Monday, April 25, 2011

Slipping Through Time In Autism

Have you ever felt like you're reliving the past?

Have you ever felt like you're reliving the past? A curious paper from Japan: ‘Time slip’ phenomenon in adolescents and adults with autism spectrum disorders. Have you ever felt like you're...OK, sorry. I'll stop that.

The paper describes the cases of two young men with autism, who suffered from an unusual affliction - very vivid memories of a single past event. These recollections were so unpleasant that they led to outbursts of violence. In the first case, the event was somewhat traumatic in itself:
Case 1, a male patient, was 16 years old at the time of his first visit to our hospital. He had not shown any delay in language development but had been isolated and unable to make friends since his infancy... He had been bullied by a classmate when he was in the 8th grade; thereafter he refused to go to school and began to stay indoors.

One day, he clearly recalled the bullying incident that had occurred a few years earlier and re-experienced the feelings of fear and frustration as if he were once again experiencing that event. Thereafter, he often had similar experiences, even though he did not purposely intend to recall the event, and he became strongly distressed.

He and his family stated that the recalled content was always the same. He thought that the distress could only be relieved by obtaining revenge on the boy who had bullied him, and he visited the boy’s house with a knife. He was subsequently admitted to the emergency ward of our hospital.
This is not, perhaps, very surprising and sounds a bit like post-traumatic stress disorder. The second case, however, is more mysterious because the event that was remembered was, in itself, completely trivial - someone throwing away a cigarette end:
Case 2, a male patient, was 27 years old at the time of his first visit. Since an early age, he had exhibited disturbed reciprocal sociality and did not have any close friendships. His interest was limited to collecting figures of comic characters. He began to be bullied during junior high school. He entered senior high school but quit during the second year. Thereafter, he tended to seclude himself at home.

One day, he watched his neighbor discarding a cigarette butt in front of his home. Thereafter, he began to be annoyed by that memory. Almost every time he heard the voice of that neighbor or saw that man, he would leave his home and curse at the neighbor. His behavior became more violent and he eventually threatened the neighbor with a wooden sword.
The authors end by saying that out of seven autistic patients who presented to their psychiatric emergency ward, no less than four of them experienced "time slips", though it's not clear how this was diagnosed and patients presenting to the emergency ward are a highly selected population - mostly people who have suddenly become violent or aggressive.

The "time slip" phenomenon seems unknown outside of Japan. Google reveals that the only papers discussing it are Japanese. Is it something that only happens in Japan, like buru-sera? Are people with autism elsewhere experiencing this, and going unnoticed?

ResearchBlogging.orgTochimoto S, Kurata K, & Munesue T (2011). 'Time slip' phenomenon in adolescents and adults with autism spectrum disorders: Case series. Psychiatry and clinical neurosciences PMID: 21489047

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