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自闭症谱系障碍个体的急性疼痛体验:综述。

Acute pain experience in individuals with autism spectrum disorders: a review.

机构信息

Liverpool John Moores University, UK

出版信息

Autism. 2015 May;19(4):387-99. doi: 10.1177/1362361314527839. Epub 2014 Mar 31.

Abstract

In addition to the diagnostic criteria for autism spectrum disorder, a number of clinically important comorbid complaints, including sensory abnormalities, are also discussed. One difference often noted in these accounts is hyposensitivity to pain; however, evidence for this is limited. The purpose of the current review therefore was to examine sensitivity to pain of individuals with autism spectrum disorder. This review is interested in reports which consider differences in subjective experience of pain (i.e. different pain thresholds) and differences in behavioural response to pain (i.e. signs of pain-related distress). Studies were included if they were conducted with human subjects, included a clearly diagnosed autism spectrum disorder population and reported data pertaining to pain experience relative to the neurotypical population. Studies were classified as being self/parent report, clinical observations, observations of response to medical procedures or experimental examination of pain. Both self/parent report and clinical observations appeared to report hyposensitivity to pain, whereas observations of medical procedures and experimental manipulation suggested normal or hypersensitive responses to pain. This review suggests that contrary to classical reports, individuals with autism spectrum disorder do not appear to have systematically altered pain responses or thresholds. More systematic experimental examination of this area is needed to understand responses to pain of individuals with autism spectrum disorder.

摘要

除了自闭症谱系障碍的诊断标准外,还讨论了一些临床上重要的伴发症状,包括感觉异常。这些描述中经常注意到的一个区别是对疼痛的低敏感性;然而,这方面的证据有限。因此,本次综述的目的是检查自闭症谱系障碍个体对疼痛的敏感性。本综述关注的是那些考虑个体对疼痛的主观体验差异(即不同的疼痛阈值)和对疼痛的行为反应差异(即与疼痛相关的痛苦迹象)的报告。如果研究是在人类受试者中进行的,包括明确诊断的自闭症谱系障碍人群,并报告了与神经典型人群相关的疼痛体验数据,则将其纳入研究。研究分为自我/父母报告、临床观察、对医疗程序的观察或对疼痛的实验检查。自我/父母报告和临床观察似乎都报告了对疼痛的低敏感性,而对医疗程序和实验操作的观察则表明对疼痛的反应正常或过度敏感。本综述表明,与经典报告相反,自闭症谱系障碍个体似乎没有系统地改变疼痛反应或阈值。需要更系统地实验研究这一领域,以了解自闭症谱系障碍个体对疼痛的反应。

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