Marcus Autism Center, Emory University School of Medicine, Atlanta, GA.
Ohio State University, Nisonger Center, Columbus, OH.
J Am Acad Child Adolesc Psychiatry. 2019 Sep;58(9):887-896.e2. doi: 10.1016/j.jaac.2018.10.016. Epub 2019 Feb 21.
Anxiety is common in youth with autism spectrum disorder (ASD). There is no accepted outcome measure for anxiety in this population.
Following a series of focus groups with parents of youth with ASD, we generated 72 items (scored 0-3). Parents of 990 youth with ASD (aged 5-17 years; 80.8% male) completed an online survey. Factor analysis and item response theory analyses reduced the content to a single factor with 25 items. Youth with at least mild anxiety (n = 116; aged 5-17 years; 79.3% male) participated in a comprehensive clinical assessment to evaluate the validity and reliability of the 25-item Parent-Rated Anxiety Scale for ASD (PRAS-ASD).
In the online sample, the mean PRAS-ASD score was 29.04 ± 14.9 (range, 0-75). The coefficient α was 0.93. The item response theory results indicated excellent reliability across a wide range of scores with low standard errors. In the clinical sample (n = 116), the PRAS-ASD mean was 31.0 ± 15.6 (range, 1-65). Pearson correlations with parent ratings of ASD symptom severity, repetitive behavior, and disruptive behavior ranged 0.33 to 0.66, supporting divergent validity of the PRAS-ASD. Pearson correlation with a parent-rated measure of anxiety used in the general pediatric population of 0.83 supported convergent validity. A total of 40 participants (32 boys, 8 girls; mean age, 11.9 ± 3.4 years) returned at time 2 (mean, 12.2 days) and time 3 (mean, 24.2 days). Intraclass correlation showed test-retest reliabilities of 0.88 and 0.86 at time 2 and time 3, respectively.
The 25-item PRAS-ASD is a reliable and valid scale for measuring anxiety in youth with ASD.
焦虑在自闭症谱系障碍（ASD）的青年中很常见。目前尚无针对该人群焦虑的公认评估方法。
通过一系列有 ASD 青年父母参与的焦点小组，我们生成了 72 个项目（评分 0-3 分）。990 名 ASD 青年的父母（年龄 5-17 岁；80.8%为男性）完成了一项在线调查。通过因素分析和项目反应理论分析，将内容简化为包含 25 个项目的单一因素。至少有轻度焦虑的 116 名青年（年龄 5-17 岁；79.3%为男性）参加了全面的临床评估，以评估自闭症父母评定焦虑量表（PRAS-ASD）的 25 项的有效性和可靠性。
在在线样本中，PRAS-ASD 的平均得分为 29.04 ± 14.9（范围，0-75）。系数α为 0.93。项目反应理论的结果表明，在广泛的分数范围内，具有较低的标准误差，具有极好的可靠性。在临床样本（n=116）中，PRAS-ASD 的平均值为 31.0 ± 15.6（范围，1-65）。与 ASD 症状严重程度、重复行为和破坏性行为的父母评定相关的 Pearson 相关系数为 0.33 至 0.66，支持 PRAS-ASD 的区别效度。与在一般儿科人群中使用的父母评定焦虑量表的 Pearson 相关系数为 0.83，支持其汇聚效度。共有 40 名参与者（32 名男孩，8 名女孩；平均年龄 11.9 ± 3.4 岁）在第 2 次（平均 12.2 天）和第 3 次（平均 24.2 天）时返回。组内相关显示第 2 次和第 3 次的测试重测信度分别为 0.88 和 0.86。
包含 25 个项目的 PRAS-ASD 是一种可靠有效的 ASD 青年焦虑评估量表。
