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自闭症谱系障碍青少年焦虑症的评估与治疗

Assessment and Treatment of Anxiety in Youth With Autism Spectrum Disorders.

作者信息

Vasa Roma A, Mazurek Micah O, Mahajan Rajneesh, Bennett Amanda E, Bernal Maria Pilar, Nozzolillo Alixandra A, Arnold L Eugene, Coury Daniel L

机构信息

Kennedy Krieger Institute and Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine, Baltimore, Maryland;

Department of Health Psychology at the University of Missouri and Thompson Center for Autism and Neurodevelopmental Disorders, Columbia, Missouri;

出版信息

Pediatrics. 2016 Feb;137 Suppl 2:S115-23. doi: 10.1542/peds.2015-2851J.

Abstract

OBJECTIVES

Anxiety is one of the most prevalent co-occurring symptoms in youth with autism spectrum disorder (ASD). The assessment and treatment recommendations proposed here are intended to help primary care providers with the assessment and treatment of anxiety in ASD.

METHODS

The Autism Speaks Autism Treatment Network/Autism Intervention Research on Physical Health Anxiety Workgroup, a multidisciplinary team of clinicians and researchers with expertise in ASD, developed the clinical recommendations. The recommendations were based on available scientific evidence regarding anxiety treatments, both in youth with ASD and typically developing youth, and clinical consensus of the workgroup where data were lacking.

RESULTS

Assessment of anxiety requires a systematic approach to evaluating symptoms and potential contributing factors across various developmental levels. Treatment recommendations include psychoeducation, coordination of care, and modified cognitive-behavioral therapy, particularly for children and adolescents with high-functioning ASD. Due to the limited evidence base in ASD, medications for anxiety should be prescribed cautiously with close monitoring of potential benefits and side effects.

CONCLUSIONS

Assessment and treatment of clinical anxiety in youth with ASD require a standardized approach to improve outcomes for youth with ASD. Although this approach provides a framework for clinicians, clinical judgment is recommended when making decisions about individual patients.

摘要

目标

焦虑是自闭症谱系障碍(ASD)青少年中最常见的共发症状之一。本文提出的评估和治疗建议旨在帮助初级保健提供者对ASD患者的焦虑进行评估和治疗。

方法

自闭症之声自闭症治疗网络/身体健康焦虑症自闭症干预研究工作组是一个由在ASD领域具有专业知识的临床医生和研究人员组成的多学科团队,制定了这些临床建议。这些建议基于关于ASD青少年和发育正常青少年焦虑症治疗的现有科学证据,以及在缺乏数据时工作组的临床共识。

结果

焦虑评估需要一种系统的方法来评估不同发育水平的症状和潜在影响因素。治疗建议包括心理教育、护理协调和改良的认知行为疗法,特别是对于高功能ASD的儿童和青少年。由于ASD的证据基础有限,应谨慎开具抗焦虑药物,并密切监测潜在益处和副作用。

结论

ASD青少年临床焦虑的评估和治疗需要一种标准化方法,以改善ASD青少年的治疗效果。虽然这种方法为临床医生提供了一个框架,但在对个体患者做出决策时,建议结合临床判断。

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