University of Pittsburgh School of Medicine, USA.
J Am Acad Child Adolesc Psychiatry. 2013 Jul;52(7):679-88. doi: 10.1016/j.jaac.2013.05.006. Epub 2013 Jun 3.
Autism spectrum disorder (ASD) is associated with amplified emotional responses and poor emotional control, but little is known about the underlying mechanisms. This article provides a conceptual and methodologic framework for understanding compromised emotion regulation (ER) in ASD.
After defining ER and related constructs, methods to study ER were reviewed with special consideration on how to apply these approaches to ASD. Against the backdrop of cognitive characteristics in ASD and existing ER theories, available research was examined to identify likely contributors to emotional dysregulation in ASD.
Little is currently known about ER in youth with ASD. Some mechanisms that contribute to poor ER in ASD may be shared with other clinical populations (e.g., physiologic arousal, degree of negative and positive affect, alterations in the amygdala and prefrontal cortex), whereas other mechanisms may be more unique to ASD (e.g., differences in information processing/perception, cognitive factors [e.g., rigidity], less goal-directed behavior and more disorganized emotion in ASD).
Although assignment of concomitant psychiatric diagnoses is warranted in some cases, poor ER may be inherent in ASD and may provide a more parsimonious conceptualization for the many associated socioemotional and behavioral problems in this population. Further study of ER in youth with ASD may identify meaningful subgroups of patients and lead to more effective individualized treatments.
自闭症谱系障碍(ASD)与情绪反应放大和情绪控制不良有关,但对于其潜在机制知之甚少。本文提供了一个理解 ASD 中情绪调节受损的概念和方法框架。
在定义情绪调节和相关结构后,回顾了研究情绪调节的方法,并特别考虑了如何将这些方法应用于 ASD。在 ASD 的认知特征和现有情绪调节理论的背景下,检查了现有研究,以确定可能导致 ASD 情绪失调的因素。
目前对于 ASD 青少年的情绪调节知之甚少。一些可能导致 ASD 中情绪调节不良的机制可能与其他临床人群(例如生理唤醒、正负情绪程度、杏仁核和前额叶皮质的改变)共享,而其他机制可能更具 ASD 特异性(例如,信息处理/感知的差异、认知因素[例如,僵化]、ASD 中较少的目标导向行为和更紊乱的情绪)。
尽管在某些情况下需要分配伴随的精神科诊断,但情绪调节不良可能是 ASD 的固有特征,并且可以为该人群中许多相关的社交情绪和行为问题提供更简洁的概念化。进一步研究 ASD 青少年的情绪调节可能会确定有意义的患者亚组,并导致更有效的个体化治疗。