Final Week 3 Flashcards
Male Dominant ASD History
Kanner: 8/11 male
Asperger: 4/4 little professors were male
Lai: this historic description has led to an underrepresentation of females in research, leading to a male-biased understanding of ASD
Gender Ratio in ASD
DSM-5: ASD is diagnosed 4x more in males, women are more likely to show accompanying intellectual disability (girls without ID/LD may go unrecognized)
Hiller:
•”Absence of intellectual impairment, ASD is diagnosed less and later in females”
•Ratio:4-1 and 9-1 with the absence of intellectual impatient
Centre of Disease Control:
•Ratio for low IQ individuals with ASD: 2-1
Measurement Bias
•ADOS and ADI did not factor in gender differences when norming instruments
Women are:
•More likely to be diagnosed with ADHD, eating disorders, language delay, and anxiety
•When diagnosed with ASD, require: more severe ASD symptoms, more severe behavioural/cognitive impairment, and are often underreported by teachers
Differences from Neurotypical Women
Jamison & Schüttler:
•Lower self-esteem, and more internalizing (depression/anxiety)/externalizing (tantrums/crying) behaviours
Katelaars: found women with ASD showed
•Emotional recognition delay
•Were able to accurately identify levels of emotional arousal but were significantly poorer at labelling the emotion
ASD and Eating Disorders
Prevalence Rates (DSM-5):
•Anorexia: 0.4%
•Bulimia: 1-1.5%
•Binge-Eating Disorder: 1.6% (F), 0.8% (M)
•Gender Ratio for first 2: 10-1
Karjalainen:
•Found prevalence rates of 7.9% with gender ratio being 2.5-1
Female ASD Differences
- Greater interest in socialization
- Fewer stereotypical and repetitive behaviours
- Restricted interests more in line with gender norms
- Higher levels of comorbid internalizing psychopathology and less externalizing
- Age of diagnosis: later for females
- Age when parents report concern: no difference
Female Autism Phenotype
Bargeila: implies a female-specific presentation of symptoms
Frazier: large sample (vast majority male)
Females were seen to have significantly more:
•Social communication impairment
•Greater externalizing problems
•Higher levels of irritability and lethargy (lack of energy)
•Lower levels of restricted interests
•Lower cognitive ability
•Weaker adaptive skills
Sex Differences in ASD (Rubenstien)
Clear differences: •Women had lower ID •Epilepsy more common in females •Restricted and repetitive behaviours more common in males •Attention to detail more common in males Unclear: •More mood/anxiety noted in females •ADHD: no sex differences
Gender and Language
Howe: relatively large study dominated by men
•No speech: no sex differences in IQ or adaptive skills
•Limited speech: significantly lower IQ and adaptive skills in females
•Good speech: similar/better IQ and adaptive skills in females
Theories for Gender Ratio
Female bi-modal distribution, male-centered, social (female) camouflage effect, female protective effect
Female Bi-Modal Distribution
May be that the lower group is more “classically” ASD (similar to males) and the higher group is “atypical” and presents differently to males
Male-Centred
Definitions and measurements of ASD are male-centric
•Mandy et al: most clinic-based studies (5-1 ratio) exclude many women with ASD
Social Camouflage Effect
Fitting into society by:
•Hiding socially unacceptable
•Performing more neurotypical social behaviour
Lai: examples of social camouflage include
•Learned eye contact and social cues
•Pre-prepared jokes/learning to follow social scripts
•Mimicking others/imitating expressions
Female Camouflage Effect
ASD women with higher IQs and language skills often have:
•Better observational learning (mirroring)
•Better eye contact
•Better emotional recognition
•Stronger internal scripting (social rules) in relationships
•Better at hiding their symptoms
Measuring the Camouflage Effect
Lai:
•External behaviour presentation in social context (measured by ADOS)
•Internal status (dispositional traits measured by the Autism Spectrum Quotient and social cognitive capability measured by the Reading the Mind in the Eyes Test)
