孤独症谱系障碍儿童胃肠问题与核心症状及预后的相关分析

目的旨在探讨孤独症谱系障碍(ASD)儿童胃肠问题与临床核心症状及预后的关系,为ASD的诊断和预后提供线索。方法纳入98例ASD儿童(ASD组)和103例发育正常的健康儿童(HC组)。评估两组儿童是否存在胃肠问题;ASD组根据是否存在胃肠问题分为胃肠道阳性组(GI+组)和胃肠道阴性组(GI-组),分别予以儿童孤独症评定量表(CARS)、孤独症儿童行为检查量表(ABC)评估患儿核心症状。经过行为康复治疗后,再次给予GI+组儿童以上量表进行评估。结果 ASD组胃肠问题的发生率明显高于HC组(P0.05);GI+组和GI-组CARS量表评分差异有统计学意义(P=0.005);胃肠症状好转的患儿治疗后儿童孤独症评定量表评分显著低于无好转者,也显著低于治疗前儿童孤独症评定量表评分(P0.05);胃肠症状加重时患儿精神症状多加重。结论 ASD组胃肠问题发生率较高,积极干预胃肠道症状可能有利于ASD的治疗,且胃肠道症状可作为预测ASD儿童病情变化的一个指标。     

儿童孤独症早期干预效果及影响因素研究

目的 探讨早期综合干预对儿童孤独症的效果及影响因素.方法 对82例孤独症儿童采取综合干预,干预前后分别应用儿童孤独症评定量表（CARS）、0-6岁儿童神经心理发育量表、儿童孤独症及相关发育障碍心理教育量表修订版（C-PEP）进行测查.结果 CARS量表评分干预后显著低于干预前（p=0.000）;发育商干预后显著高于干预前（P=0.000）;干预后C-PEP的功能发展量表中所有项目评分及发展总分均较干预前显著升高,病理学量表中所有项目评分均较干预前显著下降（P＜0.01）.多元逐步回归分析结果显示,38项自变量中的6项进入CARS评分变化的回归方程（P＜0.05）,9项进入发育商变化的回归方程（P＜0.05）.结论 早期综合干预能有效减轻孤独症患儿的病理症状,提升发育水平.     

经颅磁刺激联合家庭干预在孤独症谱系障碍中的疗效研究

目的:探讨经颅磁刺激联合家庭干预在孤独症谱系障碍中的疗效。方法:选取2020年1月至2021年12月我院接收的60例孤独症谱系障碍儿童。按随机数表法，将60例患儿分为对照组和研究组，各30例，两组均实施了团队指导下的家庭早期干预，研究组在此基础上联合背外侧前额叶(DLPFC)经颅磁刺激治疗。比较两组患者盖塞尔发育量表(Gesell)、孤独症疗效评估量表(ATEC)、孤独症行为量表(ABC)、儿童孤独症评定量表(CARS)、Achenbach儿童行为量表(CBCL)评分。结果:与干预前相比，干预后两组Gesell量表五大能区(适应性、粗大运动、精细运动、语言、个人社会)评分均明显升高(P<0.05),其中研究组Gesell量表的适应性、语言、个人社会领域较对照组明显升高(P<0.05);与干预前相比，干预后两组ATEC四个领域(语言、社交、感知、行为)分数均明显降低(P<0.05),且与对照组比较，研究组降低更明显(P<0.05);与干预前相比，干预后两组ABC评估中感觉、交往、躯体运动、语言、生活自理分数均明显降低(P<0.05),且与对照组比较，研究组感...     

孤独症谱系障碍患儿家长病耻感与应对方式和社会支持的相关性分析

背景 孤独症谱系障碍（ASD）发病率呈上升趋势,ASD患儿的治疗和训练过程漫长,给患儿家庭带来沉重的负担,导致家长容易产生病耻感,目前缺少ASD患儿家长病耻感相关的调查研究。目的 探讨ASD患儿家长病耻感与应对方式和社会支持的相关性,为降低该群体的病耻感水平并采取针对性的干预措施提供参考。方法 以2021年1月-2022年5月乌鲁木齐市某三甲医院儿童保健门诊收治的ASD患儿的家长为研究对象。采用一般资料问卷、连带病耻感量表（ASS）、简易应对方式问卷（SCSQ）和社会支持评定量表（SSRS）进行调查,采用Pearson相关分析考查病耻感与应对方式和社会支持的相关性。结果 ASD患儿家长ASS总评分为（52.40±11.22）分。相关分析结果显示,ASD患儿家长ASS总评分与SCSQ消极应对维度评分呈正相关（r=0.787,P<0.01）,与SCSQ积极应对维度评分和SSRS总评分均呈负相关（r=-0.565、-0.795,P均<0.01）。回归分析结果显示,ASD患儿家长病耻感受应对方式和社会支持的影响（?R²=0.768,F=114.931,P<0.01）,可解释总变异的76.80%。结论 ASD患儿家长病耻感处于中等偏高水平,家长的应对方式和社会支持是影响病耻感的重要因素。     

85例儿童孤独症临床分析

目的:探讨儿童孤独症的临床特征及相应的干预措施。方法:采用Gesell发育评定、孤独症行为评定(ABC)、Car’s孤独症量表、社会生活能力评定量表对85例孤独症儿童的智力、行为、社会生活能力进行测试,并与精神发育迟滞儿童相对照。结果:孤独症儿童各项发育明显落后,在语言、适应性、精细动作3方面更为突出。结论:早期发现、早期诊断、及时干预意义重大。提出矫治"孤独症行为"和提高生活能力是孤独症训练的重点。     

常州市儿童孤独症的流行病学调查

目的；了解常州市儿童孤独症的患病率。方法：抽查市区5个街道2－6岁儿童3978人，采用Clancy行为量表进行筛查，以CCMD－2－R儿童孤独症诊断标准、儿童期孤独症评定量表（CARS量表）及儿童心理教育评定量表（PEP量表）进行诊断。结果：确诊为儿童孤独症者7人，时点患病率为17．89／万。结论：常州市儿童孤独症的患病率较高，且绝大多数无任何康复措施，故培养基层儿童精神科医师及建立基层特殊康复机构十分重要。     

儿童孤独症综合治疗临床研究

目的 探讨运用综合干预方法治疗儿童孤独症的疗效.方法 30例儿童孤独症患儿采用综合干预方法,治疗前及治疗半年后采用心理教育量表(PEP) 、JL童孤独症评定量表(CARS)评估治疗效果.结果 综合治疗能提高PEP各项目得分,除模仿、表达外,差异均有显著性;CARS评分降低,差异有显著性.结论 综合干预措施能提高孤独症患...     

军校硕士研究生择偶偏好问卷的编制

目的 编制具有良好信度和效度的军校硕士研究生择偶偏好问卷。方法 于2020年12月,随机选取某军校全日制硕士研究生为研究对象。采用自编开放式问卷采集学生的择偶偏好,经过筛选与专家咨询,整理条目形成军校硕士研究生择偶偏好初始问卷,并对89名军校硕士研究生进行施测。采用项目分析和探索性因素分析对问卷进行检验,采用Pearson相关分析、Cronbach’s α系数和分半信度以检验问卷信效度。结果 形成了由4个因子（内在品质、个人能力、外在条件、生活质量）组成,包含25个条目的军校硕士研究生择偶偏好问卷。该问卷总评分与4个因子评分的相关系数为0.739~0.864,总问卷及各因子Cronbach’s α系数为0.723~0.926,分半信度为0.682~0.899。结论 所编制的军校硕士研究生择偶偏好问卷具有较好的信度和效度,可作为采集军校硕士研究生择偶偏好等婚恋心理数据的工具。     

听觉统合训练联合应用行为分析对孤独症谱系障碍训练效果的影响

目的:探讨听觉统合训练(AIT)联合应用行为分析(ABA)对孤独症谱系障碍(ASD)的临床疗效。方法:采用方便抽样法抽取84例2～5岁的ASD患儿分为试验组(n=42)与对照组(n=42)。试验组接受为期1个月的AIT和3个月ABA训练;对照组仅接受3个月ABA训练。治疗前后进行儿童孤独症评定量表(ABC)及孤独症治疗评定量表(ATEC)评估。结果:训练后,试验组各量表的减分值较对照组高,进一步计算Cohen's d值,两组ATEC语言分量表减分值差异效应较大(d0.8),ABC减分值及ATEC感知觉、行为分量表减分值的差异具有中等效应(0.5≤d0.8),ATEC社交分量表减分值差异效应较小(0.2≤d0.5)。协方差分析显示,组别效应对ABC减分值、ATEC语言、感知觉及行为分量表减分值的影响有统计学意义(P均0.01),对ATEC社交分量表减分值的影响无统计学意义(P0.05);量表基线分值对各量表减分值的影响有统计学意义(P均0.01)。结论:AIT配合ABA训练较单用ABA训练可更好地改善ASD症状,对于语言、社交、感知觉、行为等各项能力发展有促进作用。     

MATRICS成套神经认知测试在青少年双相障碍患者中的心理测量学特征

目的 检测MATRICS成套神经认知测试（MCCB）在青少年双相障碍患者中的心理测量学特征，以确定MCCB是否可用于青少年双相障碍患者的认知功能评估。方法 按照年龄、性别和受教育程度匹配的原则，纳入青少年双相障碍患者（n=38）、青少年重度抑郁发作患者（n=40）和健康对照组（n=41）。分别在基线期和2周后，对青少年双相障碍患者进行蒙特利尔认知评估量表（MoCA）和MCCB评定，其他研究对象仅接受基线期MCCB评定。采用Cronbach’s α系数评估MCCB内部一致性，使用Pearson相关分析考察重测信度与效标效度，通过协方差分析表示区分效度，使用验证性因子分析探讨MCCB的结构效度。结果 ①在对青少年双相障碍患者的评定结果中，MCCB基线期和2周后重测的Cronbach’s α系数分别为0.784、0.773。②青少年双相障碍患者2周后MCCB重测结果显示，MCCB各维度重测信度为0.630~0.812（P均<0.01）。③效标效度显示，MoCA的短期记忆维度评分与MCCB的信息处理速度以及言语学习和记忆维度评分均呈正相关（r=0.487、0.522，P<0.05或0.01）。④区分效度显示，青少年双相障碍组、青少年重度抑郁发作组和健康对照组在MCCB的信息处理速度、注意/警觉性、工作记忆、言语学习和记忆、视觉学习和记忆以及推理与问题解决能力六个维度的评分中，差异均有统计学意义（F=3.790~7.243，P均<0.01）。⑤探索性因子分析显示，MCCB中存在四个因子，累计方差解释率为71.65%。验证性因子分析提示理想7因子模型结构效度欠佳。结论 MCCB在青少年双相障碍患者中具有较好的内部一致性、重测信度以及可接受的效度。     

Prevalence of Autism in Iceland

This clinic-based study estimated the prevalence of autism in Iceland in two consecutive birth cohorts, subjects born in 1974-1983 and in 1984-1993. In the older cohort classification was based on the ICD-9 in 72% of cases while in the younger cohort 89% of cases were classified according to the ICD-10. Estimated prevalence rates for Infantile autism/Childhood autism were 3.8 per 10,000 in the older cohort and 8.6 per 10,000 in the younger cohort. The characteristics of the autistic groups are presented in terms of level of intelligence, male:female ratio, and age at diagnosis. For the younger cohort scores on the Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale are reported as well. Results are compared with a previous Icelandic study and recent population-based studies in other countries based on the ICD-10 classification system. Methodological issues are discussed as well as implications for future research and service delivery.     

The Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale: Differences Between Diagnostic Systems and Comparison Between Genders

Diagnoses for autism based on the Autism Diagnostic Interview-Revised (ADI-R) and the Childhood Autism Rating Scale (CARS) were examined for 83 individuals with suspected autism. Agreement between systems reached 85.7%. Participants receiving diagnosis of autism based on only one system were significantly younger in age than individuals receiving diagnoses according to both systems. Individuals who did not receive diagnosis of autism on the ADI-R had lower chronological and mental ages and lower CARS scores compared to individuals who received diagnosis of autism based on the ADI-R. Eighteen females and 18 males were matched to examine possible gender differences. No significant findings were revealed, suggesting that the symptoms of autism according to the ADI-R and CARS do not differ between males and females when matched for chronological and mental ages.     

奥氮平治疗儿童孤独症的临床研究

目的　研究奥氮平对儿童孤独症的疗效及其副作用。方法　用奥氮平对 17例 1岁半～ 8岁符合CCMD - 3诊断的孤独症患者进行治疗 ,剂量为 2 .5～ 10mg/d ,连续用药并观察 12周。由 2位精神科医生同时在治疗前和治疗后第 2、4、6、8、12周采用临床疗效总评量表、儿童孤独症评定量表及临床记录对患者进行评定 ,评估其病情严重程度及奥氮平的疗效和副反应。结果　 2位精神科医生所得出得评定结果是相一致的 (Kappa =0 .86 )。从用药后第 6周起 ,临床疗效总评量表中的病情严重程度因子分值与治疗前相比明显降低 ,而总体疗效分值明显升高 ,二者均具有统计学差异 (P <0 .0 5 ) ;而CARS评定分值的降低也具有统计学意义 ,提示奥氮平对儿童孤独症有较好的疗效。治疗后 12周的评定结果与治疗后 6周的结果比较仍具有统计学差异 (P <0 .0 1) ,提示疗程的延长能提高疗效。奥氮平可显著改善易激惹症状、精神病性症状及睡眠障碍 ,对于刻板的行为模式、自伤行为、活动过度和注意力不集中也有一定效果。副反应出现极少 ,主要为可控性的体重增加以及强迫症状。结论　奥氮平治疗儿童孤独症是安全有效的 ,尤其对于易激惹、精神病性症状及睡眠障碍疗效较好。     

Role of serum levels of neurotensin in children with autism spectrum disorder

AimNeuroinflammation may play a role in the pathogenesis of autism in some patients. The aim of this study was to measure serum levels of neurotensin (NTS) in relation to the degree of the severity of autism.MethodsSerum NTS was measured in autistic children (n = 38; mean age 7.02 ± 2.03 years) and healthy, unrelated sex matched controls (n = 39); mean age 7.25 ± 1.64 years). The severity of autism symptoms was assessed using Childhood Autism Rating Scale (CARS) scores.ResultsThe serum level of NTS was significantly (P < 0.001) lower in autistic children (mean ± S.D. = 54.71 ± 12.4 pg/ml) than control group (mean ± S.D. = 77.58 ± 10.29 pg/ml). Children with severe autism had significantly lower serum NTS levels than patients with mild to moderate autism (P < 0.002). There was significant negative correlation between serum levels of NTS and CARS SCORES (r² = 0.79, P = 0.001).ConclusionsSerum NTS levels were elevated in some autistic children and they were significantly correlated with the severity of autism. However, this is an initial report that warrants further research to determine the pathogenic role of NTS and its possible link to neuroinflammation in autism.     

Stability of the Autism Diagnostic Interview—Revised from Pre-School to Elementary School Age in Children with Autism Spectrum Disorders

This study examined the stability of scores on the ADI-R from pre-school to elementary school age in children with autism spectrum disorders (ASD). Participants were 35 children who, at T1, all had a clinical diagnosis of ASD. On initial assessment (mean age 3.5 years; SD 0.6 years), all met ADI-R algorithm criteria for autism. ADI-R assessments were repeated at follow up (FU; mean age 10.5 years; SD 0.8 years). Changes in ADI-R total, domain and ADI-R algorithm item scores were assessed. Twenty-eight children continued to score above the ADI-R cut-off for autism at FU, although significant decreases in ADI-R domain and item scores were also found. In conclusion while classification of children according to ADI-R criteria generally remained stable between pre-school and elementary school age, many children demonstrated significant improvements in symptom severity.     

Improving the Reliability of Autism Diagnoses: Examining the Utility of Adaptive Behavior

The classification agreement of the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) was examined in 129 children and adolescents (aged 7-18 years) who were evaluated for autism. Participants received a diagnosis of autism or non-autism based on the ADI-R. Linear discriminant analysis revealed adequate concordance between the ADI-R and ADOS, with 75% of the participants being correctly classified using the ADOS. Classification accuracy significantly improved to 84% when a measure of adaptive functioning (i.e., the Vineland Adaptive Behavior Scales) was included in the analysis. The findings suggest that when clinicians obtain discrepant information on the ADI-R and ADOS, assessment of an individual's adaptive functioning may reduce diagnostic errors.     

Change in autism core symptoms with intervention

It is still debated what is the best early intervention approach for autism. This study compared two intervention approaches, Eclectic-Developmental (ED) and Applied Behavioral Analysis (ABA) in very young children with autism/autism spectrum disorder (ASD). Nineteen children received ED intervention, using combination of methods. Twenty children received Applied Behavioral Analysis (ABA) intervention which used behavioral principles. Children in both groups were not significantly different in their autism severity, cognitive abilities and in socio-economic background at pre-intervention time. Change in the severity of autism symptoms was assessed by the Autism Diagnosis Observation Schedule (ADOS).

The ABA group showed significantly greater improvements than the ED group at post-intervention time. Pre–post intervention differences in language and communication domain were significant only for the ABA group. Both groups showed significant improvement in reciprocal social interaction domain. However, the effect size was greater for the ABA group. Changes in diagnostic classification were noted in both groups but were more pronounced for the ABA group. Pre-treatment IQ scores were positively related to ADOS scores at pre- and post-intervention times, but not to progress over time. Behavioral intervention is more effective than eclectic approach in improving autism core symptoms in young children with autism.     

The Autism Diagnostic Observation Schedule: Revised Algorithms for Improved Diagnostic Validity

Autism Diagnostic Observation Schedule (ADOS) Modules 1–3 item and domain total distributions were reviewed for 1,630 assessments of children aged 14 months to 16 years with an autism spectrum disorder (ASD) or with heterogeneous non-spectrum disorders. Children were divided by language level and age to yield more homogeneous cells. Items were chosen that best differentiated between diagnoses and were arranged into domains on the basis of multi-factor item-response analysis. Reflecting recent research, the revised algorithm now consists of two new domains, Social Affect and Restricted, Repetitive Behaviors (RRB), combined to one score to which thresholds are applied, resulting in generally improved predictive value.     

Does bilateral damage to the human amygdala produce autistic symptoms?

A leading neurological hypothesis for autism postulates amygdala dysfunction. This hypothesis has considerable support from anatomical and neuroimaging studies. Individuals with bilateral amygdala lesions show impairments in some aspects of social cognition. These impairments bear intriguing similarity to those reported in people with autism, such as impaired recognition of emotion in faces, impaired theory of mind abilities, failure to fixate eyes in faces, and difficulties in regulating personal space distance to others. Yet such neurological cases have never before been assessed directly to see if they meet criteria for autism spectrum disorders (ASD). Here we undertook such an investigation in two rare participants with developmental-onset bilateral amygdala lesions. We administered a comprehensive clinical examination, as well as the Autism Diagnostic Observation Schedule (ADOS), the Social Responsiveness Scale (SRS), together with several other standardized questionnaires. Results from the two individuals with amygdala lesions were compared with published norms from both healthy populations as well as from people with ASD. Neither participant with amygdala lesions showed any evidence of autism across the array of different measures. The findings demonstrate that amygdala lesions in isolation are not sufficient for producing autistic symptoms. We suggest instead that it may be abnormal connectivity between the amygdala and other structures that contributes to autistic symptoms at a network level.