Publications

Abstract: This perspective piece addresses critical challenges in oxytocin-based interventions for autism, drawing on neurodivergent perspectives to highlight key issues in research relevance and inclusivity. Although oxytocin has been posited to modulate social and routinized behaviors in autistic individuals, empirical findings on its efficacy remain inconsistent. We argue that these behavioral targets may reflect neurotypical biases, often disregarding autistic individuals' perspectives, thereby limiting intervention acceptability and efficacy. Past research has frequently excluded marginalized autistic populations, such as individuals with intellectual disabilities or gender-diverse identities, exacerbating generalizability issues. This piece advocates for a reorientation of research objectives in autism, proposing a shift from modifying core autistic behaviors towards enhancing quality of life through participatory research. By integrating autistic perspectives into study design and outcome selection, researchers can avoid deficit-oriented frameworks and instead prioritize socially valid outcomes, such as reducing anxiety and improving adaptive functioning. Further, the perspective piece critiques the reliance on animal models, which often lack translational validity due to autism's complex social and communicative dimensions. In closing, we underscore the importance of inclusive, reproducible autism research practices that align with the lived experiences and priorities of autistic individuals. Embracing participatory research, alongside rigorous methodological adjustments, can foster advancements that effectively support the well-being of the autistic community.

Abstract: 

Purpose of Review: Autistic individuals experience disproportionate stigma across the life course in interpersonal, healthcare, and educational contexts. These experiences contribute to negative health and healthcare outcomes for this population. This paper seeks to describe autistic individuals’ experiences of stigma and marginalization; discuss frameworks such as Campinha-Bacote's innovative concept of cultural competemility and its relevance to autistic populations; offer recommendations to healthcare providers based on this framework; and apply theory to practice in a case study. 

Recent Findings: Autistic individuals increasingly understand autism as an important aspect of their identity. There are, however, few culturally informed healthcare efforts that reflect this understanding. As a result, efforts to address stigma-related health disparities for this population have limited effectiveness.

Summary: In this manuscript, we highlight opportunities within clinical encounters, medical training, healthcare offices and systems, and research to provide higher quality culturally informed care to autistic populations and address stigma-related health disparities.

Abstract: The academic research landscape, rich with complexity, reveals its potential for innovation when explored through a neurodiversity lens. This Perspective article presents a nuanced examination of the unique strengths that autistic thinking brings to scholarly pursuits, such as enhanced pattern recognition and systematic rigor—qualities that have personally empowered my own grant writing endeavors. It also confronts the challenges that arise from the prevailing neurotypical standards within the academic milieu. Merging a scholarly review with selective personal insights, this article advocates for a redefinition of scholarly communication and mentorship that is inclusive of neurodiversity. I aim to provide insights and experiences that offer guidance to fellow autistic researchers, their mentors, research institutions, and funding bodies. Drawing from my perspective, I delve into communication complexities, the perennial struggle to conform to neurotypical writing standards, the weight of ‘imposter syndrome,’ and the pivotal role that mentors play in supporting and advocating for autistic early career researchers. The recommendations offered herein aim to establish an academic environment that not only welcomes but also leverages the distinctive capabilities of autistic researchers. This perspective aspires to serve as a catalyst for mentors, colleagues, and funding bodies to embrace a more neuroinclusive approach in their practices.

Abstract: This study investigated the impact of transgenerational racial stress on youths’ adrenal-and-gonadal hormone levels and co-regulation in response to acute stress. Black youths (N=120) residing in a U.S. metropolitan area completed the Trier Social Stress Test (TSST). Youths’ cortisol, dehydroepiandrosterone, and testosterone coupling levels were examined. Hormonal response to the TSST was influenced by their mothers’ experiences of racial discrimination. Mothers’ experiences predicted stronger positive cortisol-testosterone coupling. For high testosterone youths whose mothers experienced high discrimination, cortisol recovery was blunted after the stressor. Results suggest that mothers’ experiences of discrimination are transgenerational and impact their children’s hormonal co-regulation. 

Abstract: Activational effects of the reproductive neuroendocrine system may explain why some youths with ADHD are at greater risk for exacerbated ADHD symptoms (hyperactivity, inattention, impulsivity) during adolescence. For youths diagnosed with ADHD, first signs of ADHD symptoms become noticeable by multiple reporters (e.g., teachers, parents) when children enter schools, typically around kindergarten. The current study examined possible sex differences in ADHD, impairment, and comorbidity due to pubertal effects, as the role of pubertal development in ADHD is understudied. ADHD symptoms, depressive symptoms, impairment, and pubertal stage were assessed annually by multiple reporters in a well-characterized clinical sample of 849 children over eight years. Ages ranged from 7 to 18 years (38.16% girls). Multilevel models indicated that boys had higher levels of hyperactivity, impulsivity, and inattention than girls, but that girls had higher levels of impairment than boys. Inattention symptoms did not show marked maturation changes. Hyperactivity and impulsivity declined as youth aged and impairment increased as youth aged. Lastly, depressive symptoms largely increased as youth aged and were higher amongst youth at later pubertal stages. Put together, aging and pubertal development are associated with improved ADHD symptoms but not for youth with high impairment. Findings from this study contributes to understanding the role that aging, pubertal status, and pubertal development plays in ADHD, impairment, and comorbidity in children and adolescents.

Abstract: The common intersection of autism and transgender identities has been described in clinical and community contexts. This study investigates autism-related neurophenotypes among transgender youth. Forty-five youth, evenly balanced across non-autistic, slightly subclinically autistic, and full-criteria autistic subgroupings, completed resting-state functional magnetic resonance imaging to examine functional connectivity. Results confirmed hypothesized default mode network (DMN) hub hyperconnectivity with visual and motor networks in autism, partially replicating previous studies comparing cisgender autistic and non-autistic adolescents. The slightly subclinically autistic group differed from both non-autistic and full-criteria autistic groups in DMN hub connectivity to ventral attention and sensorimotor networks, falling between non-autistic and full-criteria autistic groups. Autism traits showed a similar pattern to autism-related group analytics, and also related to hyperconnectivity between DMN hub and dorsal attention network. Internalizing, gender dysphoria, and gender minority-related stigma did not show connectivity differences. Connectivity differences within DMN followed previously reported patterns by designated sex at birth (i.e., female birth designation showing greater within-DMN connectivity). Overall, findings suggest behavioral diagnostics and autism traits in transgender youth correspond to observable differences in DMN hub connectivity. Further, this study reveals novel neurophenotypic characteristics associated with slightly subthreshold autism, highlighting the importance of research attention to this group.

Abstract: The preprint is about how participatory research movement and neurodiversity movement can benefit the open scholarship movement and vice versa, leading to a more generalisable and accurate science of human behaviour and cognition. 

An enduring issue in the study of mental health is identifying developmental processes that explain how childhood characteristics progress to maladaptive forms. We examine the role that behavioral inhibition (BI) has on social anxiety (SA) during adolescence in 868 families of twins assessed at ages 8, 13, and 15 years. Multimodal assessments of BI and SA were completed at each phase, with additional measures (e.g., parenting stress) for parents and twins. Analyses were conducted in several steps: first, we used a cross-lagged panel model to demonstrate bidirectional paths between BI and SA; second a biometric Cholesky decomposition showed that both genetic and environmental influences on childhood BI also affect adolescent SA; next, multilevel phenotypic models tested moderation effects between BI and SA. We tested seven potential moderators of the BI to SA prediction in individual models and included only those that emerged as significant in a final conditional model examining predictors of SA. Though several main effects emerged as significant, only parenting stress had a significant interaction with BI to predict SA, highlighting the importance of environmental moderators in models examining temperamental effects on later psychological symptoms. This comprehensive assessment continues to build the prototype for such developmental psychopathology models. 

Abstract: Adolescents experience profound neuroendocrine changes, including hormone “coupling” between cortisol, testosterone, and dehydroepiandrosterone. Emerging research has only begun to elucidate the role of hormone coupling, its genetic and environmental etiology, and the extent to which coupling is impacted by gender, puberty, and family context. We included measures on parent and child mental health, parenting stress, and family conflict of 444 twin pairs and their parents across two timepoints, when youth were on average 8 and 13 years old, respectively. Structural equation models examined the impact of family context effects on coupling during adolescence. Biometric twin models were then used to probe additive genetic, shared, and non-shared environmental effects on hormone coupling. Hormones were more tightly coupled for females than males, and coupling was sensitive to parental depression and co-twin psychopathology symptoms and stress exposure in females. The association between family context and coupling varied across specific neuroendocrine measures and was largely distinct from pubertal maturation. Biometric models revealed robust shared and non-shared environmental influences on coupling. We found that family antecedents modify the strength of coupling. Environmental influences account for much of the variation on coupling during puberty. Gender differences were found in genetic influences on coupling. 

Abstract: Understanding the developmental timing of stress exposure may help inform mechanisms underlying how stress “gets under the skin” and influences the stress response system, including the HPA axis and its end-product cortisol. Early adversity may be particularly detrimental; however, it is difficult to disentangle the timing of adversity from its cumulative burden because there is typically high continuity between early and later adversity. Moreover, context and the different stressors inherent in various contexts may interact with stress exposure to influence psychophysiological functioning. To address this issue, we examined adolescents who had been reared in institutions and suffered neglect or social deprivation ranging from approximately six months to several years of life prior to adoption into U.S. homes. We focused on the stress hormone cortisol because it can reflect continued regulatory problems in youth, even years after youth transition to typical homes. We examined cortisol morning levels and diurnal rhythms across multiple contexts (home, school, lab) on 5 separate days in 41 post-institutionalized youth and 78 comparison youth. Employing hierarchical linear modeling, we found that when assessed in the lab, post-institutionalized (PI) youth displayed lower morning cortisol levels and flatter diurnal slopes than the control youth. Yet at home, PI youth displayed higher morning cortisol levels than the control youth. In addition to group effects, we also examined severity of early adversity and found that PI kids who had endured the most severe early adversity displayed lower home cortisol levels than controls. No significant predictors of diurnal cortisol on school days were identified. These data fit with the notion that the HPA axis is impacted by early adversity, even years after adoption, and with emerging theories that postulate that stress physiology calibrates within youth to help them adapt to their context. In the case of severe early adversity, the cost of such adaptation may not be desirable. It also highlights the important role of context when assessing HPA axis activity, particularly in post-institutionalized youth. 

Abstract: Sensation-seeking (SS) involves the tendency to pursue exciting activities, potentially including risky behaviors (e.g., substance use, risky sexual behavior). Testosterone is associated with cortisol, SS, and autonomic nervous system (ANS) functioning. Testosterone reactivity/recovery during sky-diving and its relationship to cortisol response, ANS response and SS were examined. Forty-four participants provided reactive saliva samples and autonomic activity data before, during and after sky-diving and as well as basal day saliva samples. Testosterone reactivity/recovery to skydiving was significantly greater than basal day measurements. Testosterone responsivity to skydiving was predicted by increased cortisol, increased sympathetic activity (heart rate) and reduced parasympathetic activity (RMSSD). Independent of physiological effects, increased SS predicted testosterone responsivity to skydiving. These data suggest that testosterone reactivity, and its relationship to ANS responsivity, may be associated with pleasurable responses to risky/intense situations. These data may be useful in developing novel intervention strategies for risky behaviors. 

Abstract: Parent-child physiological attunement, particularly during stressful situations, appears adaptive as shared stress reactivity may promote dyadic engagement. Romantic partners eventually replace parents as the primary support figure, yet it remains unclear whether romantic partners buffer physiological stress or display physiological attunement as most studies on adults examine attunement during conflict paradigms. The present study examined physiological attunement in 63 emerging adult romantic partner dyads (one partner was the active participant, the other the observer) during the Trier Social Stress Task (TSST). Heart rate (HR) and respiratory sinus arrhythmia (RSA) were continuously monitored across the visit. Repeated saliva samples were assayed for cortisol. Physiological attunement was operationalized as a correlation in biomarkers between the TSST participant and their partner; sex, social support, and physical proximity were examined as moderators. We then compared the biomarker profiles of partnered-TSST participants to individuals who participated in the TSST solo (n = 63) to determine if partner presence buffered stress biomarker reactivity during the TSST. RSA attunement between partners was found but was not further moderated by social support or sex. Adrenocortical attunement was moderated, such that lower social support and increased proximity resulted in higher attunement. HR attunement was higher when the participant was male and when partners were in close physical proximity. Compared to TSST solo, romantic partner presence increased participant cortisol levels and altered HR reactivity, suggesting that emerging adult romantic partners do not buffer physiological stress reactivity. Future research should examine whether physiological attunement and partner presence is protective in more established relationships. 

Abstract: Laboratory stress tasks such as the Trier Social Stress Test (TSST) have provided a key piece to the puzzle for how psychosocial stress impacts the hypothalamic-pituitary-adrenal axis, other stress-responsive biomarkers, and ultimately wellbeing. These tasks are thought to work through biopsychosocial processes, specifically social evaluative threat and the uncontrollability heighten situational demands. The present study integrated an experimental modification to the design of the TSST to probe whether additional social evaluative threat, via negative verbal feedback about speech performance, can further alter stress reactivity in 63 men and women. This TSST study confirmed previous findings related to stress reactivity and stress recovery but extended this literature in several ways. First, we showed that additional social evaluative threat components, mid-task following the speech portion of the TSST, were still capable of enhancing the psychosocial stressor. Second, we considered stress-reactive hormones beyond cortisol to include dehydroepiandrosterone (DHEA) and testosterone, and found these hormones were also stress-responsive, and their release was coupled with one another. Third, we explored whether gain- and loss-framing incentive instructions, meant to influence performance motivation by enhancing the personal relevance of task performance, impacted hormonal reactivity. Results showed that each hormone was stress reactive and further had different responses to the modified TSST compared to the original TSST. Beyond the utility of showing how the TSST can be modified with heightened social evaluative threat and incentive-framing instructions, this study informs about how these three stress-responsive hormones have differential responses to the demands of a challenge and a stressor. 

Abstract: The current study focused on the childhood to adolescence transition and sought to determine why some children are more compliant than others as well as why children comply more often with some of their parents’ rules than with others. Indices of parents’ agency and children’s agency were tested as predictors of compliance. Parent-based decision-making and parents’ responses to expressed disagreement served as indices of parents’ agency while children’s beliefs regarding the legitimacy of parents’ rules and felt obligation to obey rules served as indices of children’s agency. Parent–child dyads (n = 218; 51 % female, 49 % European American, 47 % African American) were interviewed during the summers following the children’s 5th (M adolescent age = 11.9 years) and 6th grade school years. Children who felt that their parents’ rules were more legitimate were more compliant overall than were children who felt that the rules were less legitimate. Children compiled more with rules governing topics perceived to be legitimately regulated by parents, when parents made more decisions regarding the topic and when parents responded to disagreement by standing strong. Results were generally consistent across parents’ and children’s reports of compliance and across cross-sectional and longitudinal analyses. At the transition from childhood to adolescence, only children’s agency explained why some children are more compliant than others, but parents’ and children’s agency helped to explain why children complied with some rules more than others. 

Abstract: 

Background

Given the established relation between testosterone and aging in older adults, we tested whether buccal telomere length (TL), an established cellular biomarker of aging, was associated with testosterone levels in youth.

Methods

Children, mean age 10.2 years, were recruited from the greater New orleans area, and salivary testosterone was measured diurnally and during an acute stressor. Buccal TL was measured using monochrome multiplex quantitative real-time polymerase chain reaction. Testosterone and TL data were available on 77 individuals. The association between buccal TL and testosterone was tested using multivariate generalized estimating equations to account for clustering of children within families.

Results

Greater peak testosterone levels (β=−0.87, P<0.01) and slower recovery (β=−0.56, P<0.01) and reactivity (β=–1.22, P<0.01) following a social stressor were significantly associated with shorter buccal TL after controlling for parental age at conception, child age, sex, sociodemographic factors and puberty. No association was initially present between diurnal measurements of testosterone or morning basal testosterone levels and buccal TL. Sex significantly moderated the relation between testosterone reactivity and buccal TL.

Conclusions

The association between testosterone and buccal TL supports gonadal maturation as a developmentally sensitive biomarker of aging within youth. As stress levels of testosterone were significantly associated with buccal TL, these findings are consistent with the growing literature linking stress exposure and accelerated maturation. The lack of association of diurnal testosterone or morning basal levels with buccal TL bolsters the notion of a shared stress-related maturational mechanism between cellular stress and the hypothalamic pituitary gonadal axis. These data provide novel evidence supporting the interaction of aging, physiologic stress and cellular processes as an underlying mechanism linking negative health outcomes and early life stress.

Abstract: The authors conjecture that to understand normal stress regulation, including cortisol stress reactivity, it is important to understand why these biomarkers are released and what they function to accomplish within the individual. This perspective holds that high (or rising) cortisol has advantages and disadvantages that must be understood within a context to understand how individual differences unfold. This perspective is juxtaposed with a popular vantage point of this stress hormone or of stress exposure that emphasizes the deleterious consequences or problems of this hormone. While the costs and benefits of cortisol are emphasized for normal stress regulation, this dynamic context-dependent purpose of stress hormones should extend to the development of psychopathology as well. This functional and dynamic view of cortisol is helpful for interpreting why Tackett and colleagues (2014) appear to observe advantageous cortisol recovery from stress in individuals with elevated personality disorder symptoms. 

Abstract: The concept of fetal programming is based on the idea that the developmental trajectory of infants is adjusted in response to in utero conditions. In species with extended parental care, these prenatally derived tendencies are further substantiated by behavioral attributes of the mother during the postnatal period. We investigated the stability of maternal behavioral interactions with infant monkeys and carefully varied prenatal conditions across siblings reared by the same mother. We hypothesized that effects of prenatal disturbance and the infant’s susceptibility would be differentially affected by maternal attributes. Using hierarchical linear modeling, we analyzed observational data on 121 rhesus macaques reared by a total of 35 multiparous mothers. A portion of the variance in 5 dyadic behaviors was statistically driven by the infant (or was unique to a particular mother–infant pair), but stable maternal propensities and a consistent style of care across siblings also substantially influenced behavioral interactions. Moreover, the magnitude and direction of the prenatal effects were contingent on a female’s intrinsic dispositions. When mothers typically exhibited high levels of a corresponding behavior, responsiveness to infants was enhanced as a consequence of prenatal disturbance. The opposite was true for less expressive females. Challenges to the well-being of pregnancy thus served to accentuate maternal predispositions and served to magnify the range of variation in mother–infant behavior across the whole population. 

Many autistic people and their caregivers express dissatisfaction with therapies provided for autistic children in early childhood. Research efforts to improve autism therapies are critical to driving clinical change. However, there is substantial evidence to suggest that research largely excludes many people in the autism and autistic communities such as autistic girls, children of color, and multilingual children (and those at the intersection). This has created and exacerbated disparities in access to effective and equitable therapies for autistic children from these populations. This tool is intended to teach early childhood autism researchers how to conduct community-engaged research with autistic people and caregivers in inclusive, satisfying ways.

Many autistic people and their caregivers express dissatisfaction with therapies provided for autistic children in early childhood. Research efforts to improve autism therapies are critical to driving clinical change. However, there is substantial evidence to suggest that research largely excludes many people in the autism and autistic communities such as autistic girls, children of color, and multilingual children (and those at the intersection). This has created and exacerbated disparities in access to effective and equitable therapies for autistic children from these populations. This tool is intended to teach early childhood autism researchers how to conduct community-engaged research with autistic people and caregivers in inclusive, satisfying ways.

This chapter presents a broad overview of the measurement of hormones, spanning from the collection of these molecules across biospecimens and the assay of concentrations across laboratory strategies to statistical treatment and analysis that extracts the construct of interest from measure of the molecule. We organize each section into a description of measurement tools followed by an agnostic analysis of the tools for their strengths and weaknesses, prospects and pitfalls. We do not view any single approach as “best” or “optimal”. This view is commensurate with the production and cellular conversion of hormones themselves in which adaptive physiological processes are not “best” or “optimal” but rather constantly changing biobehavioral entities that shift according to the demands of the environment. Measuring the hormone is just the beginning of exploring the multifaceted ways that hormones can inform health, development, morbidity and mortality.

Adolescence begins with pubertal maturation, driven by hormones released by the brain and body. Hormonal biomarkers show that developmental processes begun in utero are reawakened at puberty. This chapter describes how useful seemingly objective hormonal biomarkers are in shedding light on adolescent development, but also how the biomarkers themselves are often misfits to psychologists' constructs for what it means to grow up. The chapter uses a social justice lens to understand when and why it is necessary to rethink what we ‘know’ about hormones to continue the self-correcting scientific process. 

Abstract: The hypothalamic–pituitary–adrenal (HPA) axis and hypothalamic–pituitary–gonadal (HPG) axis are associated with numerous health and behavioral outcomes, yet emerging research suggests that HPA–HPG interactions may impact health and behavior beyond either axis alone. While once thought to inhibit each other, a dual-axis view suggests that HPA–HPG associations may actually be flexible depending on salient contextual factors. We review studies of cross-axis ‘coupling’ at different ages and in different contexts in order to demonstrate the robustness of this phenomenon, variance by developmental stage, sex differences and implications for psychopathology. 

Abstract: It is important to clearly define stress and social support in order to better understand how the body regulates when under stressful conditions because stress has implications for treatment and coping interventions. The widely known stress hormone cortisol is frequently used as an index of the body’s ability to regulate itself during stress because cortisol has a profound impact on health and development. Consistently, strong evidence from research has found that social support from affiliated others serve as a buffer of stress, and certain types of social support may enhance stress regulation more than others. Self-report subjective measurements of stress can provide valuable information on saliency of the stressor, however the chance of response biases is possible due to a number of contributing factors that entails answering questionnaires. The same can be found for subjective social support self-report measurements. In addition to external factors of social support, recent research has found that oxytocin, known as the social bonding hormone, can also buffer the negative impact of stress and attenuate cortisol activity. Typically, when social support is provided, endogenous levels of oxytocin is increased in stressful moments. In this thesis study, I presented a theoretical model to examine moderating effects of different social support measures on the association between stress and cortisol levels in romantically dating couples. The findings showed that perceived social support moderately buffered cortisol stress reactivity, while nonverbal behavioral support significantly buffered cortisol stress reactivity. Oxytocin reactivity and level of exposure only showed a trend effect on cortisol stress reactivity. Consummate love between the couples significantly buffered cortisol stress reactivity. The findings of this study gave empirical support for specific measures of social support in predicting cortisol reactivity to psychosocial stress in each of its own way. 

Abstract: Mental health problems among adolescents remain a public health concern in the U.S. despite growing efforts to support mental well-being of youth. A part of the problem is a dearth of knowledge on evidence-based mechanisms on declining mental health in a particular subset of adolescents, and that subset is males and males on the autism spectrum. While studies on gender preponderance of mental health disorders contribute to the knowledge base on treating categorical psychopathology disorders sensitive to gendered issues, limitations include overlooking heterotypic comorbidities and understanding its underlying processes leading up to the development of mental health problems. Pubertal maturation is a process at which all adolescents transition through and for some adolescents, internalizing and externalizing symptoms may arise and can be overlooked. This is partly due to puberty viewed as a normative process for all adolescents going through “raging hormones,” a misconception of the role of hormones and behavior during development. Along with the social and physical changes that come with adolescent development, neurobiological activities are taking place implicating brain development and behaviors. Hormones play a role in adolescent development; however, their mechanistic impact, particularly in males, is less understood. This dissertation had three specific aims. The first aim was to investigate the effect of pubertal maturation on internalizing and externalizing (I-E) symptoms in children and adolescent males across development. The second aim was to examine the role of puberty and autistic stereotypy on I-E symptoms in typically developing and autistic youths. The third aim was to test the effect of pubertal hormone testosterone, physical changes, and autistic stereotypy on depressive symptoms in typically developing and autistic adolescent males. Findings from this dissertation contribute to a small literature knowledge base on male adolescent development and psychopathology comorbidities.