South Mikle, Rodgers Jacqui
Departments of Psychology and Neuroscience, Brigham Young University Provo, UT, USA.
Institute of Neuroscience, Newcastle University Newcastle, UK.
Front Hum Neurosci. 2017 Jan 24;11:20. doi: 10.3389/fnhum.2017.00020. eCollection 2017.
Severe symptoms of anxiety add substantial additional burden to many individuals diagnosed with Autism Spectrum Disorder (ASD). Improved understanding of specific factors that contribute to anxiety in ASD can aid research regarding the causes of autism and also provide targets for more effective intervention. This mini-review article focuses on emerging evidence for three concepts that appear to be related to each other and which also strongly predict anxiety in ASD samples. is included in the diagnostic criteria for ASD and is likely an important contributor to anxiety. Difficulties in understanding and labeling emotions (), although a co-morbidity, may arise in part from atypical sensory function and can lead to confusion and uncertainty about how to respond to social and emotional situations. describes people who have a particularly hard time with ambiguity and is known to be a key mechanism underlying some anxiety disorders. While evidence for linking these ideas is to date incomplete, we put forward a model including each concept as a framework for future studies. Specifically, we propose that IU is a critical mediator for anxiety in ASD, and explore the relationships between sensory function, alexithymia and IU. We further explore the role of the medial prefrontal cortex (mPFC) in regulating emotional response, in connection with limbic and insula-based networks, and suggest that disrupted integration in these networks underlies difficulties with habituation to strong emotional stimuli, which results in an enhanced perception of threat in many people with ASD. Behavioral and biologically-based treatments for anxiety in ASD will benefit from attending to these specific mechanisms as adjunct to traditional interventions.
严重的焦虑症状给许多被诊断患有自闭症谱系障碍(ASD)的个体带来了极大的额外负担。更好地理解导致ASD患者焦虑的具体因素,有助于自闭症病因的研究,也能为更有效的干预提供目标。这篇小型综述文章聚焦于三个概念的新证据,这三个概念似乎相互关联,且在ASD样本中也强烈预示着焦虑。[此处原文有缺失内容]被纳入ASD的诊断标准,可能是焦虑的一个重要促成因素。理解和标记情绪方面的困难([此处原文有缺失内容]),尽管是一种共病,但可能部分源于非典型的感觉功能,并可能导致在应对社交和情感情境时产生困惑和不确定性。[此处原文有缺失内容]描述的是那些特别难以应对模糊性的人,已知是一些焦虑症的关键潜在机制。虽然迄今为止将这些观点联系起来的证据并不完整,但我们提出一个模型,将每个概念纳入其中,作为未来研究的框架。具体而言,我们提出[此处原文有缺失内容]是ASD患者焦虑的关键中介因素,并探讨感觉功能、述情障碍和[此处原文有缺失内容]之间的关系。我们进一步探讨内侧前额叶皮质(mPFC)在调节情绪反应中的作用,以及与边缘系统和基于脑岛的网络的联系,并认为这些网络中整合功能的破坏是难以适应强烈情绪刺激的基础,这导致许多ASD患者对威胁的感知增强。针对ASD患者焦虑的行为和基于生物学的治疗方法,若将这些具体机制作为传统干预的辅助手段,将会从中受益。