Department of Psychiatry, National Taiwan University Hospital, Hsin-Chu Branch, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taiwan.
Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taiwan.
Res Dev Disabil. 2024 Aug;151:104768. doi: 10.1016/j.ridd.2024.104768. Epub 2024 Jun 12.
Little is known about how clinical features prospectively influence peer relationships in autistic populations.
This study investigated the clinical symptoms mediating the link between autism spectrum disorder (ASD) diagnosis and peer relationships at follow-up, i.e. the second time evaluation of this study.
The sample consisted of 366 autistic youths and 134 non-autistic comparisons. The autistic traits and emotional/behavioral problems were measured at baseline by Social Responsiveness Scale (SRS) and Child Behavior Checklist (CBCL). The interactions and problems with peers were assessed by the Social Adjustment Inventory for Children and Adolescents (SAICA) at follow-up.
Each subscore of SRS and CBCL showed significant mediation effects. Multiple mediation analyses showed atypical social communication, social awareness problems, and delinquent behaviors mediated the link from ASD to less active peer interactions after controlling for sex, age, and IQ. Moreover, atypical social communication, social-emotional problems, and attention difficulties predicted problems with peers. After considering these mediation effects, the diagnosis of ASD still demonstrated a significantly direct effect on peer relationships at follow-up.
Our findings support that social-related autistic features, attention problems, and delinquent behaviors mediated a link between ASD and peer relationships. These mediators are potential measures for improving interactions and decreasing difficulties with peers in the autistic population.
关于临床特征如何前瞻性地影响自闭症患者的同伴关系，目前知之甚少。
本研究旨在调查自闭症谱系障碍（ASD）诊断与随访时同伴关系之间的联系的中介临床症状，即本研究的第二次评估。
该样本包括 366 名自闭症青少年和 134 名非自闭症对照组。自闭症特征和情绪/行为问题在基线时通过社交反应量表（SRS）和儿童行为检查表（CBCL）进行测量。在随访时，通过儿童和青少年社交适应量表（SAICA）评估同伴之间的互动和问题。
SRS 和 CBCL 的每个子分数均显示出显著的中介效应。多重中介分析表明，在控制性别、年龄和智商后，非典型社交沟通、社会意识问题和违法行为介导了 ASD 与较少的积极同伴互动之间的联系。此外，非典型社交沟通、社会情感问题和注意力困难预测了与同伴的问题。在考虑这些中介效应后，ASD 的诊断仍对随访时的同伴关系具有显著的直接影响。
我们的研究结果支持社交相关的自闭症特征、注意力问题和违法行为在 ASD 与同伴关系之间存在联系。这些中介因素是改善自闭症人群中互动和减少与同伴困难的潜在措施。
