Irritability in boys with autism spectrum disorders: an investigation of physiological reactivity
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BACKGROUND: Irritability in people with autism spectrum disorders (ASD) is common and impairing, yet its mechanisms remain understudied. We investigated symptom reporting and mechanisms of irritability in ASD, focusing on the relation between irritability and physiological stress responses. METHODS: Forty-seven unmedicated boys with high-functioning ASD (hfASD) and 23 typically developing boys aged 10-16 years completed a psychosocial stress test. Changes in cortisol, heart rate and heart rate variability throughout the test were recorded. Self- and parent-reported measures of irritability were obtained. Irritability symptom reporting in the hfASD group was compared to two groups of boys without ASD: highly irritable boys (severe mood dysregulation, SMD; n = 40) and healthy-control boys (HC; n = 30). RESULTS: Boys with hfASD scored significantly higher on irritability than HC boys, and they reported a pattern of irritability symptoms closely resembling that of boys with SMD. The internal consistency of irritability in hfASD was high by parent- and self-report. Although boys with hfASD showed significant stress-induced changes in cortisol and heart rate, those who rated themselves as highly irritable had lower cortisol levels throughout the test compared to those low on irritability. Participants rated as highly irritable by their parents showed blunted cortisol and heart rate responses to stress. The effects of irritability on heart rate, but not cortisol, were accounted for by trait anxiety. CONCLUSIONS: Irritability can be measured reliably in hfASD and is associated with distinct biological responses to stress.
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Another brain region implicated in emotional dysregulation is the prefrontal dorsolateral cortex, while other studies reported autonomic nervous system deregulation, such as an alteration in cortisol levels and heart rate, in autism spectrum disorder individuals.
“Another brain region implicated in ED is the prefrontal dorsolateral cortex (72) while, together with genetic and anatomical alterations, other studies reported autonomic nervous system deregulation, such as an alteration in cortisol levels and heart rate, in ASD individuals (73, 75).”
From Emotional dysregulation as a part of the autism spectrum continuum: a literature review from late childhood to adulthood (2023) · cites this paper as [75]
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Experimental — accuracy not yet measuredThe high functioning autism spectrum disorder group had higher score on irritability than the healthy control group, together with a pattern of irritability symptoms closely resembling that of the severe mood dysregulation group.
“Results reported that the HF-ASD group had higher score on irritability than the HC, together with a pattern of irritability symptoms closely resembling that of the SMD group.”
From Emotional dysregulation as a part of the autism spectrum continuum: a literature review from late childhood to adulthood (2023) · cites this paper as [75]
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- Authors
- Mikita, N., Hollocks, M. J., Papadopoulos, A. S., Aslani, A., Harrison, S., Leibenluft, E., Simonoff, E., & Stringaris, A.
- Affiliations
- King's College London (GB)
- National Institute of Mental Health (US)
- Corresponding author
- Mikita, Nina
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2015-01-28
- Volume
- 56
- Issue
- 10
- Pages
- 1118-1126
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC4737220
- OpenAlex
- W2056570385
- Cited by
- 82
- References
- 51
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 10 · 2023: 10 · 2022: 7 · 2021: 12 · 2020: 7 · 2019: 8 · 2018: 3 · 2017: 8 · 2016: 9 · 2015: 3
- FWCI
- 4.61
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (King's College London) (publishedVersion, other-oa)
- Funders
- Wellcome Trust
- National Institute for Health Research (NIHR) Biomedical Research Centre
- Dementia Unit
- Maudsley NHS Foundation Trust
- King's College London
- King's College Hospital NHS Foundation Trust
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Keywords
- irritability, autism spectrum disorder, high-functioning autism, physiological stress response, cortisol, heart rate, heart rate variability, severe mood dysregulation, trait anxiety, boys
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Child, Heart Rate, Humans, Hydrocortisone, Irritable Mood, Male, Stress, Psychological
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