̽��ֱ�� of Cambridge - NIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation Trust

One in four patients in vegetative or minimally conscious state able to perform cognitive tasks, study finds

cjb250 — Wed, 14 Aug 2024 21:00:11 +0000

Severe brain injury can leave individuals unable to respond to commands physically, but in some cases they are still able to activate areas of the brain that would ordinarily play a role in movement. This phenomenon is known as ‘cognitive motor dissociation’.

To determine what proportion of patients in so-called ‘disorders of consciousness’ experience this phenomenon – and help inform clinical practice – researchers across Europe and North America recruited a total of 353 adults with disorders of consciousness, including the largest cohort of 100 patients studied at Cambridge ̽��ֱ�� Hospitals NHS Foundation Trust.

Participants had mostly sustained brain injury from severe trauma, strokes or interrupted oxygen supply to the brain after heart attacks. Most were living in specialised long-term care facilities and a few were living at home with extensive care packages. ̽��ֱ��median time from injury for the whole group was about eight months.

Researchers assessed patterns of brain activation among these patients using functional magnetic resonance imaging (fMRI) or electroencephalography (EEG). Subjects were asked to repeatedly imagine performing a motor activity (for example, “keep wiggling your toes”, “swinging your arm as if playing tennis”, “walking around your house from room to room”) for periods of 15 to 30 seconds separated by equal periods of rest. To be able to follow such instructions requires not only the understanding of and response to a simple spoken command, but also more complex thought processes including paying attention and remembering the command.

̽��ֱ��results of the study are published today in the New England Journal of Medicine.

Dr Emmanuel Stamatakis from the Department of Clinical Neurosciences at the ̽��ֱ�� of Cambridge said: “When a patient has sustained a severe brain injury, there are very important, and often difficult, decisions to be made by doctors and family members about their care. It’s vitally important that we are able to understand the extent to which their cognitive processes are still functioning by utilising all available technology.”

Among the 241 patients with a prolonged disorder of consciousness, who could not make any visible responses to bedside commands, one in four (25%) was able to perform cognitive tasks, producing the same patterns of brain activity recorded with EEG and/or fMRI that are seen in healthy subjects in response to the same instructions.

In the 112 patients who did demonstrate some motor responses to spoken commands at the bedside, 38% performed these complex cognitive tasks during fMRI or EEG. However, the majority of these patients (62%) did not demonstrate such brain activation. This counter-intuitive finding emphasises that the fMRI and EEG tasks require patients to have complex cognitive abilities such as short-term memory and sustained concentration, which are not required to the same extent for following bedside commands.

These findings are clinically very important for the assessment and management of the estimated 1,000 to 8,000 individuals in the UK in the vegetative state and 20,000 to 50,000 in a minimally conscious state. ̽��ֱ��detection of cognitive motor dissociation has been associated with more rapid recovery and better outcomes one year post injury, although the majority of such patients will remain significantly disabled, albeit with some making remarkable recoveries.

Dr Judith Allanson, Consultant in Neurorehabilitation, said: “A quarter of the patients who have been diagnosed as in a vegetative or minimally conscious state after detailed behavioural assessments by experienced clinicians, have been found to be able to imagine carrying out complex activities when specifically asked to. This sobering fact suggests that some seemingly unconscious patients may be aware and possibly capable of significant participation in rehabilitation and communication with the support of appropriate technology.

“Just knowing that a patient has this ability to respond cognitively is a game changer in terms of the degree of engagement of caregivers and family members, referrals for specialist rehabilitation and best interest discussions about the continuation of life sustaining treatments.”

̽��ֱ��researchers caution that care must be taken to ensure the findings are not misrepresented, pointing out, for example, that a negative fMRI/EEG result does not per se exclude cognitive motor dissociation as even some healthy volunteers do not show these responses.

Professor John Pickard, emeritus professorial Fellow of St Catharine's College, Cambridge, said: “Only positive results – in other words, where patients are able to perform complex cognitive processes – should be used to inform management of patients, which will require meticulous follow up involving specialist rehabilitation services.”

̽��ֱ��team is calling for a network of research platforms to be established in the UK to enable multicentre studies to examine mechanisms of recovery, develop easier methods of assessment than task-based fMRI/EEG, and to design novel interventions to enhance recovery including drugs, brain stimulation and brain-computer interfaces.

̽��ֱ��research reported here was primarily funded by the James S. McDonnell Foundation. ̽��ֱ��work in Cambridge was supported by the National Institute for Health and Care Research UK, MRC, Smith’s Charity, Evelyn Trust, CLAHRC ARC fellowship and the Stephen Erskine Fellowship (Queens’ College).

Reference
Bodien, YG et al. Cognitive Motor Dissociation in Disorders of Consciousness. NEJM; 14 Aug 2024; DOI: 10.1056/NEJMoa2400645

Adapted from a press release from Weill Cornell Medicine

Around one in four patients with severe brain injury who cannot move or speak – because they are in a prolonged coma, vegetative or minimally conscious state – is still able to perform complex mental tasks, a major international study has concluded in confirmation of much smaller previous studies.

When a patient has sustained a severe brain injury, there are very important, and often difficult, decisions to be made by doctors and family members about their care

Emmanuel Stamatakis

Witthaya Prasongsin (Getty Images)

Male patient in a hospital bed - stock image

Acknowledgements

̽��ֱ��multidisciplinary Cambridge Impaired Consciousness Research Group, led by Emeritus Professors John Pickard (Neurosurgery) & David Menon (Anaesthesia) and Drs Judith Allanson & Emmanuel A. Stamatakis (Lead, Cognition and Consciousness Imaging Group), started its research programme in 1997, partly in response to emerging concern over the misdiagnosis of the vegetative state. This pioneering work has only been possible by having access to the world class resources of the Wolfson Brain Imaging Centre, the NIHR/Wellcome Clinical Research Facility at Addenbrooke’s Hospital, the MRC Cognition and Brain Sciences Unit (Professors Barbara Wilson & Adrian Owen), the Royal Hospital for Neuro-disability (Putney) and the Central England Rehabilitation Unit (Royal Leamington Spa).

̽��ֱ��text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Mindfulness training may lead to altered states of consciousness, study finds

cjb250 — Wed, 17 Jul 2024 18:00:20 +0000

̽��ֱ��team say that while these experiences can be very positive, that is not always the case. Mindfulness teachers and students need to be aware that they can be a side-effect of training, and students should feel empowered to share their experiences with their teacher or doctor if they have any concerns.

Mindfulness-based programmes have become very popular in recent years. According to recent surveys, 15% of adults in the UK have learnt some form of mindfulness. They are often practised as a way of reducing stress or coping with depression and anxiety. There is anecdotal evidence that practising mindfulness can lead to alterations of the senses, self, and body boundaries, some even similar to those induced by psychotropic drugs.

From September 2015 to January 2016, the ̽��ֱ�� of Cambridge conducted a randomised controlled trial to assess the effectiveness of mindfulness training as a way of coping with the stress of examinations and found that it can help support students at risk of mental health problems.

Dr Julieta Galante from the Department of Psychiatry at the ̽��ֱ�� of Cambridge, who led the trial, said: “There’s been anecdotal evidence that people who practice mindfulness experience changes in how they perceive themselves and the world around them, but it’s difficult to know whether these experiences are a result of mindfulness practice or whether people who are more prone to such experiences are also more likely to practise mindfulness.

“Because we’d been running a randomised trial of mindfulness practice with several hundred students at Cambridge, we realised this offered us an opportunity to explore this question further.”

̽��ֱ��team behind the trial followed up with participants a year later to investigate whether they had experienced any of the altered states of consciousness being reported anecdotally. ̽��ֱ��results are published today in PLOS ONE.

Participants were asked to complete a questionnaire that explored 11 ‘dimensions’ such as: spiritual experience; blissful state; disembodiment; and unity. In experiences of unity there is a sense that borders dissolve and everything, sometimes including the sense of time, is perceived in an integrated way. Disembodiment experiences often consist of a floating sensation or a dissolution of body boundaries, which may facilitate strong unity experiences.

In total, 670 participants took part in the randomised trial. Around a third each from the mindfulness trial and the control arm went on to complete the questionnaire about experiences of altered states of consciousness.

̽��ֱ��researchers found that people who had received the mindfulness training were twice as likely as those in the control group to experience unity and disembodiment.

When the researchers explored the relationship between the total hours of formal mindfulness practice and the presence and intensity of experiences of altered states of consciousness, they found that the more people practised, the more likely they were to have an experience of unity, disembodiment, or of a blissful state.

Participants who reported having meditated in the six months prior were asked if altered states of consciousness happened during meditation. Based on this sub-sample of 73 participants, 43% reported unity experiences during meditation, 47% blissful states, 29% disembodiment experiences, and 25% insightfulness experiences.

Dr Galante said: “Although we can’t say definitively, our results at least suggest the possibility that mindfulness training causes these experiences of unity and disembodiment. It aligns with other studies showing that people who practice mindfulness training are more likely to describe experiencing a sense of relaxed self-boundaries and broadening their spatial awareness beyond the physical body.”

Dr Galante, who practices mindfulness, has herself experienced these altered states of consciousness.

“I’ve benefited a lot personally from meditation and mindfulness and I’ve also had many of these experiences,” she said. “They were intense, and at first I found it difficult to share them with my meditation teacher. I didn’t know if they were normal or desirable or if they were a sign of problems with my mental health.”

While many experiences of altered states of consciousness are likely to be interpreted as pleasant, this may not always be the case, and Dr Galante says that it is important for teachers and their students to be aware that they may arise and be open to talking about them.

She added: “ ̽��ֱ��most common and intense experiences tend to be those that do not have intrinsically unpleasant characteristics. Some, such as bliss, can feel extremely pleasant. But some experiences, such as disembodiment or altered sense of self could be perceived as unpleasant, or startling, even alarming, especially if you’re not expecting them.

“It’s important that people who are offered mindfulness are told about the possibility that they may come across these experiences. That way, if they do experience them, they shouldn’t be disconcerted. There may be nothing wrong with their experience, but it may be useful for them to check in with their mindfulness teacher, and if the experience was negative, to also consider discussing it with their doctor.”

̽��ֱ��research was supported by the ̽��ֱ�� of Cambridge Vice-Chancellor’s Endowment Fund, the ̽��ֱ�� Counselling Service and the National Institute for Health Research (NIHR) Applied Research Collaboration East of England programme.

Reference

Galante, J & Montero-Marin, J et al. Altered states of consciousness caused by a mindfulness-based programme up to a year later: results from a randomised controlled trial. PLOS ONE; 17 July 2024; DOI: 10.1371/journal.pone.0305928

Mindfulness training may lead participants to experience disembodiment and unity – so-called altered states of consciousness – according to a new study from researchers at the ̽��ֱ�� of Cambridge.

I’ve benefited a lot personally from meditation and mindfulness and I’ve also had many of these experiences. I didn’t know if they were normal or desirable

Julieta Galante

Dingzeyu Li

Woman sitting on sand at sunset meditating

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Study unpicks why childhood maltreatment continues to impact on mental and physical health into adulthood

cjb250 — Thu, 11 Apr 2024 14:31:51 +0000

Individuals who experienced maltreatment in childhood – such as emotional, physical and sexual abuse, or emotional and physical neglect – are more likely to develop mental illness throughout their entire life, but it is not yet well understood why this risk persists many decades after maltreatment first took place.

In a study published in Proceedings of the National Academy of Sciences, scientists from the ̽��ֱ�� of Cambridge and Leiden ̽��ֱ�� found that adult brains continue to be affected by childhood maltreatment in adulthood because these experiences make individuals more likely to experience obesity, inflammation and traumatic events, all of which are risk factors for poor health and wellbeing, which in turn also affect brain structure and therefore brain health.

̽��ֱ��researchers examined MRI brain scans from approximately 21,000 adult participants aged 40 to 70 years in UK Biobank, as well as information on body mass index (an indicator of metabolic health), CRP (a blood marker of inflammation) and experiences of childhood maltreatment and adult trauma.

Sofia Orellana, a PhD student at the Department of Psychiatry and Darwin College, ̽��ֱ�� of Cambridge, said: “We’ve known for some time that people who experience abuse or neglect as a child can continue to experience mental health problems long into adulthood and that their experiences can also cause long term problems for the brain, the immune system and the metabolic system, which ultimately controls the health of your heart or your propensity to diabetes for instance. What hasn’t been clear is how all these effects interact or reinforce each other.”

Using a type of statistical modelling that allowed them to determine how these interactions work, the researchers confirmed that experiencing childhood maltreatment made individuals more likely to have an increased body mass index (or obesity) and experience greater rates of trauma in adulthood. Individuals with a history of maltreatment tended to show signs of dysfunction in their immune systems, and the researchers showed that this dysfunction is the product of obesity and repeated exposure to traumatic events.

Next, the researchers expanded their models to include MRI measures of the adult’s brains and were able to show that widespread increases and decreases in brain thickness and volume associated with greater body mass index, inflammation and trauma were attributable to childhood maltreatment having made these factors more likely in the first place. These changes in brain structure likely mean that some form of physical damage is occurring to brain cells, affecting how they work and function.

Although there is more to do to understand how these effects operate at a cellular level in the brain, the researchers believe that their findings advance our understanding of how adverse events in childhood can contribute to life-long increased risk of brain and mind health disorders.

Professor Ed Bullmore from the Department of Psychiatry, Cambridge, said: “Now that we have a better understanding of why childhood maltreatment has long term effects, we can potentially look for biomarkers – biological red flags – that indicate whether an individual is at increased risk of continuing problems. This could help us target early on those who most need help, and hopefully aid them in breaking this chain of ill health.”

Professor Bullmore is a Fellow at Lucy Cavendish College and and an Honorary Fellow at Downing College.

̽��ֱ��research was supported by MQ: Transforming Mental Health, the Royal Society, Medical Research Council, National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre, the NIHR Applied Research Collaboration East of England, Girton College and Darwin College.

Reference
Orellana, SC et al. Childhood maltreatment influences adult brain structure through its effects on immune, metabolic and psychosocial factors. PNAS; 9 Apr 2024 ; DOI: 10.1073/pnas.230470412

Childhood maltreatment can continue to have an impact long into adulthood because of how it effects an individual’s risk of poor physical health and traumatic experiences many years later, a new study has found.

We’ve known for some time that people who experience abuse or neglect as a child can continue to experience mental health problems long into adulthood

Sofia Orellana

mali desha (Unsplash)

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Largest genetic study of brain structure identifies how the brain is organised

cjb250 — Thu, 17 Aug 2023 15:00:47 +0000

Our brains are very complex organs, with huge variety between individuals in terms of the overall volume of the brain, how it is folded and how thick these folds are. Little is known about how our genetic make-up shapes the development of the brain.

To answer this question, a team led by researchers at the Autism Research Centre, ̽��ֱ�� of Cambridge, accessed MRI scans from over 32,000 adults from the UK Biobank cohort and over 4,000 children from the US-based ABCD study. From these scans, the researchers measured multiple properties of the outermost layer of the brain called the cortex. These included measures of the area and volume of the cortex as well as how the cortex is folded.

They then linked these properties, measured both across the entire cortex as well as in 180 individual regions of the cortex, to genetic information across the genome. ̽��ֱ��team identified over 4,000 genetic variants linked to brain structure.

These findings have allowed researchers to confirm and, in some cases, identify, how different properties of the brain are genetically linked to each other.

Dr Varun Warrier from the Autism Research Centre, who co-led the study, said: “One question that has interested us for a while is if the same genes that are linked to how big the cortex is – measured as both volume and area – are also linked to how the cortex is folded. By measuring these different properties of the brain and linking them to genetics, we found that different sets of genes contribute to folding and size of the cortex.”

̽��ֱ��team also checked whether the same genes that are linked to variation in brain size in the general population overlap with genes linked to clinical conditions where head sizes are much larger or smaller than the general population, known as cephalic conditions.

Dr Richard Bethlehem, also from the Autism Research Centre and a co-lead of the study, said: “Many of the genes linked with differences in the brain sizes in the general population overlapped with genes implicated in cephalic conditions. However, we still do not know how exactly these genes lead to changes in brain size.”

Dr Warrier added: “This work shows that how our brain develops is partly genetic. Our findings can be used to understand how changes in the shape and size of the brain can lead to neurological and psychiatric conditions, potentially leading to better treatment and support for those who need it.”

This study was supported by the Wellcome Trust. It was conducted in association with the NIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation Trust, and the NIHR Cambridge Biomedical Research Centre.

Reference
Warrier, V et al. Genetic insights into human cortical organisation and development through genome-wide analyses of 2,347 neuroimaging phenotypes. Nat Gen; 17 Aug 2023; DOI: 10.1038/s41588-023-01475-y

̽��ֱ��largest ever study of the genetics of the brain – encompassing some 36,000 brain scans – has identified more than 4,000 genetic variants linked to brain structure. ̽��ֱ��results of the study, led by researchers at the ̽��ֱ�� of Cambridge, are published in Nature Genetics.

Our findings can be used to understand how changes in the shape and size of the brain can lead to neurological and psychiatric conditions, potentially leading to better treatment and support for those who need it

Varun Warrier

holdendrils

Illustration of brain anatomy

̽��ֱ��text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Autism rates have increased and show differences in ethnic minorities and links to social disadvantage

cjb250 — Mon, 29 Mar 2021 15:00:20 +0000

Black and Chinese pupils were 26% and 38% more likely to be autistic respectively and autistic children were much more likely to face significant social disadvantage. ̽��ֱ��results are published today in JAMA Pediatrics.

̽��ֱ��team drew on data from the School Census from the National Pupil Database, collected by the Department for Education from individuals aged 2-21 years old in state-funded schools in England. Of more than seven million pupils studied, 119,821 pupils had a diagnosis of autism in their record in the English state educational system, of whom 21,660 also had learning difficulties (18.1%). Boys showed a prevalence of autism of 2.8% and girls showed a prevalence of 0.65%, with a boy-to-girl ratio of 4.3:1.

Prevalence was highest in pupils of black ethnicity (2.1%) and lowest in Roma/Irish Travellers (0.85%), with these estimates being the first to be published for these populations. Pupils with a record of autism in schools were 60% more likely to also be socially disadvantaged, and 36% less likely to speak English. ̽��ֱ��findings reveal significant differences in autism prevalence, as recorded in formal school systems, across ethnic groups and geographical location.

̽��ֱ��lead researcher of the study, Dr Andres Roman-Urrestarazu from the Autism Research Centre (ARC) and Cambridge Public Health at the ̽��ֱ�� of Cambridge, said: “We can now see that autism is much more common than previously thought. We also found significant variations in autism diagnosis in different ethnic minorities, though the reason why this should be the case isn’t clear and warrants further research.”

Previous estimates of the prevalence of autism in the UK by the same research group in Cambridge, and based on a school-based survey, suggested that one in 64 children (1.57%) were autistic. ̽��ֱ��new study, based on school records that usually underestimate the actual proportion of children who meet diagnostic criteria, shows a considerable increase in the autism prevalence in England. ̽��ֱ��researchers say the increase is likely to be because autism has become better recognised by both parents and schools in recent years.

Professor Carol Brayne, Co-chair of Cambridge Public Health and Professor of Public Health Medicine, said: “This study shows how we can draw on large datasets in a way that is rigorous and valuable for our understanding of autism.”

Professor Fiona Matthews from Newcastle ̽��ֱ�� added: “This study highlights the need for more attention to the unrecognised and differing needs of autistic children from disadvantaged and diverse backgrounds.”

Professor Simon Baron-Cohen, Director of the ARC, said: “We can now see a snapshot of how many autistic children there are, and can drill down into local and ethnic variation, and reveal links with vulnerability. It is important that we safeguard the rights of children to access diagnostic services and education, tailored to their needs.”

This research was made possible by a generous donation for a Global Public Health Leadership programme by Dennis and Mireille Gillings Fellowship awarded to Dr Andres Roman-Urrestarazu. This study was also supported by the Autism Research Trust, the Wellcome Trust, the Innovative Medicines Initiative 2 Joint Undertaking (JU), the NIHR Cambridge Biomedical Research Centre and the NIHR Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation Trust.

Reference
Roman-Urrestarazu, R et al. Association of Race/Ethnicity and Social Disadvantage With Autism Prevalence in 7 Million School Children in England. JAMA Pediatrics; 29 March 2021; DOI: 10.1001/jamapediatrics.2021.0054

Around one in 57 (1.76%) children in the UK is on the autistic spectrum, significantly higher than previously reported, according to a study of more than seven million children carried out by researchers from the ̽��ֱ�� of Cambridge’s Department of Psychiatry, in collaboration with researchers from Newcastle ̽��ֱ�� and Maastricht ̽��ֱ��.

It is important that we safeguard the rights of children to access diagnostic services and education, tailored to their needs

Simon Baron-Cohen

Artsy Solomon

Boy at sunset

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Transgender and gender-diverse individuals are more likely to be autistic and report higher autistic traits

cjb250 — Fri, 07 Aug 2020 08:50:07 +0000

This research, conducted using data from over 600,000 adult individuals, confirms previous smaller scale studies from clinics. ̽��ֱ��results are published today in Nature Communications.

A better understanding of gender diversity in autistic individuals will help provide better access to health care and post-diagnostic support for autistic transgender and gender-diverse individuals.

̽��ֱ��team used five different datasets, including a dataset of over 500,000 individuals collected as a part of the Channel 4 documentary “Are you autistic?”. In these datasets, participants had provided information about their gender identity, and if they received a diagnosis of autism or other psychiatric conditions such as depression or schizophrenia. Participants also completed a measure of autistic traits.

Strikingly, across all five datasets, the team found that transgender and gender-diverse adult individuals were between three and six times more likely to indicate that they were diagnosed as autistic compared to cisgender individuals. While the study used data from adults who indicated that they had received an autism diagnosis, it is likely that many individuals on the autistic spectrum may be undiagnosed. As around 1.1% of the UK population is estimated to be on the autistic spectrum, this result would suggest that somewhere between 3.5.-6.5% of transgender and gender-diverse adults is on the autistic spectrum.

Dr Meng-Chuan Lai, a collaborator on the study at the ̽��ֱ�� of Toronto, said: “We are beginning to learn more about how the presentation of autism differs in cisgender men and women. Understanding how autism manifests in transgender and gender-diverse people will enrich our knowledge about autism in relation to gender and sex. This enables clinicians to better recognize autism and provide personalised support and health care.”

Transgender and gender-diverse individuals were also more likely to indicate that they had received diagnoses of mental health conditions, particularly depression, which they were more than twice as likely as their cisgender counterparts to have experienced. Transgender and gender-diverse individuals also, on average, scored higher on measures of autistic traits compared to cisgender individuals, regardless of whether they had an autism diagnosis.

Dr Varun Warrier, who led the study, said: “This finding, using large datasets, confirms that the co-occurrence between being autistic and being transgender and gender-diverse is robust. We now need to understand the significance of this co-occurrence, and identify and address the factors that contribute to well-being of this group of people.”

̽��ֱ��study investigates the co-occurrence between gender identity and autism. ̽��ֱ��team did not investigate if one causes the other.

Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge, and a member of the team, said: “Both autistic individuals and transgender and gender-diverse individuals are marginalized and experience multiple vulnerabilities. It is important that we safe-guard the rights of these individuals to be themselves, receive the requisite support, and enjoy equality and celebration of their differences, free of societal stigma or discrimination.”

Dr Warrier is a Research Fellow at St Catharine's College and Professor Baron Cohen is a Fellow at Trinity College.

This study was supported by the Autism Research Trust, the Medical Research Council, the Wellcome Trust, and the Templeton World Charity Foundation., Inc. It was conducted in association with the NIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation Trust, and the NIHR Cambridge Biomedical Research Centre.

Reference
Warrier, V et al. Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses and autistic traits in transgender and gender-diverse individuals. Nat Comms; 7 Aug 2020; DOI: 10.1038/s41467-020-17794-1

Transgender and gender-diverse adults are three to six times more likely as cisgender adults (individuals whose gender identity corresponds to their sex assigned at birth) to be diagnosed as autistic, according to a new study by scientists at the ̽��ֱ�� of Cambridge’s Autism Research Centre.

Both autistic individuals and transgender and gender-diverse individuals are marginalized and experience multiple vulnerabilities. It is important that we safe-guard the rights of these individuals to be themselves, receive the requisite support, and enjoy equality and celebration of their differences, free of societal stigma or discrimination

Simon Baron Cohen

katlove

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Higher rates of post-natal depression among autistic mothers

Anonymous — Wed, 15 Jan 2020 09:37:39 +0000

̽��ֱ��team recruited an advisory panel of autistic mothers with whom they co-developed an anonymous, online survey. After matching, this was completed by 355 autistic and 132 non-autistic mothers, each of whom had at least one autistic child.

Sixty percent of autistic mothers in the study reported they had experienced post-natal depression. By comparison, only 12% of women in the general population experience post-natal depression. In addition, autistic mothers had more difficulties in multi-tasking, coping with domestic responsibilities, and creating social opportunities for their child.

̽��ֱ��study also found that when autistic mothers disclosed their autism diagnosis to a professional, they were not believed the majority of the time. Autistic women felt misunderstood by professionals more frequently during pre- and post-natal appointments and found motherhood an isolating experience. Despite these challenges, autistic mothers reported they were able to act in the best interest of their child, putting their child’s needs first and seeking opportunities to boost their child’s self-confidence.

Dr Alexa Pohl, who led the study, said: “Autistic mothers face unique challenges during the perinatal period and parenthood. Despite these challenges, an overwhelming majority of autistic mothers reported that parenting overall was a rewarding experience. This research highlights the need for increased awareness of the experiences of motherhood for autistic women and the need for more tailored support.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge, and part of the team, said: “This worryingly high number of autistic mothers who experience post-natal depression means we are failing them and their infants at a critical point in their lives. We now need more research into why the rates are so much higher, whether they are seeking help and not getting it, or if they are not seeking help and for what reasons. A new research priority is to develop autism-relevant screening tools and interventions for post-natal depression in these mothers.”

Monique Blakemore, an autistic advocate and member of the team, said: “This vital study was initiated by the autistic community, who collaborated as equal partners with researchers in the design, dissemination and interpretation of the survey. This is an excellent example of what can be achieved through such partnership.”

The study was supported by the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC), East of England, at Cambridgeshire and Peterborough NHS Foundation Trust, the Autism Research Trust, the MRC, the NIHR Cambridge Biomedical Research Centre, and Autistica.

Reference
A comparative study of autistic and nonautistic women’s experience of motherhood by Alexa Pohl, Sarah Crockford, Monique Blakemore, Carrie Allison and Simon Baron-Cohen. Molecular Autism. DOI: 10.1186/s13229-019-0304-2

Autistic mothers are more likely to report post-natal depression compared to non-autistic mothers, according to a new study of mothers of autistic children carried out by researchers at the ̽��ֱ�� of Cambridge. A better understanding of the experiences of autistic mothers during pregnancy and the post-natal period is critical to improving wellbeing. ̽��ֱ��results are published in Molecular Autism.

Autistic mothers face unique challenges during the perinatal period and parenthood. Despite these challenges, an overwhelming majority of autistic mothers reported that parenting overall was a rewarding experience

Alexa Pohl

angel4leon

Infant newborn love

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Genetic variants for autism linked to higher rates of self-harm and childhood maltreatment

cjb250 — Tue, 29 Oct 2019 01:03:43 +0000

Previous studies by the Cambridge team established that autistic individuals experience higher levels of self-harm, including suicidal thoughts and feelings, and higher rates of childhood maltreatment. This new study shows that the findings hold true even for those with a higher genetic likelihood of autism rather than a formal diagnosis.

̽��ֱ��team calculated the genetic likelihood for autism in 100,000 individuals from the UK Biobank Study who had their DNA analysed and who had also provided self-reported information about childhood maltreatment, suicidal ideation, and self-harm. They found that individuals with higher number of genetic variants associated with autism are more likely to report childhood maltreatment, self-harm and suicidal ideation. Those with the highest genetic predisposition to autism on average have a 28% increase in childhood maltreatment, and a 33% increase in self-harm and suicidal ideation, compared to those with the lowest genetic predisposition to autism.

Dr Varun Warrier, who led the study, said: “While we have found an association between a genetic likelihood for autism and adverse life events, we cannot conclude the former causes the latter. We suspect this association reflects that genes partly influence how many autistic traits you have, and some autistic traits such as difficulties in social understanding may lead to a person to be vulnerable to maltreatment. This research highlights the risks of such adverse outcomes for those with a high number of autistic traits, if adequate safe-guarding and support aren’t provided.”

Professor Simon Baron-Cohen, Director of the Autism Research Centre at Cambridge, said: “This new study extends our earlier work by showing that individuals who carry more of the genes associated with autism have higher risks for maltreatment and self-harm. Our work highlighting unacceptably high rates of suicide in autistic people was published 5 years ago, yet almost no new support has been provided. Governments need to provide far greater support for autistic individuals and for those with a high number of autistic traits.”

He added: “Autistic individuals may need a variety of interventions – there’s no ‘one size fits all’ – and these may include an individual support worker, a mentor, opportunities to build social and communication skills and self confidence through activities that the person enjoys, peer support groups, and supported employment schemes. Schools may also need to increase safe-guarding given the risks of victimisation.”

This study was supported by the Autism Research Trust, the Medical Research Council, Wellcome, and the Templeton World Charity Foundation., Inc. It was conducted in association with the NIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation Trust, and the NIHR Cambridge Biomedical Research Centre.

Reference
Warrier, V and Baron-Cohen, S. Childhood trauma, life-time self-harm, and suicidal behaviour and ideation are associated with polygenic scores for autism. Molecular Psychiatry; 29 Oct 2019; DOI: 10.1038/s41380-019-0550-x

People with a higher genetic likelihood of autism are more likely to report higher childhood maltreatment, self-harm and suicidal thoughts according to a new study by researchers at the ̽��ֱ�� of Cambridge. A better understanding of these issues is critical to improving wellbeing in autistic people. ̽��ֱ��results are published today in Molecular Psychiatry.

Our work highlighting unacceptably high rates of suicide in autistic people was published 5 years ago, yet almost no new support has been provided. Governments need to provide far greater support for autistic individuals and for those with a high number of autistic traits

Simon Baron Cohen

Sasha Freemind

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