Garcia Danilo, Anckarsäter Henrik, Lundström Sebastian
Centre for Ethics, Law and Mental Health CELAM, University of Gothenburg, Wallinsgatan 8, Mölndal, 431 41 Gothenburg, Sweden.
ScientificWorldJournal. 2013 Apr 28;2013:416981. doi: 10.1155/2013/416981. Print 2013.
The acronym ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) highlights that children seeking clinical treatment are often multiply impaired, thus requiring treatment from several specialties. The aim was to map and relate, on a population level, ESSENCE to two salient predictors of health and adaptation to adversities, namely, Self-Directedness and Cooperativeness and also to dysfunction and suffering.
Participants were twins (N = 1892) aged 9 or 12 whose parents were interviewed with the Autism-Tics, ADHD and other Comorbidities inventory (A-TAC), and the Junior Temperament and Character Inventory (J-TCI). The A-TAC was first used to discern four ESSENCE-related screening diagnoses: autism spectrum disorders, attention deficit hyperactivity disorder, learning disabilities, and developmental coordination disorder; second, to quantify dysfunction and suffering in important social areas.
ESSENCE symptoms were continuously and categorically associated with deficiency in Self-Directedness and Cooperativeness and higher ratings of dysfunction and suffering. The impact of ESSENCE symptoms on these measures of mental health was found in a milder form in about 16% of all children and in a severe form in about 2%.
Therapeutic interventions focusing on Self-Directedness and Cooperativeness might provide a novel method for child psychiatry in its approach to ESSENCE.
首字母缩略词ESSENCE(引发神经发育临床检查的早期症状综合征)突出表明,寻求临床治疗的儿童往往存在多种障碍,因此需要多个专科的治疗。目的是在人群层面上,将ESSENCE与健康和适应逆境的两个显著预测因素,即自我导向和合作性,以及功能障碍和痛苦联系起来。
参与者为9岁或12岁的双胞胎(N = 1892),其父母接受了自闭症-抽动症、注意力缺陷多动障碍及其他共病量表(A-TAC)和青少年气质与性格量表(J-TCI)的访谈。A-TAC首先用于识别四种与ESSENCE相关的筛查诊断:自闭症谱系障碍、注意力缺陷多动障碍、学习障碍和发育协调障碍;其次,用于量化重要社会领域的功能障碍和痛苦程度。
ESSENCE症状与自我导向和合作性的缺陷以及功能障碍和痛苦程度的较高评分呈连续和分类相关。在所有儿童中,约16%的儿童ESSENCE症状对这些心理健康指标的影响较轻,约2%的儿童影响严重。
关注自我导向和合作性的治疗干预可能为儿童精神病学处理ESSENCE提供一种新方法。