"greater autism severity predicted greater pain response"

Among the many pressing topics that require [significant] research funds and attention when it comes to autism, I can think of only a few (one actually) that top the observation that pain *might* be something particularly important when it comes to autism (see here). It is with this in mind that I briefly bring the findings reported by Domingo Garcia-Villamisar and colleagues [1] to the blogging table, and their conclusion that: "greater autism severity predicted greater pain response" that "was partially mediated by anxiety and depression."

Authors describe how they 'observed' over 40 adults diagnosed with autism and "intellectual delay" whilst they were undergoing either vaccination or dental cleaning. We are told that "their pain behaviours [were] coded and measures of autism symptom severity, anxiety, depression and obsessivity taken." When the data was gathered and analysed, authors observed that *association* between the intensity/severity of autistic signs and symptoms and the expression of pain. They concluded also that: "Mood must therefore be considered in future research on pain in ASD [autism spectrum disorder] as well as clinical pain management."

Accepting that 'pain coding' is something that requires a little more research, particularly in the context of autism, I'm willing to accept the authors' findings as a road-map to further investigations in this area. Given that conditions/states/symptoms like depression and anxiety are no strangers to autism (see here) it's perhaps implied that they may have quite a large bearing on pain expression in the context of autism.

And if something like anxiety and depression might be 'mediators' of the pain response, shouldn't we doing everything we can to alleviate such issues in the context of autism? Even if that means targeting core symptoms (see here and see here)?

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[1] Garcia-Villamisar D. et al. Internalizing Symptoms Mediate the Relation Between Acute Pain and Autism in Adults. J Autism Dev Disord. 2018 Sep 27.

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