Behavioral addiction and autism spectrum disorder: A systematic review.

BACKGROUND: According to DSM-5 criteria, Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficiencies in social communication and interaction along with the presence of restrictive and repetitive patterns of behavior. Few studies have explored the prevalence of behavioral addiction in individuals with ASD. Since addiction and ASD share common characteristics, individuals with ASD may be more vulnerable to addictive behaviors. Some typical behavioral addictions include internet, gaming, and gambling addiction. While most previous studies on ASD and addiction have looked at chemical addiction, behavioral addiction has not been thoroughly studied to date. AIMS: The objective of this study was to investigate the presence of behavioral addiction among individuals diagnosed with autism spectrum disorder. METHODS AND PROCEDURES: A systematic literature search of five databases was conducted in accordance with the PRISMA guidelines. Search results were reviewed for the predetermined inclusion criteria independently by two authors. OUTCOMES AND RESULTS: The search yielded 539 publications after the removal of duplicates. 61 met the inclusion criteria for title and abstract review. Full texts were reviewed resulting in an additional 31 being removed. The remaining 30 included 4 case reports and 26 original studies. Results included 27 studies that found a positive correlation (15 of significance, 12 of unknown significance) between a behavioral addiction and either ASD or Autistic traits, 1 found a significant negative correlation, 3 did not find a correlation. CONCLUSIONS AND IMPLICATIONS: This review is inconclusive about links between ASD and behavioral addictions. While a vast majority of studies show a positive correlation, many do not provide the statistical analysis to show if the correlations are significant. In addition, a positive correlation between ASD and behavioral addiction is observed in the presence of comorbid mental health conditions in many of the studies. Further research with proper controls and statistical analysis is needed to determine whether the development of behavioral addiction is directly influenced by ASD or if the presence of a comorbid mental health condition is the true cause.

Mobile device applications and treatment of autism spectrum disorder: a systematic review and meta-analysis of effectiveness.

OBJECTIVE: The current study was performed to assess the evidence for effects of therapeutic intervention with mobile device applications (apps) for individuals with autism spectrum disorder (ASD). DESIGN: The main methodology of the current study was systematic review with meta-analysis. SETTING: Only randomised controlled trials (RCTs) for mobile device apps for individuals with ASD were considered for review in the current study. PATIENTS: The target population was individuals clinically diagnosed with ASD. INTERVENTIONS: Applications that are operable on a smart (mobile) device and interactive with users. MAIN OUTCOME MEASURES: The main outcomes were based on standardised mean differences in pretrial and post-trial scales in each control and intervention group. RESULTS: Out of a total of 1100 studies (after duplicate removal), 7 RCTs were selected for final analysis. Of the seven studies, two RCTs were further analysed for effects based on the visual and fine motor subscales of the Mullen Scales of Early Learning, which favoured the intervention groups (standardised mean difference (SMD)=0.41, 95% CI 0.03 to 0.80; SMD=0.41, 95% CI 0.03 to 0.80), without either having any heterogeneity (p>0.1) or publication bias. CONCLUSIONS: Although it is still early to draw a conclusion, available studies are showing promise for use of mobile device apps for treatment of individuals with ASD. More well-designed and large-scale studies focused on improving behavioural symptoms of ASD are warranted. PROSPERO REGISTRATION NUMBER: CRD42019128362.