Psychophysiological Associations with Gastrointestinal Symptomatology in Autism Spectrum Disorder.
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. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
Interdisciplinary Neuroscience Program, University of Missouri.|The Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri.
Bradley J
BJ
Ferguson
Department of Child and Adolescent Psychiatry, Vanderbilt University Medical Center.
Sarah
S
Marler
Massachusetts General Hospital Biostatistics Center.
Lily L
LL
Altstein
Departments of Pediatrics, Psychology, and Psychiatry, Vanderbilt University.
Evon Batey
EB
Lee
The Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri.
Jill
J
Akers
The Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri.|Department of Child Health, University of Missouri.
Kristin
K
Sohl
University of Missouri School of Medicine.
Aaron
A
McLaughlin
College of Arts and Sciences, University of Missouri.
Kaitlyn
K
Hartnett
Department of Psychological Sciences, University of Missouri.
Briana
B
Kille
The Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri.|Department of Health Psychology, University of Missouri.
Micah
M
Mazurek
Massachusetts General Hospital Biostatistics Center.|Harvard Medical School.
Eric A
EA
Macklin
Massachusetts General Hospital Biostatistics Center.
Erin
E
McDonnell
Massachusetts General Hospital Biostatistics Center.
Mariah
M
Barstow
Boston University School of Medicine.
Margaret L
ML
Bauman
Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University.
Kara Gross
KG
Margolis
Department of Psychiatry and Sackler Institute for Developmental Psychobiology, Columbia University.|New York State Psychiatric Institute; New York Presbyterian Hospital Center for Autism and the Developing Brain.
Jeremy
http://orcid.org/0000-0002-6349-1076
J
Veenstra-VanderWeele
Interdisciplinary Neuroscience Program, University of Missouri.|The Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri.|William and Nancy Thompson Chair in Radiology, Departments of Radiology, Neurology, and Psychological Sciences, University of Missouri.
David Q
DQ
Beversdorf
D000293:Adolescent; D001007:Anxiety / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D000067877:Autism Spectrum Disorder / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D002648:Child; D003248:Constipation / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005767:Gastrointestinal Diseases / Q000503:physiopathology* / Q000523:psychology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male
anxiety; autism spectrum disorder; autonomic nervous system; constipation; gastrointestinal; parasympathetic; sympathetic