自闭症谱系障碍中的重复和受限行为和兴趣：与个体特征和心理健康问题的关系。
Repetitive and restricted behaviors and interests in autism spectrum disorder: relation to individual characteristics and mental health problems.
机构信息
Department of Psychology, York University, Toronto, ON, Canada.
出版信息
BMC Psychiatry. 2023 May 23;23(1):356. doi: 10.1186/s12888-023-04766-0.
BACKGROUND
Although repetitive and restricted behaviors and interests (RRBIs) may interfere with well-being and functioning in autistic individuals, research on their relation to sex, age, cognitive level, and mental health problems remains unclear. Much of the research to date has used broad categorizations rather than specific categorizations of RRBIs to examine the difference in RRBIs between individuals. The purpose of this study was to explore, in different groups of individuals, the presence of specific RRBI subtypes, and to examine the association of specific RRBI subtypes with symptoms of internalizing and externalizing behaviors.
METHODS
Secondary data analyses were conducted using the Simons Simplex Collection dataset, which included 2,758 participants (aged 4 to 18). Families of autistic children completed the Repetitive Behavior Scale-Revised (RBS-R) and the Child Behavior Checklist.
RESULTS
Across all RBS-R subtypes, results revealed no sex differences. Older children showed higher rates of Ritualistic/Sameness behaviors than younger children and adolescents, whereas younger and older children showed more Stereotypy than adolescents. Additionally, lower cognitive level groups showed higher rates of RBS-R subtypes except for Ritualistic/Sameness. After controlling for age and cognitive level, RBS-R subtypes accounted for a substantial amount of variance in internalizing and externalizing behaviors (23% and 25%, respectively). Specifically, Ritualistic/Sameness and Self-Injurious Behavior both predicted internalizing and externalizing behaviors, whereas Stereotypy only predicted internalizing behavior.
CONCLUSIONS
These findings have key clinical implications that emphasize not only the consideration of sex, age, and cognitive level, but also specific RRBIs and co-occurring mental health problems, when assessing for ASD and designing individualized interventions.
背景
尽管重复性和局限性行为和兴趣（RRBIs）可能会干扰自闭症个体的幸福感和功能，但关于它们与性别、年龄、认知水平和心理健康问题的关系的研究仍不清楚。迄今为止，大多数研究都使用广泛的 RRBIs 分类而不是具体的分类来检查个体之间 RRBIs 的差异。本研究的目的是在不同人群中探索特定 RRBI 亚型的存在，并研究特定 RRBI 亚型与内化和外化行为症状的关联。
方法
使用西蒙斯单纯集合数据集进行二次数据分析，该数据集包括 2758 名参与者（年龄 4 至 18 岁）。自闭症儿童的家庭完成了重复行为量表修订版（RBS-R）和儿童行为检查表。
结果
在所有 RBS-R 亚型中，结果均未显示出性别差异。年长的儿童比年幼的儿童和青少年表现出更高的仪式/相同行为率，而年幼和年长的儿童比青少年表现出更多的刻板行为。此外，除了仪式/相同行为之外，认知水平较低的群体表现出更高的 RBS-R 亚型率。在控制年龄和认知水平后，RBS-R 亚型在内化和外化行为中占很大比例（分别为 23%和 25%）。具体而言，仪式/相同行为和自我伤害行为均预测内化和外化行为，而刻板行为仅预测内化行为。
结论
这些发现具有重要的临床意义，强调在评估 ASD 和设计个性化干预措施时，不仅要考虑性别、年龄和认知水平，还要考虑特定的 RRBIs 和同时存在的心理健康问题。
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