Longitudinal relations between autistic-like features and functional somatic symptoms in adolescence 2022 Hogendoorn, Rosmalen et al

Abstract

Autistic-like features and functional somatic symptoms (FSS) frequently co-occur. It remains unknown how autistic-like features and FSS affect each other and develop throughout adolescence. This study examined reciprocal relations between autistic-like features and FSS in adolescence. Participants were 2772 adolescents (52.5% male) from the Tracking Adolescents’ Individual Lives Survey population and clinical cohort. Data from four waves were included, covering the ages between 11 and 19 years.

Autistic-like features were measured using the Children’s Social Behavior Questionnaire. FSS were assessed using the Youth Self Report and Adult Self Report, respectively. Using the random intercept cross-lagged panel model, a stable positive, moderately strong between-persons association was found between autistic-like features and FSS. No within-persons reciprocal effects from wave to wave were observed. Secondary analyses revealed a consistent relation with FSS for three different domains of autistic-like features (social and communication behaviors, repetitive behaviors, and self-regulatory behaviors), and highly similar interrelations in a subsample of adolescents with a clinical autism spectrum disorder diagnosis.

In conclusion, the co-occurrence between autistic-like features and FSS is stable throughout adolescence. Clinicians working with adolescents with autistic-like features should be alert to the presence FSS, and vice versa.

Open access, https://journals.sagepub.com/doi/10.1177/13623613221143874

 

The "functional somatic symptoms" here were measured by asking people to report any aches/pains, headache, nausea, stomach pain, vomiting, overtiredness, and dizziness they experienced, that hadn't been explained medically.

I think they mean:

"Clinicians working with adolescents with autistic-like features in particular should not feel at all uneasy about attributing any unexplained somatic symptoms to psychological factors. These adolescents frequently somatise".

Eww, makes you want to vomit.

 

I don't know much about autism, but from what I see from social media, medicine isn't any better at this than they are at chronic illness, basically clueless.

When the pathophysiology and the biology are well understood, I'll go with the professionals every time. When it isn't, it's usually the patients who are right.

This really looks like the usual backward reattribution of symptoms by asking about symptoms and labeling it as some weird thing the author fancies.

 

The biggest problem I have with this study is that there's no conceivable way it will make people's lives better. It could well worsen systemic ableism by fobbing off autistic people's signs of serious illness as psychosomatic.

People with more signs of autism are more likely to report having various (often minor) symptoms. The fact that they use a proxy, degree of signs of autism, rather than actual autism diagnosis, makes their study minimally applicable to actual autistic folks. Regardless, there are so many explanations for their findings:

• Autistic people are more likely to notice small bodily sensations
• Autistic people are more likely to remember mild symptoms or report them as significant
• Autistic people are more likely to have various odd symptoms due to biological differences (for example, differences in gut microbiome leading to gastrointestinal symptoms)
  
• Autistic people have more unexplained symptoms because they receive inferior healthcare due to ableism, thus have more undiagnosed diseases. This could be doubly true for complex disease that produce vague symptoms
  
• Autistic people are more likely to have anxiety and thus more likely to have symptoms that are uncontroversially caused by anxiety (such as stress-induced headaches)
• Autistic people are more likely to encounter highly stressful situations due to ableism and lack of appropriate accommodations, leading to said anxiety
• Living in a society that isn't designed for you is inherently fatiguing and fatigue is probably on their list of symptoms
• Autistic people may have a broader definition of what they consider "medically unexplained."

You're right, doctors are basically clueless about autism. (I'm an autistic PwME) Autism doesn't have pathophysiology because it's a neurological difference, not a disease. The biological factors that cause it are poorly understood but more of a curiosity to most autistic people. Autism is plagued by misspent research funds much like ME. Most autistic people want research to help society understand and meet our support needs at all stages of life, and treating co-occurring conditions or the specific aspects of autism that may keep people from their desired activities. But a lot of the research goes towards biological studies on young children and therapies to eliminate signs/symptoms of autism, including the ones that are totally benign or even beneficial.

 

As redfox said most doctors are clueless.
Teasing functional syndromes from specific groups of people tells you how rotten to the core medicine is with psychosomatics and have given up on healing peiple.

Could it be autistix people may have slight biological differences that may be undetctable

 

Oh, I even forgot to add that one. Edited.

 

A close relative with autism has quite a few health glitches (osteoporosis, cardiac stuff) which are likely related to a very restricted diet throughout childhood and adolescence, caused by sensory issues. I don’t think this is unusual.