Autism is a neurodevelopmental disorder characterized by impaired social interaction, verbal and non-verbal communication, and by restricted and repetitive behavior. The diagnostic criteria require that symptoms become apparent before a child is three years old.
Autism affects information processing in the brain by altering how nerve cells and their synapses connect and organize; how this occurs is not well understood. It is one of three recognized disorders in the autism spectrum (ASDs), the other two being Asperger syndrome, which lacks delays in cognitive development and language, and pervasive developmental disorder, not otherwise specified (commonly abbreviated as PDD-NOS), which is diagnosed when the full set of criteria for autism or Asperger syndrome are not met.
Autism has a strong genetic basis, although the genetics of autism are complex and it is unclear whether ASD is explained more by rare mutations, or by rare combinations of common genetic variants. In rare cases, autism is strongly associated with agents that cause birth defects.
Controversies surround other proposed environmental causes, such as heavy metals, pesticides or childhood vaccines; the vaccine hypotheses are biologically implausible and have been disproven in scientific studies. The prevalence of autism is about 1-2 per 1,000 people worldwide, and it occurs four to five times more often in boys than girls.
The Centers for Disease Control and Prevention (CDC) report 1.5% of children in the United States (one in 68) are diagnosed with ASD as of 2014, a 30% increase from one in 88 in 2012. The number of people diagnosed with autism has been increasing dramatically since the 1980s, partly due to changes in diagnostic practice and government-subsidized financial incentives for named diagnoses; the question of whether actual prevalence has increased is unresolved.
Parents usually notice signs in the first two years of their child's life. The signs usually develop gradually, but some autistic children first develop more normally and then regress.Early behavioral, cognitive, or speech interventions can help autistic children gain self-care, social, and communication skills.
Although there is no known cure, there have been reported cases of children who recovered. Not many children with autism live independently after reaching adulthood, though some become successful. An autistic culture has developed, with some individuals seeking a cure and others believing autism should be accepted as a difference and not treated as a disorder. Read more ...
Taking antidepressants during pregnancy increases risk of autism by 87 percent - December 14, 2015
Using antidepressants during pregnancy greatly increases the risk of autism. Prof. Berard, an internationally renowned expert in the fields of pharmaceutical safety during pregnancy, came to her conclusions after reviewing data covering 145,456 pregnancies. The World Health Organization indicates that depression will be the second leading cause of death by 2020, which leads the researchers to believe that antidepressants will likely to remain widely prescribed, including during pregnancy.
5 Early Signs Of Autism All Parents Should Know Huffington Post - December 9, 2015
1. Doesn't respond to his or her own name.
2. Doesn't engage "joint attention."
3. Doesn't imitate others' behavior.
4. Doesn't engage in pretend play.
5. Doesn't respond emotionally.
New Survey Method Finds More Kids With Autism NBC - November 13, 2015
A new government survey finds that more than 2 percent of U.S. kids have been diagnosed with autism - or 1 in 45 children aged 3 and older.
1 in 45 US Kids Has an Autism Spectrum Disorder Live Science - November 13, 2015
About 1 in 45 children in the United States has an autism spectrum disorder, according to a new government estimate of the condition's prevalence in 2014. This new report is based on data collected during the yearly National Health Interview Survey, from interviews of parents about their children, and is the first report of the prevalence of autism in the U.S. to include data from the years 2011 to 2014, according to the researchers from the Centers for Disease Control and Prevention (CDC). Although the new estimate looks like a significant increase from the CDC's previous estimate - which put the autism spectrum disorder rate at 1 in 68 children - the previous estimate was made using data from a different CDC survey, called the Autism and Developmental Disabilities Monitoring Network, which gathers information from children's medical records. This 1-in-68 estimate was reported in 2014, but was based on data collected during 2010.
My 5-year-old son is a telepathic genius NY Post - November 5, 2015
Research examines relationship between autism and creativity Science Daily - August 14, 2015
People with high levels of autistic traits are more likely to produce unusually creative ideas, new research confirms. While the researchers found that people with high autistic traits produced fewer responses when generating alternative solutions to a problem, the responses they did produce were more original and creative. It is the first study to find a link between autistic traits and the creative thinking processes.
Measles Vaccine Not Linked with Autism, Even in High-Risk Kids Live Science - April 21, 2015
Another study has found no link between autism and the vaccine against measles, mumps and rubella (called the MMR vaccine). This time, the finding comes from a study of children at high risk of developing autism. Although numerous studies have shown that vaccines do not cause autism, some parents still believe that vaccines and autism are related, and thus choose to not vaccinate their kids, researchers say. In the new study, researchers examined health data and vaccination records of about 96,000 children who all had older siblings. The researchers found that there was no link between receiving the MMR vaccine and developing autism, even for the children who had an increased risk of autism because their older siblings had been diagnosed with the condition. Other studies have shown that having an older sibling with autism is a risk factor for developing the condition.
Autism risk genes also linked to higher intelligence Science Daily - March 10, 2015
Genes linked with a greater risk of developing autism may also be associated with higher intelligence, a study suggests. Researchers have found new evidence linking genetic factors associated with autism to better cognitive ability in people who do not have the condition. The relationship between autism and intelligence is not clear, researchers say. Although up to 70 per cent of individuals with autism have an intellectual disability, some people with the disorder have relatively well-preserved, or even higher than average, non-verbal intelligence, the team says. Autism is a developmental disability that can cause significant language and speech difficulties. Non-verbal intelligence enables people to solve complex problems using visual and hands-on reasoning skills requiring little or no use of language.
'Innovative' Intervention Helps Babies at High Risk of Autism Live Science - January 22, 2015
Babies who have a high risk of developing autism may benefit when their parents receive some video-based lessons on how to work with their infants, a new study finds. Researchers found that the babies of parents who completed the lessons were moderately more engaged with other people, did a better job of paying attention and showed more social behaviors, compared with babies whose parents didn't complete the lessons. The results suggest that although early intervention does not prevent autism, it may lessen its features in some children who have a high risk of developing the disorder.
Century-old drug reverses autism-like symptoms in fragile X mouse model Science Daily - January 18, 2015
Researchers previously reported that a drug used for almost a century to treat trypanosomiasis, or sleeping sickness, reversed environmental autism-like symptoms in mice. Now, a new study suggests that a genetic form of autism-like symptoms in mice are also corrected with the drug, even when treatment was started in young adult mice.
Samsung's 'Look at Me' App is Designed to Help Children With Autism Epoch Times - January 5, 2015
The app features 7 different interactive missions that train users to recognize facial expressions, remember faces and thus boost their understanding of other's emotions. The different missions each utilize sound and visual incentives along with a points based reward system to encourage children to participate every day for just 15-20 minutes. It also allows users to take pictures of their own face when they are experiencing different emotions so they can better recognize the same emotion in other people. Although the app is in an initial trial phase it has shown positive results and so has been released to the Play store for everyone to use.
Brain inflammation a hallmark of autism, large-scale analysis shows PhysOrg - December 10, 2014
While many different combinations of genetic traits can cause autism, brains affected by autism share a pattern of ramped-up immune responses, an analysis of data from autopsied human brains reveals. There are many different ways of getting autism, but we found that they all have the same downstream effect. The causes of autism, also known as autistic spectrum disorder, remain largely unknown and are a frequent research topic for geneticists and neuroscientists. Researchers reported that for autism, studies of whether and how much genes were being used - known as gene expression - had thus far involved too little data to draw many useful conclusions. Given the known genetic contributors to autism, inflammation is unlikely to be its root cause. This is a downstream consequence of upstream gene mutation. The next step would be to find out whether treating the inflammation could ameliorate symptoms of autism.
Missing gene linked to autism PhysOrg - November 25, 2014
Researchers at the University of Leeds have shed light on a gene mutation linked to autistic traits. The team already knew that some people with autism were deficient in a gene called neurexin-II. To investigate whether the gene was associated with autism symptoms, the Leeds team studied mice with the same defect. They found behavioral features that were similar to autism symptoms, including a lack of sociability or interest in other mice.
Brain anatomy differences between autistic and typically developing individuals are indistinguishable PhysOrg - November 4, 2014
In the largest MRI study to date, researchers from Ben-Gurion University of the Negev and Carnegie Mellon University have shown that the brain anatomy in MRI scans of people with autism above age six is mostly indistinguishable from that of typically developing individuals and, therefore, of little clinical or scientific value.
Gene duplications associated with autism evolved recently in human history PhysOrg - October 19, 2014
Human geneticists have discovered that a region of the genome associated with autism contains genetic variation that evolved in the last 250,000 years, after the divergence of humans from ancient hominids, and likely plays an important role in disease.
Presence or absence of early language delay alters anatomy of the brain in autism PhysOrg - September 23, 2014
A new study led by researchers from the University of Cambridge has found that a common characteristic of autism - language delay in early childhood - leaves a 'signature' in the brain.The researchers studied 80 adult men with autism: 38 who had delayed language onset and 42 who did not. They found that language delay was associated with differences in brain volume in a number of key regions, including the temporal lobe, insula, ventral basal ganglia, which were all smaller in those with language delay; and in brainstem structures, which were larger in those with delayed language onset.
Timeline of human origins revised: New synthesis of research links changing environment with Homo's evolutionary adaptability Science Daily - July 5, 2014
Many traits unique to humans were long thought to have originated in the genus Homo between 2.4 and 1.8 million years ago in Africa. Although scientists have recognized these characteristics for decades, they are reconsidering the true evolutionary factors that drove them. Many traits unique to humans were long thought to have originated in the genus Homo between 2.4 and 1.8 million years ago in Africa. Although scientists have recognized these characteristics for decades, they are reconsidering the true evolutionary factors that drove them.
Autism 'begins long before birth' BBC - March 27, 2014
Scientists say they have new evidence that autism begins in the womb. Patchy changes in the developing brain long before birth may cause symptoms of autism spectrum disorder (ASD), research suggests. US scientists analyzed post-mortem brain tissue of 22 children with and without autism, all between two and 15 years of age. They used genetic markers to look at how the outermost part of the brain, the cortex, wired up and formed layers. Abnormalities were found in 90% of the children with autism compared with only about 10% of children without. The changes were dotted about in brain regions involved in social and emotional communication, and language, long before birth, they say.
For Kids with Autism, Sights and Sounds Are Disjoined Live Science - January 14, 2014
The world for children with autism may resemble watching a movie with the audio out of sync. New research shows these children have trouble putting together what they see with what they hear, and that these deficits may underlie their speech and communication problems. For most people, the signals arriving in the brain from the ears and the eyes within a time window of 100 to 200 milliseconds, are put together, to form one perception. For example, hearing the sound of a word and seeing the movement of lips together creates the perception of a spoken word. The new study showed that in children with autism, the time window for binding signals together is wider, meaning that the brain integrates events that happened as much as half a second (500 milliseconds) apart, and should have been perceived as separate events, according to the study.
Study reveals senses of sight and sound separated in children with autism PhysOrg - January 14, 2014
The study is the first to illustrate the link and strongly suggests that deficits in the sensory building blocks for language and communication can ultimately hamper social and communication skills in children with autism. The study found that children with autism have an enlargement in something known as the temporal binding window (TBW), meaning the brain has trouble associating visual and auditory events that happen within a certain period of time.
People with Autism More Likely to Hear Colors, See Sounds Live Science - November 20, 2013
People with autism may be more likely than others to have synesthesia, a condition in which people experience a mixing of their senses, such as hearing tastes and shapes, and seeing numbers in colors, a new study from Europe suggests. Researchers tested 164 people with autism and 97 people without autism by giving them online questionnaires designed to evaluate whether they had synesthesia. They found synesthesia occurred in about 7 percent of people who didn't have autism, a figure within the range of previously reported rates. In contrast, 19 percent of people with autism appeared to have synesthesia.
Study finds that a subset of children often considered to have autism may be misdiagnosed PhysOrg - September 18, 2013
Children with a genetic disorder called 22q11.2 deletion syndrome, who frequently are believed to also have autism, often may be misidentified because the social impairments associated with their developmental delay may mimic the features of autism, a study by researchers with the UC Davis MIND Institute suggests. The study is the first to examine autism in children with chromosome 22q11.2 deletion syndrome, in whom the prevalence of autism has been reported at between 20 and 50 percent, using rigorous gold-standard diagnostic criteria. The research found that none of the children with 22q11.2 deletion syndrome "met strict diagnostic criteria" for autism. The researchers said the finding is important because treatments designed for children with autism, such as widely used discrete-trial training methods, may exacerbate the anxiety that is commonplace among the population.
Traits of Autism Seen in Some Kids with ADHD Live Science - August 26, 2013
Nearly one in five children with attention-deficit/hyperactivity disorder (ADHD) have traits that are common among children with autism, and having these traits appears to increase children's risk of experiencing impairments in their everyday lives, a new study suggests. Among children in the study with ADHD, 18 percent had autistic traits, while less than 1 percent of children without ADHD had such traits. Children with ADHD and autistic traits were more likely to get in fights, be rejected by their peers, and have problems in school and with their siblings, compared with children with ADHD who did not have the autistic profile, the researchers said in their study.
Is It Possible to Recover from Autism? Scientific American - July 29, 2013
A study, published the Journal of Child Psychology and Psychiatry, suggests that for some people, the answer is yes. The researchers found that some individuals who had been diagnosed with autism as young children no longer had symptoms - such as difficulty interacting and communicating with others, rigid adherence to rituals and routines, and repetitive movements of their bodies and objects - when they were older.
Detecting Autism from Brain Activity Science Daily - April 17, 2013
Neuroscientists from Case Western Reserve University School of Medicine and the University of Toronto have developed an efficient and reliable method of analyzing brain activity to detect autism in children. The researchers recorded and analyzed dynamic patterns of brain activity with magnetoencephalography (MEG) to determine the brain's functional connectivity - that is, its communication from one region to another. MEG measures magnetic fields generated by electrical currents in neurons of the brain.
Five psychiatric disorders 'linked' BBC - March 1, 2013
Autism, attention deficit-hyperactivity disorder, bipolar disorder, major depressive disorder and schizophrenia all share several genetic risk factors, according to a major study. Versions of four genes increased the odds of all five disorders. Researchers hope to move the psychiatry away from describing symptoms towards fundamentally understanding what is going wrong in the brain.
Study: Some Kids Outgrow Autism News Max Health - January 16, 2013
Some children who are diagnosed with autism at an early age will ultimately shed all signs and symptoms of the disorder as they enter adolescence or young adulthood, a new analysis contends. Whether that happens because of aggressive interventions or whether it boils down to biology and genetics is still unclear, the researchers noted, although experts suspect it is most likely a combination of the two. The finding stems from a methodical analysis of 34 children who were deemed "normal" at the study's start, despite having been diagnosed with autism before the age of 5.
Boosting natural marijuana-like brain chemicals treats fragile X syndrome symptoms PhysOrg - September 26, 2012
American and European scientists have found that increasing natural marijuana-like chemicals in the brain can help correct behavioral issues related to fragile X syndrome, the most common known genetic cause of autism.
New Genes Contributing to Autism Discovered; Genetic Links Between Neurodevelopment and Psychiatric Disorders Science Daily - April 21, 2012
A new approach to investigating hard-to-find chromosomal abnormalities has identified 33 genes associated with autism and related disorders, 22 for the first time. Several of these genes also appear to be altered in different ways in individuals with psychiatric disorders such as schizophrenia, symptoms of which may begin in adolescence or adulthood. Results of the study by a multi-institutional research team will appear in the April 27 issue of Cell and have been released online
Early Autism Sign: Babies' Brain Responses to Eye Contact Live Science - January 27, 2012
The way that babies as young as six months look at the eyes of other people may be an early sign of autism, a new study suggests. Researchers looked at brain scans of infants as they were shown pictures of faces, and those who were later diagnosed with autism showed marked differences in brain activity from those who were not later diagnosed with the condition when the eyes in the pictures were directed at the infants. The study included 104 babies who either had a higher risk of developing autism, because they had a sibling with the condition, or had no family history of autism. "This study takes us a step further in understanding what goes on in the brain that subsequently causes autism to emerge in children," said study researcher Mayada Elsabbagh, a scientist at McGill University in Canada.
The Hidden Potential of Autistic Kids Live Science - November 30, 2011
When I was in fifth grade, my brother Alex started correcting my homework. This would not have been weird, except that he was in kindergarten—and autistic. His disorder, characterized by repetitive behaviors and difficulty with social interactions and communication, made it hard for him to listen to his teachers. He was often kicked out of class for not being able to sit for more than a few seconds at a time. Even now, almost 15 years later, he can still barely scratch out his name. But he could look at my page of neatly written words or math problems and pick out which ones were wrong.
Brain find sheds light on autism BBC - November 28, 2011
Cells taken from people with a rare syndrome linked to autism could help explain the origins of the condition, scientists suggest. The Stanford University team turned skin cells from people with "Timothy syndrome" into fully-fledged brain cells. The abnormal activity found in these cells could be partially corrected using an experimental drug, Nature Medicine reports.
Autistic brains develop more slowly than healthy brains: study PhysOrg - October 20, 2011
Researchers at UCLA have found a possible explanation for why autistic children act and think differently than their peers. For the first time, they've shown that the connections between brain regions that are important for language and social skills grow much more slowly in boys with autism than in non-autistic children.
Autistic facial characteristics identified PhysOrg - October 20, 2011
The face and brain develop in coordination, with each influencing the other, beginning in the embryo and continuing through adolescence. Now, University of Missouri researchers have found distinct differences between the facial characteristics of children with autism compared to those of typically developing children. This knowledge could help researchers understand the origins of autism.
Biomarker for autism discovered PhysOrg - July 12, 2011
Siblings of people with autism show a similar pattern of brain activity to that seen in people with autism when looking at emotional facial expressions. The University of Cambridge researchers identified the reduced activity in a part of the brain associated with empathy and argue it may be a 'biomarker' for a familial risk of autism.
Genetic Component of Autism Spectrum Disorders May Be Moderate Compared to Environment, Twin Study Suggests Science Daily - July 4, 2011
After evaluating twin pairs in which at least one child has autism or autism spectrum disorder (ASD), researchers suggest that the shared environment may play a more substantial role in development of the condition than shared genes do
Balance tips toward environment as heritability ebbs in autism? PhysOrg - July 4, 2011
The largest and most rigorous twin study of its kind to date has found that shared environment influences susceptibility to autism more than previously thought.
Researchers link spontaneous gene mutations to autism PhysOrg - May 16, 2011
Using high-throughput gene sequencing technology, researchers have identified several harmful spontaneous gene mutations in children with autism spectrum disorders (ASDs) that may cause the disorder.
Brain Overgrowth in Tots Is Linked to Autism Live Science - May 3, 2011
The brains of children who have autism spectrum disorder are larger than those of other children, a difference that seems to arise before they are 2 years old, according to a new study. In 2005, researchers from the University of North Carolina at Chapel Hill found that 2-year-old children with autism had brains up to 10 percent larger than other children of the same age. This new study reveals that the children with enlarged brains at age 2 continued to have enlarged brains at ages 4 and 5, but by no more than the amount at age 2. Brain enlargement resulting from increased folding on the surface of the brain is most likely genetic in origin and a result of an increase in the proliferation of neurons in the developing brain.
Discovering Autism in One-year Olds
A five-minute questionnaire for parents is accurate enough to diagnose autism in children as young as one in three-quarters of the cases, claims study. Researchers said the checklist, which could be filled out in the waiting room of doctor's surgery, could help catch the condition earlier and lead to more effective treatment. Identifying Autism Spectrum Disorder (ASD) at an early age allows children to start treatment sooner, which can greatly improve their later development and learning.
Autism detected in voice of children Telegraph.co.uk - July 21, 2010
Toddlers with the developmental disorder pronounce words differently to their healthy peers which can be picked up by a new automated vocal analysis system created by scientists. The device called LENA (Language Environment Analysis) could lead to the screening for autism spectrum disorders (ASD) for which early intervention is important.
World's Largest DNA Scan Reveals Rare Variants That Disrupt Gene Activity in Autistic Children Science Daily - June 10, 2010
The world's largest DNA scan for familial autism has uncovered new genetic changes in autistic children that are often not present in their parents. Identified in less than 1 percent of the population, these rare variants occur nearly 20 percent more in autistic children.
Dozens of genetic mutations linked to autism in children discovered Telegraph.co.uk - June 10, 2010
A new test for autism in children has come a step closer after the world's largest study into the disability discovered a number of genetic links to the condition.
Children with autistic traits remain undiagnosed PhysOrg - March 22, 2010
There has been a major increase in the incidence of autism over the last twenty years. While people have differing opinions as to why this is (environment, vaccines, mother's age, better diagnostic practice, more awareness etc.) there are still many children who have autistic traits that are never diagnosed clinically. Therefore, they do not receive the support they need through educational or health services.
Autism's earliest symptoms not evident in children under 6 months PhysOrg - February 16, 2010
A study of the development of autism in infants, comparing the behavior of the siblings of children diagnosed with autism to that of babies developing normally, has found that the nascent symptoms of the condition -- a lack of shared eye contact, smiling and communicative babbling - are not present at 6 months, but emerge gradually and only become apparent during the latter part of the first year of life.
New clue why autistic people don't want hugs PhysOrg - February 11, 2010
Why do people with fragile X syndrome, a genetic defect that is the best-known cause of autism and inherited mental retardation, recoil from hugs and physical touch - even from their parents?
Vaccine-Autism Link Had Long, Inaccurate History Live Science - February 11, 2010
This year thousands of children in Afghanistan will die from measles; they're among the quarter million of children worldwide who die annually from this preventable disease, a tragic situation that is at least improving. Meanwhile, in the United States this year, thousands of parents will deny the measles vaccine for their children, having heard from someone somewhere that vaccines cause autism. At the hub between these contrasting trajectories - measles deaths dropping from about a million to 250,000 annually since 1999 as a result of focused immunization programs, and measles on the rise year by year in the United States and United Kingdom since 1999 as a result of dramatic declines in immunization rates - is a 1998 study published in the Lancet that invented the vaccine-autism myth.
New study confirms link between advanced maternal age and autism PhysOrg - February 8, 2010
Advanced maternal age is linked to a significantly elevated risk of having a child with autism, regardless of the father's age, according to an exhaustive study of all births in California during the 1990s by UC Davis Health System researchers. Advanced paternal age is associated with elevated autism risk only when the father is older and the mother is under 30, the study found.
How autistic brain distinguishes oneself from others PhysOrg - December 14, 2009
Scientists at the University of Cambridge have discovered that the brains of individuals with autism are less active when engaged in self-reflective thought. The study published today in the journal Brain provides new evidence for the neural correlates of self-awareness and a new window into understanding social difficulties in autism spectrum conditions.
New gene linked to autism risk, especially in boys PhysOrg - May 19, 2009
Classic autism strikes boys four times more often than girls. When including the entire spectrum of autism disorders, such as the milder Asperger syndrome, boys are diagnosed 10 times more often than girls.
Inherited Retardation And Autism Corrected In Mice Science Daily - December 20, 2007
Researchers at MIT's Picower Institute for Learning and Memory have corrected key symptoms of mental retardation and autism in mice. They have significantly alleviated a wide range of abnormalities due to fragile X syndrome by altering only a single gene, countering the effects of the fragile X mutation.
Autism symptoms reversed in lab BBC - June 28, 2007
Symptoms of mental retardation and autism have been reversed for the first time in laboratory mice. US scientists created mice that showed symptoms of Fragile X Syndrome - a leading cause of mental retardation and autism in humans.
Autism gene breakthrough hailed BBC - February 21, 2007
Scientists have found new autism genes by scanning the largest collection of families with multiple cases of autism ever assembled. The monumental task of studying the 1,200 families took more than 120 scientists from more than 50 institutions across 19 countries.
Scientists Decode Molecular Details Of Genetic Defect That Causes Autism Science Daily - September 26, 2006
Autism is one of the most common psychiatric illnesses. Around 0.5 percent of all young children have a syndrome belonging to the "autistic spectrum". The main symptoms of this developmental malfunction are delayed language development or no language development at all, disturbed social behavior and repetitive behavior patterns. In many patients, the disease is accompanied by mental disability. Autistic individuals exhibiting high intelligence or outstanding skills in a particular area, called "savants", such as the main character in the film "Rain Man", are rare.
'Copying' nerves broken in autism BBC - December 5, 2005
Abnormal activity in neurons that help individuals imitate others may underlie some of the social deficits found in autism, US researchers believe. A Nature Neuroscience study found autistic children had less brain activation in an area involved in understanding others' state of mind. The degree of activation of the 'mirror neurons' housed in this area correlated with measures of social impairment.
Research Reveals That Eye Contact Triggers Threat Response in Autistic Children Scientific American - March 2005
Children suffering from autism pay very little attention to faces, even those of people close to them. Indeed, this characteristic can become apparent as early as the age of one, and is often used as a developmental sign of the disease. The results of a new study provide additional insight into why autistic children avoid eye contact: they perceive faces as an uncomfortable threat, even if they are familiar.
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