Clinical assessment of DSM-IV anxiety disorders in fragile X syndrome: prevalence and characterization
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Fragile X syndrome (FXS) is the most common form of inherited intellectual disability (ID). Anxiety and social withdrawal are considered core features of the FXS phenotype, yet there is limited diagnostic evidence of the prevalence of formal anxiety disorders in FXS. This study assessed the prevalence of anxiety disorders in a sample of 58 males and 39 females with FXS (ages 5.0-33.3 years). Participants' parents completed the Anxiety Disorders Interview Schedule (ADIS-IV), a clinical interview based on DSM-IV criteria, and the Anxiety Depression and Mood Scale (ADAMS), a psychiatric disorders screening instrument normed in ID. We conducted cognitive (IQ) and autism (AUT) assessments and surveyed medication use. Despite a high rate of psychopharmacological treatment, 86.2% of males and 76.9% of females met criteria for an anxiety disorder, with social phobia and specific phobia the most commonly diagnosed. Proband status, gender, and IQ were not significantly related to any anxiety disorders, however significantly higher rates of a few anxiety disorders were found in older age and AUT groups. Significant correlations between ADIS diagnoses and ADAMS scores provided cross-validation of instruments, indicating that the ADIS is suitable for use in FXS. A greater percentage of our sample met criteria for most anxiety disorders than has been reported in other ID groups or the general population. The rate of anxiety compared to general ID suggests that the FMR1 full mutation confers an especially high risk for these disorders, regardless of factors commonly associated with FXS clinical involvement. A thorough clinical assessment and treatment of anxiety should be included in the FXS standard of care.
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Boys with fragile X syndrome typically show ADHD with impulsivity and anxiety, repetitive language, hand biting, hand stereotypies, rocking, and sometimes head banging.
“The behavior of boys with FXS typically includes attention deficit hyperactivity disorder (ADHD), with significant impulsivity and anxiety, as well as behaviors that include repetitive language, hand biting, hand stereotypies, rocking, and sometimes head banging (24,25).”
From Fragile X syndrome: causes, diagnosis, mechanisms, and therapeutics (2012) · cites this paper as [24]
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Self-citationA Spoken-Language Intervention for School-Aged Boys With Fragile X Syndrome
McDuffie, A., Machalicek, W., Bullard, L., Nelson, S., Mello, M., Tempero-Feigles, R., Castignetti, N., & Abbeduto, L. (2016) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-121.3.236 · Cited by 41 · see citing works
Turk, J. (2011) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e328349bb77 · Cited by 35 · see citing works
Grigsby, J. (2016) · The Clinical Neuropsychologist · doi:10.1080/13854046.2016.1184652 · Cited by 34 · see citing works
- Authors
- Cordeiro, L., Ballinger, E., Hagerman, R., & Hessl, D.
- Affiliations
- University of California Davis Medical Center (US)
- Corresponding author
- Hessl, David
- Venue
- Journal of Neurodevelopmental Disorders
- Published
- 2010-12-03
- Volume
- 3
- Issue
- 1
- Pages
- 57-67
- ISSN
- 1866-1947 (ISSN-L)
- 1866-1955
- PMC
- PMC3057014
- OpenAlex
- W2060911896
- Cited by
- 316
- References
- 75
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 14 · 2023: 16 · 2022: 30 · 2021: 29 · 2020: 21 · 2019: 32 · 2018: 18 · 2017: 30 · 2016: 19 · 2015: 14 · 2014: 31 · 2013: 17 · 2012: 15
- FWCI
- 8.10
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Journal of Neurodevelopmental Disorders (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- ProQuest Demo Repository (submittedVersion)
- Funders
- National Institutes of Health (HD02274)
- National Institute of Mental Health (R21MH080025, K23MH077554)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD002274)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Keywords
- fragile X syndrome, anxiety disorders, prevalence, social anxiety disorder, specific phobia, intellectual disability, FMR1 full mutation, autism spectrum disorder, psychopharmacological treatment, gender differences, age differences
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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