Gordon Kate, Murin Marianna, Baykaner Ozlem, Roughan Laura, Livermore-Hardy Vaan, Skuse David, Mandy Will
Oxford Health NHS Foundation Trust, Aylesbury, Buckinghamshire, UK.
J Child Psychol Psychiatry. 2015 Apr;56(4):468-76. doi: 10.1111/jcpp.12304. Epub 2014 Aug 1.
Psychoeducation is an essential component of postdiagnostic care for people with ASD (autism spectrum disorder), but there is currently no evidence base for clinical practice. We designed, manualised and evaluated PEGASUS (psychoeducation group for autism spectrum understanding and support), a group psychoeducational programme aiming to enhance the self-awareness of young people with ASD by teaching them about their diagnosis.
This single-blind RCT (randomised control trial) involved 48 young people (9-14 years) with high-functioning ASD. Half were randomly assigned to PEGASUS, administered in six weekly group sessions, with the others receiving no additional intervention. ASD-related self-awareness, the primary outcome, was evaluated using the bespoke Autism Knowledge Quiz (AKQ). Secondary outcome measures included the Rosenberg Self-Esteem Scale. All measures were collected during home visits and scored by researchers blind to group assignment. The trial is registered on ClinicalTrials (NCT01187940, http://www.clinicaltrials.gov) and was funded by the Baily Thomas Charitable Trust.
Bootstrap multiple regression showed ASD knowledge (β = .29, p < .001, 95% CIs [0.13, 0.44]) and ASD self-awareness (β = .42, p = .001, 95% CIs [0.17, 0.67]), measured by number of ASD-related personal strengths and difficulties listed by participants, increased for those who attended PEGASUS (n = 24) compared with controls (n = 24). There was no effect of PEGASUS on self-esteem by self-report (β = .10, p = .404, 95% CIs [-0.14, 0.35]) or parent report (β = .12, p = .324, 95% CIs [-0.12, 0.36]).
After PEGASUS, participants had more general knowledge about ASD, and showed a greater awareness of their collection of unique strengths and difficulties associated with ASD. Psychoeducation did not lower self-esteem. This RCT provides initial evidence for PEGASUS's efficacy as a psychoeducation programme for people with ASD.
心理教育是自闭症谱系障碍(ASD)患者诊断后护理的重要组成部分,但目前尚无临床实践的证据基础。我们设计、编写了手册并评估了PEGASUS(自闭症谱系理解与支持心理教育小组),这是一个团体心理教育项目,旨在通过向患有ASD的年轻人传授其诊断信息来提高他们的自我意识。
这项单盲随机对照试验(RCT)纳入了48名9至14岁的高功能ASD青少年。其中一半被随机分配到PEGASUS组,接受为期六周的每周一次的团体课程,另一半则不接受额外干预。主要结局指标是与ASD相关的自我意识,使用定制的自闭症知识测验(AKQ)进行评估。次要结局指标包括罗森伯格自尊量表。所有测量均在家庭访视期间收集,并由对分组情况不知情的研究人员评分。该试验已在ClinicalTrials(NCT01187940,http://www.clinicaltrials.gov)上注册,由贝利·托马斯慈善信托基金资助。
自举多元回归显示,与对照组(n = 24)相比,参加PEGASUS组(n = 24)的参与者列出的与ASD相关的个人优势和困难数量所衡量的ASD知识(β = 0.29,p < 0.001,95%置信区间[0.13, 0.44])和ASD自我意识(β = 0.42,p = 0.001,95%置信区间[0.17, 0.67])有所增加。PEGASUS对自我报告的自尊(β = 0.10,p = 0.404,95%置信区间[-0.14, 0.35])或家长报告的自尊(β = 0.12,p = 0.324,95%置信区间[-0.12, 0.36])没有影响。
参加PEGASUS项目后,参与者对ASD有了更多的一般知识,并对自己与ASD相关的独特优势和困难有了更强的认识。心理教育并没有降低自尊。这项随机对照试验为PEGASUS作为ASD患者心理教育项目的有效性提供了初步证据。