Plesa Skwerer Daniela, Joseph Robert M, Eggleston Brady, Meyer Steven R, Tager-Flusberg Helen
Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States.
Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United States.
Front Psychiatry. 2019 Feb 18;10:43. doi: 10.3389/fpsyt.2019.00043. eCollection 2019.
Despite many studies documenting the prevalence of various co-occurring psychiatric symptoms in children and adults with ASD, less is known about how these symptoms relate to subtypes defined by particular phenotypic features within the ASD population. We examined the severity and prevalence of comorbid symptoms of psychopathology, emotion dysregulation, and maladaptive behaviors, as well as adaptive functioning, in a group of 65 minimally verbal children ( = 33) and adolescents ( = 32) with ASD. On the (CASI-5), for all the symptom classifications except oppositional defiant disorder and conduct disorder, more participants in our sample showed elevated or clinically concerning severity scores relative to the general population. On the , the mean scores for Reactivity and Dysphoria factors in our sample were lower than in the autism calibration sample, which included a large number of inpatient youth with ASD. Overall, few differences were found between the children and adolescents within this severely impaired group of ASD individuals based on clinical cutoff scores on the CASI-5 and EDI factor scores. Psychiatric comorbidities and emotion dysregulation measures were not correlated with autism symptom severity or with measures of adaptive functioning, and were largely unrelated to IQ in our sample. The number of clinically significant psychiatric symptoms on the CASI-5 emerged as the main predictor of maladaptive behaviors. Findings suggest a wide range of co-occurring psychopathology and high degree of maladaptive behavior among minimally verbal children and adolescents with ASD, which are not directly attributable to autism symptom severity, intellectual disability or limitations in adaptive functioning.
尽管许多研究记录了自闭症谱系障碍（ASD）儿童和成人中各种共发精神症状的患病率，但对于这些症状如何与ASD人群中由特定表型特征定义的亚型相关联，人们了解得较少。我们对一组65名轻度言语能力的ASD儿童（n = 33）和青少年（n = 32）的精神病理学、情绪调节障碍和适应不良行为的共病症状严重程度及患病率，以及适应性功能进行了研究。在儿童青少年症状清单（CASI - 5）上，除对立违抗障碍和品行障碍外，我们样本中的更多参与者相对于一般人群表现出升高或临床关注的严重程度得分。在情绪和行为问卷（EDI）上，我们样本中反应性和烦躁不安因子的平均得分低于自闭症校准样本，该校准样本包括大量患有ASD的住院青少年。总体而言，基于CASI - 5的临床临界分数和EDI因子得分，在这组严重受损的ASD个体中，儿童和青少年之间几乎没有发现差异。精神共病和情绪调节障碍测量与自闭症症状严重程度或适应性功能测量不相关，并且在我们的样本中与智商基本无关。CASI - 5上具有临床意义的精神症状数量成为适应不良行为的主要预测因素。研究结果表明，在轻度言语能力的ASD儿童和青少年中存在广泛的共发精神病理学和高度的适应不良行为，这些并非直接归因于自闭症症状严重程度、智力残疾或适应性功能受限。
