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Panic-agoraphobic symptoms in adults with ASD: the role of ruminative thinking and inflexibility

Published online by Cambridge University Press:  09 May 2024

Liliana Dell’Osso ,
Giulia Amatori Open the ORCID record for Giulia Amatori [Opens in a new window] ,
Chiara Bonelli ,
Benedetta Nardi Open the ORCID record for Benedetta Nardi [Opens in a new window] ,
Enrico Massimetti ,
Ivan Mirko Cremone  and
Barbara Carpita Open the ORCID record for Barbara Carpita [Opens in a new window]
Liliana Dell’Osso
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Giulia Amatori*
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Chiara Bonelli
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Benedetta Nardi
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Enrico Massimetti
Affiliation:
Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Pisa, Italy
Ivan Mirko Cremone
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Barbara Carpita
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
*
Corresponding author: Giulia Amatori; Email: g.amatori1992@gmail.com
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Abstract

Background

Scientific literature has highlighted the link between autism spectrum disorder (ASD) and anxiety disorders, but few studies have delved into the relationship between ASD and panic-agoraphobic disorders. The aim of this study is to investigate the relationship between autism spectrum and panic-agoraphobic symptoms, examining whether and which autistic domains are predictive of the presence of specific panic-agoraphobic symptoms.

Materials and methods

Forty-five adult subjects with ASD and 50 healthy controls (HCs) were evaluated through the Structured Clinical Interview for DSM-5, Research Version and assessed with the Adult Autism Subthreshold Spectrum (AdAS Spectrum) and the Panic-Agoraphobic – Short Version (PAS-SV) questionnaires. Statistical analyses included Mann–Whitney U test, chi-square test, and a set of linear and logistic regression analyses.

Results

The PAS-SV total and domain scores were significantly higher in the ASD group than in the HC group. A higher AdAS total score appeared to be predictive of a higher PAS-SV total score. The AdAS domain Restricted Interests and Rumination would increase the risk of obtaining higher PAS-SV total and domain scores. Conversely, the AdAS Spectrum domain Inflexibility and Adherence to Routine would predict lower total PAS-SV score.

Conclusion

This study revealed a greater representation of panic-agoraphobic symptoms in adults with ASD, as well as an increased risk of showing such symptoms in the presence of significant autistic traits. Restricted interests and ruminative thinking emerged as predominant risk factors for panic-agoraphobic manifestations.

Keywords

panic disorderagoraphobiaautism spectrum disorderruminative thinkinginflexibility
Type
Original Research
Information
CNS Spectrums , Volume 29 , Issue 5 , October 2024 , pp. 369 - 375
Copyright
© The Author(s), 2024. Published by Cambridge University Press

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