TABLE VIII.

Challenging behavior for individuals with Angelman syndrome, late-adolescence through adulthood

	Full Cohort % (n)	Female odds ratio	21–25y odds ratio	26–30y odds ratio	31–50y odds ratio	UBE3A odds ratio	UPD odds ratio
Challenging behavior
Aggressive towards others a	72% (109)	1.302	0.377	0.222*	0.284	1.387	1.585
Self-injurious	52% (109)	0.715	0.601	0.992	0.212*	4.118	1.765
Obsessive or persistent	48% (109)	0.643	1.313	0.453	1.362	0.758	0.406
Identified emotional trigger
Anxiety	20% (85)	0.465	0.985	1.173	0.678	0.762	3.200
Frustration	47% (85)	1.031	0.524	2.241	0.372	2.464	1.478
Behavior function
Social attention	61% (109)	1.123	1.212	0.699	1.406	0.304	1.420
Tangible demand	61% (109)	1.507	0.587	3.080	0.634	1.364	0.682
Avoidant escape	57% (109)	1.452	0.992	1.631	0.317	0.952	1.143
Sensory stimulation	45% (109)	0.327*	1.394	1.306	1.122	0.656	1.969
Behavior modification
Consistent routine	93% (109)	0.290	0.344	0.159	0.172	IS (100%, 9)	0.794
Sensitive to change in routine	50% (109)	1.119	0.699	0.556	1.898	2.111	0.452
Motivation
Immediate reward	55% (84)	2.185	0.824	0.326	0.169*	3.222	7.519
Delayed reward	15% (84)	4.060	0.376	0.179	0.435	1.857	13.000*
Psychiatric medications
Anxyolytic/antidepressant
Current	12% (109)	0.261	1.204	0.669	1.046	2.063	0.802
Past	6% (109)	1.356	1.450	IS (0%, 23)	0.841	2.187	4.375
SSRI
Current	10% (109)	0.836	0.361	0.221	0.324	11.833*	5.917
Past	11% (109)	1.032	1.066	1.948	0.616	IS (0%, 9)	1.806
Antipsychotic
Current	10% (109)	0.838	0.835	1.078	IS (0%, 16)	1.196	IS (0%, 10)
Past	19% (109)	0.701	1.592	0.865	0.275	0.587	3.128
Stimulant/antihypnotic
Current	5% (109)	4.456	0.666	IS (0%, 23)	2.835	IS (0%, 9)	IS (0%, 10)
Past	8% (109)	1.301	0.680	0.421	1.318	IS (100%, 9)	0.917

Age sub-groups compared with the 16–20y cohort. Genotype sub-groups compared with the Del cohort.

^bbehavior that has the potential to harm others.

^*statistically significant odds ratio (α = 0.05). IS: infinite solution (%, n), SSRI: selective serotonin reuptake inhibitor. Behavior medications: anxyolytic/anti-depressants (current: busparone-3, guanfacine-2, trazedone-2, clonidine-1, duloxetine-1, alprazolam-1, clobazam-1, clomipramine-1, clorazepate-1, diazepam-1, lorazepam-1, past: clonidine-3, guanfacine-2, clonazepam-2, diezepam-2, busarone-1); selective seratonin reuptake inhibitor (current: fluoxetine - 4, sertraline- 4, citalopram-3, escitalopram-1, past: sertraline-4, fluvoxetine-3, fluvoxamine-2, paroxetine-2, citalopram-1, escitalopram-1); antipsychotics (current: risperidone-6, quetiapine-2, aripiprazole-1, olazapine-1, paliperidone-1, past: risperdal-19, aripiprazol-5, olanzapine-4, quetiapine-2, promethazine-1, haloperidol (PRN)-1, ziprasidone-1); anxyolytic/anti-depressants (current: busparone-3, guanfacine-2, trazedone-2, clonidine-1, duloxetine-1, alprazolam-1, clobazam-1, clomipramine-1, clorazepate-1, diazepam-1, lorazepam-1, past: clonidine-3, guanfacine-2, clonazepam-2, diezepam-2, busarone-1); antihypnotic/stimulant (current: atomoxetine-2, buprobion-1, modafinil-1, dexmethamphetamine-1, past: methylphenidate-7, dexmethamphetamine-6); antiepileptics (current: oxcarbazepine-2, lamotrigine-1, topiramate-1, past: valproic acid-1, ethosuximide-1); Other: (current: vitamin B complex - 3, past: vitamin B complex-1, lithium-1).