Departamento de Psiquiatria da Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK.
J Child Psychol Psychiatry. 2022 Feb;63(2):143-151. doi: 10.1111/jcpp.13436. Epub 2021 May 13.
Previous research investigating the overlap between attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (henceforth, autism) symptoms in population samples have relied on latent variable modeling in which averaged scores representing dimensions were derived from observed symptoms. There are no studies evaluating how ADHD and autism symptoms interact at the level of individual symptom items.
We aimed to address this gap by performing a network analysis on data from a school survey of children aged 6-17 years old (N = 7,405). ADHD and autism symptoms were measured via parent-report on the Swanson, Nolan, Pelham-IV questionnaire and the Childhood Autism Spectrum test, respectively.
A relatively low interconnectivity between ADHD and autism symptoms was found with only 10.06% of possible connections (edges) between one ADHD and one autism symptoms different than zero. Associations between ADHD and autism symptoms were significantly weaker than those between two symptoms pertaining to the same construct. Select ADHD symptoms, particularly those presenting in social contexts (e.g. 'talks excessively', 'does not wait turn'), showed moderate-to-strong associations with autism symptoms, but some were considered redundant to autism symptoms.
The present findings indicate that individual ADHD and autism symptoms are largely segregated in accordance with diagnostic boundaries corresponding to these conditions in children and adolescents from the community. These findings could improve our clinical conceptualization of ADHD and autism and guide advancements in diagnosis and treatment.
此前，针对人群样本中注意力缺陷多动障碍（ADHD）和自闭症谱系障碍（下文简称自闭症）症状重叠的研究，依赖于潜在变量模型，该模型从观察到的症状中得出代表维度的平均分数。目前尚无研究评估 ADHD 和自闭症症状在个体症状项目层面上如何相互作用。
我们旨在通过对 7405 名 6-17 岁儿童的学校调查数据进行网络分析来解决这一差距。ADHD 和自闭症症状分别通过家长报告的 Swanson、Nolan、Pelham-IV 问卷和儿童自闭症谱系测试进行测量。
ADHD 和自闭症症状之间的相互联系相对较低，只有 10.06%的 ADHD 和自闭症症状之间的可能连接（边）不同于零。ADHD 和自闭症症状之间的关联明显弱于同一结构的两个症状之间的关联。一些 ADHD 症状，特别是那些出现在社交环境中的症状（例如“过度说话”、“不等待轮到自己”），与自闭症症状存在中度到高度的关联，但有些症状被认为与自闭症症状重复。
本研究结果表明，个体 ADHD 和自闭症症状在很大程度上是根据这些病症的诊断边界来区分的，符合社区中儿童和青少年的诊断。这些发现可以改善我们对 ADHD 和自闭症的临床概念化，并指导诊断和治疗的进展。
