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社论:自闭症患者情绪调节轨迹的临床意义

Editorial: Clinical Implications of Emotional Dysregulation Trajectories in Autism.

作者信息

Lin Ping-I

机构信息

School of Medicine, Saint Louis University, St. Louis, Missouri; School of Clinical Medicine, University of New South Wales, Australia.

出版信息

J Am Acad Child Adolesc Psychiatry. 2025 Jun;64(6):665-667. doi: 10.1016/j.jaac.2025.01.025. Epub 2025 Jan 31.

DOI:10.1016/j.jaac.2025.01.025
PMID:39894208
Abstract

Emotional dysregulation (ED) presents a persistent and multifaceted challenge for autistic children, their families, clinicians, and educators. Characterized by intense emotional responses, frequent irritability, and reactive aggression, ED can disrupt social, academic, and daily functioning, impacting the child's life and placing immense strain on families. Autistic children have a 9-fold increased risk of emergency room visits for psychiatric symptoms compared with neurotypical children, which is at least partly attributable to the substantially high prevalence of clinically significant emotional regulation difficulties in this population. Understanding the trajectories of ED in autistic children is crucial for several reasons. First, ED has long-term impacts on internalizing symptomatology and maladaptive behaviors. Second, ED is correlated with all core features of ASD, making processing social information a challenging task, in turn leading to heightened emotional responses. Third, the variation in ED may reflect the heterogeneity in ASD, which may impede effective interventions that cannot accommodate between-individual differences. Finally, trajectories of ED may shed light on developmental changes, family dynamics, and educational outcomes, as well as comorbidity patterns. By focusing on these trajectories, researchers and clinicians can gain a more nuanced understanding of ED in ASD, leading to more effective, timely, and personalized interventions that can significantly improve the quality of life for autistic individuals and their families.

摘要

情绪调节障碍(ED)对自闭症儿童、他们的家庭、临床医生和教育工作者来说是一个持续且多方面的挑战。ED的特征是强烈的情绪反应、频繁的易怒和反应性攻击行为,它会扰乱社交、学业和日常功能,影响孩子的生活,并给家庭带来巨大压力。与神经典型儿童相比,自闭症儿童因精神症状前往急诊室就诊的风险增加了9倍,这至少部分归因于该人群中临床上显著的情绪调节困难的高患病率。了解自闭症儿童情绪调节障碍的发展轨迹至关重要,原因如下。首先,情绪调节障碍对内化症状和适应不良行为有长期影响。其次,情绪调节障碍与自闭症谱系障碍的所有核心特征相关,使得处理社会信息成为一项具有挑战性的任务,进而导致情绪反应加剧。第三,情绪调节障碍的差异可能反映出自闭症谱系障碍的异质性,这可能会阻碍无法适应个体差异的有效干预措施。最后,情绪调节障碍的发展轨迹可能会揭示发育变化、家庭动态、教育成果以及共病模式。通过关注这些发展轨迹,研究人员和临床医生可以对自闭症谱系障碍中的情绪调节障碍有更细致入微的理解,从而带来更有效、及时和个性化的干预措施,显著提高自闭症患者及其家庭的生活质量。

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