Psychiatric and psychosocial implications of Asperger syndrome and high-functioning autism

Psychiatric and Psychosocial Implications Associated With as/Hfa

What are the psychiatric and psychosocial implications associated with Asperger syndrome and high functioning autism?

Asperger Syndrome and High Functioning Autism are two disorders that are overlapping and characterized by the impairment of social-communication and over-focused repetitive behaviors and interests. The two disorders are part of the autism spectrum, and the major difference is believed to be in language development. People with AS will not have suffered any delayed language development when they were young. According to Barbalat, Leboyer, and Zalla (2014) a person suffering from AS/HFA will demonstrate pedantic speech mostly with exaggerated or monotonous vocal intonation, motor clumsiness, and poor nonverbal communication. Though AS and classic autism belong to the same group of ASDs, people with AS mostly demonstrate a distinct pattern of social impairment, which seems milder than in classic autism. It has been hypothesized many times that the differences between classic autism and AS are both qualitative and quantitative. Clinicians and families are faced with challenges trying to manage the behavioral problems associated with autism spectrum disorders. The psychiatric disorders associated with this disorder could exacerbate the behavioral dyscontrol. Since individuals with AS and HFA have an impairment describing their feelings and emotions, it is not easy to recognize and detect other psychiatric disorders masked by the autistic symptoms.

Psychiatric disorders frequently associated with AS/HFA

Internalizing symptoms like bipolar disorders, depression, and anxiety have been associated with AS/HFA. Research has shown that there is a bidirectional association between autistic symptoms and internalizing disorders. In comparison to healthy control subjects, people with AS had more social anxiety symptoms in a controlled study. There have been documented associations with OCD, but this is difficult to determine if the obsessive-repetitive behaviors are expressions of other forms of OCD. Various studies have been carried out with an aim of establishing the association between OCD and autistic symptoms, but they have all had different results. There have been reported associations between AS/HFA with attention deficit hyperactivity disorder. Disruptive behavior and conduct behaviors are other externalizing behaviors associated with AS/HFA. Although it is not possible to perform a diagnosis of ADHD in terms of ASD according to DSM-IV criteria. However, in the DSM-V proposal the debate of ADHD comorbidity in ASDs is open.

The relationship between psychopathy and AS/HFA is controversial, but some studies have strongly suggested there is a relation by demonstrating the increased risk of crimes in AS. This suggestion is not clear because there have been contrasting results in different studies. It has been established that Tourette syndrome and other tic disorders are associated with AS (Wilson et al., 2014). It was established by a Swedish study that 20% of school-age children with AS fitted the full criteria for Tourette syndrome (TS). Other authors believe this comorbidity is a predictor of better outcome autistic symptoms. The data collected so far has not been sufficient to support this hypothesis.

Challenges trying to determine if psychiatric symptoms are phenotypic manifestations of AS/HFA

The use of longitudinal studies would allow researchers to follow developmental trajectories and detect any subtle changes. This would be an effective methodology to determine if the psychiatric symptoms are manifestations of AS/HFA. The masking of symptoms is a major challenge that clinicians and researchers are faced with. If the symptoms were clear, it would be easy to establish if they are related to AS/HFA or are merely psychiatric. The onset of AS is normally associated with the decrease in obsessive and repetitive disorders. This would make it hard for a clinician to establish easily if the person is recovering from OCD, or they are developing AS. If the clinician had used a longitudinal study, they would have determined the reasons for the decrease. The tools available for diagnosing AS/HFA are limited in that they must be modified to fit the diagnosis. This presents many challenges because each researcher would interpret or modify the scale differently. Clinicians have the huge challenge because they would be forced to use clinical interviews, which would be difficult to administer for people with AS/HFA. A person with AS/HFA would find it difficult to sustain a reciprocal conversation, discuss about their self, or perform any self-reporting.