Autism and attachment disorder symptoms in the general population: Prevalence, overlap, and burden

Minnis, H. , Messow, C.-M., McConnachie, A., Bradshaw, P., Briggs, A., Wilson, P. and Gillberg, C. (2020) Autism and attachment disorder symptoms in the general population: Prevalence, overlap, and burden. Developmental Child Welfare, 2(1), pp. 37-51. (doi: 10.1177/2516103220902778)

Abstract

Background: Co-occurring trauma-related and neurodevelopmental problems are common in maltreated children. In population research and clinical practice, these tend to be considered separately. Overlapping health problems, that is, “multi-morbidity,” in adulthood is associated with increased service burden and costs, but this has not been investigated in childhood. Methods: Using well-validated parent-report questionnaires, we examined the overlap between symptoms of the neurodevelopmental disorder autism (autism spectrum disorder, ASD) and symptoms of the trauma- and stressor-related disorders (reactive attachment disorder [RAD] and disinhibited social engagement disorder [DSED]) in a representative general population sample of over 3,300 children aged 5–6 years of age. We investigated sociodemographic factors, service burden, and costs in association with these problems when considered separately and when co-occurring. Results: Nearly 2% of this population had symptoms suggestive of both ASD and RAD/DSED. High symptom scores for ASD were associated with male gender, (younger) age of mother at birth, and being in a single-parent family, while high symptom scores for RAD/DSED were associated with (younger) age of mother at birth, being in a single-parent family, and the number of accidents reported. Service use costs per likely case of both ASD and RAD/DSED in the preschool years were increased by £348.62 (95% confidence interval 121.04–391.11)—nearly double the costs of ASD alone. Conclusions: There is considerable overlap between symptoms of ASD and RAD/DSED in the general population, indicating that multi-morbidity is already present in childhood and is associated with increased service use and costs even in the preschool years.

• Item Type: Articles
• Additional Information: This work was supported by the Chief Scientist Office of the Scottish Government (CZG/2/565) and the Gillberg Neuropsychiatry Centre.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Minnis, Professor Helen
• Authors: Minnis, H., Messow, C.-M., McConnachie, A., Bradshaw, P., Briggs, A., Wilson, P., and Gillberg, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: Developmental Child Welfare
• Publisher: SAGE Publications
• ISSN: 2516-1032
• ISSN (Online): 2516-1040
• Published Online: 17 February 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in Developmental Child Welfare 2(1):37-51
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
190501		Autism and Reactive Attachment Disorder symptons in the Scottish Population: associations with health and service use.	Helen Minnis	Chief Scientist Office (CSO)	CZG/2/565	HW - Mental Health and Wellbeing