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创伤与自闭症谱系障碍:综述、拟议的治疗调整及未来方向

Trauma and Autism Spectrum Disorder: Review, Proposed Treatment Adaptations and Future Directions.

作者信息

Peterson Jessica L, Earl Rachel, Fox Emily A, Ma Ruqian, Haidar Ghina, Pepper Micah, Berliner Lucy, Wallace Arianne, Bernier Raphael

机构信息

Seattle Children's Autism Center,

University of Washington, Psychiatry and Behavioral Sciences / Seattle Children's Hospital.

出版信息

J Child Adolesc Trauma. 2019 Dec;12(4):529-547. doi: 10.1007/s40653-019-00253-5. Epub 2019 Apr 10.

Abstract

Empirical investigations of trauma and post-traumatic stress disorder (PTSD) in individuals with autism spectrum disorder (ASD) are lacking despite indications of increased risk for exposure to potentially traumatic events in this population. Research on the treatment of traumatic stress psychopathology in ASD is even more limited and suggests a critical need for guidance in the area of ASD-specific treatment adaptations. The current paper provides preliminary recommendations for adapting current evidenced-based, trauma-specific interventions, specifically trauma-focused cognitive behavioral therapy (TF-CBT), for individuals with ASD based on well-established and evidence-based practices for working with this population. These adaptations highlight the need to incorporate treatment goals related to ASD core symptoms and associated characteristics during treatment targeting traumatic stress symptoms. Future directions are discussed, including the development of instruments measuring trauma reactions in ASD, empirical investigations of modified trauma interventions for children with ASD to evaluate effectiveness, and collaboration between professionals specializing in ASD and trauma/PTSD to advance research and facilitate effective care for this community.

摘要

尽管有迹象表明自闭症谱系障碍(ASD)患者遭受潜在创伤性事件的风险增加,但针对该人群创伤及创伤后应激障碍(PTSD)的实证研究却很缺乏。关于ASD患者创伤应激心理病理学治疗的研究更为有限,这表明在针对ASD的特定治疗调整领域迫切需要指导。本文基于与该人群合作的成熟且有证据支持的实践,为将当前基于证据的、针对创伤的干预措施,特别是创伤聚焦认知行为疗法(TF-CBT),调整应用于ASD患者提供了初步建议。这些调整突出了在针对创伤应激症状进行治疗时,纳入与ASD核心症状及相关特征相关的治疗目标的必要性。文中还讨论了未来的方向,包括开发测量ASD患者创伤反应的工具、对ASD儿童改良创伤干预措施的有效性进行实证研究,以及ASD专家与创伤/PTSD专家之间的合作,以推动研究并促进为该群体提供有效的护理。

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