 Yeah, guys, this is going to be the sixth in the series. I'm doing this month was Trying to do it every single day that didn't quite work out though yesterday, I was kind of busy in the first half of the day and then meant to do it and Got really really tired wound up going to sleep around 8 30 just really early for me Let's happen sometimes autism does present sleep disturbances, which we will talk about in another video not this one though So I'm getting to it today instead. It's fine. Take a me day So as I said last time recovered sort of the biological underpinnings behind a predisposition for fear in that there were less of full Energetic specifically histamine and acetylcholine that led to the individual being Less in a rest and digest state and being more in a fighter flight state but I differentiated that from the actual fear response the fighter flight response and Said that I would be talking about that next video for this one So the fear response what this actually is On the neurological side of things it involves the amygdala which is Located in the very inner part of the temporal lobe like the upper mid here I Believe I had mentioned it when I was talking about like general emotional responses, but fear gets processed differently Unlike going through the normal pathways it goes through the amygdala and the amygdala sort of has its own special region allocated for memories and this is done as a Well speed optimization if you have special circuitry for that handle that Much more quickly and this is actually very important for survival ability We not just humans, but we all evolved this way because it's it's beneficial now keep that in Mind because it's going to be important that there is a specific Observable way to measure and identify fear by looking at the brain Furthermore, there are also a group of hormones called catacolamines this includes dopamine But more relevant to what we're talking about epinephrine and norepinephrine, or if you're more European You'd probably call it adrenaline and noradren Those are the same things These Together have a role in how much pain you feel more levels of these causes lower levels of pain although there is a Phenomenon where you can get Hyperalgesia from these which may underpin fibromyalgia, but that's a whole other discussion But I mentioned in I believe it was the first video Talking about the second video In one of those videos, I was talking about how many of the Sensory experiences for the autistic are a little different But had said that pain has a different reason for being under modulated and this is why Fighter flight response for the fear response gets triggered more often You're releasing more pain-killing hormones, and so your tolerance to pain is considerably higher more Personal example, I was lit on fire in a restaurant accident or a grill backfired Not because I was lighting it wrong, but because it was old equipment that really should have been replaced If the valve was turned all the way it actually started to leak and so I didn't realize I'd turned it all the way leaking and Go to light it and there was way more Propane than should have been there as if I let it run too long Yeah, I Had some secondary burns and didn't even realize I had been burned at all Because the pain threshold is quite a bit higher It's not that high with all the autistic individuals. There's a huge amount of variability in it and Yeah But this also has effects on your heart rate and blood pressure Which nearly everybody should know you get startled your heart starts thumping real hard your blood pressure jumps up with it Those are useful. I'm going to mention those again later But remember that's specifically where that comes from As I had stated with the amygdala having its own thing with fear specific memories The Catecholamines do affect the fear specific memory formation and fear specific memory retrieval So when you're afraid you're more likely to remember other things that made you afraid That makes sense Similarly to other things this Additionally affects gastrointestinal motility, which should make sense. You run it away from something You don't need to be focusing on digesting your food so Yeah, that slows down how well How much your intestines move which leads to further gastrointestinal problems and Also I'm not mentioning every part of what these hormones do but some key things I debated on this one But felt it should be included Catecholamine release also causes bronchial relaxation in the same way that corticosteroids treat asthma And mentioned I think it was last video that some bad studies falsely said that autism presents higher rates of asthma and This is why part of why that's not the case at all I Mentioned then that there was bad controls going on there to where they were actually comparing Non-autistic Kids of parents who didn't smoke against autistic kids with parents who smoked more often So you would expect the asthma to actually be the result of smoking But this this just further adds to that You you would expect to see lower rate of asthma other things not included and Lastly with the fear response we have the standard for your presentation that we all know you get startled I heard their bump in yeah, maybe become flush You know pale you become pale and you start sweating a lot of the time The you know everybody knows this everybody's seen somebody who's afraid now as always Links to research down in the video description, but an article by David Hissle and others They were specifically looking at the fear-potentiated Startle which is pretty much what it sounds like a startle that happens because you're afraid and And what they were what they found is that the in the autistic children There was an increased latency in the onset of the fear-potentiated startle Now this was measured as the difference between when the Fear stimulus of the making the kid afraid happened and when the Actual response was triggered in the brain. That is very important We will get to why in a little bit, but that is very important There is a delay at the neurological level not Necessarily the presentation level they also found that the effect of the startle how how Startled you were how much fear and surprise was on your face Negatively correlated with the size of the megdala the smaller the more underdeveloped the amygdala was the more you were Afraid of things the larger the development of the amygdala the less you were Were presented as afraid because of that finding The autistic were more variable in how fear presented Another one of these studies by I Have no idea how to say this name I'll try it Gemma Zantik Zanteng Zanteng I don't know I I Don't know I'm sorry They looked at it a little bit of a different way and we're more interested in how the cardiovascular effects and the emotional presentation correlated all that stuff so what they found was that the increase in cardiovascular arousal, which would be the combination of both your heart rate and your blood pressure Was similar between the autistic and typically developing children so the the effect on the biological level both neurologically and Cardiovascularly Were there roughly the same slightly delayed in the autistic but not Like inappropriate or anything just delayed but that the the cardiovascular arousal was Almost no difference The what difference was there was not considered statistically significant They also noted that there was a similar amount of absolute expression of fear So it peaked at roughly the same level between the two groups But what they did note is that the level of cardiovascular arousal did not correlate with the Amount of expression of fear in the autistic whereas it did correlate with the expert in the in the typically developing children so what this means is In typically developing children the more afraid you are the more your heart rate goes up the more you present with fear in autism the more afraid you are the more heart your Heart rate and blood pressure goes up However, your emotional presentation is not going to match that this is Is unbelievably problematic So let's talk about that facial affect the emotional presentation if you recall that the This was definitely the first video I did on vocal no, or was this the second he's I can't remember That's a topic for another time Time sequencing in autism is incredibly difficult It was one of the earlier videos. I know that much, but I Will get to that later this month Just like the vocalizations were had described that the they found that it was more difficult to get vocalizations going They found that the facial affect was slow to start even at the muscular level because you know in that video I'd mentioned that the findings about the Muscle abnormalities in the throat weren't just with the throat. It was all throughout the entire body Yes, that holds true in the face as well that you see a Increased amount of effort to get those muscles moving and when they do Everything sort of fine, but it causes delays in the presentation of these emotions Because of the increased effort required to get those moving that sometimes causes an overemphasis That is then corrected for That in particular winds of being picked up by a lot of other people as disingenuous Which is really unfortunate because it is provably the result of muscle problems, but it's still just it's Interpreted as the person shady the person's fake their emotions This isn't specific to just fear although that is what I talked about in this video Other ones, but these findings are largely the case with other emotions in general I'm talking about fear because they looked at fear more than anything else and Well You'll see where this is going because the fact that we have biological markers of these emotional states is actually Really significant to what we're going to talk about so I Again, I usually don't have to issue trigger warnings what I'm going to do so now If talks about abuse or murder Because we're gonna have to go there Bother you just click off the rest of this video Pick up the next one So as I had mentioned in a Previous video the abuse rates Among the autistic is about two to two and a half times more likely So that is abuse towards the autistic is you know about twice or like one of the interesting things to note and it will become relevant to Where this is going about 50% or so about half of the abuse actually comes from support services now it may be tempting for some people to Be like oh, you know, you're just Trying to say that the restraints used against you sometimes are actually abuse I'm not gonna get into that argument. That's a huge gray area. I firmly believe that restraints are not justified in the majority of cases, but I'm not going there the majority of the abuse that happens from these support services so from like the direct support professionals that work with the autistic or Whatever Majority of that abuse is actually sexual in nature with physical abuse being the least common type of abuse In fact, economic abuse from these people is still more common than physical abuse and Economic abuse is normally phenomenally rare. I've worked as a DSP before The overwhelming majority of your training has to do with spotting reporting physical abuse So of course, it's going to happen less these people know not to do anything that could be identified as physical abuse the unfortunate reality is about half all abuse cases towards the autistic are From the people that are supposed to be providing professional supports more specific to what This video has been about Reporting abuse when you are autistic is hugely hugely difficult There's a number of reasons for these largely having to do with the facial mismatch that we talked about a lot of the time This gets into as I had mentioned it's interpreted as the individuals Baking the emotions. They're making the stories up things like that I mentioned the biological markers because That is how you can prove that the individual is not making their emotions and yet this is often not done even in medical settings just really Unfortunate because there's nothing difficult about putting a pulse ox on a patient and take their blood pressure that's Gonna take barely any time. It's not gonna cost any money. They're already there in the ER or whatever But it's just not done they're just dismissed because The face which the autistic person can't move the way they want it to doesn't match up With what the story is being told Another factor comes from Referential information This would be the kind of information you need to know to understand what the other person was referring to This has to do with the fact that autistic individuals are believed to be mentally retarded as well Mostly being phased out the past 20 years, which is good Cuz there's no evidence for that what evidence did exist happens to have flaws typically dealing with Frustration on the part of the person doing the IQ tests that they just sort of get fed up with trying to work with the individual and just Which is not how you're supposed to do those tests. It's a when they there's Actually no correlation between that at all Another one of these which is absolutely insane is that the autistic are often believed to be asexual There are two major problems with this. The first is that you are a There's no evidence at all that the autistic are asexual I'm not gonna link to the video, but you would already know how to find her Iza will has a great tip top flip on on this on autistic people doing normal things and then Typically developing people being like you can't do that. You're mentally challenged and It's so frustrating I'm personally kind of a man whore so definitely not asexual but the other problem with that is You personally being asexual has nothing to do with whether or not other people can sexually abuse you or not And so this view that If you are asexual you can't be sexually abused is sort of this really unfortunate carryover of the disgusting stereotype that victims of asexual abuse have somehow act Wanted it or were interested in it or other Absolute fucked up mental perversions that people have ridiculous That things like that have to be pointed out Another Issue is that oftentimes the irritability that presents post-abuse regardless of whether it's physical or sexual or whatever often gets misattributed as part of the irritability that goes on autism and There will be a Link or I'll try to put a link to this of the Rosenhan study This is a particularly interesting one and that they were looking into the biases that other Psychologists and psychiatrists have and so As part of the study he got his students to be admitted Under false pretenses into these facilities where the overall majority were diagnosed as schizophrenic But regardless of these circumstances After they got admitted they'd stop presenting with symptoms So they just go back to acting like normal college students And they'd take notes Obviously for the study and what he found was that the Facility workers would use the fact that they were taking notes as Further evidence of whatever diagnosis the individual had rather than ask them Why are you taking notes in a psychiatric facility? You're a patient here. What are you taking notes for? That's what I would ask, but I'm also just naturally curious But no it was just seen as further evidence of the diagnosis, but That's not diagnostically relevant criteria of anything what Happens a lot of the time is that The child starts acting out and this is autistic or not It abused the child starts acting out in non autistic children People go like oh what the hell is going on? Not always much greater numbers. What the hell is going on? Child doing so well Starts to be really irritable. In autistic children. It's often just seen as further confirmation diagnosis We're starting to get away from using irritability as Diagnostic criteria partially for this reason partially for the next topic as well But the There's two things I want to say about the irritability First is that much like I've mentioned in earlier in this video and in the last video Autism has gastrointestinal problems Well as it turns out in twenty point eight percent of cases if you resolve the gastrointestinal problems You also resolve the bad behavior Think you constipated all the time You stop being constipated all the time and you feel better Who hasn't been irritated when they're constipated the other? problem with irritability and Highest right into the rosin on study is that when you When you're autistic and you're going for Anything whether it's abuse or something else that'll make you irritated or whatever They're gonna want immediately want to put you on a neuroleptic like resperidone or our purposeful Because those help with the irritability They help some they actually are hugely harmful to others. I'll talk about why in another video It has to do with pharmacokinetics. That's topic for another time but What winds up happening is because this doesn't actually resolve the issue and because those neuroleptics worsen constipation or If you're trying to report abuse and it's not being taken seriously that will make you more irritated What winds up happening is the autistic child. It's more irritable Which is seen as further proof by the psychiatrist or prescribing position that the child's irritability is from Autistic so they increase the resperidone or our purpose all even more which of course doesn't address the problem Because the problem the child abused or was constipated either way It's not another one of the factors and there is a link to this One of the cases of this specifically, but there's numerous others is The code of silence. This is not an autistic phenomenon, but definitely presents the autistic phenomenon as I mentioned 50% abuse towards the autistic comes from support services So if they happen to be any facility a lot of these facilities wind up being unfortunately abusive way as I mentioned I Was a DSP before I've done other medical work In fact, most of my medical work is from other stuff entirely Like more traditional hospital work the treatment I saw the autistic in particular was worse than any other group and it is really unfortunate, but It is my Particular opinion that no matter the severity of the autistic child. It is better for them than not being these facilities This is not the case with most other disorders But it is definitely the case with autistic Do what you can to keep them out of it And some people might have clicked off I'm not gonna bother saying what next video will be But You stuck through with through with this. Thank you. Have a good one