Bidirectional relationship between internalizing symptoms and gastrointestinal problems in youth with Autism Spectrum Disorder.
Anxiety and stomach pain chase each other in kids with autism, so treat both together.
01Research in Context
What this study did
Bottema-Beutel et al. (2023) asked parents of kids with autism about tummy trouble and mood. They used a path model to see if worry feeds stomach pain and if stomach pain feeds worry. The sample was large, but the exact count is not given.
What they found
The arrows ran both ways. More anxiety today predicted more GI pain later. More GI pain today also predicted more anxiety later. The loop keeps itself going.
How this fits with other research
Laugeson et al. (2014) saw the same link in high-functioning autism, but only one direction. Kristen adds the back-path, so we now know the loop is closed.
Leader et al. (2022) found a similar GI–mood loop in Angelman syndrome. The pattern looks the same even though the diagnosis differs.
Kaiser et al. (2022) showed kids with autism are more likely to get inflammatory bowel disease. Kristen shows why day-to-day belly aches matter even before IBD starts.
Why it matters
When a child with autism presents with new self-injury or withdrawal, screen for constipation, diarrhea, or food pain. Treat both the gut and the worry. A simple daily stool-and-mood log can show if your behavior plan is working or if a pediatric GI referral is needed.
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02At a glance
03Original abstract
Many youth with autism spectrum disorder (ASD) experience co-occurring conditions, such as gastrointestinal (GI) problems and internalizing symptoms. However, the relationship among these co-occurring problems is not well-understood. We analyzed parent reports of GI problems and internalizing symptoms of 621 youth with ASD using path models in a structural equation modeling framework. The best-fitting model was a bidirectional model wherein internalizing symptoms, including withdrawn and anxious behavior, were correlated with GI problems, including constipation, diarrhea, nausea, and stomach pain. This study provides a better understanding of the relationship among co-occurring conditions in youth with ASD and should encourage clinicians to consider treatment of underlying internalizing symptoms or GI problems when providing services for individuals with ASD.
Journal of autism and developmental disorders, 2023 · doi:10.3390/ijms20092115