Gohari Dena, Schiltz Hillary, Lord Catherine
Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA.
J Autism Dev Disord. 2024 Sep 27. doi: 10.1007/s10803-024-06559-0.
Aggression is common in autism and neurodevelopmental disorders, but longitudinal research on aggression is lacking. We longitudinally tracked aggression in 254 individuals from toddlerhood to emerging adulthood. Our sample included participants with a range of cognitive abilities, with 39.9% classified as more-cognitively-abled (MCA; IQ ≥ 70) and 60.1% as less-cognitively-abled (LCA; IQ < 70). Aggression Composite scores were derived from data from the autism diagnostic observation schedule, autism diagnostic interview-revised, and child behavior checklist at ages 2, 9, and 18. Fifty-four percent, 69%, and 42% of the sample showed aggression in toddlerhood, school age, and emerging adulthood, respectively. LCA individuals had higher rates of aggression in school age (80%) and emerging adulthood (58%) compared to MCA individuals (48 and 22%, respectively). Longitudinal aggression profiles revealed distinct patterns of change over time: 31% displayed persistent aggression, 25% increased, 23% decreased, and 13% never displayed aggression. Higher autism symptoms, lower VIQ, NVIQ, and less-developed adaptive skills correlated with more aggression cross-sectionally. Nonverbal IQ and repetitive behaviors related to aggression longitudinally: people in decreasing or absent profiles had higher NVIQ and fewer RRBs than those with persistent or increasing profiles. Participants with aggression at 9 were four times likelier to exhibit aggression at 18. Aggression is common in autism and NDDs, peaking around age 9, and declining in emerging adulthood. Patterns of change varied widely, with evidence that higher NVIQ and fewer RRBs may be protective. Findings have implications for clinical practices, highlighting important developmental periods and high-risk subgroups.
攻击行为在自闭症和神经发育障碍中很常见，但缺乏关于攻击行为的纵向研究。我们对254名个体从幼儿期到成年早期进行了攻击行为的纵向跟踪。我们的样本包括具有一系列认知能力的参与者，其中39.9%被归类为认知能力较强（MCA；智商≥70），60.1%为认知能力较弱（LCA；智商<70）。攻击行为综合得分来自2岁、9岁和18岁时的自闭症诊断观察量表、修订版自闭症诊断访谈以及儿童行为清单的数据。样本中分别有54%、69%和42%的个体在幼儿期、学龄期和成年早期表现出攻击行为。与MCA个体（分别为48%和22%）相比，LCA个体在学龄期（80%）和成年早期（58%）的攻击行为发生率更高。纵向攻击行为概况揭示了随时间变化的不同模式：31%表现出持续攻击行为，25%攻击行为增加，23%攻击行为减少，13%从未表现出攻击行为。较高的自闭症症状、较低的言语智商、非言语智商以及较差的适应技能与横断面的更多攻击行为相关。非言语智商和与攻击行为相关的重复行为存在纵向关联：攻击行为减少或不存在的个体比攻击行为持续或增加的个体具有更高的非言语智商和更少的重复刻板行为。9岁时表现出攻击行为的参与者在18岁时表现出攻击行为的可能性是其他人的四倍。攻击行为在自闭症和神经发育障碍中很常见，在9岁左右达到峰值，在成年早期下降。变化模式差异很大，有证据表明较高的非言语智商和较少的重复刻板行为可能具有保护作用。这些发现对临床实践具有启示意义，突出了重要的发育阶段和高危亚组。
