Kerns Connor M, Kendall Philip C, Zickgraf Hana, Franklin Martin E, Miller Judith, Herrington John
Drexel University, A.J. Drexel Autism Institute.
Temple University.
Behav Ther. 2015 Jan;46(1):29-39. doi: 10.1016/j.beth.2014.03.005. Epub 2014 Mar 20.
This study's objective was to examine associations between comorbid anxiety disorders and difficulties commonly attributed to both anxiety and ASD (autism spectrum disorder) including self-injury, depressive symptoms, functional communication, social skill deficits and parent stress, in a well-characterized sample of youth with ASD. Fifty-nine verbally fluent participants (7-17 years; 93% Caucasian) diagnosed with ASD and their parents completed semistructured diagnostic interviews to confirm ASD diagnosis and assess for anxiety disorders. Parents completed questionnaires on child behavior and social skill as well as parental stress. Co-occurring anxiety disorders were associated with more parent-reported self-injurious behavior, depressive symptoms, and parental stress in youth with ASD, after controlling for other influential variables (e.g., ASD severity, cognitive ability, medication status). In contrast, youth with co-occurring anxiety disorders appeared to have significantly stronger parent-reported functional communication than youth with ASD alone as well as a comparable ability, according to parents, to initiate social interaction and develop relationships. Findings support a profile of challenges and relative strengths associated with the presence of anxiety disorders in youth with ASD. Though more research is needed to determine the direction of these associations, results provide further rationale for improving recognition and targeted treatment of this comorbidity in clinical practice.
本研究的目的是在一个特征明确的自闭症谱系障碍（ASD）青少年样本中，考察共病焦虑症与通常归因于焦虑和ASD的困难之间的关联，这些困难包括自我伤害、抑郁症状、功能性沟通、社交技能缺陷和家长压力。59名语言流利的参与者（7 - 17岁；93%为白种人）被诊断为患有ASD，他们及其父母完成了半结构化诊断访谈，以确认ASD诊断并评估焦虑症。父母完成了关于孩子行为、社交技能以及家长压力的问卷调查。在控制了其他影响变量（如ASD严重程度、认知能力、用药情况）后，共病焦虑症与更多家长报告的ASD青少年的自我伤害行为、抑郁症状和家长压力相关。相比之下，据家长报告，共病焦虑症的青少年似乎比仅患有ASD的青少年具有显著更强的功能性沟通能力，并且在发起社交互动和建立关系方面能力相当。研究结果支持了与ASD青少年中存在焦虑症相关的挑战和相对优势的概况。尽管需要更多研究来确定这些关联的方向，但研究结果为在临床实践中提高对这种共病的识别和针对性治疗提供了进一步的理论依据。
