Measuring Self and Informant Perspectives of Restricted and Repetitive Behaviours (RRBs): Psychometric Evaluation of the Repetitive Behaviours Questionnaire-3 (RBQ-3) in Adult Clinical Practice and Research Settgs

Overview

Journal Mol Autism

Publisher Biomed Central

Date 2024 Jun 6

PMID 38845057

Authors

Catherine R G Jones

Lucy A Livingston

Christine Fretwell

Mirko Uljarevic

Sarah J Carrington

Punit Shah

Susan R Leekam

Affiliations

Soon will be listed here.

Abstract

Background: Brief questionnaires that comprehensively capture key restricted and repetitive behaviours (RRBs) across different informants have potential to support autism diagnostic services. We tested the psychometric properties of the 20-item Repetitive Behaviours Questionnaire-3 (RBQ-3), a questionnaire that includes self-report and informant-report versions enabling use across the lifespan.

Method: In Study 1, adults referred to a specialised adult autism diagnostic service (N = 110) completed the RBQ-3 self-report version, and a relative or long-term friend completed the RBQ-3 informant-report version. Clinicians completed the abbreviated version of the Diagnostic Interview for Social and Communication Disorders (DISCO-Abbreviated) with the same adults as part of the diagnostic process. For half of the assessments, clinicians were blind to the RBQ-3 ratings. We tested internal consistency, cross-informant reliability and convergent validity of the RBQ-3. In Study 2, a follow-up online study with autistic (N = 151) and non-autistic (N = 151) adults, we further tested internal consistency of the RBQ-3 self-report version. We also tested group differences and response patterns in this sample.

Results: Study 1 showed good to excellent internal consistency for both self- and informant-report versions of the RBQ-3 (total score, α = 0.90, ω = 0.90, subscales, α = 0.76-0.89, ω = 0.77-0.88). Study 1 also showed cross-informant reliability as the RBQ-3 self-report scores significantly correlated with RBQ-3 informant-report scores for the total score (r = 0.71) and subscales (r= 0.69-0.72). Convergent validity was found for both self and informant versions of the RBQ-3, which significantly correlated with DISCO-Abbreviated RRB domain scores (r = 0.45-0.54). Moreover, the RBQ-3 scores showed significantly weaker association with DISCO -Abbreviated scores for the Social Communication domain, demonstrating divergent validity. Importantly, these patterns of validity were found even when clinicians were blind to RBQ-3 items. In Study 2, for both autistic and non-autistic groups, internal consistency was found for the total score (α = 0.82-0.89, ω = 0.81-0.81) and for subscales (α = 0.68-0.85, ω = 0.69-0.85). A group difference was found between groups.

Limitations: Due to the characteristics and scope of the specialist autism diagnostic service, further testing is needed to include representative samples of age (including children) and intellectual ability, and those with a non-autistic diagnostic outcome.

Conclusions: The RBQ-3 is a questionnaire of RRBs that can be used across the lifespan. The current study tested its psychometric properties with autistic adults without intellectual disability and supported its utility for both clinical diagnostic and research settings.

References

Leekam S, Nieto C, Libby S, Wing L, Gould J . Describing the sensory abnormalities of children and adults with autism. J Autism Dev Disord. 2006; 37(5):894-910. DOI: 10.1007/s10803-006-0218-7. View

English M, Gignac G, Visser T, Whitehouse A, Enns J, Maybery M . The Comprehensive Autistic Trait Inventory (CATI): development and validation of a new measure of autistic traits in the general population. Mol Autism. 2021; 12(1):37. PMC: 8130295. DOI: 10.1186/s13229-021-00445-7. View

Nygren G, Hagberg B, Billstedt E, Skoglund A, Gillberg C, Johansson M . The Swedish version of the Diagnostic Interview for Social and Communication Disorders (DISCO-10). Psychometric properties. J Autism Dev Disord. 2009; 39(5):730-41. DOI: 10.1007/s10803-008-0678-z. View

Brierley N, McDonnell C, Parks K, Schulz S, Dalal T, Kelley E . Factor Structure of Repetitive Behaviors Across Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. J Autism Dev Disord. 2020; 51(10):3391-3400. DOI: 10.1007/s10803-020-04800-0. View

Moore H, Brice S, Powell L, Ingham B, Freeston M, Parr J . The Mediating Effects of Alexithymia, Intolerance of Uncertainty, and Anxiety on the Relationship Between Sensory Processing Differences and Restricted and Repetitive Behaviours in Autistic Adults. J Autism Dev Disord. 2021; 52(10):4384-4396. PMC: 9508023. DOI: 10.1007/s10803-021-05312-1. View

Uljarevic M, Frazier T, Jo B, Scahill L, Youngstrom E, Spackman E . Dimensional Assessment of Restricted and Repetitive Behaviors: Development and Preliminary Validation of a New Measure. J Am Acad Child Adolesc Psychiatry. 2022; 62(5):568-581. DOI: 10.1016/j.jaac.2022.07.863. View

Ratto A, Bascom J, daVanport S, Strang J, Anthony L, Verbalis A . Centering the Inner Experience of Autism: Development of the Self-Assessment of Autistic Traits. Autism Adulthood. 2023; 5(1):93-105. PMC: 10024271. DOI: 10.1089/aut.2021.0099. View

Baron-Cohen S, Wheelwright S, Skinner R, Martin J, Clubley E . The autism-spectrum quotient (AQ): evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. J Autism Dev Disord. 2001; 31(1):5-17. DOI: 10.1023/a:1005653411471. View

Wing L, Leekam S, Libby S, Gould J, Larcombe M . The Diagnostic Interview for Social and Communication Disorders: background, inter-rater reliability and clinical use. J Child Psychol Psychiatry. 2002; 43(3):307-25. DOI: 10.1111/1469-7610.00023. View

10.

Cuccaro M, Shao Y, Grubber J, Slifer M, Wolpert C, Donnelly S . Factor analysis of restricted and repetitive behaviors in autism using the Autism Diagnostic Interview-R. Child Psychiatry Hum Dev. 2003; 34(1):3-17. DOI: 10.1023/a:1025321707947. View

11.

Brugha T, McManus S, Smith J, Scott F, Meltzer H, Purdon S . Validating two survey methods for identifying cases of autism spectrum disorder among adults in the community. Psychol Med. 2011; 42(3):647-56. DOI: 10.1017/S0033291711001292. View

12.

Clutterbuck R, Callan M, Taylor E, Livingston L, Shah P . Development and validation of the Four-Item Mentalising Index. Psychol Assess. 2021; 33(7):629-636. DOI: 10.1037/pas0001004. View

13.

Jones C, Barrett S, Bite I, Legzdina M, Arina K, Higgins A . Development of the Signposting Questionnaire for Autism (SQ-A): measurement comparison with the 10-item Autism Spectrum Quotient-Child and the Strengths and Difficulties Questionnaire in the UK and Latvia. Mol Autism. 2020; 11(1):64. PMC: 7429457. DOI: 10.1186/s13229-020-00368-9. View

14.

Lewis L . A Mixed Methods Study of Barriers to Formal Diagnosis of Autism Spectrum Disorder in Adults. J Autism Dev Disord. 2017; 47(8):2410-2424. DOI: 10.1007/s10803-017-3168-3. View

15.

Insel T, Cuthbert B, Garvey M, Heinssen R, Pine D, Quinn K . Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry. 2010; 167(7):748-51. DOI: 10.1176/appi.ajp.2010.09091379. View

16.

Frazier T, Whitehouse A, Leekam S, Carrington S, Alvares G, Evans D . Reliability of the Commonly Used and Newly-Developed Autism Measures. J Autism Dev Disord. 2023; 54(6):2158-2169. DOI: 10.1007/s10803-023-05967-y. View

17.

Tavakol M, Dennick R . Making sense of Cronbach's alpha. Int J Med Educ. 2016; 2:53-55. PMC: 4205511. DOI: 10.5116/ijme.4dfb.8dfd. View

18.

Burbidge C, Oliver C, Moss J, Arron K, Berg K, Furniss F . The association between repetitive behaviours, impulsivity and hyperactivity in people with intellectual disability. J Intellect Disabil Res. 2010; 54(12):1078-92. DOI: 10.1111/j.1365-2788.2010.01338.x. View

19.

Johnson S, Filliter J, Murphy R . Discrepancies between self- and parent-perceptions of autistic traits and empathy in high functioning children and adolescents on the autism spectrum. J Autism Dev Disord. 2009; 39(12):1706-14. DOI: 10.1007/s10803-009-0809-1. View

20.

Bishop S, Hus V, Duncan A, Huerta M, Gotham K, Pickles A . Subcategories of restricted and repetitive behaviors in children with autism spectrum disorders. J Autism Dev Disord. 2012; 43(6):1287-97. PMC: 3579001. DOI: 10.1007/s10803-012-1671-0. View