Tag: Autism

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Group CBT targeting hostile attribution bias in adolescents and young adults with ASD traits

BackgroundAdolescence is characterized by heightened self-consciousness and sensitivity to social evaluations. During this period, hostile attribution bias—interpreting ambiguous social cues as hostile—can lower quality of life (QOL) and contribute to future mental health problems. Adolescents with autism spectrum disorder (ASD) show similar difficulties, often more pronounced due to their cognitive style and interpersonal vulnerabilities. Group cognitive behavioral therapy (CBT) aims to correct such biases through structured cognitive and social experiences. This study evaluated the psychological effects of group CBT on hostile attribution bias, social functioning, and QOL in adolescents and young adults with ASD traits.MethodsWe conducted an 8-session group CBT program focusing on hostile attribution bias and suspiciousness in 21 adolescents and young adults with ASD traits attending a hospital psychiatric outpatient department. The 15 participants who completed the program were included in analyzes. Psychological indices included hostile attribution bias (Ambiguous Intentions Hostility Questionnaire), social functioning (Social Responsiveness Scale, Second Edition [SRS-2]), and subjective QOL. Pre–post changes were quantified as change rates ((post − pre)/pre × 100). Group-level changes were tested with paired analyzes; exploratory associations among change rates were examined using Spearman correlations.ResultsGroup CBT significantly improved hostile attribution bias (effect size [ES] = 0.698, p = 0.017), social communication and interaction (SRS-2; ES = 0.780, p = 0.012), and subjective QOL (ES = 0.752, p = 0.011). Exploratory individual-level analyzes showed a discordant pattern: smaller reductions in hostile attribution bias (less negative change rates) were associated with greater increases in subjective QOL (ρ = 0.597, p = 0.019).ConclusionsThis pilot study suggests that group CBT may reduce hostile attribution bias and improve QOL and social functioning in adolescents and young adults with ASD traits. Notably, the positive correlation between hostile attribution bias change rates and QOL change rates suggests that greater QOL gains were not necessarily accompanied by larger reductions in hostile attribution bias, indicating that improvements in cognitive bias and perceived well-being may arise through partly distinct or non-linear pathways rather than a simple one-to-one relationship.Clinical trial registryUniversity Hospital Medical Information Network (UMIN000030140).
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Iron dyshomeostasis in neuropsychiatric disorders

Iron is an indispensable element for the normal physiological function of the brain. In terms of neuronal metabolism, iron is involved in multiple critical biological processes such as oxygen transport, energy metabolism, DNA synthesis, neurotransmitter synthesis and myelin formation. Maintaining brain iron homeostasis is crucial for neurodevelopment and function. Iron dyshomeostasis has been associated with the onset and progression of various neuropsychiatric disorders, including Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, attention deficit hyperactivity disorder, and autism spectrum disorder. In neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease, abnormally elevated iron levels can be detected in specific brain regions, including the basal ganglia and the prefrontal cortex. These changes are often accompanied by pathological processes such as oxidative stress, neuroinflammation, and pathological protein aggregation. Therefore, brain iron metabolism is an important entry point for understanding the pathophysiological process of neuropsychiatric disorders. Mechanistically, iron overload induces oxidative damage through the Fenton reaction, exacerbating mitochondrial dysfunction and abnormal protein aggregation. The effects of iron deficiency vary across different diseases; its impact on myelination and neurotransmitter synthesis may increase the risk of neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD), while its effects on immune activation and energy metabolism may contribute to the development of mental disorders such as depression. This article systematically reviews the current research progress of the role of cerebral iron metabolism in neuropsychiatric diseases. It focuses on the mechanisms underlying iron homeostasis imbalances in neurodegenerative and psychiatric diseases. Building on this foundation, the article analyzes the therapeutic targets and clinical significance of iron metabolism-related interventions and outlines future research directions in this field.
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[Comment] Assessing adolescents’ use of artificial intelligence in psychiatric practice

In a recent clinical encounter with one of the authors (AP), a young boy with autism insisted that his mother hated him—because ChatGPT said so. After asking whether a parent who sets limits must dislike their child, he interpreted the bot’s confident, literal response as truth. By the time the boy arrived at the clinic, this exchange had already reshaped his affect, relationships, and risk. Encounters like this are increasingly common, and many adolescents now present with beliefs—and sometimes safety concerns—influenced by generative artificial intelligence (AI).

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A longitudinal analysis of the prevalence of restrictive interventions involving women with mental health conditions, learning disabilities or autism in mental health services in England

IntroductionRestrictive interventions, including physical restraint, seclusion, chemical restraint, and segregation, continue to be used within mental health services, despite sustained policy efforts to promote least-restrictive and trauma-informed care. However, little is known about national trends affecting women, for whom restrictive interventions often carry heightened risks of re-traumatisation and stigma.MethodsWe conducted a longitudinal secondary analysis of publicly available administrative data from the Mental Health Bulletin covering NHS-funded mental health services in England between 2017 and 2025. Annual counts of restrictive interventions involving women were examined relative to the number of women detained under the Mental Health Act to estimate annual rates per 1,000 detained. Regression modelling was used to assess temporal trends overall, by age group and type of restrictive intervention, and interrupted time-series analyses to examine changes following implementation of the Mental Health Units (Use of Force) Act 2018 (“Seni’s Law”). Trends were also examined alongside available national data on restrictive interventions involving men.ResultsRates of restrictive interventions involving women increased by approximately 12 percent per year over the study period, with no evidence of a reduction following the introduction of Seni’s Law. Increases were most pronounced for chemical restraint, seclusion, and segregation, while physical and mechanical restraint remained stable. Restrictive interventions declined among women under 18 but increased consistently across all adult age groups, indicating a widening age-related divergence. Although overall trends broadly mirrored those observed among men, the types of restrictive interventions used and their potential impact may differ, highlighting gendered dimensions in how restrictive practices are experienced and applied.DiscussionDespite extensive national initiatives, restrictive interventions involving women have continued to rise in England, highlighting a persistent gap between policy intent and practice. The findings suggest that legislative frameworks alone are insufficient to achieve meaningful reductions without operational changes in clinical practice, organisational culture, and monitoring systems. Internationally, the study contributes rare gender-disaggregated longitudinal evidence and highlights the need for comparable monitoring systems and coordinated research to inform rights-based, trauma-informed strategies to reduce restrictive interventions in mental health services.
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Unequal voices: examining autism identification and diagnosis disparities for indigenous Mixtec families

Autism racial/ethnic disproportionality in special education is a significant concern in California and beyond, with White students often overidentified and Latinx and Indigenous (Zapotec/Mixtec) students under-identified. This mixed-methods study investigates the root causes of autism racial/ethnic disproportionality in a California high school district identified as significantly disproportionate for the overidentification of White students with autism. The study was conducted in two stages. First, a Likert-type scale survey (N = 147) was administered to caregivers to examine autism identification and service barriers. In the second stage, three open-response questions within the survey were used to gather qualitative insights from Latinx and Indigenous caregivers. Findings reveal systemic cultural and linguistic barriers contributing to the delayed diagnosis of autism in Latinx and Indigenous students. The qualitative responses further underscore the need for early screening, translation services, and culturally sensitive caregiver support particularly for Indigenous, Mixtec families.