Autism and Schizophrenia Spectrum Conditions: A Review of Overlapping Characteristics

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Cognition

Measuring the cognitive abilities of autistic people and people with SSDs is a potential tool for explaining relationships between genetics, brain and phenotype (Cannon, van Erp & Glahn 2002).

One area of cognitive overlap between autism, SSD and related dimensional traits is lower executive functioning (Green, Boyle & Raine 2008; Happe, Booth, Charlton & Hughes 2006; Hill 2004; Ozonoff & Jensen 1999)“ which is understood as the set of abilities required to effortfully guide behavior toward a goal, especially in nonroutine situations (Banich 2009). In psychiatric disorders, executive functioning impairments are a major predictor of real-life functional outcomes and degree of disability (Royall et al. 2002). Poor executive functioning in schizophrenia and SPD is linked to negative symptoms, social impairment and odd speech (Diforio, Walker & Kestler 2000). Poor executive functioning in these conditions is evident on the Wisconsin card sorting test, where poor performance in autism and SSD is particularly linked to perseverationpersisting in the same behavior instead of adapting to new goals and circumstances in the test. (Goldstein, Minshew, Allen & Seaton 2002; Raine et al. 1992; Sanders et al. 2008; Tallent and Gooding 1999).

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Another well-studied area of cognitive overlap between ASC and SSD is significantly impaired working memorythe ability to retain and work with information in the short termand especially visual spatial working memory (Rosell et al. 2014; Sanders et al 2008; Schuh & Eigsti 2012). In one study, working memory accounted for other cognitive deficits in SPD, which according to the authors suggests it may be a core schizophrenia spectrum impairment (Mitropolou et al. 2015). In autism, impaired working memory is related to significant variance in language skills and prominence of autistic symptoms (Schuh & Eigsti 2012).

A promising, but relatively overlooked area of overlap in cognition is the slower processing speed associated with both autism and SSD. Both autism (Eack et al. 2013; Goldstein et al 2002; Karalunas et al. 2018; Nader, Jelenic & Soulieres 2015) and SSD (Dickinson, Ramsey & Gold 2007; Eack et al. 2013; Goldstein et al 2002; Matsui, Sumiyoshi, Kato, Yoneyama & Kurachi 2004; Mollon, David, Zammit, Lewis & Reichenberg 2018) are related to major reduction in processing speed. However, handwriting is often an integral part of processing speed tests (Benedict et al 2017) and autism is associated with impaired motor abilities (Duffield et al. 2013) and sometimes dysgraphia (poor handwriting), which is a potential confound.

However, conclusions about cognition in ASC and SSD should be mindful of individual cognitive variation between these groups, which can be considerable. Goldstein et al. (2002) found that while on a group level autism may appear cognitively similar to schizophrenia, they only resemble a minority of schizophrenic individuals. This similarity was driven by a schizophrenic subgroup which exhibited a mix of impaired and unimpaired abilities,

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