MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK.
Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, Bristol, UK.
Psychol Med. 2023 Jul;53(9):4210-4219. doi: 10.1017/S0033291722000940. Epub 2022 Apr 28.
Multiple risk behaviours (MRBs), typically beginning in adolescence, are associated with increased risk of adverse health and social outcomes. The association between autism and MRBs is little understood.
Data were from the Avon Longitudinal Study of Parents and Children, an UK-based longitudinal, birth cohort study. Exposures were diagnosed autism and four autistic traits: social communication difficulties, pragmatic language, repetitive behaviours and reduced sociability. Outcomes were participation in up to 14 risk behaviours, including alcohol consumption, smoking, risky sexual behaviours and physical inactivity. Outcome data were collected at ages approximately 12, 14, 16 and 18.
Up to 4300 participants were included in latent basis growth curve analyses with adjustment for confounders. Social communication difficulties were associated with an above average level of MRBs engagement at ~12 years (mean difference 0.26; 95% CI 0.13-0.40), and above average rate of engagement from ages ~12-18 ( 0.08; 95% CI 0.02-0.13). Repetitive behaviours were associated with above average levels of engagement in MRBs at ~12 years ( 0.24; 95% CI 0.09-0.38). Contrastingly, reduced sociability was associated with a reduced rate of engagement in MRBs from ages ~12-18 ( -0.06; 95% CI -0.11 to -0.02). In sex-specific analyses, persisting differences in MRB engagement patterns from ages ~12-18 were observed in males with social communication difficulties and females with reduced sociability temperament.
Having elevated levels of some autistic traits appear to have differentiated effects on MRB engagement patterns. These findings could reflect difficulties fitting in and/or coping mechanisms relating to difficulties with fitting in.
多种风险行为（MRBs）通常始于青春期，与增加的不良健康和社会结果风险相关。自闭症与 MRBs 之间的关联尚未被充分理解。
数据来自英国基于纵向、出生队列的雅芳纵向研究父母和孩子。暴露于自闭症和四种自闭症特征的诊断：社交沟通困难、语用语言、重复行为和社交能力减弱。结果是参与多达 14 种风险行为，包括饮酒、吸烟、危险性行为和缺乏身体活动。结果数据在大约 12、14、16 和 18 岁时收集。
在调整混杂因素的基础上，对多达 4300 名参与者进行了潜在基础增长曲线分析。社交沟通困难与 12 岁左右的平均水平以上的 MRBs 参与度相关（平均差异 0.26；95%置信区间 0.13-0.40），以及从 12-18 岁的平均水平以上的参与度（0.08；95%置信区间 0.02-0.13）。重复行为与 12 岁左右的平均水平以上的 MRBs 参与度相关（0.24；95%置信区间 0.09-0.38）。相反，社交能力减弱与 12-18 岁期间 MRBs 的参与率降低有关（-0.06；95%置信区间-0.11 至-0.02）。在性别特异性分析中，在患有社交沟通困难的男性和患有社交能力减弱气质的女性中，从 12-18 岁期间，MRB 参与模式的持续性差异得到了观察。
某些自闭症特征的水平升高似乎对 MRB 参与模式有不同的影响。这些发现可能反映了适应困难和/或适应困难相关的应对机制。
