PAIN In ADHD & AUTISM

(Differences in sensory Processing are at least recognized in Autism as affecting perceptions of PAIN)

Val's Take/Conjecture

• I'm going to be focusing initially on "emotional pain" and then "physical pain."
  
• The History of "REJECTION SENSITIVE DYSPHORIA" (RSD) is interesting as told by now retired Colorado Psychiatrist William Dodson ---- who is not only considered a national expert, but also an international expert.
  • The term "REJECTION SENSITIVE DYSPHORIA" originally referred to "ATYPICAL DEPRESSION."
  • Dodson noticed that his ADHD clients had seemed to experience it and it seemed appropriate in every way ---- except --- PROPORTION.
    • I think this is one of the critical reasons you see so many people in Criminal Justice tagged with ADHD and so many people struggling with substance problems trying to medicate this pain.
  • See also:  The Bizarre Intersection Between Law & "Giftedness" -- Adulting with Exceptionalities in the  Criminal Justice System
• But it is NOT just ADHDers --- many in the Autism Camp have said --- "Hey, that sounds like me."
•  Further, ADHD and Autism are now at least by the researchers viewed as very BLURRED --- and part of a Neuro-Developmental -- Psychiatric Continuum.
• Additionally, EMOTIONAL INTENSITY is the calling card of the "gifted"/asynchronous.

BUT --- it is NOT just emotional pain that neuro-diverse folks are more sensitive too --- they are also more sensitive to PHYSICAL PAIN.

Oregon Health & Science University School of Medicine

Associations between Chronic Pain and Attention-Deficit Hyperactivity Disorder (ADHD) in Youth: A Scoping Review.

January 2023

"We also outline future directions to inform future research and interventions directed to youth with comorbid pain and ADHD. Design: A scoping review of the literature was performed in MEDLINE, PsycInfo, and Cochrane Database of Systematic Reviews using a wide range …"

"Conclusions:  Findings from this scoping review suggest an association between chronic pain and ADHD among youth. Little research was found to examine the etiology of this association. Future studies should examine underlying mechanisms of comorbid chronic pain and ADHD."

Effect of atomoxetine on ADHD-pain hypersensitization comorbidity in 6-OHDA lesioned mice.

April 2023

BACKGROUND: Methylphenidate and atomoxetine are used for the treatment of attention-deficit/hyperactivity disorder (ADHD).

Our previous studies established the validity of the 6-hydroxydopamine (6-OHDA) mouse model of ADHD and demonstrate …

Conclusion: "These findings demonstrated that when administered chronically, atomoxetine has a significant effect on ADHD-associated pain hypersensitization, likely mediated by both α- and β-adrenergic and D2/D3 dopaminergic receptors, and suggest new indications for atomoxetine that will need to be confirmed by well-designed clinical trials."

The Current View on the Paradox of Pain in Autism Spectrum Disorders.

July 2022

"Autism spectrum disorder (ASD) is a neurodevelopmental disorder, which affects 1 in 44 children and may cause severe disabilities. ...An integrative view on the regulation of the pain cycle offers a more robust framework to characterize the experience …

"A growing body of evidence is challenging the idea of alterations in pain processing in ASD due to a single factor, and calls for an integrative view.

"We propose a model of the pain cycle that includes the interplay between the molecular and neurophysiological pathways of pain processing and it conscious appraisal that may interfere with pain reactivity and coping in autism.

The role of social factors in pain-induced response is also discussed. Pain assessment in clinical care is mostly based on subjective rather than objective measures.

This review clarifies the strong need for a consistent methodology, and describes innovative tools to cope with the heterogeneity of pain expression in ASD, enabling individualized assessment.

Incidental physical pain reduces brain activities associated with affective social feedback and increases aggression.

February 2023

"Thus, this study aimed to investigate the neural mechanisms underlying pain-induced aggression using functional magnetic resonance imaging. ...The results revealed that participants in the pain group exhibited more aggression than those in the control …