Developmental Psychology, 41, 733–746.CrossRefGoogle ScholarPubMed
Mayes, S. D., Calhoun, S. L., Murray, M. J., & Zahid, J. (2011). Variables associated with anxiety and depression in children with autism. Journal of Developmental and Physical Disabilities, 23, 325–337. doi:10.1007/s10882-011-9231-7 CrossRefGoogle Scholar
McCarty, C. A., Lau, A. S., Valeri, S. M., & Weisz, J. R. (2004). Parent–child interactions in relation to critical and emotionally overinvolved expressed emotion (EE): Is EE a proxy for behavior? Journal of Abnormal Child Psychology, 32, 83–93.CrossRefGoogle Scholar
McCarty, C. A., & Weisz, J. R. (2002). Correlates of expressed emotion in mothers of clinically-referred youth: An examination of the five-minute speech sample. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 43, 759–768. doi:10.1111/1469-7610.00090 CrossRefGoogle ScholarPubMed
McCarthy, J., & Boyd, J. (2001). Psychopathology and young people with Down's syndrome: Childhood predictors and adult outcome of disorder. Journal of Intellectual Disability Research, 45, 99–105. doi:10.1046/j.1365-2788.2001.00335.x CrossRefGoogle Scholar
McClintock, K., Hall, S., & Oliver, C. (2003). Risk markers associated with challenging behaviours in people with intellectual disabilities: A meta-analytic study. Journal of Intellectual Disability Research, 47, 405–416. doi:10.1046/j.1365-2788.2003.00517.x CrossRefGoogle ScholarPubMed
Mouridsen, S. E., Rich, B., Isager, T., & Nedergaard, N. J. (2008). Psychiatric disorders in individuals diagnosed with infantile autism as children: A case control study. Journal of Psychiatric Practice, 14, 5–12. doi:10.1097/01.pra.0000308490.47262.e0 CrossRefGoogle ScholarPubMed
Murphy, G. H., Beadle-Brown, J., Wing, L., Gould, J., Shah, A., & Holmes, N. (2005). Chronicity of challenging behaviours in people with severe intellectual disabilities and/or autism: A total population sample. Journal of Autism and Developmental Disorders, 35, 405–418. doi:10.1007/s10803-005-5030-2 CrossRefGoogle ScholarPubMed
Nagin, D. S. (1999). Analyzing developmental trajectories: A semiparametric, group-based approach. Psychological Methods, 4, 139–157. doi:10.1037/1082-989X.4.2.139 CrossRefGoogle Scholar
Nagin, D. S. (2005). Group-based modeling of development. Cambridge, MA: Harvard University Press.CrossRefGoogle Scholar
Nagin, D. S., & Tremblay, R. E. (2001). Analyzing developmental trajectories of distinct but related behaviors: A group-based method. Psychological Methods, 6, 18–34. doi:10.1037/1082-989X.6.1.18 CrossRefGoogle ScholarPubMed
Ormel, J. J., Oldehinkel, A. J., Ferdinand, R. F., Hartman, C. A., De Winter, A. F., Veenstra, R. R., et al. (2005). Internalizing and externalizing problems in adolescence: General and dimension-specific effects of familial loadings and preadolescent temperament traits. Psychological Medicine, 35, 1825–1835. doi:10.1017/S0033291705005829 CrossRefGoogle ScholarPubMed
Overbeek, G., Stattin, H., Vermulst, A., Ha, T., & Engels, R. C. M. E. (2007). Parent–child relationships, partner relationships, and emotional adjustment: A birth-to-maturity prospective study. Developmental Psychology, 43, 429–437. doi:10.1037/0012-1649.43.2.429 CrossRefGoogle ScholarPubMed
Pandolfi, V., Magyar, C. I., & Dill, C. A. (2009). An initial psychometric evaluation of the CBCL 6–18 in a sample of youth with autism spectrum disorders. Research in Autism Spectrum Disorders, 6, 96–108.CrossRefGoogle Scholar
Pandolfi, V., Magyar, C. I., & Dill, C. A. (2012). Confirmatory factor analysis of the Child Behavior Checklist 1.5–5 in a sample of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 986–995.CrossRefGoogle Scholar
Paskiewicz, T. L. (2009). A comparison of adaptive behavior skills and IQ in three populations: Children with learning disabilities, mental retardation, and autism. Doctoral dissertation, Temple University.Google Scholar
Peris, T. S., & Baker, B. L. (2000). Applications of the expressed emotion construct to young children with externalizing behavior: Stability and prediction over time. Journal of Child Psychology and Psychiatry, 41, 457–462. doi:10.1111/1469-7610.00630 CrossRefGoogle ScholarPubMed
Richardson, S. A., & Koller, H. (1996). Twenty-two years: Causes and consequences of mental retardation. Cambridge, MA: Harvard University Press.Google Scholar
Seltzer, M. M., Krauss, M. W., Shattuck, P. T., Orsmond, G., Swe, A., & Lord, C. (2003). The symptoms of autism spectrum disorders in adolescence and adulthood. Journal of Autism and Developmental Disorders, 33, 565–581. doi:10.1023/B:JADD.0000005995.02453.0b CrossRefGoogle ScholarPubMed
Sepulveda, A. R., Todd, G., Whitaker, W., Grover, M., Stahl, D., & Treasure, J. (2010). Expressed emotion in relatives of patients with eating disorders following skills training program. International Journal of Eating Disorders, 43, 603–610. doi:10.1002/eat.20749 CrossRefGoogle ScholarPubMed
Shattuck, P. T., Seltzer, M. M., Greenberg, J. S., Orsmond, G. I., Bolt, D., Kring, S., et al. (2007). Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 1735–1747. doi:10.1007/s10803-006-0307-7 CrossRefGoogle ScholarPubMed
Smith, L. E., Greenberg, J. S., & Mailick, M. R. (2012). Adults with autism: Outcomes, family effects, and the multi-family group psychoeducation model. Current Psychiatry Reports. Advance online publication. doi:10.1007/s11920-012-0328-1 CrossRefGoogle ScholarPubMed
Smith, L. E., Greenberg, J. S., & Mailick, M. R. (in press). The family context of autism spectrum disorders: Influence on the behavioral phenotype and quality of life. Child and Adolescent Psychiatric Clinics of North America. Google Scholar
Smith, L. E., Greenberg, J. S., Seltzer, M. M., & Hong, J. (2008). Symptoms and behavior problems of adolescents and adults with autism: Effects of mother-child relationship quality, warmth, and praise. American Journal on Mental Retardation, 113, 387–402. doi:10.1352/2008.113:387-402 CrossRefGoogle ScholarPubMed
Solomon, M., Miller, M., Taylor, S. L., Hinshaw, S. P., & Carter, C. S. (2012). Autism symptoms and internalizing psychopathology in girls and boys with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 48–59. doi:10.1007/s10803-011-1215-z CrossRefGoogle ScholarPubMed
Taffe, J. R., Tonge, B. J., Gray, K. M., & Einfeld, S. L. (2008). Extracting more information from behaviour checklists by using components of mean based scores. International Journal of Methods in Psychiatric Research, 17, 232–240. doi:10.1002/mpr.260 CrossRefGoogle ScholarPubMed
Tenneij, B. H., & Hoot, H. M. (2007). A preliminary investigation into the utility of the Adult Behavior Checklist in the assessment of psychopathology in people with low IQ. Journal of Applied Research in Intellectual Disabilities, 20, 391–400.CrossRefGoogle Scholar
Tomas, E. P., Hurtado, G., Noguer, S., Domenech, C., Garcia, M., Lopez, N., et al. (2011). Effectiveness of family work interventions on schizophrenia: Evidence from a multicentre study in Catalonia. International Journal of Social Psychiatry, 58, 587–595. doi:10.1177/0020764011415595 CrossRefGoogle ScholarPubMed
Totsika, V., Felce, D., Kerr, M., & Hastings, R. P. (2010). Behavior problems, psychiatric symptoms, and quality of life for older adults with intellectual disability with and without autism. Journal of Autism and Developmental Disorders, 40, 1171–1178. doi:10.1007/s10803-010-0975-1 CrossRefGoogle ScholarPubMed
Totsika, V., Toogood, S., Hastings, R. P., & Lewis, S. (2008). Persistence of challenging behaviours in adults with intellectual disability over a period of 11 years. Journal of Intellectual Disability Research, 52, 446–457. doi:10.1111/j.1365-2788.2008.01046.x CrossRefGoogle Scholar
Tsakanikos, E., Costello, H., Holt, G., Sturmey, P., & Bouras, N. (2007). Behavior management problems as predictors of psychotropic medication and use of psychiatric services in adults with autism. Journal of Autism and Developmental Disorders, 37, 1080–1085.CrossRefGoogle ScholarPubMed
van der Meer, J. M. J., Oerlemans, A. M., van Steijn, D. J., Lappenschaar, M. G. A., de Sonneville, L. M. J., Buitelaar, J. K., et al. (2012). Are autism spectrum disorder and attention-deficit/hyperactivity disorder different manifestations of one overarching disorder? Cognitive and symptom evidence from a clinical and population-based sample. Journal of the American Academy of Child & Adolescent Psychiatry, 51, 1160–1172. doi:10.1016/j.jaac.2012.08.024 CrossRefGoogle ScholarPubMed
Vickerstaff, S., Heriot, S., Wong, M., Lopes, A., & Dossetor, D. (2007). Intellectual ability, self-perceived social competence, and depressive symptomatology in children with high-functioning autistic spectrum disorders. Journal of Autism and Developmental Disorders, 37, 1647–1664.CrossRefGoogle ScholarPubMed
Wearden, A. J., Tarrier, N., Barrowclough, C., Zastowny, T. R., & Rahill, A. A. (2000). A review of expressed emotion research in health care. Clinical Psychology Review, 20, 633–666.CrossRefGoogle ScholarPubMed
Werry, J. S., & Quay, H. C. (1971). The prevalence of behavior symptoms in younger elementary school children. American Journal of Orthopsychiatry, 41, 136.CrossRefGoogle ScholarPubMed
Widaman, K. F. (2006). Best practices in quantitative methods for developmentalists: Missing data: What to do with or without them. Monographs of the Society for Research in Child Development, 71, 42–64. doi:http://dx.doi.org.proxy.bc.edu/10.1111/j.1540-5834.2006.00404.x Google Scholar
Williams, L., Degnan, K. A., Perez-Edgar, K. E., Henderson, H. A., Rubin, K. H., Pine, D. S., et al. (2009). Impact of behavioral inhibition and parenting style on internalizing and externalizing problems from early childhood through adolescence. Journal of Abnormal Child Psychology, 37, 1063–1075. doi:10.1007/s10802-009-9331-3 CrossRefGoogle ScholarPubMed
World Health Organization. (1992). The ICD-10 classification of mental and behavioral disorders: Clinical descriptions and diagnostic guidelines. Geneva: Author.Google Scholar
Worley, J. A., & Matson, J. L. (2011). Psychiatric symptoms in children diagnosed with an autism spectrum disorder: An examination of gender differences. Research in Autism Spectrum Disorders, 5, 1086–1091. doi:10.1016/j.rasd.2010.12.002 CrossRefGoogle Scholar
Zahn-Waxler, C., Shirtcliff, E. A., & Marceau, K. (2008). Disorders of childhood and adolescence: Gender and psychopathology. Annual Review of Clinical Psychology, 4, 275–303. doi:10.1146/annurev.clinpsy.3.022806.091358 CrossRefGoogle ScholarPubMed