针对自闭症谱系障碍患者的正念干预:一项系统文献综述。
Mindfulness-Based Interventions for People with Autism Spectrum Disorder: A Systematic Literature Review.
作者信息
Simione Luca, Frolli Alessandro, Sciattella Francesca, Chiarella Salvatore Gaetano
机构信息
Dipartimento di Scienze Umanistiche e Sociali Internazionali, Università degli Studi Internazionali, 00147 Rome, Italy.
Istituto di Scienze e Tecnologie della Cognizione, Consiglio Nazionale delle Ricerche, 00185 Rome, Italy.
出版信息
Brain Sci. 2024 Sep 30;14(10):1001. doi: 10.3390/brainsci14101001.
BACKGROUND/OBJECTIVES: Mindfulness-based interventions (MBIs) have emerged in recent years as a strong candidate for the treatment of a range of difficulties faced by individuals with autism spectrum disorder (ASD), including cognitive, emotional, and social aspects. Therefore, we aimed to conduct a review that systematically examined the efficacy of MBIs for individuals with ASD and their caregivers.
METHODS
This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our literature search was conducted within the MEDLINE database. We included in the review only longitudinal or intervention studies focusing mainly on mindfulness principles, while we excluded mixed intervention studies. We only included studies that explicitly utilized quantitative methodologies for evaluating the outcomes of the interventions, including mental health indices (e.g., stress, anxiety, depression) and assessments of cognitive and social skills (e.g., attention, prosociality). We conducted also a risk of bias assessment through the method of the Cochrane risk of bias tool for intervention studies ROBINS-I.
RESULTS
Thirty-seven studies were included in the review, and we grouped the studies by the targets of the interventions, i.e., adults ( = 12), children and adolescents ( = 9), caregivers and medical staff ( = 13), and combined intervention for both children/adolescents and their parents/caregivers ( = 5). The reviewed papers seem to support the feasibility and utility of mindfulness interventions for persons with ASD and their caregivers, but any recommendations based on this body of evidence should be made with caution due to the overall low quality of the studies conducted so far.
CONCLUSIONS
The review reveals a positive outcome, including the alleviation of psychological distress, reduced behavioral problems, and enhanced cognitive and social skills in individuals with ASD. Despite such promising results, the review notes a limitation in the scarcity of MBIs for young patients, emphasizing caution in universally endorsing the existing literature. Moreover, the results underline the urgency of the exploration of tailored interventions for different ASD subgroups, considering varying levels of autism, and expanding support to teachers in educational settings.
背景/目的:近年来,基于正念的干预措施(MBIs)已成为治疗自闭症谱系障碍(ASD)患者所面临的一系列困难的有力候选方法,这些困难包括认知、情感和社交方面。因此,我们旨在进行一项综述,系统地研究MBIs对ASD患者及其照顾者的疗效。
方法
本系统综述按照系统评价和Meta分析的首选报告项目(PRISMA)指南进行。我们在MEDLINE数据库中进行文献检索。我们纳入综述的仅为主要关注正念原则的纵向或干预研究,同时排除混合干预研究。我们仅纳入明确使用定量方法评估干预结果的研究,包括心理健康指标(如压力、焦虑、抑郁)以及认知和社交技能评估(如注意力、亲社会性)。我们还通过Cochrane干预研究偏倚风险工具ROBINS-I的方法进行了偏倚风险评估。
结果
该综述纳入了37项研究,我们根据干预目标对研究进行了分组,即成人(n = 12)、儿童和青少年(n = 9)、照顾者和医务人员(n = 13),以及针对儿童/青少年及其父母/照顾者的联合干预(n = 5)。综述的论文似乎支持正念干预对ASD患者及其照顾者的可行性和实用性,但由于目前所开展研究的整体质量较低,基于这一证据体系做出的任何建议都应谨慎。
结论
该综述揭示了积极的结果,包括减轻ASD患者的心理困扰、减少行为问题以及提高认知和社交技能。尽管有这些令人鼓舞的结果,但综述指出针对年轻患者的MBIs稀缺这一局限性,强调在普遍认可现有文献时要谨慎。此外,结果凸显了针对不同ASD亚组探索量身定制干预措施的紧迫性,要考虑到不同程度的自闭症,并在教育环境中扩大对教师的支持。