Magyar Caroline I, Pandolfi Vincent
Caroline I. Magyar, Ph.D., BCBA, Associate Professor, University of Rochester School of Medicine, 601 Elmwood Ave, Box 671, Rochester, NY 14642, United States.
Vincent Pandolfi, Associate Professor, Rochester Institute of Technology, Psychology Department, 18 Lomb Memorial Drive, Rochester, N.Y. 14623-5604, United States.
Res Autism Spectr Disord. 2017 May;37:11-20. doi: 10.1016/j.rasd.2017.01.009. Epub 2017 Feb 20.
Youth with autism spectrum disorder (ASD) are at risk for one or more emotional disorders (ED) including depressive and anxiety conditions. DSM-5 diagnostic guidelines indicate that co-occurring ED must be specified when present (APA, 2013). While ED may be evaluated for during initial diagnostic assessment, routine monitoring and screening is needed to identify emerging ED in later childhood and adolescence, a period of high risk.
Confirmatory factor analysis, convergent and divergent validity analyses, criterion-related validity, and diagnostic accuracy analyses of the CBCL's Affective Problems and Anxiety Problems DSM Oriented Scales was completed on 93 well-characterized youth, ages 6 to 18 years with ASD (6:1 M:F), with and without intellectual impairment. These youth were from predominately white, middle-class backgrounds.
Each scale measured a single construct reliably (depressive and anxiety disorders), neither scale measured symptoms of ASD, and youth with a depressive disorder had other ED co-morbidities.
Findings demonstrate the DSM Oriented Affective and Anxiety Problem Scales can be used to screen for depression and anxiety in youth with ASD. Replication is needed with various subgroups representing gender, age, developmental level, autism, and mental health severity differences, and with groups across a broader set of demographics.
患有自闭症谱系障碍(ASD)的青少年有患一种或多种情绪障碍(ED)的风险,包括抑郁和焦虑症。《精神疾病诊断与统计手册》第五版(DSM-5)的诊断指南指出,共存的情绪障碍在出现时必须明确说明(美国精神病学协会,2013年)。虽然在初始诊断评估期间可能会对情绪障碍进行评估,但仍需要进行常规监测和筛查,以识别儿童后期和青少年期(这一高风险时期)出现的情绪障碍。
对93名年龄在6至18岁、患有ASD(男女性别比为6:1)、有或无智力障碍的特征明确的青少年,完成了儿童行为检查表(CBCL)中面向DSM的情感问题量表和焦虑问题量表的验证性因素分析、收敛效度和区分效度分析、与标准相关的效度分析以及诊断准确性分析。这些青少年主要来自白人中产阶级背景。
每个量表都能可靠地测量单一结构(抑郁和焦虑症),两个量表均未测量ASD症状,患有抑郁症的青少年还存在其他共存的情绪障碍。
研究结果表明,面向DSM的情感和焦虑问题量表可用于筛查患有ASD的青少年的抑郁和焦虑情况。需要在代表性别、年龄、发育水平、自闭症和心理健康严重程度差异的不同亚组以及更广泛人口统计学的群体中进行重复研究。