Essays & Theses

Aims: Pathological Demand Avoidance (PDA) is an increasingly used label that describes a subset of children diagnosed with Autism Spectrum Disorder (ASD) who display extreme behaviours in response to everyday demands. To date, little is known about the cognitive profiles associated with these behaviours. The aim of this study was to investigate the potential role of parent-reported Executive Function (EF) in PDA traits in the context of ASD, with a particular focus on emotion dysregulation and non-compliance behaviour. Methods: Sixty-four parents of children with ASD and 31 parents of children without ASD, aged between 6-11 years old, were recruited to complete questionnaires at a single time point. Questionnaires assessed ASD traits, PDA traits, EF, non-compliance behaviours, and emotion dysregulation. Results: Group differences in parent-reported EF were found, with children with ASD showing greater deficits than children without ASD. EF was significantly related to global PDA traits in the context of ASD, as well as to dimensional measures of specific associated behaviours such as emotional dysregulation and behavioural non-compliance. Executive Function accounted for a significant proportion of the variance (r2 = 34%) in PDA traits. Indices of EF were found to differentially predict non-compliance behaviours and ASD traits confounded some of these relationships. Conclusion: These findings suggest that a range of EF deficits may contribute to PDA behaviours in children with ASD. Evidence for differential involvement of EF in PDA traits suggests that further exploration using more direct measures of EF is warranted to gain a clearer understanding of this relationship, which could benefit interventions and behavioural strategy development

Premenstrual Dysphoric Disorder (PMDD) is thought to be a cyclical affective disorder affecting some women during the premenstrual or luteal phase of the menstrual cycle. Criticisms have been raised about the incremental validity of this disorder as a distinct entity from other mood and affective problems such as Major Depressive Disorder. The purpose of the current study was to investigate the validity of a premenstrual-phase-specific mood disorder and to investigate the role of two psychological constructs for women reporting premenstrual affective symptoms and women reporting general depressive symptoms. A multi-method approach to premenstrual affect assessment was used such that presence of premenstrual affective problems was retrospectively reported by participants and prospectively measured via daily diary across 30 days. Self-report measures collected at baseline assessed premenstrual affective symptoms, depressive symptoms, anxiety symptoms, rumination, and anxiety sensitivity. Daily measures of negative and positive affect and sexual behavior were also collected. Hierarchical linear modeling was utilized to examine the presence of a relationship between the menstrual cycle and daily affect as well as to investigate whether anxiety sensitivity and rumination influenced daily affect across the menstrual cycle. Primary analyses indicated that women with high scores on the baseline PMDD measure experienced high levels of negative affect irrespective of menstrual cycle phase. Women with high scores on a measure of general depressive symptoms did display a pattern of increased negative affect during the luteal phase. Exploratory analyses revealed the moderating effect of both anxiety sensitivity and rumination in predicting negative affect in the luteal phase; this effect was found in women reporting severe depressive symptoms and those reporting severe premenstrual affective symptoms. Further research is needed to clarify the presence of a premenstrual mood disorder separate from other mood disorders.

This qualitative dissertation investigates current research gaps regarding autistic individuals’ experience of trauma and resilience in the face of adversity. Specifically, it conceptualizes trauma and resilience through a neurodiverse lens, through identifying themes in memoirs written by five autistic authors related to trauma, potentially traumatic events, resiliency, and posttraumatic growth. Through Interpretive Phenomenological Analysis, I identified individual, interpersonal, and societal factors impacting the memoirists experiences of trauma, through the identification of 11 superordinate themes. Prominent themes at the individual level included self-acceptance and emotion regulation promoting resilience. At the contextual level, sensory processing and uncertainty coincided with experiences of trauma. At the interpersonal level, many memoirists describe interpersonal traumas, including mutual misunderstanding between themselves and others. Finally, at the societal level, themes across the memoirs point to the importance of mental health professional training and awareness regarding autism and expanding our understanding of traumatic experiences. Thus, I propose a sociocultural approach for conceptualizing how autism and trauma intersect. Based on this approach, I advocate for systemic-level changes, community, contextual, and individual interventions to support the resiliency of autistic individuals.

The thesis identified and elucidated the phenomena in the timing of diagnosis when autism and ADHD co-occur. This included understanding the delay in autism diagnosis when ADHD is present and provided possible evidence for where along a diagnostic pathway such a delay might be occurring. A biopsychosocial framework was also used to consider multiple psychological and social aspects of this process including the experiences of complex neurodevelopmental cases for families and clinicians. The experience for families and clinicians grappling with an imperfect diagnostic model suggests that multiple resources, time delays and stressful situations are common. This thesis concludes with theoretical and practical recommendations for an improved diagnostic pathway and experience for clinicians and families.

Maybe She’s Born With It, Maybe It’s Neurodivergency is an homage to my lived experience as a Queer-Neurodivergent individual navigating a world that was not made for me. It challenges the hegemonic notion of ‘normalcy’ and opens up a dialogue about the oppressive structures that we live within and are confined by. I impart the meaning of the grid as a symbol for neurotypicality, white supremacy, heteronormativity, and patriarchy. Alongside the grid is a hieroglyph of my own creation, a tight yet explosive gestural mark, a visual metaphor for my neurodivergent physical, mental and emotional discomfort. Combining these seemingly oppositional forms, I disrupt the grid visually and physically through a variety of print and papermaking processes. Through an interactive installation, the work calls attention to the importance of embracing intuition, relinquishing control, and audience participation in contemporary art— providing a platform to challenge the status quo both within the conventional art world and beyond.

Premenstrual Dysphoric Disorder (PMDD) is a debilitating disorder that adversely affects the lives of individuals and their intimate relationships. The purpose of this transcendental phenomenological study was to describe the lived experience of the partners of individuals who suffer from Premenstrual Dysphoric Disorder. The theories guiding this study were the interpersonal theory of suicide and the adult attachment theory. This study examined the overall relationship experience of partners of individuals suffering from PMDD and their cyclic attachment styles during the luteal and follicular phases of the menstrual cycle. A selection of three PMDD partners and three PMDD sufferers, who have been in an intimate relationship for six months or longer, were interviewed to measure the fluctuation in the overall relationship experience and cyclic attachment styles. Overall, the attachment styles of the PMDD partners may be affected because of the cyclic anguish of the PMDD sufferers during the luteal and follicular phases of menstruation. The fluctuating attachment styles of the PMDD sufferer can impact the PMDD partner’s overall relationship experience.

Autistic women are much more likely to be misdiagnosed, undiagnosed, and underserved than autistic men, yet our relationship with our identities is much more complicated than simply “underdiagnosis.” At least in part because we are not as interested in or responsive to social norms, we are more likely to be transgender, non-binary, and/or gender non-conforming: some of us may not identify as women at all. Furthermore, because autism is a way of being that is uniquely different from allism (i.e., not being autistic), we are capable of experiencing gender in ways that are inherently unrelatable and inaccessible to allistic people. With increasing awareness of and support for the neurodiversity paradigm, which posits that autism is an expression of human biodiversity rather than a pathological condition, and increasing availability of queer and transgender resources, more and more autistic people are able to both access and express queer autistic genders. Working within the neurodiversity paradigm and drawing from queer theory and neuroqueer theory, which suggests that it is possible and even potentially positive to intentionally “queer” one’s own neurodivergence, this study seeks to describe the ways in which autistic women and autistic woman-proximal people are neuroqueering gender. I establish the social and historical context in which autistics navigate queer genders and queer neurotypes, and examine existing writing about autistic woman-proximal gender. Given this context, I conduct qualitative interviews to describe how queer / non-cisgender, neurodiversity-oriented, woman-proximal autistics understand, create, and intentionally push the boundaries of our genders and our neurodivergences.

Ageing in autism spectrum conditions is a growing but still relatively under-researched field of enquiry. Changes in the diagnostic features, particularly social and communication difficulties, and emotional and mental health needs of autistic adults as they age is one area that is not well understood. This thesis presents a program of work encompassing both empirical and theoretical research.  Firstly, it used an exploratory qualitative methodology to investigate the social and emotional functioning of cognitively able older autistic adults. Secondly, using theoretical analysis it outlines and provides empirical evidence for the application of the theory of lifespan psychology to the developmental trajectory of autism across the lifespan. The aim of this research was twofold: to explore older autistic adults’ experiences and perspectives of ageing, with particular focus on social-emotional functioning; and to investigate the relevance of lifespan developmental psychology as a theoretical framework for understanding adaptive change and the potential for successful ageing in autism. The first part of this research program used Interpretative Phenomenological Analysis, a psychological experiential methodology, that lends itself to participatory research and is well-suited to generating theory, particularly in under-researched areas such as ageing in autism. Semi-structured interviews with ten autistic adults (age range 53-74 years) explored their life history and experiences of autistic identity, social interaction, mental health and coping, and concerns for the future. Analyses revealed four overarching themes: negotiating diagnosis and an autistic identity in later life; social instinct; mental health problems and solutions; and positive outlook. Participants’ insights highlighted that respect for, and accommodation of, diverse experiences is critical in autism research, and in treatment and support contexts. Further, despite experiencing many life difficulties, participants suggested older age brought with it resilience and a generally positive outlook on life. This finding contrasts with other studies of autistic adults that report a steady and unchanging life trajectory of isolation, loneliness and longing for connection, and suggests that older autistic adults with low support needs might attain normative developmental gains in later life despite their autistic characteristics. Negative misconceptions about the inevitability of decline and loss in old age abound in society and the literature on autism and ageing. But there is a paradox of ageing – most typically developing adults experience a peak in their life satisfaction and emotional wellbeing in later life that is fundamental to successful ageing. The resilience and positive outlook of older autistic adults revealed in the first part of this research program was an unexpected finding, and raised the tantalising question: could it be that the paradox of ageing is true for older autistic adults too? Although autism has been analysed in the context of many theoretical frameworks, most take as their starting point impairment and disability even as they advocate for a positive neurodiverse conceptualisation of autism. By contrast, there has been no attempt to consider ageing in autism from the perspective of lifespan psychology and developmental models that guide much of the contemporary gerontological research on social and emotional development and successful ageing.  The second part of this research addressed this gap in the literature by exploring how lifespan psychology, and the developmental model of selective optimisation with compensation, might inform our understanding of the developmental trajectory of autism across the lifespan and in later life. Drawing on evidence from the autism literature and the case studies of three older autistic adults in the current program of research, it is contended that lifespan psychology provides a novel conceptualisation of successful ageing in autism as the outcome of lifelong adaptive processes in the pursuit of personal meaning and goals. The program of research described here adds to our knowledge of autism and ageing by providing unique and nuanced insights into social and emotional functioning across the lifespan from the perspectives of older autistic adults. Further, it proposes lifespan developmental psychology as a novel evidence-based theoretical framework that challenges existing negative expectations and offers an opportunity to reframe future autism research and clinical practice. Overall, this body of work extends our understanding of ageing in autism and offers a fresh and creative direction for future research that focuses on the potential for growth, wellbeing, and successful ageing in autism. Limitations of the research and areas for future research are also discussed.

Attention-deficit hyperactivity disorder (ADHD) and Autism spectrum disorder (ASD) are two of the most common neurodevelopmental disorders found in children and they show significant symptom overlap. Because both disorders are diagnosed based on behavioral observation, inferring which disorder (or combination of disorders) is causing symptoms in an individual child can be challenging for clinicians, particularly when an individual shows behaviors consistent with comorbid ASD+ADHD. The current study examined resting electroencephalography (EEG), as well as task-related EEG and behavior during a modified flanker task in 50 children (aged 6-12) with either a diagnosis of ADHD (n=17), ASD (n=5), both (comorbid ADHD+ASD, COM; n=8), or no clinical diagnosis (typically developing control, TDC; n=20). EEG and behavioral analyses began by comparing a set of features that have previously been used to discriminate single disorders from TDC. Next, the data from TDC and children with a single diagnosis (ASD-only, ADHD-only) were submitted to k-means cluster analysis to evaluate data-driven subgroups regardless of diagnosis. After recovery of the optimal number of clusters (3), the data from COM participants were sorted into the cluster in which they best fit. While none of the regularities found in the literature properly explain the relationships between ADHD, ASD, and COM participants, the use of cluster analysis suggested potential phenotypes that differ in Stimulus Engagement and Feedback Responsivity. These dimensions may have bearing on the efficacy of treatments that target dopaminergic systems, such as methylphenidate. Methods such as these may give insight into the neurobiological underpinnings of an individual’s symptoms, which has the potential to guide decisions about appropriate pharmacological treatment and behavioral interventions.

The term “neurodivergent” should be used over the phrase “mental disability” because it is a more accurate, much safer, and easily accessible term to use.  There are many reasons why the language surrounding mental disabilities should be changed.  The stigma of the word “disability” alone can be damaging enough to a disabled person.  Furthermore, the phrase “mental disability” doesn’t accurately describe what they are and instead implies an inability to mentally function.  Both of these factors combined has led to openly mentally disabled people fear for their safety as their diagnosis can be used against them once it’s public knowledge.  The already used term “neurodivergent” helps remedy these problems with mental disability language.  The term has yet to be associated with negative stigma due to it being a word created by disabled people and disability activists.  The phrasing of the word implies more of a difference in brain function, which more accurately describes what a mental disability is.  Finally, using the term can help set more protected boundaries than giving out specifics would.

Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are heterogeneous neurodevelopmental disorders with similar functional impairments. Specifically, working memory (WM) deficits have been found in studies of both ADHD and ASD and social competence has been identified as an area in which these individuals also struggle. The purpose of this study was (a) to identify which components of working memory (WM; based on Baddeley's 2000 model) are deficient and (b) to explore how WM deficits contribute to social problems in individuals with varying levels of ADHD symptoms and ASD traits. It was hypothesized that visuospatial (VS) WM deficits would be evident in the three analogue clinical groups, phonological (PH) WM and central executive (CE) deficits would be more evident in groups with high ADHD symptoms, all three analogue clinical groups would have lower social competence, and WM abilities would moderate the relationship between ADHD symptoms and social competence. In Phase I, 1311 undergraduate students participated in an online survey on general psychopathology, ADHD symptoms, and ASD traits. From this sample, a subgroup (n = 60) completed Phase II, an in-lab session that included WM tasks, a brief cognitive assessment, and social conversation task. Although WM deficits were not identified for any group, all participants demonstrated worse performance on the VS WM task than the PH WM task. However, WM abilities did not moderate the relationship between ADHD symptoms and social competence. Exploratory analyses were conducted with similar results. Limitations and suggestions for future research are discussed.

There is a dearth of research and literature on the use of transformative practices by autistic people as a means of pursuing self-actualization and the realization of positive psychospiritual potentials. In this autoethnographic inquiry I examine my experience as an autistic participant in transformative somatic practices, with a focus on my four decades as a student and teacher of aikido and my two decades as a member of an experiential research group exploring movement-oriented ritual as a tool for accessing the realms of the unconscious and the transpersonal. In reflecting upon my experiences, I aim to derive broader insights regarding the ways in which practices like the ones in which I’ve engaged can interact with autistic ways of knowing and being, and regarding the use of such practices toward the realization of autistic potentials and the cultivation of psychospiritual wellbeing and self-actualization in autistic people.  The inquiry is grounded a humanistic perspective and in the neurodiversity paradigm, an emergent framework for research and scholarship that foregrounds the voices and experiences of autistics and other members of neurocognitive minorities. Autoethnography, which utilizes the lived experience of the researcher as a foundation for cultural insight, is a methodology particularly well-suited to  v this foregrounding of traditionally marginalized voices. In interpreting my experiences and seeking to glean insight from them, I draw upon multiple bodies of theory and literature; I include a literature review that aims at formulating a coherent picture of the overall nature and distinctive qualities of autistic experience, and the subsequent autoethnographic narrative incorporates theories and concepts from the fields of somatic psychology and humanistic psychology.  I conclude the inquiry with reflections on the implications of my narrative with regard to praxis, and with a discussion of possibilities for future research on autistic participation in transformative practices.