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利用认知僵化-灵活性维度加深我们对自闭症谱系的理解。

Using the cognitive rigidity-flexibility dimension to deepen our understanding of the autism spectrum.

作者信息

Cahalan Shannon, Mitroff Stephen R, Subiaul Francys, Rosenblau Gabriela

机构信息

Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA.

The GW Autism and Neurodevelopmental Disorders Institute, Washington, DC, USA.

出版信息

Personal Neurosci. 2025 Sep 1;8:e3. doi: 10.1017/pen.2025.10002. eCollection 2025.

Abstract

Autism Spectrum Disorder (ASD) is defined as a unidimensional condition, and autism traits are measured on a continuum where the high end of the spectrum represents individuals likely to have an ASD diagnosis. However, the large heterogeneity of ASD has thrown this unidimensional conceptualization into question. With the exact underlying cause(s) of autism yet to be identified, there is a pressing need to establish core, underlying dimensions of ASD that can capture heterogeneity within the autism spectrum, thereby better specifying both autistic traits and ASD symptoms. Here we describe one important transdiagnostic dimension, , that may impact autistic traits and symptoms across symptom-relevant cognitive domains. We first discuss how diminished cognitive flexibility manifests in core autistic traits and autism symptoms in perception, attention, learning, social cognition, and communication. We then propose to supplement assessments of autistic traits in the general population and autism symptoms in individuals with an ASD diagnosis with a comprehensive batter of cognitive flexibility measures in these symptom-relevant domains. We conjecture that systematic differences in domain-general versus domain-specific cognitive flexibility can distill subgroups within the autism phenotype. While we focus on the cognitive flexibility dimension here, we believe that it is important to extend this framework to other higher order dimensions that can capture core autism symptoms and transdiagnostic symptom severity. This approach can characterize the latent, multi-faceted structure of autism, thereby yielding greater precision in diagnostic classification and the creation of more targeted interventions.

摘要

自闭症谱系障碍(ASD)被定义为一种单一维度的病症,自闭症特征是在一个连续体上进行测量的,其中谱系的高端代表可能被诊断为患有ASD的个体。然而,ASD的巨大异质性使这种单一维度的概念化受到质疑。由于自闭症的确切潜在病因尚未确定,迫切需要确立ASD的核心潜在维度,以捕捉自闭症谱系内的异质性,从而更好地明确自闭症特征和ASD症状。在此,我们描述一个重要的跨诊断维度,它可能会影响与症状相关的认知领域中的自闭症特征和症状。我们首先讨论认知灵活性降低如何在核心自闭症特征以及感知、注意力、学习、社会认知和沟通方面的自闭症症状中表现出来。然后,我们建议在一般人群的自闭症特征评估以及ASD诊断个体的自闭症症状评估中,补充这些与症状相关领域的全面认知灵活性测量方法。我们推测,领域通用与领域特定认知灵活性的系统差异可以区分出自闭症表型中的亚组。虽然我们在此聚焦于认知灵活性维度,但我们认为将这个框架扩展到其他能够捕捉核心自闭症症状和跨诊断症状严重程度的高阶维度很重要。这种方法可以刻画出自闭症潜在的多方面结构,从而在诊断分类中提高精度,并制定更具针对性的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fd3/12450550/5843a9544ebe/S2513988625100023_fig1.jpg

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