Frazier Thomas W, Chetcuti Lacey, Al-Shaban Fouad A, Haslam Nick, Ghazal Iman, Klingemier Eric W, Aldosari Mohammed, Whitehouse Andrew J O, Youngstrom Eric A, Hardan Antonio Y, Uljarević Mirko
Department of Psychology John Carroll University University Heights Ohio USA.
Olga Tennison Autism Research Centre School of Psychology and Public Health La Trobe University Melbourne Victoria Australia.
JCPP Adv. 2023 Feb 21;3(2):e12142. doi: 10.1002/jcv2.12142. eCollection 2023 Jun.
A key question for any psychopathological diagnosis is whether the condition is continuous or discontinuous with typical variation. The primary objective of this study was to use a multi-method approach to examine the broad latent categorical versus dimensional structure of autism spectrum disorder (ASD).
Data were aggregated across seven independent samples of participants with ASD, other neurodevelopmental disorders (NDD), and non-ASD/NDD controls (aggregate s = 512-16,755; ages 1.5-22). Scores from four distinct phenotype measures formed composite "indicators" of the latent ASD construct. The primary indicator set included eye gaze metrics from seven distinct social stimulus paradigms. Logistic regressions were used to combine gaze metrics within/across paradigms, and derived predicted probabilities served as indicator values. Secondary indicator sets were constructed from clinical observation and parent-report measures of ASD symptoms. Indicator sets were submitted to taxometric- and latent class analyses.
Across all indicator sets and analytic methods, there was strong support for categorical structure corresponding closely to ASD diagnosis. Consistent with notions of substantial phenotypic heterogeneity, the ASD category had a wide range of symptom severity. Despite the examination of a large sample with a wide range of IQs in both genders, males and children with lower IQ were over-represented in the ASD category, similar to observations in diagnosed cases.
Our findings provide strong support for categorical structure corresponding closely to ASD diagnosis. The present results bolster the use of well-diagnosed and representative ASD groups within etiologic and clinical research, motivating the ongoing search for major drivers of the ASD phenotype. Despite the categorical structure of ASD, quantitative symptom measurements appear more useful for examining relationships with other factors.
对于任何精神病理学诊断而言，一个关键问题是该病症与典型变异是连续的还是不连续的。本研究的主要目的是采用多方法途径来检验自闭症谱系障碍（ASD）的广义潜在类别结构与维度结构。
数据来自七个独立样本，包括患有ASD、其他神经发育障碍（NDD）以及非ASD/NDD对照的参与者（样本总量s = 512 - 16755；年龄1.5 - 22岁）。来自四种不同表型测量的分数构成了潜在ASD结构的复合“指标”。主要指标集包括来自七种不同社会刺激范式的目光注视指标。使用逻辑回归来合并范式内/跨范式的注视指标，并将推导得到的预测概率用作指标值。次要指标集由ASD症状的临床观察和家长报告测量构建而成。将指标集提交进行分类分析和潜在类别分析。
在所有指标集和分析方法中，都有力支持了与ASD诊断紧密对应的类别结构。与显著的表型异质性概念一致，ASD类别具有广泛的症状严重程度范围。尽管对大量具有广泛智商范围的男女样本进行了检查，但ASD类别中男性和低智商儿童的比例过高，这与诊断病例中的观察结果相似。
我们的研究结果有力支持了与ASD诊断紧密对应的类别结构。目前的结果支持在病因学和临床研究中使用诊断明确且具有代表性的ASD群体，这激发了对ASD表型主要驱动因素的持续探索。尽管ASD具有类别结构，但定量症状测量对于检查与其他因素的关系似乎更有用。
