학술논문

Observable Symptoms of Anxiety in Individuals with Fragile X Syndrome: Parent and Caregiver Perspectives
Document Type
article
Source
Genes. 13(9)
Subject
Biological Sciences
Genetics
Mind and Body
Behavioral and Social Science
Fragile X Syndrome
Rare Diseases
Clinical Research
Mental Health
Intellectual and Developmental Disabilities (IDD)
Pediatric
Brain Disorders
Adolescent
Adult
Aged
Aged
80 and over
Anxiety
Anxiety Disorders
Caregivers
Child
Child
Preschool
Female
Humans
Male
Middle Aged
Parents
Young Adult
FMR1 gene
intellectual disability
autism
assessment
Language
Abstract
Caregiver reports, clinical observations, and diagnostic assessments indicate that most individuals with fragile X syndrome experience high levels of chronic anxiety. However, anxiety is a challenging endpoint for outcome measurement in FXS because most individuals cannot reliably report internal emotional or body states. A comprehensive survey of the presence, frequency, and duration of anxiety-related symptoms and questions to elicit open-ended responses was completed by caregivers of 456 individuals with FXS, ages 2-81 years (87 female, 369 male) and 24 female and 2 male FXS self-advocates ages 15-66 years. Caregivers reported classic behavioral indicators of anxiety, such as avoidance, irritability, motor agitation, and physiological symptoms, as well as behavioral features in FXS such as repetitive behavior, aggression, and self-injury. Self-advocate accounts largely paralleled caregiver data. Factor analyses yielded four factors: (1) increased irritability, aggression, and self-injury; (2) increased physical movement, nervous activity, and restlessness; (3) physical and physiological features of anxiety; and (4) internalizing and gastrointestinal symptoms. Caregivers are capable of observing and reporting behaviors that are valid indicators of anxious states that are usually reported in self-report standardized assessments. These results support the development of an anxiety measure for FXS that minimizes problems with rater inference.