How do you solve a problem like aggression?

Irritability and aggression are dangerous behaviors that can lead to harm and injury and are overlooked in research. Unfortunately there are only two FDA medications approved to treat them in autism. The drugs have many side effects, and there are efforts to improve these treatments and minimize side effects by lowering the dose with adjunct therapies that enhance the efficacy of the drug. So far, there are a few promising leads, but nothing that is ready for the clinic. How do scientists make the move from an interesting discovery in a lab to testing the safety and efficacy of a drug? Through animal models or model systems that examine different phenotypes in an animal and test medications on outcomes like aggression. Mice are not people, but they are necessary to ensure safe and effective treatments are translated into practice.

https://pubmed.ncbi.nlm.nih.gov/38263251/

How to predict severe and dangerous behavior

On the first podcast of 2024, we describe a new paper in the Journal of the American Medical Association or JAMA which uses physiological measurements like heart rate and skin conductance to predict severe and dangerous behaviors, specifically aggression. If aggression can be predicted, it might be able to be prevented. It turns out aggression can be predicted up to 3 minutes before an episode occurs, in the future these measures can be used to possibly redirect aggression. In a separate study, the issue of stigma is addressed. There is an intense debate over “person first” vs. “identity first” language in autism, promoting recommendations of using one over the other because fear that person first language promotes stigma against autism. A new study shows that there is no added prejudice or fear using either person first or identity first language, but the stigma associated with schizophrenia is worse than it is for autism. What contributes to stigma? There is a wide range of experiences and perceptions of autism that need to be addressed. It’s not as simple as the language used.

https://pubmed.ncbi.nlm.nih.gov/38127348/

https://pubmed.ncbi.nlm.nih.gov/37965364/

From being high to being aggressive

There are many many potential factors that influence a diagnosis of ASD that have been underexplored, and recreational drugs are one of them. Of course it would never explain all the cases of ASD, not one singular thing does, but does cannabis consumption during pregnancy lead to an increased probability of having a child with ASD? As it turns out, yes, a small increase, meaning it isn’t the only thing causing ASD but: JUST SAY NO if you are pregnant. On the other end of the spectrum is aggression, a completely horrible feature of some people with ASD. About 30% of people who are aggressive and have an ASD diagnosis are not responsive to any medications or therapies, which is horrifying. Researchers in Canada and Brazil have studied the brains of this group, with what is called “refractory aggression” to try to get to the mechanism.

https://pubmed.ncbi.nlm.nih.gov/32778828/

https://pubmed.ncbi.nlm.nih.gov/32762791/