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《孤独症诊断访谈修订版》的结构:诊断及表型意义

The structure of the Autism Diagnostic Interview-Revised: diagnostic and phenotypic implications.

作者信息

Snow Anne V, Lecavalier Luc, Houts Carrie

机构信息

Nisonger Center and Department of Psychology, Ohio State University, Columbus, Ohio 43210-1257, USA.

出版信息

J Child Psychol Psychiatry. 2009 Jun;50(6):734-42. doi: 10.1111/j.1469-7610.2008.02018.x. Epub 2008 Dec 16.

Abstract

BACKGROUND

Multivariate statistics can assist in refining the nosology and diagnosis of pervasive developmental disorders (PDD) and also contribute important information for genetic studies. The Autism Diagnostic Interview-Revised (ADI-R) is one of the most widely used assessment instruments in the field of PDD. The current study investigated its factor structure and convergence with measures of adaptive, language, and intellectual functioning.

METHODS

Analyses were conducted on 1,861 individuals with PDD between the ages of 4 and 18 years (mean = 8.3, SD = 3.2). ADI-R scores were submitted to confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Analyses were conducted according to verbal status (n = 1,329 verbal, n = 532 nonverbal) and separately for algorithm items only and for all items. ADI-R scores were correlated with scores on measures of adaptive, language, and intellectual functioning.

RESULTS

Several factor solutions were examined and compared. CFAs suggested that two- and three-factor solutions were similar, and slightly superior to a one-factor solution. EFAs and measures of internal consistency provided some support for a two-factor solution consisting of social and communication behaviors and restricted and repetitive behaviors. Measures of functioning were not associated with ADI-R domain scores in nonverbal children, but negatively correlated in verbal children.

CONCLUSIONS

Overall, data suggested that autism symptomatology can be explained statistically with a two-domain model. It also pointed to different symptoms susceptible to be helpful in linkage analyses. Implications of a two-factor model are discussed.

摘要

背景

多变量统计有助于完善广泛性发育障碍(PDD)的疾病分类学和诊断,也能为遗传学研究提供重要信息。《自闭症诊断访谈修订版》(ADI-R)是PDD领域使用最广泛的评估工具之一。本研究调查了其因子结构以及与适应性、语言和智力功能测量指标的相关性。

方法

对1861名年龄在4至18岁之间的PDD患者进行分析(平均年龄 = 8.3岁,标准差 = 3.2)。将ADI-R评分进行验证性因子分析(CFA)和探索性因子分析(EFA)。根据语言能力状况进行分析(1329名有语言能力者,532名无语言能力者),并分别对仅算法项目和所有项目进行分析。将ADI-R评分与适应性、语言和智力功能测量指标的得分进行相关性分析。

结果

研究并比较了几种因子解决方案。CFA表明,两因子和三因子解决方案相似,且略优于单因子解决方案。EFA和内部一致性测量为一个由社交和沟通行为以及局限和重复行为组成的两因子解决方案提供了一些支持。功能测量指标与无语言能力儿童的ADI-R领域得分无关,但与有语言能力儿童的得分呈负相关。

结论

总体而言,数据表明自闭症症状可以用一个两领域模型进行统计学解释。它还指出了在连锁分析中可能有用的不同症状。讨论了两因子模型的意义。

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