Asperger's syndrome manifests itself in early childhood. The reasons are unknown. This is probably a complex combination of external factors affecting the expectant mother with a hereditary predisposition.
Until 1994, Asperger's syndrome, one of the types of autism, did not have its own code in diagnosis, it was not singled out separately in the statistics of mental illness. It was later calculated that this syndrome occurs on average in 0.06 percent of the population, but the number of such diagnoses has recently been growing sharply. With what it can be connected.
Normality versus weirdness
In 1985, an average of five in ten thousand suffered from autism; now it is one in one hundred and fifty. They started talking about the "autism epidemic", and serious programs were launched to study and treat it.
The term "autism" refers to several pathological conditions, including Asperger's syndrome, which manifests itself in a person's isolation, inability to recognize other people's emotions. The patient pronounces long monologues in a peculiar monotonous manner.
Interest in this syndrome is strongly fueled by tabloids discussing the psychological portraits of the mass murderer Anders Breivik, environmental activist Greta Thunberg and even the fictional hero of The Big Bang Theory series, the brilliant physicist Sheldon Cooper.
However, not observing a person, not talking with him, talking about mental abnormalities, all the more giving out comments to the media on this matter, is unprofessional, says psychiatrist, professor Marina Kinkulkina, director of the Institute of Clinical Medicine at Sechenov University.
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“Asperger's syndrome is characterized by low contact, turning inward, pronounced isolation from the outside world, focus on one's own interests, fixation on one task, misunderstanding of the motives of other people, impaired fine motor skills, which can normalize with age, and can be fixed in the form of eccentric movements. At the same time, mental abilities are normal. Sometimes such patients are ahead of their peers in intelligence. This gives a very unusual clinical picture,”says the doctor.
Asperger's syndrome is diagnosed clinically. No biochemical, hormonal, or genetic markers have yet been found that unambiguously accompany this condition. Nor can it be detected when scanning the brain.
“We do not always see structural changes in the brain in Asperger's syndrome - unlike tumors, cysts or vascular abnormalities. In adult patients, a normal electroencephalogram is more common,”the doctor specifies.
Genetics plus unknown factors
Asperger's syndrome, like other types of autism, manifests itself in early childhood and determines all subsequent human development. It is possible that the surge in autism is partly due to the overly broad interpretation of the term by doctors of other specialties, who, along with psychiatrists, make a diagnosis.
“There is no specific treatment. This is for life. With the child, only correctional work is carried out in order to facilitate his adaptation in the team, to develop social skills. Educate parents. Sometimes symptomatic treatment is prescribed if, for example, a person's mood has decreased, anxiety has increased,”explains Kinkulkina.
Mountains of scientific literature have been written about the causes of Asperger's syndrome, but there is no complete clarity. Observations of identical twins gave reason to talk about the great contribution of genetics to the development of the disease. Several genes on the X chromosome have been identified whose breakdowns are associated with autism. This probably explains why the syndrome is four times more common in boys - they have one X chromosome, so there is no second copy of all genes.
There is also evidence of the influence of environmental and immunological factors that can act alone or in combination with a hereditary predisposition. Now they are actively finding out what toxins, for example, in the air, are dangerous for a pregnant woman. Perhaps the antibodies produced in the body of the expectant mother in response to some external stress, penetrate the placenta and cause abnormalities in the development of the fetus. Among toxins and negative factors are drugs, alcohol.
Social factors such as immigration are also taken into account. In 2015, Finnish scientists analyzed the stories of children born from 1987 to 2005 and by 2007 who had received a corresponding diagnosis. It turned out that the disease in children of immigrants is not observed more often, and in some cases (when both parents immigrated) even less often. However, the authors of the work admit that the statistics are distorted by the reluctance of this category to seek psychiatric help.
There is no reason to say that there are more autists among those born as a result of IVF. Statistics are not enough to draw such conclusions.
"I have not yet seen the results of a well-planned study on this topic," the doctor emphasizes.
Friendship effect
The public also wonders how dangerous people with Asperger Syndrome can be, whether they are more likely to have a murderous tendency. There is also no evidence for this.
“A study by Austrian scientists has shown that there are no more offenders among people with Asperger's syndrome than among healthy people,” says Marina Kinkulkina.
A child with Asperger Syndrome has a higher risk of becoming an outcast at school and subject to bullying. Features of behavior, manner of communication, inability to make friends and maintain friendship repels children, forcing them to avoid a special classmate.
As the researchers from France write, communication with peers is very important for children and adolescents. Friendship forms emotional contact, develops communication skills, a sense of sympathy, teaches to empathize with others. This is difficult for children with Asperger Syndrome. They prefer games according to clear, clearly defined rules, activity, where a minimum of interaction with others is required. Autistic people have difficulty deciphering communication characteristics such as tone of voice, gestures, facial expressions, and body language. They literally understand words, do not catch jokes, and often enter the conversation at random. They are characterized by stereotypical behavior, unnatural intonation, alienation, unusual hobbies.
Meanwhile, special children want to be friends and do not understand why they are alone. They often have depressive symptoms and anxiety.
According to a study by scientists from Cambridge, adults with Asperger Syndrome are much more likely to have suicidal thoughts than healthy and even psychotic patients: 66 percent versus 17 percent and 55 percent. This is primarily due to depression against a background of social isolation, loneliness, lack of communication, disorder and unemployment.
Who Discovered Asperger Syndrome
In the first years of Soviet power, a child psychiatrist from Kiev Grunya Efimovna Sukhareva founded a school in Moscow and a treatment department for children with psychoneurological problems. Observing six boys with mental disabilities there, she described the new disease and its clinical symptoms in 1925 in a Soviet scientific journal, and later in a German one. At first she spoke of "schizoid psychopathy", later - "autistic psychopathy." Moreover, she noted a paradoxical combination of traits: a high level of intelligence of patients and poor motor skills. This is exactly what is characteristic of Asperger's syndrome.
The scientific community did not notice this article, and autistic psychopathy was "rediscovered" by Austrian psychiatrist Hans Asperger in 1938 and a little later by his fellow countryman who immigrated to the United States, Leo Kanner. Some believe, based on indirect evidence, that they were familiar with Sukhareva's work.
Be that as it may, but also Asperger's articles gained wide popularity in the English-speaking world only in 1981, when they were translated. And two years ago it turned out that he, most likely, collaborated with the Nazis, although he himself positioned himself as an active fighter against the Third Reich.
As established by the historian of medicine Herwig Cech, studying previously unknown archives, during the war, Asperger practiced at the university children's clinic in Vienna. He selected children with severe mental disorders and wrote them directions to the clinic "Am Spiegelgrund", included in the Nazi program of eugenics and the purification of the nation. From July 1940 until the collapse of Nazi Germany, 789 children died there, many of them were killed.
Tatiana Pichugina