An empirical investigation into autistic catatonia: The development of the Autistic Catatonia Questionnaire (ACQ)

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Abstract

ABSTRACT: “An empirical investigation into autistic catatonia: The development of the Autistic Catatonia Questionnaire” - A thesis submitted to the University of Manchester for the degree of MPhil in the Faculty of Medical and Human Sciences (School of Psychological Sciences) in 2014 by Jennifer Breen.Introduction: Research indicates that a small proportion of young people with Autistic Spectrum Disorder (ASD) experience onset of catatonic-like symptoms in adolescence, termed ‘autistic catatonia’. Autistic catatonia is an under-researched neurologically-based condition, and little is known about the presentation and variation of symptoms. The current study aims to empirically investigate ‘autistic catatonia’ in children and adolescents with ASD via a systematic examination of the prevalence and presentation of symptoms associated with autistic catatonia. A 34-item Autistic Catatonia Questionnaire (ACQ) was developed which could be used in clinical practice and for research purposes. A secondary aim of the study is to complete preliminary investigations into the usefulness of the ACQ as a clinical measure.Method: Caregivers or parents (n=99) provided information about the presentation of symptoms in a young person they care for via the online completion of the ACQ and two established clinical measures (the Repetitive Behaviour Questionnaire and Carer Supplement to the Glasgow Depression Scale for people with Learning Disability. Results: Catatonic symptoms are relatively common in young people with ASD and the prevalence in the current study is much higher than has been found elsewhere, with 20.2% having an existing diagnosis of autistic catatonia. The number of core symptoms provided key information about the presentation of autistic catatonia, with the data indicating an autistic catatonia continuum and a potential clinical cut-off for diagnosis when three or more core symptoms are present. The results indicate that the ACQ is a workable clinical measure in this population with a degree of discriminant validity. Statistical analysis reduced the ACQ from 34 to 28 items, comprising six core symptom items and 22 supplementary items. There is also evidence of a relationship between the presentation of autistic catatonia and measures of depression and repetitive and restricted behaviours, although a causal relationship was not determined.Conclusion: Preliminary investigations into the utility of the ACQ as a clinical measure and research tool are promising. Future researchers must further investigate autistic catatonia empirically and finalise diagnostic criteria to allow the progression of theoretical understanding, enable the development of safe and effective evidence-based treatments and raise the profile of autistic catatonia in mainstream ASD research.

Keyword(s)

ASD; Autism; Autistic Catatonia; Autistic Spectrum Disorder; Catatonia

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