Current Status of Psychopharmacological, Neuromodulation, and Oxytocin Treatments for Autism: Implications for Clinical Practice

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Abstract

Objectives

To provide an overview of the current literature regarding the neurobiological treatments of psychopharmacology, neuromodulation, oxytocin therapy, and psychological resilience, as treatments for autism-related difficulties, and to distil the research findings from those treatments for everyday clinical application.

Methods

Instead of producing another specific systematic summary of the efficacy of these treatments, this review took an overview of each field of research, identified its key research findings, and evaluated the treatment-ready status of each of them in terms of their evidence base. From this information, a set of recommendations were derived for their clinical applications, so as to inform practice in the field.

Results

These treatments represent relatively recent and neurobiologically based approaches to the challenges of autism, and are in the development stage. Each treatment is promising, and has some evidential basis for its success, but all need further research to establish their evidence-based validity for everyday clinical usage.

Conclusions

While most of these treatments can be applied with caution, clinicians should acknowledge their restrictive benefits and costs, that are described herein. Within those caveats, each of these treatments should be considered as an emerging therapy that clinicians should consider utilising in appropriate settings and with specific cases.

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Most cited references 61

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Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

Kathryn M Connor, Jonathan Davidson (2003)

Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.

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Diagnostic and Statistical Manual of Mental Disorders : DSM-5-TR

American Psychiatric Association (2022)

"The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), is the most comprehensive, current, and critical resource for clinical practice available to today's mental health clinicians and researchers. DSM-5-TR includes fully revised text and references, updated diagnostic criteria and ICD-10-CM codes since DSM-5 was published in 2013. It features a new disorder, prolonged grief disorder, as well as codes for suicidal behavior available to all clinicians of any discipline without the requirement of any other diagnosis. With contributions from over 200 subject matter experts, this updated volume boasts the most current text updates based on the scientific literature. Now in four-color and with the ability to authenticate each printed copy, DSM-5-TR provides a cohesive, updated presentation of criteria, diagnostic codes, and text. This latest volume offers a common language for clinicians involved in the diagnosis and study of mental disorders and facilitates an objective assessment of symptom presentations across a variety of clinical settings-inpatient, outpatient, partial hospital, consultation-liaison, clinical, private practice, and primary care. Important updates in DSM-5-TR include 1) fully revised text for each disorder with updated sections on associated features, prevalence, development and course, risk and prognostic factors, culture, diagnostic markers, suicide, differential diagnosis, and more; 2) addition of prolonged grief disorder (PGD) to Section II; 3) over 70 modified criteria sets with helpful clarifications since publication of DSM-5; 4) fully updated Introduction and Use of the Manual to guide usage and provide context for important terminology; 5) considerations of the impact of racism and discrimination on mental disorders integrated into the text; 6) new codes to flag and monitor suicidal behavior, available to all clinicians of any discipline and without the requirement of any other diagnosis; 7) fully updated ICD-10-CM codes implemented since 2013, including over 50 coding updates new to DSM-5-TR for substance intoxication and withdrawal and other disorders"--