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Zack Williams, MD, PhD

@quantpsychiatry.bsky.social

3.1K followers 5.2K following 650 posts

•Autistic (+ADHD, OCD, Tourettes) autism researcher and trainee psychiatrist (rising PGY-1) •YaleCSC➡️VanderbiltMSTP➡️UCLA •Catatonia enthusiast, patient advocate, stats guy •MH research/methods/advocacy, autism/neurodiversity, academic medicine, dumb jokes

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Nov 20

For all my friends who just got here to BlueSky and want some cool people to follow, I've now delved into the wonderful world of Starter Packs (full list at blueskydirectory.com/starter-pack...). Here's a thread of some of the cool ones I found!

Bluesky Starter Packs - Bluesky Directory

Browse a list of Bluesky Starter Packs. Discover and connect with your community on Bluesky

blueskydirectory.com

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Reposted by Zack Williams, MD, PhD

Hari Srinivasan @neuroscientist.bsky.social · May 5

"Doctor-Doctor" Zack Williams shares insights into his research and his view of the world, in this spotlight interview with me. Check out the link below.

Wishing you lots of luck Zack in the next chapter of your life.
www.vanderbilt.edu/autismandinn...

@quantpsychiatry.bsky.social

FCAI Spotlight: The Many Layers of Zack Williams by Hari Srinivasan

This article is part of a series highlighting the work and people associated with the Frist Center for Autism and Innovation (FCAI) at Vanderbilt University. The Frist Center brings together engineers...

www.vanderbilt.edu

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Reposted by Zack Williams, MD, PhD

Hannah Morton @hannahmorton.bsky.social · Apr 25

Excited for another year of the Autism PROMnet Special Interest Group at #INSAR2025!

Come chat with us about using valid, accessible, and inclusive measures for and by autistic people in autism research 🙌

Friday, May 2 at 10:30AM (#706)

www.autismpromnet.org
@quantpsychiatry.bsky.social

Improving patient reported outcome measures (proms) in autism research. Bridging the gap between advanced psychometric techniques and stakeholder priorities. Friday May 2 10:30 AM - 12:00 PM Room 4C-1,2 (4th floor). SIG Leaders Hillary K. Schiltz Zachary J. Williams. INSAR annual meeting.

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Mar 20

There's a little bit on that in the discussion to talk about some sex asymmetries in certain outcomes (as sex asymmetries in BPD, fibro, and other conditions that would greatly increase suicide risk are totally a thing, and it's not like being autistic makes you immune to having those conditions)

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Mar 20

So I hope everyone enjoys the paper. For those of you without access to the paper, you can find a version of the PDF on my ResearchGate! Enjoy! www.researchgate.net/publication/...

(PDF) Elevated Suicidal Thoughts and Behaviors and Nonsuicidal Self-Injury in Autistic Youth and Adults: A Multinational Study

PDF | On Mar 13, 2025, Jessica M. Schwartzman and others published Elevated Suicidal Thoughts and Behaviors and Nonsuicidal Self-Injury in Autistic Youth and Adults: A Multinational Study | Find, read...

www.researchgate.net

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Mar 20

And even though the autistic sample is clearly not representative of the whole autistic population (they are much more depressed and suicidal than average, being selected from three studies that oversampled people for those topics), the descriptive clinical phenotype of that group *is* the paper.

Portion of table from paper showing descriptive statistics about suicidality characteristics.

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Mar 20

Similar age trends were observed for some but not all of the C-SSRS items representing suicidal ideation severity, as well as the ordinal "level of ideation," as seen below. No meaningful sex differences were observed across the sample in any of these outcomes.

Four-panel graph with curvilinear trends in inverse U patterns in all four quadrants.

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Mar 20

Below are the plots of (lifetime) suicidality and NSSI likelihood as a function of age in the sample. Both were quite common and had some complex/interesting age relationships that reflected both real clinical effects (like peaks in early adulthood) and recruitment biases (drop-offs later on)...

Two-paned plot. Left-hand side shows inverted U trend that flattens at about 25 years of age and drops back down at about 50 years. Right side shows curvilinear trend with peak at 30 years and nadir at 50 years.

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Mar 20

Excited to share my latest paper in @autisminadulthood.bsky.social (led by the fantastic @drjessicaphd.bsky.social). We pooled data from the Columbia Suicidality Severity Rating Scale from autistic youth and adults in 3 countries (US, Canada, Australia) to assess trajectories across the lifespan...

Elevated Suicidal Thoughts and Behaviors and Nonsuicidal Self-Injury in Autistic Youth and Adults: A Multinational Study | Autism in Adulthood

Background: Autistic people are at significant risk for suicidal thoughts and behaviors (STBs) and nonsuicidal self-injury (NSSI). We examined STB and NSSI in different age-groups, considering sex- an...

www.liebertpub.com

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Feb 12

Really enjoyed being interviewed for this feature on misophonia and misophonia research in @asteriskmag.bsky.social!
asteriskmag.com/issues/09/th...

The Unbearable Loudness of Chewing—Asterisk

Why do some people find certain sounds intolerable? And why has it taken so long for scientists to get even a preliminary answer?

asteriskmag.com

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Reposted by Zack Williams, MD, PhD

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Feb 1

To all of the #INSAR members voting in the upcoming board election, (not that anyone cares but) I'm officially endorsing my good (bluesky-less) friend and colleague Mirko Uljarević for INSAR treasurer! With quant skills like his, the society's money is in good hands.

A very handsome and competent physician-scientist who is totally able to handle the finances of the major autism research professional society.

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Feb 1

P. S. I'm proud of how good I could make him look with a little Facebook stalking and a B+W filter. Shows what you get for accepting my friend requests 😉

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Feb 1

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 30

Really exciting news - new med soon to be on the market for acute pain, mechanism of peripheral Nav1. 8 channel inhibition (not habit forming). Super exciting to see what this med and others like it can do to transform health care!
news.vrtx.com/news-release...

Vertex Announces FDA Approval of JOURNAVX™ (suzetrigine), a First-in-Class Treatment for Adults With Moderate-to-Severe Acute Pain | Vertex Pharmaceuticals Newsroom

-- JOURNAVX is the first and only approved non-opioid oral pain signal inhibitor and the first new class of pain medicine approved in more than 20 years -- -- JOURNAVX is an effective and well-tolerat...

news.vrtx.com

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

I think it's going to depend on just which services those are going to be. Home an community-based services through medicaid in the US, at least, definitely require a medical diagnosis, and I don't expect those to ever be granted on the basis of anything other than that.

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

Though this paper made some pretty strong mechanistic claims, it was peak replication crisis for experimental psychology, and I'm not sure that the findings re: the association of pitch discrimination and clinical features actually hold up in later studies (or support that mechanism).

Reposted by Zack Williams, MD, PhD

Awais Aftab @awaisaftab.bsky.social · Jan 19

The Unbearable Incoherence of Heritability: Interview with Eric Turkheimer ( @ent3c.bsky.social )

“The empirical end to the Galtonian project is more whimper than bang.”

www.psychiatrymargins.com/p/the-unbear...

The Unbearable Incoherence of Heritability: Interview with Eric Turkheimer

Eric Turkheimer is Hugh Scott Hamilton Professor of Psychology at University of Virginia.

www.psychiatrymargins.com

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

I guess a question is whether ND activists will ever develop a clinically practicable alternative to medical autism diagnosis, because self-ID is clearly not sufficient for services/accommodations in many settings (hence the need to interface with the medical system).

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

But once again, in a pluralistic field, it behooves us to respect the values of the other side and not force our approach on them, particularly if we acknowledge that both approaches are needed for some autistic people at least sometimes.

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

I would argue that those using medical-model approaches should control the ways in which ASD is defined medically, and people who wish to have different (non-medical) definitions of autism "caseness" that reject the autism diagnosis (as many already do by including self-identification) can do so.

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

of interest and make people eligible for medical services under that medical model. This is largely the function of a medical diagnosis in the first place.

ND activists also view diagnosis as a much more collaborative process than it has been historically, where a clinician just assigns labels.

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

Though this is a reasonable perspective to have, I do wonder to what extent it actually makes sense to try and shift official DSM criteria to include non-pathological traits.

After all, the DSM and associated ASD diagnosis are clearly situated in a medical model *meant* to pathologize the traits

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

intellectual disability and medical problems that are "co-occurring" with the characteristic physical features and hypotonia that signal the condition early in life. Again, @awaisaftab.bsky.social discusses how psychiatric labels go beyond simply being reflections if the same criteria on his blog.

The Explanatory Value of Descriptive Diagnosis

There is a legitimate sense in which depression can be said to affect how people think, feel and act

www.psychiatrymargins.com

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Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

Imagine, for a second, if we diagnosed rare genetic NDD syndromes clinically and only used the features that didn't overlap with other conditions to make the diagnosis. Those diagnoses would have high specificity, but we would come to absurd conclusions like Down syndrome is highly associated with >

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

Nevertheless, "autism" as a syndrome can go beyond DSM/ICD because the features exist in the world/phenotyping literature. This is why sensory features didn't magically appear in 2013--they were present all along and just elevated to be part of the diagnostic criteria at that point.

Zack Williams, MD, PhD @quantpsychiatry.bsky.social · Jan 19

is one example of a "non-DSM" feature of autism that's pretty uncontroversial, and gets used as a soft sign sometimes when making diagnoses. It's also not present in many autistic people, especially those with more significant forms of ID and rare genetic syndromes, so far from universal.