Mundy Peter C, Henderson Heather A, Inge Anne Pradella, Coman Drew C
University of Miami, Department of Psychology, Marino Autism Research Institute.
Res Pract Persons Severe Disabl. 2007 Jun 1;32(2):124-139. doi: 10.2511/rpsd.32.2.124.
The study of phenotypic variability in social impairments and comorbid emotional disorders in autism is important because it provides information on phenotypic differences that currently complicate diagnosis, research, and treatment of this disorder. Currently, though, relatively little is known about the processes that contribute to individual differences in social impairments and comorbidity in autism. In this paper, we present a model that suggests modifier processes (MPs), which are not necessarily specific to the syndrome refractor alter the expression of autism and contribute to fundamental behavioral and psychological differences in children diagnosed with this disorder. One MPs involves the somewhat surprising tendency of some children with higher functioning autism (HFA) to make attributions about other peoples thoughts, although they have social cognitive deficits Just as in other children, the attributions of children with HFA are linked to some of their behavioral problems Another MP involves the influence of differences in motivation associated with the behavioral activation and inhibition systems that can be assessed with measures of anterior EEG asymmetry. This dimension of motivation may be linked to how active but inappropriate and withdrawn children with HFA may appear. Third, differences in the self-monitoring of errors among children with HFA appear to be related to individual differences in IQ and social symptom severity in these children. The possible role of these MPs in diagnostic subgroups and differences in treatment responses among children with HFA are discussed. In addition, the role of MPs in understanding the effects associated with specific genetic functions in autism, such as those associated with the serotonin transporter gene (5-HTTLPR), is discussed. A conclusion of this paper is that the varied expression of autism may require that we understand how autism interacts with other non-syndrome-specific processes that are related to individual differences in all people.
对自闭症社交障碍和共病情绪障碍中的表型变异性进行研究很重要，因为它能提供有关目前使该疾病的诊断、研究和治疗变得复杂的表型差异的信息。然而，目前对于导致自闭症社交障碍和共病个体差异的过程了解相对较少。在本文中，我们提出了一个模型，该模型表明修饰过程（MPs）不一定特定于该综合征，却能改变自闭症的表现，并导致被诊断患有该疾病的儿童出现基本的行为和心理差异。一种修饰过程涉及一些高功能自闭症（HFA）儿童的某种令人惊讶的倾向，即尽管他们存在社会认知缺陷，但仍会对他人的想法进行归因。与其他儿童一样，HFA儿童的归因与他们的一些行为问题有关。另一种修饰过程涉及与行为激活和抑制系统相关的动机差异的影响，这种影响可以通过前额脑电图不对称测量来评估。这种动机维度可能与HFA儿童看似活跃但不适当且退缩的表现有关。第三，HFA儿童在错误自我监测方面的差异似乎与这些儿童的智商和社会症状严重程度的个体差异有关。本文讨论了这些修饰过程在诊断亚组中的可能作用以及HFA儿童治疗反应的差异。此外，还讨论了修饰过程在理解自闭症中特定基因功能（如与血清素转运体基因（5-HTTLPR）相关的功能）所产生的影响方面的作用。本文的一个结论是，自闭症的多样表现可能要求我们了解自闭症如何与其他与所有人个体差异相关的非综合征特异性过程相互作用。
