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Autism Res. 2017 Feb;10(2):276-288. doi: 10.1002/aur.1646. Epub 2016 Jun 20.

Psychophysiological Associations with Gastrointestinal Symptomatology in Autism Spectrum Disorder.

Author information

1
Interdisciplinary Neuroscience Program, University of Missouri.
2
The Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri.
3
Department of Child and Adolescent Psychiatry, Vanderbilt University Medical Center.
4
Massachusetts General Hospital Biostatistics Center.
5
Departments of Pediatrics, Psychology, and Psychiatry, Vanderbilt University.
6
Department of Child Health, University of Missouri.
7
University of Missouri School of Medicine.
8
College of Arts and Sciences, University of Missouri.
9
Department of Psychological Sciences, University of Missouri.
10
Department of Health Psychology, University of Missouri.
11
Harvard Medical School.
12
Boston University School of Medicine.
13
Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University.
14
Department of Psychiatry and Sackler Institute for Developmental Psychobiology, Columbia University.
15
New York State Psychiatric Institute; New York Presbyterian Hospital Center for Autism and the Developing Brain.
16
William and Nancy Thompson Chair in Radiology, Departments of Radiology, Neurology, and Psychological Sciences, University of Missouri.

Abstract

Autism spectrum disorder (ASD) is often accompanied by gastrointestinal disturbances, which also may impact behavior. Alterations in autonomic nervous system functioning are also frequently observed in ASD. The relationship between these findings in ASD is not known. We examined the relationship between gastrointestinal symptomatology, examining upper and lower gastrointestinal tract symptomatology separately, and autonomic nervous system functioning, as assessed by heart rate variability and skin conductance level, in a sample of 120 individuals with ASD. Relationships with co-occurring medical and psychiatric symptoms were also examined. While the number of participants with significant upper gastrointestinal tract problems was small in this sample, 42.5% of participants met criteria for functional constipation, a disorder of the lower gastrointestinal tract. Heart rate variability, a measure of parasympathetic modulation of cardiac activity, was found to be positively associated with lower gastrointestinal tract symptomatology at baseline. This relationship was particularly strong for participants with co-occurring diagnoses of anxiety disorder and for those with a history of regressive ASD or loss of previously acquired skills. These findings suggest that autonomic function and gastrointestinal problems are intertwined in children with ASD; although it is not possible to assess causality in this data set. Future work should examine the impact of treatment of gastrointestinal problems on autonomic function and anxiety, as well as the impact of anxiety treatment on gastrointestinal problems. Clinicians should be aware that gastrointestinal problems, anxiety, and autonomic dysfunction may cluster in children with ASD and should be addressed in a multidisciplinary treatment plan. Autism Res 2017, 10: 276-288.

KEYWORDS:

anxiety; autism spectrum disorder; autonomic nervous system; constipation; gastrointestinal; parasympathetic; sympathetic

PMID:
27321113
PMCID:
PMC5526214
DOI:
10.1002/aur.1646
[Indexed for MEDLINE]
Free PMC Article

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