Lerner Matthew D, White Susan W, McPartland James C
Department of Psychology, University of Virginia, Charlottesville, VA 22904-4400, USA.
Dialogues Clin Neurosci. 2012 Sep;14(3):307-18. doi: 10.31887/DCNS.2012.14.3/mlerner.
Research into psychosocial interventions (particularly cognitive-behavior therapies and social skills training) for social-communication deficits among individuals with autism spectrum disorder (ASD) has proliferated over the past decade. While this research has provided some empirical support for the efficacy of these interventions, little work has begun to elucidate therapeutic mechanisms-the when, why, how, for whom, and under what conditions an intervention may produce change, identification of mechanisms underlying these effects should help advance ASD intervention research. This article describes methods for assessing such mechanisms (ie, mediators and moderators) and presents promising candidates for common mechanisms impacting treatment response: behavior modification, therapeutic relationship, social knowledge, social motivation, social information processing, executive functioning, and internalizing comorbidities. Finally, future directions are discussed as a program of psychosocial intervention research designed to identify predictors of individual differences in treatment response (including biomarkers), isolate active therapeutic ingredients, and promote dissemination of optimized interventions.
在过去十年中，针对自闭症谱系障碍（ASD）个体社交沟通缺陷的心理社会干预（尤其是认知行为疗法和社交技能训练）研究大量涌现。虽然这项研究为这些干预措施的有效性提供了一些实证支持，但很少有工作开始阐明治疗机制——干预何时、为何、如何、对谁以及在何种条件下可能产生变化，确定这些效果背后的机制应有助于推动ASD干预研究。本文描述了评估此类机制（即中介变量和调节变量）的方法，并提出了影响治疗反应的常见机制的有前景的候选因素：行为改变、治疗关系、社会知识、社会动机、社会信息处理、执行功能和内化共病。最后，讨论了未来的方向，作为一个心理社会干预研究项目，旨在确定治疗反应个体差异的预测因素（包括生物标志物），分离出有效的治疗成分，并促进优化干预措施的传播。
