Papers by Denis Sukhodolsky
Brain Imaging and Behavior, Nov 5, 2014
We investigated the mechanisms by which Pivotal Response Treatment (PRT) improves social communic... more We investigated the mechanisms by which Pivotal Response Treatment (PRT) improves social communication in a case series of 10 preschool-aged children with Autism Spectrum Disorder (ASD). Functional magnetic resonance imaging (fMRI) identified brain responses during a biological motion perception task conducted prior to and following 16 weeks of PRT treatment. Overall, the neural systems supporting social perception in these 10 children were malleable through implementation of PRT; following treatment, neural responses were more similar to those of typically developing children (TD). However, at baseline, half of the children exhibited hypoactivation, relative to a group of TD children, in the right posterior superior temporal sulcus (pSTS), and half exhibited hyperactivation in this region. Strikingly, the groups exhibited differential neural responses to treatment: The five children who exhibited hypoactivation at baseline evidenced increased activation in components of the reward system including the ventral striatum and putamen. The five children who exhibited hyperactivation at baseline evidenced decreased activation in subcortical regions critical for regulating the flow of stimulation and conveying signals of salience to the cortex-the thalamus, amygdala, and hippocampus. Our results support further investigation into the differential effects of particular treatment strategies relative to specific neural targets. Identification of treatment strategies that address the patterns of neural vulnerability unique to each patient is consistent with the priority of creating individually tailored interventions customized to the behavioral and neural characteristics of a given person.
Research in Autism Spectrum Disorders, Nov 1, 2017
Journal of Autism and Developmental Disorders, May 26, 2016
Personality and Individual Differences, Oct 1, 2001
European Psychiatry, Apr 1, 2017
IntroductionIn addition to problems with inattention and hyperactivity, children with ADHD show p... more IntroductionIn addition to problems with inattention and hyperactivity, children with ADHD show poor organizational skills required for managing time and materials in academic projects. Poor organizational skills are associated with academic underachievement as well as psychosocial, occupational and economic difficulties. Behavioral approaches for ADHD are effective in reducing hyperactivity symptoms and behavioral problems, but the effects on academic functioning have been modest. An increasing emphasis on treatment of organizational skills has emerged in recent years, as difficulties with time management and organization of materials tend to persist and increase with age despite medication and behavioral treatments.ObjectivesThe primary objective is to investigate whether organizational skills training has a positive effect on organizational skills. The secondary and exploratory objectives are to investigate the effect on ADHD symptoms, adaptive functioning, academic performance and cognitive functions with a 24 weeks follow up.AimsOur goal is to provide cost-effective group-based treatment for children with ADHD and their parents. This will be the first randomized and controlled trial of organizational skills in Denmark.MethodsParticipants are included in two sites in Southern Denmark and will be randomized to Organizational skills training or treatment as usual. Organizational skills training will be provided in a group format for children and parents over 10 weeks.Perspectives Given the strong association between organizational skills and functional outcome, it is very important to address organizational skills in children and adolescents with ADHD as organizational skills deficits hinder the academic performance of even gifted students with ADHD and increase with age.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Oxford University Press eBooks, Apr 1, 2022
Research Square (Research Square), Dec 5, 2022
Previous research has indicated that anger and aggression may be elevated in adolescents with a b... more Previous research has indicated that anger and aggression may be elevated in adolescents with a bulimia nervosa (BN) diagnosis. However, as yet, little is known about whether bulimia symptoms are linked to anger and aggression or if these associations exist in adolescents in the general population. To address this de cit this study aimed to explore the associations between a clinical level of bulimia symptoms (CLBS) and anger, anger rumination and aggression in community-based adolescents, and determine whether gender is important in this context. This study was conducted on a representative sample of youth from northwestern Russia (N = 2613, age 13-17 years old, 59.5% female) using self-report scales. A proxy variable for a CLBS was created using the Eating Disorder Diagnostic Scale. Aggression, anger and anger rumination were assessed by the Trait Anger Scale of the State Trait Anger Expression Inventory, the Anger Rumination Scale, and scales created to assess physically and verbally aggressive behavior. Multivariate analysis of covariance was used to examine the associations between the study variables. A CLBS was more prevalent in girls than in boys (13.4% vs 3.5%). The association with anger and aggression was stronger in both genders with a CLBS, compared to those adolescents without a CLBS. In the CLBS group, boys as compared to girls scored higher on verbal and physical aggression, anger rumination and social aggression. In both the CLBS and Non-CLBS group higher anger and aggression scores were associated with increasing age. Findings suggest that aggression and anger rumination are elevated in adolescents with BN symptoms, and that the associations between anger, aggression and BN symptoms may be stronger in boys. As previous research has indicated that the presence of aggressive behaviors may affect the prognosis of BN and complicate management of the disorder, clinician screening for these behaviors in adolescents with BN symptoms may facilitate the provision of more effective treatment, especially among boys.
Autism and child psychopathology series, 2017
The prevalence of Gilles de la Tourette syndrome (GTS) is approximately 0.8% between the ages of ... more The prevalence of Gilles de la Tourette syndrome (GTS) is approximately 0.8% between the ages of 6 and 18 years. GTS is complicated by psychiatric comorbidities (attention-deficit/hyperactivity disorder [ADHD], obsessive-compulsive disorder, anxiety/depressive disorders, autism spectrum disorders) in about 90% of cases. Secondary tic disorders are less frequent than primary tic disorders and should be suspected in older onset (>20 years) and associated neurologic abnormalities. GTS is associated with abnormal trajectories of cortico-subcortical and corticocortical circuits regulating motor control. Management of GTS rests first on psychoeducational intervention. a-2-Agonists (clonidine and guanfacine) are first-line medications for the treatment of tics in the United States and Canada and may be more effective in patients with GTS and ADHD compared with GTS alone. Antipsychotic medications (mostly risperidone, haloperidol, pimozide, fluphenazine, aripiprazole) are also effective, but with a less favorable sideeffect profile.
Research Square (Research Square), Mar 30, 2021
Disruptions in frontoparietal networks supporting emotion regulation have been long implicated in... more Disruptions in frontoparietal networks supporting emotion regulation have been long implicated in maladaptive childhood aggression. However, the association of connectivity between large-scale functional networks in the human connectome with aggressive behavior has not been tested. By using a data-driven, machine learning approach, we show that the functional organization of the connectome during emotion processing predicts severity of aggression in children (n=129). Connectivity predictive of aggression was identi ed within and between large-scale networks implicated in cognitive control (frontoparietal), social functioning (default mode), and emotion processing (subcortical). Out-of-sample replication and generalization of ndings predicting aggression from the functional connectome was conducted in an independent sample of children from the Adolescent Brain Cognitive Development study (n=1,791; n=1,701). These results de ne novel connectivity-based networks of child aggression that can serve as biomarkers to inform targeted treatments for aggression.
PubMed, 2005
In conclusion, data from community surveys suggest that tic disorders, including TS, exist on a s... more In conclusion, data from community surveys suggest that tic disorders, including TS, exist on a spectrum from transient to persistent, multiple motor, and vocal tics that interfere with activities of daily living. The presence of isolated and transitory tics is common and appears to be of minimal consequence. On the other hand, persistent tics, even mild tics, appear to be associated with ADHD, disruptive behavior, and learning problems (though not necessarily formal learning disability). The presence of ADHD with tics increases the likelihood of disruptive behavior and learning problems, but learning problems can be observed in community samples of children with tic disorders, even in the absence of ADHD. To date, few studies have clearly defined the nature of the learning problems in children with tic disorders. Nonetheless, the data do suggest that having chronic tics is associated with impairment independent of ADHD. Community samples and recent investigations in clinical samples confirm that the presence of ADHD predicts greater disability than that associated with tic disorders alone.
Research on Child and Adolescent Psychopathology, Nov 24, 2020
Although parents' socialization of children's emotional experiences and expression has been widel... more Although parents' socialization of children's emotional experiences and expression has been widely studied in typically developing (TD) populations, these processes have been largely unexplored in families of children with autism spectrum disorder (ASD). The present study examined parent emotion socialization in a well-characterized sample of verbally fluent children with ASD and comorbid anxiety disorders. Participants included 64 children, aged 8-15 years, who had ASD and co-occurring anxiety and 24 matched TD children without psychiatric disorders. Parents completed ratings of their responses to their children's emotional experiences using the Coping with Children's Negative Emotions Scale (CCNES), and both parents and children completed ratings of child anxiety using the Multidimensional Anxiety Rating Scale (MASC). Parents of children with ASD and anxiety did not differ from parents of TD children without psychiatric disorders in their endorsement of different emotion socialization practices. However, among children with ASD and anxiety, greater anxiety was associated with more emotion-focused responses from parents, and for children with less ASD symptom severity, lower levels of anxiety were associated with more punitive responses from parents. Results suggest that certain types of more directive emotion socialization approaches may be associated with lower anxiety in children with ASD, whereas emotion socialization approaches focused on altering the child's emotional experiences may be associated with greater anxiety in this population. While it is likely that parent emotion socialization practices impact children's emotional experiences of anxiety, it is also likely that children with distinct profiles of anxiety and ASD symptomology elicit specific styles of emotion socialization from parents.
Oxford University Press eBooks, Dec 1, 2010
Journal of Neurodevelopmental Disorders, Jan 17, 2017
Background: Disruptive behavior in autism spectrum disorder (ASD) is an important clinical proble... more Background: Disruptive behavior in autism spectrum disorder (ASD) is an important clinical problem, but its neural basis remains poorly understood. The current research aims to better understand the neural underpinnings of disruptive behavior in ASD, while addressing whether the neural basis is shared with or separable from that of core ASD symptoms. Methods: Participants consisted of 48 male children and adolescents: 31 ASD (7 had high disruptive behavior) and 17 typically developing (TD) controls, well-matched on sex, age, and IQ. For ASD participants, autism symptom severity, disruptive behavior, anxiety symptoms, and ADHD symptoms were measured. All participants were scanned while viewing biological motion (BIO) and scrambled motion (SCR). Two fMRI contrasts were analyzed: social perception (BIO > SCR) and Default Mode Network (DMN) deactivation (fixation > BIO). Age and IQ were included as covariates of no interest in all analyses. Results: First, the between-group analyses on BIO > SCR showed that ASD is characterized by hypoactivation in the social perception circuitry, and ASD with high or low disruptive behavior exhibited similar patterns of hypoactivation. Second, the between-group analyses on fixation > BIO showed that ASD with high disruptive behavior exhibited more restricted and less DMN deactivation, when compared to ASD with low disruptive behavior or TD. Third, the within-ASD analyses showed that (a) autism symptom severity (but not disruptive behavior) was uniquely associated with less activation in the social perception regions including the posterior superior temporal sulcus and inferior frontal gyrus; (b) disruptive behavior (but not autism symptom severity) was uniquely associated with less DMN deactivation in the medial prefrontal cortex (MPFC) and lateral parietal cortex; and (c) anxiety symptoms mediated the link between disruptive behavior and less DMN deactivation in both anterior cingulate cortex (ACC) and MPFC, while ADHD symptoms mediated the link primarily in ACC. Conclusions: In boys with ASD, disruptive behavior has a neural basis in reduced DMN deactivation, which is distinct and separable from that of core ASD symptoms, with the latter characterized by hypoactivation in the social perception circuitry. These differential neurobiological markers may potentially serve as neural targets or predictors for interventions when treating disruptive behavior vs. core symptoms in ASD.
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Papers by Denis Sukhodolsky