Prevalence of autistic traits in functional neurological disorder and relationship to alexithymia and psychiatric comorbidity 2023 Cole et al

Andy

Andy

Retired committee member
Highlights
  • We report new evidence of high rates of autistic traits in a group with FND.
  • 40% of participants scored positive on the AQ-10.
  • 40% of patients also scored positive for alexithymia.
Abstract

Introduction
In a cohort of adults with Functional Neurological Disorder (FND), we aim to:

  1. Report the prevalence of autistic traits and alexithymia.
  2. Report psychiatric comorbidity associated with autistic traits and alexithymia.
  3. Explore whether alexithymia mediates the association between autistic traits and comorbidity.

Methods
91 patients participating in a FND 5-week outpatient program completed baseline self-report questionnaires for total phobia, somatic symptom severity, attention deficit hyperactivity disorder (ADHD) and dyslexia. Patients were grouped by Autism Spectrum Quotient (AQ-10) score of <6 or ≥ 6 and compared for significant differences in tested variables. This analysis was repeated with patients grouped by alexithymia status. Simple effects were tested using pairwise comparisons. Multistep regression models tested direct relationships between autistic traits and psychiatric comorbidity scores, and mediation by alexithymia.

Results
36 patients (40%) were AQ-10 positive (scoring ≥6 on AQ-10). A further 36 patients (across AQ-10 positive and AQ-10 negative groups) (40%) screened positive for alexithymia. AQ-10 positive patients scored significantly higher for alexithymia, depression, generalised anxiety, social phobia, ADHD, and dyslexia. Alexithymia positive patients scored significantly higher for generalised anxiety, depression, somatic symptoms severity, social phobia, and dyslexia. Alexithymia score was found to mediate the relationship between autistic trait and depression scores.

Conclusion
We demonstrate a high proportion of autistic and alexithymic traits, in adults with FND. A higher prevalence of autistic traits may highlight a need for specialised communication approaches in FND management. Mechanistic conclusions are limited. Future research could explore links with interoceptive data.

Open access, https://www.jns-journal.com/article/S0022-510X(23)00045-X/fulltext#
 
The paper said:
In FND neurological symptoms demonstrate clinical features incompatible with structural pathology, there is abnormal function a system that is capable of normal function
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It seems that abnormal functioning affected their proofreading.

The paper said:
Psychiatric comorbidities are common in FND including depression, anxiety, panic disorder, personality disorders and obsessive compulsive personality disorders, as are functional somatic syndromes (such as irritable bowel, chronic fatigue and fibromyalgia) [1]. Common neurological comorbidities include epilepsy, migraine, and traumatic brain injury.
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Having never heard of alexithymia I looked it up:

https://en.wikipedia.org/wiki/Alexithymia

"Alexithymia is a neuropsychological phenomenon expressing important difficulties in identifying and describing the experienced emotions by oneself or others.[1][2][3] It also involves emotional issues in terms of social attachment and interpersonal relations.[4] There is no scientific agreement whether this neuropsychological phenomenon is a personality trait, a medical symptom or eventually (in few researches) a mental disorder.[5][6]"

Sounds like a very vague idea.
 
RedFox said:
Do they realize what their own research implies? If people/w FND are more likely to be autistic, it's strongly correlated to structural changes in the brain.
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Yeah, but then their argument would be that structural changes prove the validity of the FND diagnosis. It doesn't have to make sense, they just need to repeat it often enough.
 
Looking at the AQ-10, there will be many positive responses from any generic chronic illness where exhaustion and cognitive impairment are involved. Several of the questions are ambiguous enough to be misinterpreted.

Autism science is terrible. I see much of the same criticism from this community, the same being talked down to by people who don't bother to listen and interpret people's personality based on superficial outward behavior. And to say nothing of how even more awful it used to be, started on extremely shaky ground.

What this says more than anything is that their methods and instruments are bad, arbitrary and feature very little actual science. They're as useful as Meyers-Briggs, not much.

Look at some of the questions and how easily most of us would answer yes, but not as baseline, in our current chronically ill state. So unless autism can be transient, it doesn't even make any sense to claim this based on a temporary state, or at least a state that was not lifelong. Especially as FND is supposed to be transient. Or whatever.
  1. I often notice small sounds when others do not (noise intolerance will check that)
  2. I usually concentrate more on the whole picture, rather than the small details (can't concentrate on details, so some would check, I would)
  3. If there is an interruption, I can switch back to what I was doing very quickly (brain fog will check that)
  4. I find it easy to ‘read between the lines’ when someone is talking to me (ditto)
Some of the other questions are ambiguous enough. The AQ-10 isn't even a test of autism anyway, it's a tool to assess the need for a referral. Completely invalid claims here, but that's typical for the BPS ideology.

https://docs.autismresearchcentre.com/tests/AQ10.pdf
 
I often notice small sounds when others do not (noise intolerance will check that)

As will somebody being merely more observant than average. Or more musical.

Sound is very important to me. I listen very carefully to the world around me. Always have. I am usually the first person to hear a subtle problem with a car, or the first signs of a hard drive on its way out, or somebody coming up the path to the front door, for example.

Why is that a pathology?

This assumption loaded, context free garbage is just mindless pathologising of any deviance from the statistical norm, independent of whether it is actually a pathology or not. An awful lot of what passes for 'normal' in this world is anything but. The real pathology here lies in the mind of those doing the pathologising, not those being pathologised.

MeSci said:
Sounds like a very vague idea.
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A very conveniently vague idea.
 
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