Stress and Mental Flexibility in Autism Spectrum Disorders

Authors

  • William S. Stone, PhD
  • Lisa Iguchi, PhD

Abstract

Cognitive deficits are well-established core features in autism spectrum disorders (ASD). In this paper, we review representative studies on cognitive flexibility, which is one type of neuropsychological weakness that is often related to repetitive and restricted clinical symptoms in ASD. We also review effects of stress in both typically developing individuals and in individuals with ASD, to show the importance of this factor in modulating relationships between cognitive inflexibility and clinical symptoms related reflecting inflexibility, such as repetitive and restricted behaviors. Finally, we present three case vignettes involving higher functioning individuals to illustrate some of these relationships in individuals, and to suggest the utility of clinical interventions. 

 [N A J Med Sci. 2013;6(3):145-153.   DOI:  10.7156/najms.2013.0603145]


References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Washington DC: American Psychiatric Association.

Baron-Cohen S, Belmonte MK. Autism: a window onto the development of the social and the analytic brain. Annu Rev Neurosci. 2005;28:109-126.

Bird G, Catmur C, Silani G, Frith C, Frith U. Attention does not modulate neural responses to social stimuli in autism spectrum disorders. Neuroimage. 2006;31(4):1614-1624.

Bowler DM, Gaigg SB, Gardiner JM. Effects of related and unrelated context on recall and recognition by adults with high-functioning autism spectrum disorder. Neuropsychologia. 2008;46(4):993-999.

Bowler DM, Gaigg SB, Gardiner JM. Free recall learning of hierarchically organised lists by adults with Asperger's syndrome: additional evidence for diminished relational processing. J Autism Dev Disord. 2009;39(4):589-595.

Cahill L, Gorski L, Le K. Enhanced human memory consolidation with post-learning stress: interaction with the degree of arousal at encoding. Learn Mem. 2003;10(4):270-274.

Cath DC, Ran N, Smit JH, van Balkom AJ, Comijs HC. Symptom overlap between autism spectrum disorder, generalized social anxiety disorder disroder and obsessive compulsive disorder in adults: a preliminary case-controlled study. Psychopathology. 2008;41(2):101-110.

Cheshire WP. Highlights in clinical autonomic science: new insights into autonomic dysfunction in autism. Auton Neurosci. 2012;171(1-2):4-7.

Corbett BA, Mendoza S, Abdullah M, Wegelin JA, Levine S. Cortisol circadian rhythms and response to stress in children with autism. Psychoneuroendocrinology. 2006;31(1):59-68.

Corbett BA, Schupp CW, Simon D, Ryan N, Mendoza S. Elevated cortisol during play is associated with age and social engagement in children with autism. Mol Autism. 2010;27;1(1):13.

Courchesne E, Townsend J, Akshoomoff NA, et al. Impairment in shifting attention in autistic and cerebellar patients. Behav Neurosci. 1994;108(5):848-865.

Cutting J, David A, Murphy D. The nature of overinclusive thinking in schizophrenia. Psychopathology. 1987;20(3-4):213-219.

D'Cruz A-M, Ragozzino ME. Reduced behavioral flexibility in autism spectrum disorders. Neuropsychology. 2013;27(2):152-160.

de Kloet ER, Joels M, Holsboer F. 2005. Stress and the brain: from adaptation to disease. Nat Rev Neurosci. 2005;6(6):463-475.

de Vries M, Geurts HM. 2012. Cognitive flexibility in ASD; task switching with emotional faces. Journal of Autism and Developmental Disorder. 2012; 42:2558-68

Diamond A. Executive functions. Annu Rev Psychol. 2013;64:135-168.

Doughty OJ, Lawrence VA, Al-Mousawi A, Ashaye K, Done DJ. Overinclusive thought and loosening of associations are not unique to schizophrenia and are produced in Alzheimer's dementia. Cogn Neuropsychiatry. 2009;14(3):149-164.

Eack SM, Bahorik AL, McKnight SA, et al. Commonalities in social and non-social cognitive impairments in adults with autism spectrum disorder and schizophrenia. Schizophr Res. 2013. [Epub ahead of print]

Gabriels RL, Agnew JA, Pan Z, Holt KD, Reynolds A, Laudenslager ML. Elevated repetitive behaviors are associated with lower dirnal salivary cortisol levels in autism spectrum disorder. Biol Psychol. 2013;93(2):262-268.

Geurts HM, Corbett B, Solomon M. The paradox of cognitive flexibility in autism. Trends Cogn Sci. 2009;13(2):74-82.

Gold PE, Stone WS. Neuroendocrine effects on memory in aged rodents and humans. Neurobiol Aging. 1988;9(5-6):709-717.

Gras-Vincendon A, Bursztejn C, Danion JM. Functioning of memory in subjects with autism. Encephale. 2008;34(6):550-556.

Green MF, Kern RS, Braff DL, Mintz J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the "right stuff"? Schizophr Bull. 2000;26(1):119-136.

Green MF, Schooler NR, Kern RS, et al. Evaluation of Co-Primary Measures for Clinical Trials of Cognition Enhancement in Schizophrenia. Am J Psychiatry. 2011;168(4):400-407.

Grubb MA, Behrmann M, Egan R, Minshew NJ, Carrasco M, Heeger DJ. Endogenous spatial attention: evidence for intact functioning in adults with autism. Autism Res. 2013. [Epub ahead of print]

Happe F. Studying weak central coherence at low levels: children with autism do not succumb to visual illusions. A research note. J Child Psychol Psychiatry. 1996;37(7):873-877.

Happe F. Autism: cognitive deficit or cognitive style? Trends Cogn Sci. 1999;3(6):216-222.

Happe F, Briskman J, Frith U. Exploring the cognitive phenotype of autism: weak “central coherence” in parents and siblings of children with autism: I. Experimental tests. J Child Psychol Psychiatry. 2001;42(3):299-307.

Happe F, Frith U. The weak coherence account: detail focused cognitive style in autism spectrum disorders. J Autism Dev Disord. 2006;36(1):5-25.

Heaton RK, Chelune GJ, Talley JL, Kay GG, Curtiss G. 1993. Wisconsin Card Sorting Test Manual - Revised. Odessa, Florida.: Psychological Assessment Resources.

Kidd SA, Corbett BA, Granger DA, Boyce WT, Anders TF, Tager IB. Daytime secretion of salivary cortisol and alpha-amylase in preschool-aged children with autism and typicall developing children. J Autism Dev Disord. 2012;42(12):2648-2658.

Lind SE, Bowler DM. Episodic memory and episodic future thinking in adults with autism. J Abnorm Psychol. 2010;119(4):896-905.

Lopez BR, Lincoln AJ, Ozonoff S, Lai Z. Examining the relationship between executive functions and restricted, repetitive symptoms of autistic disorder. Journal of Autism and Developmental Disorders. 2005;35:445-460.

Losh M, Adolphs R, Poe MD, et al. Neuropsychological profile of autism and the broad autism phenotype. Arch Gen Psychiatry. 2009;66(5):518-526.

McCormack CM, Lewis E, Somley B, Kahan TA. Individual differences in cortisol levels and performance on a test of executive function in men and women. Physiology & Behavior. 2007;91(1):87-94.

McGaugh JL. 2002. The amygdala regulates memory consolidation. In Neuropsychology of Memory, ed. LR Squire, DL Schacter, 437-449. New York: The Guilford Press.

Mesholam-Gately R, Giuliano AJ, Faraone SV, Goff KP, Seidman LJ. Neurocognition in first-episode schizophrenia: A meta-analytic review. Neuropsychology. 2009;23(3):315-336.

Mosconi MW, Kay M, D'Cruz A-M, et al. Impaired inhibitory control is associated with higher-order repetitive behaviors in autism spectrum disorders. Psychol Med. 2009;39(9):1559-1566.

Nater UM, Marca RL, Florin L, et al. Stress-induced changes in human salivary alpha-amylase activity - associations with adrenergic activity. Psychoneuroendocrinology. 2006;31(1):49-58.

Oerlemans AM, Droste K, van Steijn DJ, de Sonneville LM, Buitelaar JK, Rommelse NN. Co-segregation of social cognition, executive function and local processing style in children with ASD, their siblings and normal controls. J Autism Dev Disord. 2013. [Epub ahead of print]

Pennington BF, Ozonoff S. Executive functions and developmental psychopathology. J Child Psychol Psychiatry. 1996;37(1):51-87.

Plessow F, Fischer R, Kirschbaum C, Goschke T. Inflexibly focused under stress: acute psychosocial stress increases shielding of action goals at the expense of reduced cognitive flexibility with increasing time lag to the stressor. J Cogn Neurosci. 2011;23(11):3218-3227.

Plessow F, Kiesel A, Kirschbaum C. 2012a. The stressed prefrontal cortex and goal-directed behavior: acute psychosocial stress impairs the flexible implementation of task goals. Exp Brain Res. 2012;216(3):397-408.

Plessow F, Schade S, Kirschbaum C, Fischer R. Better not to deal with two tasks at the same time when stressed? Acute psychosocial stress reduces task shielding in dual-task performance. Cogn Affect Behav Neurosci. 2012;12(3):557-570.

Resmini E, Santos A, Gomez-Anson B, et al. Verbal and visual memory performance and hippocampal volumes, measures by 3-Tesla magnetic resonance imaging, in patients with Cushing's syndrome. J Clin Endocrinol Metab. 2012;97(2):663-671.

Ridley NJ, Homewood J, Walters J. Cerebellar dysfunction, cognitive flexibility and autistic traits in a non-clinical sample. Autism. 2011;15(6):728-745.

Schilling TM, Kolsch M, Larra MF, et al. For whom the bell (curve) tolls: cortisol rapidly affects memory retrieval by an unverted U-shaped dose-response relationship. Psychoneuroendocrinology. 2013. [Epub ahead of print]

Sigman M, Spence SJ, Wang AT. Autism from developmental and neuropsychological perspectives. Ann Rev Clin Psychol. 2006;2:327-355.

Spratt EG, Nicholas JS, Brady KT, et al. Enhanced cortisol response to stress in children in autism. J Autism Dev Disord. 2012;42(1):75-81.

Stone WS, Iguchi L. Do apparent overlaps between schizophrenia and autistic spectrum disorders reflect superficial similarities or etiological commonalities? N A J Med Sci. 2011;4(3):124-133.

Stone WS, Rudd RJ, Gold PE. Amphetamine, epinephrine and glucose enhancement of memory retrieval. Psychobiology. 1990;18:227-230.

Tiemensma J, Kokshoorn NE, Biermasz NR, et al. Subtle cogntive impairments in patient's with long-term cure of Cushing's disease. J Clin Endocrinol Metab. 2011;96(4):964-971.

Wainwright JA, Bryson SE. Visual-spatial orienting in autism. J Autism Dev Disord. 1996;26(4):423-438.

Yerkes RM, Dodson JD. 1908. The relation of strength of stimulus to rapidity of habit-formation. Journal of Comparative Neurology and Psychology.1908;18:459-482.

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Published

2013-07-31

How to Cite

Stone, PhD, W. S., & Iguchi, PhD, L. (2013). Stress and Mental Flexibility in Autism Spectrum Disorders. North American Journal of Medicine and Science, 6(3). Retrieved from https://www.najms.com/index.php/najms/article/view/192

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Section

Case Report