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Case report: Co-occurring autism spectrum disorder (Level One) and obsessive-compulsive disorder in a gender-diverse adolescent

This fictionalized case report captures the common themes and considerations during the diagnostic assessment and behavioral treatment of adolescents demonstrating symptoms of autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD), as...

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Autores principales: Guastello, Andrea D., Lieneman, Corey, Bailey, Brittany, Munson, Melissa, Barthle-Herrera, Megan, Higham, Miranda, Druskin, Lindsay, McNeil, Cheryl B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10227521/
https://www.ncbi.nlm.nih.gov/pubmed/37260756
http://dx.doi.org/10.3389/fpsyt.2023.1072645
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author Guastello, Andrea D.
Lieneman, Corey
Bailey, Brittany
Munson, Melissa
Barthle-Herrera, Megan
Higham, Miranda
Druskin, Lindsay
McNeil, Cheryl B.
author_facet Guastello, Andrea D.
Lieneman, Corey
Bailey, Brittany
Munson, Melissa
Barthle-Herrera, Megan
Higham, Miranda
Druskin, Lindsay
McNeil, Cheryl B.
author_sort Guastello, Andrea D.
collection PubMed
description This fictionalized case report captures the common themes and considerations during the diagnostic assessment and behavioral treatment of adolescents demonstrating symptoms of autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD), as well as gender-diversity concerns. Our patient was a white, non-Hispanic 17-year-old individual who identified as gender-neutral but had been assigned female at birth. Symptoms presented were social withdrawal, rigid rule-following behavior, unusual repetitive behavior, impairments in social communication skills, sensory sensitivity, body dissatisfaction, self-injury, and anxiety related to contamination, perfectionism, and social interactions. These symptoms contributed to functional impairment with school attendance, school achievement, family relationships, and the activities of daily living. This case report summarizes instruments employed for differential diagnosis concerning cognitive functioning, ASD, OCD, ADHD, depression, anxiety, and commonly co-occurring repetitive behavior. This patient was ultimately diagnosed with ASD, level one for both social communication and restricted, repetitive behaviors, without accompanying intellectual or language impairment; OCD with panic attacks; gender dysphoria; major depressive disorder (single episode and moderate); and ADHD. The subsequent 40-session course of cognitive-behavioral therapy with exposure and response prevention (CBT/ERP) to treat OCD tailored to an individual with ASD and gender diversity concerns is described in detail. Components of family involvement are highlighted. As a result, significant improvements in school attendance, OCD symptoms, depression, social relationships, and adaptive functioning were measured. Lastly, recommendations for clinicians are summarized.
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spelling pubmed-102275212023-05-31 Case report: Co-occurring autism spectrum disorder (Level One) and obsessive-compulsive disorder in a gender-diverse adolescent Guastello, Andrea D. Lieneman, Corey Bailey, Brittany Munson, Melissa Barthle-Herrera, Megan Higham, Miranda Druskin, Lindsay McNeil, Cheryl B. Front Psychiatry Psychiatry This fictionalized case report captures the common themes and considerations during the diagnostic assessment and behavioral treatment of adolescents demonstrating symptoms of autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD), as well as gender-diversity concerns. Our patient was a white, non-Hispanic 17-year-old individual who identified as gender-neutral but had been assigned female at birth. Symptoms presented were social withdrawal, rigid rule-following behavior, unusual repetitive behavior, impairments in social communication skills, sensory sensitivity, body dissatisfaction, self-injury, and anxiety related to contamination, perfectionism, and social interactions. These symptoms contributed to functional impairment with school attendance, school achievement, family relationships, and the activities of daily living. This case report summarizes instruments employed for differential diagnosis concerning cognitive functioning, ASD, OCD, ADHD, depression, anxiety, and commonly co-occurring repetitive behavior. This patient was ultimately diagnosed with ASD, level one for both social communication and restricted, repetitive behaviors, without accompanying intellectual or language impairment; OCD with panic attacks; gender dysphoria; major depressive disorder (single episode and moderate); and ADHD. The subsequent 40-session course of cognitive-behavioral therapy with exposure and response prevention (CBT/ERP) to treat OCD tailored to an individual with ASD and gender diversity concerns is described in detail. Components of family involvement are highlighted. As a result, significant improvements in school attendance, OCD symptoms, depression, social relationships, and adaptive functioning were measured. Lastly, recommendations for clinicians are summarized. Frontiers Media S.A. 2023-05-16 /pmc/articles/PMC10227521/ /pubmed/37260756 http://dx.doi.org/10.3389/fpsyt.2023.1072645 Text en Copyright © 2023 Guastello, Lieneman, Bailey, Munson, Barthle-Herrera, Higham, Druskin and McNeil. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Guastello, Andrea D.
Lieneman, Corey
Bailey, Brittany
Munson, Melissa
Barthle-Herrera, Megan
Higham, Miranda
Druskin, Lindsay
McNeil, Cheryl B.
Case report: Co-occurring autism spectrum disorder (Level One) and obsessive-compulsive disorder in a gender-diverse adolescent
title Case report: Co-occurring autism spectrum disorder (Level One) and obsessive-compulsive disorder in a gender-diverse adolescent
title_full Case report: Co-occurring autism spectrum disorder (Level One) and obsessive-compulsive disorder in a gender-diverse adolescent
title_fullStr Case report: Co-occurring autism spectrum disorder (Level One) and obsessive-compulsive disorder in a gender-diverse adolescent
title_full_unstemmed Case report: Co-occurring autism spectrum disorder (Level One) and obsessive-compulsive disorder in a gender-diverse adolescent
title_short Case report: Co-occurring autism spectrum disorder (Level One) and obsessive-compulsive disorder in a gender-diverse adolescent
title_sort case report: co-occurring autism spectrum disorder (level one) and obsessive-compulsive disorder in a gender-diverse adolescent
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10227521/
https://www.ncbi.nlm.nih.gov/pubmed/37260756
http://dx.doi.org/10.3389/fpsyt.2023.1072645
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