Department of Psychology, Louisiana State University, Baton Rouge, LA, USA.
CNS Drugs. 2011 Jul;25(7):597-606. doi: 10.2165/11591700-000000000-00000.
Autism spectrum disorder (ASD) is a particularly important risk factor for challenging behaviours such as aggression, tantrums, self-injury and pica. Adults with ASD have rarely been studied with respect to these problems. This is particularly disconcerting since there are far more adults than children with ASD. In addition, because of adults' increased physical size and longer history of these problems, treating these behaviours effectively is important. Psychological methods, particularly applied behaviour analysis, and pharmacotherapy have been the most frequently addressed treatments for challenging behaviours associated with ASD in the research literature. In many cases, challenging behaviours have clear environmental antecedents. In these cases, behavioural interventions, such as applied behaviour analysis, should be used to reduce the behaviours. When environmental factors cannot be identified or when challenging behaviours are very severe, pharmacological treatments may be necessary in combination with behavioural interventions. Newer antipsychotics are the most researched medications for use with this population. Currently, risperidone and aripiprazole are the only medications that have US FDA approval for the treatment of behaviours associated with ASD, specifically irritability; however, they are indicated for use in children not adults. It is important not to use medications unnecessarily, due to possible side effects associated with their use. Based on available research, some recommendations for the treatment of challenging behaviours of adults (and children) with ASD include the use of functional assessment, side-effect monitoring of medications and behavioural methods whenever possible. Additionally, future research in this area needs to focus more on adults, as most current research has used child samples.
自闭症谱系障碍（ASD）是具有挑战性的行为，如攻击、发脾气、自残和异食癖等的一个特别重要的风险因素。患有 ASD 的成年人在这些问题上很少被研究。这尤其令人不安，因为患有 ASD 的成年人比儿童多得多。此外，由于成年人的体型更大，这些问题的历史更长，因此有效地治疗这些行为非常重要。在研究文献中，心理方法，特别是应用行为分析和药物治疗，是针对与 ASD 相关的具有挑战性的行为最常被提及的治疗方法。在许多情况下，具有挑战性的行为都有明确的环境前提。在这些情况下，应该使用行为干预，如应用行为分析，来减少这些行为。当无法确定环境因素或具有挑战性的行为非常严重时，可能需要结合行为干预进行药物治疗。新型抗精神病药物是针对该人群研究最多的药物。目前，利培酮和阿立哌唑是唯一获得美国食品和药物管理局批准用于治疗与 ASD 相关行为的药物，特别是易激惹；然而，它们被批准用于儿童而非成年人。由于可能与使用相关的副作用，不不必要地使用药物非常重要。根据现有研究，一些针对 ASD 成人（和儿童）具有挑战性的行为的治疗建议包括尽可能使用功能评估、药物副作用监测和行为方法。此外，该领域的未来研究需要更多地关注成年人，因为大多数现有研究都使用了儿童样本。
