Maison Départementale de l'Adolescent et Centre Médico-Psycho-Pédagogique, Conseil Général des Bouches-du-Rhône, Laboratoire de Santé Publique EA3279 de la Faculté de Médecine de la Timone, Marseille, France.
PLoS One. 2010 Dec 21;5(12):e14358. doi: 10.1371/journal.pone.0014358.
Parents, caregivers and mental health professionals have often reported violence and aggression in children or adolescents with autistic disorder. However, most of these observations derived from anecdotal reports, and studies on frequency and characterization of aggression in autism remain limited. Our objective was to better characterize and understand the different types of aggressive behaviors displayed by a large group of individuals with autism in different observational situations.
METHODOLOGY/FINDINGS: The study was conducted on 74 children and adolescents with autism and 115 typically developing control individuals matched for sex, age and pubertal stage. Other-Injurious Behaviors (OIB) were assessed in three observational situations (parents at home, two caregivers at day-care, a nurse and a child psychiatrist during blood drawing) using validated scales. The frequency of OIB was significantly higher in individuals with autism compared to typically developing control individuals during the blood drawing (23% vs. 0%, P<0 .01). The parents observed significantly less OIB in their children than caregivers (34% vs. 58%, P<0.05). In addition, the most frequent concurrent behaviors occurring just before the appearance of OIB in individuals with autism were anxiety-related behaviors and excitation according to the parental as well as the caregiver observation.
CONCLUSIONS/SIGNIFICANCE: The results suggest that in a stressful situation, such as the blood drawing, individuals with autism release their stress through behaviors such as OIB, whereas typically developing individuals regulate and express their stress through cognitive skills such as mental coping strategies, symbolization skills with representation and anticipation of the stressful situation, social interaction and verbal or non-verbal communication. The findings underline also the key role of the environment in assessing OIB and developing therapeutic perspectives, with an individual who modulates his/her behavior according to the environment, and an environment that perceives this behavior and reacts to it with different tolerance thresholds according to the observers.
父母、照顾者和精神卫生专业人员经常报告自闭症儿童或青少年的暴力和攻击行为。然而，这些观察结果大多来自传闻报告，关于自闭症中攻击行为的频率和特征的研究仍然有限。我们的目的是更好地描述和理解在不同观察情况下自闭症患者表现出的不同类型的攻击行为。
方法/结果：本研究对 74 名自闭症儿童和青少年和 115 名年龄、性别和青春期阶段相匹配的正常发育对照组进行了研究。使用经过验证的量表，在三种观察情况下（父母在家中、两名照顾者在日托中心、护士和儿童精神科医生在采血时）评估了其他伤害行为（OIB）。与正常发育对照组相比，在采血时自闭症患者的 OIB 频率明显更高（23%对 0%，P<0.01）。与照顾者相比，父母在其子女中观察到的 OIB 明显较少（34%对 58%，P<0.05）。此外，根据父母和照顾者的观察，在自闭症患者出现 OIB 之前最常见的并发行为是焦虑相关行为和兴奋。
结论/意义：结果表明，在压力情况下，如采血时，自闭症患者通过 OIB 等行为释放压力，而正常发育的个体则通过认知技能，如心理应对策略、符号化技能、对压力情况的表示和预期、社会互动和言语或非言语沟通来调节和表达压力。这些发现还强调了环境在评估 OIB 和制定治疗观点方面的关键作用，个体根据环境调节行为，而环境则根据观察者的不同容忍度感知这种行为并做出反应。
