Storch Eric A, Ehrenreich May Jill, Wood Jeffrey J, Jones Anna M, De Nadai Alessandro S, Lewin Adam B, Arnold Elysse B, Murphy Tanya K
Department of Pediatrics, University of South Florida, St. Petersburg, Florida 33701, USA.
J Child Adolesc Psychopharmacol. 2012 Aug;22(4):292-9. doi: 10.1089/cap.2011.0114. Epub 2012 Aug 2.
The purpose of this study was to examine child, parent, and clinician's consensus agreement on the Anxiety Disorders Interview Schedule, Child and Parent versions (ADIS-C/P) in a sample of children and adolescents with autism spectrum disorders (ASD).
Youth with ASD (n=85; age range=7-17 years) and their parents were each administered the ADIS-C/P by a trained clinician. Consensus diagnoses were determined in a clinical conference using best estimate procedures that incorporated all available information.
Children and youth with ASD diagnoses generally showed poor diagnostic agreement with parents and clinical consensus, whereas parents showed good-to-excellent diagnostic agreement with clinical consensus diagnoses. Diagnostic agreement between parents and consensus was moderated by the specific ASD diagnosis. Otherwise, the pattern of relationships did not systematically differ as a function of age or externalizing comorbidity.
These data suggest that parent and youth agreement regarding the presence of clinical levels of anxiety is markedly poor among youth with ASD. Additionally, clinicians are likely to base their diagnostic impressions on parent report, placing minimal emphasis on child report.
本研究旨在考察自闭症谱系障碍(ASD)儿童及青少年样本中,儿童、家长与临床医生在《焦虑症访谈量表》儿童版和家长版(ADIS-C/P)上的一致性。
85名年龄在7至17岁的患有ASD的青少年及其家长分别由一名经过培训的临床医生进行ADIS-C/P测试。在临床会议上,采用综合所有可用信息的最佳估计程序确定一致性诊断。
被诊断为ASD的儿童和青少年与家长及临床一致性诊断的诊断一致性普遍较差,而家长与临床一致性诊断的诊断一致性良好至优秀。家长与一致性诊断之间的诊断一致性受特定ASD诊断的影响。此外,关系模式并未因年龄或外化共病而系统地有所不同。
这些数据表明,在患有ASD的青少年中,家长与青少年在临床焦虑水平的存在上的一致性明显较差。此外,临床医生可能会基于家长报告形成诊断印象,而对儿童报告的重视程度最低。