Chisholm Katharine, Schirmbeck Frederike, Pinkham Amy E, Sasson Noah J, Simons Claudia J P, de Haan Lieuwe, Harvey Philip D, Penn David L, Ziermans Tim
School of Psychology, Institute of Health and Neurodevelopment, Aston University, Aston St, Birmingham, B4 7ET, UK.
Department of Psychiatry, Amsterdam University Medical Center, Meibergdreef, University of Amsterdam, Amsterdam, The Netherlands.
Schizophr Bull. 2024 Dec 20;51(1):186-197. doi: 10.1093/schbul/sbad161.
Autism and psychosis co-occur at elevated rates, with implications for clinical outcomes, functioning, and suicidality. The PANSS-Autism-Severity-Score (PAUSS) is a measure of autism trait severity which has not yet been validated externally or longitudinally.
Participants were derived from the GROUP and SCOPE datasets. Participants included 1448 adults with schizophrenia spectrum disorder (SSD), 800 SSD-siblings, 103 adults diagnosed with an autistic spectrum condition (ASC), and 409 typically-developing controls (TC). Analyses from the original validation study were conducted with SSD participants, and extended into ASC, SSD-sibling, and TC participants. Test-retest reliability of the PAUSS at 2-weeks and long-term stability 3 and 6-years was also examined.
Results differed in important ways from the original validation. SSD participants reported higher PAUSS scores than other groups, with only a fraction of ASC participants scoring as "PAUSS-Autistic." Cronbach's alpha was acceptable for the SSD cohort only. Two-week stability of the PAUSS was fair to good for all PAUSS scores. Long-term stability was poor for most PAUSS items but fair for total PAUSS score.
Results suggest that the PAUSS does not appear appropriate for assessing autism, with the low rate of PAUSS-Autistic in the ASC population suggesting the PAUSS may not accurately reflect characteristics of autism. The relative lack of long-term stability is cause for concern and suggestive that the PAUSS is capturing features of psychosis rather than autism traits.
自闭症和精神病共病率较高，这对临床结果、功能和自杀倾向都有影响。泛自闭症严重程度量表（PAUSS）是一种衡量自闭症特质严重程度的工具，但尚未经过外部或纵向验证。
参与者来自GROUP和SCOPE数据集。参与者包括1448名患有精神分裂症谱系障碍（SSD）的成年人、800名SSD患者的兄弟姐妹、103名被诊断患有自闭症谱系障碍（ASC）的成年人以及409名发育正常的对照组（TC）。最初的验证研究对SSD参与者进行了分析，并扩展到ASC、SSD患者的兄弟姐妹和TC参与者。还检查了PAUSS在2周时的重测信度以及3年和6年的长期稳定性。
结果在重要方面与最初的验证不同。SSD参与者报告的PAUSS得分高于其他组，只有一小部分ASC参与者的得分属于“PAUSS自闭症”。仅SSD队列的Cronbach's alpha值可以接受。PAUSS所有得分在2周时的稳定性为中等至良好。大多数PAUSS项目的长期稳定性较差，但PAUSS总分的长期稳定性为中等。
结果表明，PAUSS似乎不适合评估自闭症，ASC人群中PAUSS自闭症的低发生率表明PAUSS可能无法准确反映自闭症的特征。相对缺乏长期稳定性令人担忧，这表明PAUSS捕捉到的是精神病特征而非自闭症特质。
