Department of Child and Adolescent Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health, Uni Research, P.O. Box 7800, 5020 Bergen, Norway; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, P.O. Box 7800, Bergen, Norway.
Res Dev Disabil. 2013 Dec;34(12):4495-503. doi: 10.1016/j.ridd.2013.09.032. Epub 2013 Oct 28.
With a view to developing a brief screening instrument for autism symptoms in a general population of adolescents, seven items from the Asperger syndrome (and high-functioning autism) diagnostic interview were adapted for use as self-report in an online questionnaire for youths aged 16-19 years (N=10,220). The selected items target lack of social understanding (4 items) and rigid and repetitive behavior and interests (RRBI; 3 items). Factor analyses were performed, and the seven items were also validated against self-reported ASD diagnosis. Best statistical model fit was found for a bifactor model with one general factor and two domain specific factors tied to social difficulties and RRBI. Both the general and the domain specific factors were associated with self-reported ASD diagnoses. The scale (referred to as the Autism Symptom SElf-ReporT for Adolescents and Adults--ASSERT) had good screening properties with a receiver operating curve-area under the curve (ROC-AUC) of 0.87 and a diagnostic odds ratio (DOR) of 15.8. Applying a modified scoring of the scale further improved the screening properties leading to a ROC-AUC of 0.89 and a DOR of 24.9. The ASSERT holds promise as a brief self-report screen for autism symptoms in adolescents, and further studies should explore its usefulness for adults.
为了开发一种用于青少年普通人群自闭症症状的简短筛查工具，我们对自闭症谱系障碍（和高功能自闭症）诊断访谈中的七个项目进行了改编，以便作为 16-19 岁青少年在线问卷的自我报告（N=10220）。选择的项目针对缺乏社交理解（4 个项目）和僵化和重复行为和兴趣（RRBI；3 个项目）。进行了因子分析，并且这七个项目也针对自我报告的 ASD 诊断进行了验证。最佳的统计模型拟合是一个双因素模型，有一个一般因素和两个与社交困难和 RRBI 相关的特定领域因素。一般因素和特定领域因素都与自我报告的 ASD 诊断相关。该量表（称为自闭症症状自我报告青少年和成人量表-ASSERT）具有良好的筛查特性，接受者操作曲线下面积（ROC-AUC）为 0.87，诊断比值比（DOR）为 15.8。应用改良的量表评分进一步提高了筛查特性，ROC-AUC 为 0.89，DOR 为 24.9。ASSERT 有望成为青少年自闭症症状的简短自我报告筛查工具，进一步的研究应该探索其在成年人中的有用性。
