“Driven and Tense,Stressed Out and Anxious”: Clinicians’ Perceptions of Post-Traumatic Stress Disorder Symptom Expressions in Adults with Autism and Intellectual Disability

ABSTRACT

Introduction

Individuals with autism spectrum disorder (ASD) and intellectual disability (ID) seem to be at increased risk for post-traumatic stress disorder (PTSD), but knowledge is sparse regarding its identification in this population. Previous research indicates that certain symptoms of PTSD may be more easily recognized, and that identifying reexperiencing and avoidance is particularly challenging.     

维生素D在孤独症谱系障碍中作用的研究进展

孤独症谱系障碍(ASD)是影响儿童健康的严重公共问题之一,以社交沟通障碍、兴趣或活动范围狭窄以及重复刻板行为为特征。近年来越来越多的研究显示,ASD患儿维生素D(VitD)水平明显低于同龄健康儿童,VitD缺乏可能与ASD的发病机制相关。本文就VitD与ASD的相关研究进行综述。     

P-Values and Power in Orthopedic Research: Myths and Reality

The results of statistical tests in orthopedic studies are typically reported using P-values. If a P-value is smaller than the pre-determined level of significance (eg, < .05), the null hypothesis is rejected in support of the alternative. This automaticity in interpreting statistical results without consideration of the power of the study has been denounced over the years by statisticians, since it can potentially lead to misinterpretation of the study conclusions. In this paper, we review fundamental misconceptions and misinterpretations of P-values and power, along with their connection with confidence intervals, and we provide guidelines to orthopedic researchers for evaluating and reporting study results. We provide real-world orthopedic examples to illustrate the main concepts. Please visit the following https://youtu.be/bdPU4luYmF0 for videos that explain the highlights of the paper in practical terms.     

Psychometric properties of the Repetitive Behavior Scale-Revised for individuals with autism spectrum disorder in Japan

Restricted and repetitive behaviors (RRBs) constitute a core symptom of autism spectrum disorder (ASD). The Repetitive Behavior Scale-Revised (RBS-R) is a widely used questionnaire administered by parents or caregivers to assess RRBs in individuals with ASD. This study evaluated the psychometric properties of the RBS-R Japanese Version (RBS-R-J). The ASD and non-ASD groups comprised 274 and 36 participants, respectively. We examined corrected item-total correlation, Cronbach's alpha, and RBS-R-J scores of different diagnostic groups, as well as correlations between RBS-R-J scores and intelligence quotient (IQ), autistic symptoms, adaptive/maladaptive functioning, aberrant behaviors, and sensory processing. All items showed moderate corrected item-total correlations. Cronbach's alpha coefficient was .93. We found significant differences in the mean RBS-R-J scores of the low-functioning ASD group and the intellectual disabilities group, and of low-functioning and high-functioning ASD groups. RBS-R-J scores negatively correlated with IQ and scores on the Sensory Profile (Japanese version) and Adaptive Behavior Composite of the Maladaptive Behavior Index of the Vineland Adaptive Behavior Scales-Second Edition (VABS-II; Japanese version), but positively correlated with scores on the peak and current symptoms subscales of the Pervasive Developmental Disorders Autism Society Japan Rating Scale, the VABS-II, and the Aberrant Behavior Checklist-Community (Japanese version). From these results, we conclude that RBS-R-J showed good reliability, diagnostic validity, and convergent validity, indicating that it is a reliable, valid instrument for use among ASD individuals in clinical and research settings.     

行为-结构化-关系干预模式对短期住院孤独症谱系障碍儿童的疗效分析

目的 探讨以行为-结构化-关系(BSR)干预模式对短期住院孤独症谱系障碍(ASD)儿童的干预疗效,为改善ASD儿童的预后提供参考依据。方法 选取2015年12月－2016年12月确诊为ASD的2~6岁儿童141例,随机分为治疗组和对照组。治疗组ASD儿童均接受BSR模式的短期课程训练,训练课程包括个别辅导、游戏课、运动课、音乐课等,每天训练时间6 h,持续1个月;对照组ASD儿童处于干预等待,接受随访观察和评估。所有ASD儿童干预前、后均接受儿童心理教育评估(第三版)(PEP-3)来进行各方面能力变化的评估。结果 治疗组、对照组干预前各副测验的原积分差异无统计学意义(P>0.05)。两组ASD儿童干预后认知、语言理解、模仿、情感表达、社会互动、行为特征-非语言、适应行为的原积分比较,差异均有统计学意义(t=2.41、2.02、4.14、3.69、4.42、2.69、2.96,P<0.05);但小肌肉、大肌肉、自理的原积分比较,差异无统计学意义(t=-1.13、-1.05、-0.84,P>0.05)。结论 BSR干预模式能够有效改善短期住院ASD儿童的预后,可推广用于儿童ASD的治疗。     

薄层色谱法在当前中药质量标准中的应用探讨

薄层色谱鉴别在历版《中国药典》中的应用经历了从无到有、从少到多的过程；而薄层扫描含量测定在最近几版《中国药典》中的应用比例逐渐降低。随着对中药质量标准体系要求的进一步提高，薄层色谱法的不足之处陆续显现，如仪器普及率低、设备并不简单、结果重复性和稳定性较差、鉴别速度及准确性不及高效液相色谱法、展开剂毒性大等，逐渐不合时宜。在制定中药质量标准时，研究者不应该墨守成规，薄层色谱鉴别也不应该是雷打不动的定性鉴别必备选项。高效液相色谱法具备完全取代薄层色谱法的可行性，薄层色谱法可作为高效液相色谱法的补充。为充分降低检测成本、缩短检测周期、提高鉴别效率，笔者建议中药质量标准体系应该大幅减少薄层色谱鉴别方法的应用，增加高效液相特征图谱鉴定，尽量做到“一个条件，一张图谱”；除非确有必要，《中国药典》等国家质量标准体系应将薄层色谱鉴别作为推荐方法，而非强制标准。     

The roles of prostaglandin E2 and D2 in lipopolysaccharide-mediated changes in sleep

When living organisms become sick as a result of a bacterial infection, a suite of brain-mediated responses occur, including fever, anorexia and sleepiness. Systemic administration of lipopolysaccharide (LPS), a common constituent of bacterial cell walls, increases body temperature and non-rapid eye movement (NREM) sleep in animals and induces the production of pro-inflammatory prostaglandins (PGs). PGE₂ is the principal mediator of fever, and both PGE₂ and PGD₂ regulate sleep–wake behavior. The extent to which PGE₂ and PGD₂ are involved in the effect of LPS on NREM sleep remains to be clarified. Therefore, we examined LPS-induced changes in body temperature and NREM sleep in mice with nervous system-specific knockouts (KO) for the PGE₂ receptors type EP₃ or EP₄, in mice with total body KO of microsomal PGE synthase-1 or the PGD₂ receptor type DP, and in mice treated with the cyclooxygenase (COX) inhibitor meloxicam. We observed that LPS-induced NREM sleep was slightly attenuated in mice lacking EP₄ receptors in the nervous system, but was not affected in any of the other KO mice or in mice pretreated with the COX inhibitor. These results suggest that the effect of LPS on NREM sleep is partially dependent on PGs and is likely mediated mainly by other pro-inflammatory substances. In addition, our data show that the main effect of LPS on body temperature is hypothermia in the absence of nervous system EP₃ receptors or in the presence of a COX inhibitor.     

Fathers of children with autism spectrum disorder: Their perceptions of paternal role a predictor of caregiving satisfaction,self-efficacy and burden

BackgroundThe positive effect of a father’s involvement in children’s upbringing is now recognised. However, research on fathers raising children with autism spectrum disorder (ASD) are still few. This study examines the relationship between the perception, fathers of children with ASD have of the importance of their role in the development of their children and the feelings (self-efficacy, caregiving burden, satisfaction) they express about their parenting experience.MethodSixty-three Swiss Italian fathers of children with ASD completed The Role of the Father Questionnaire (ROFQ), three sub-scales of the Caregiver Survey, a subtest of the Child Adjustment and Parent Efficacy Scale and a home-made questionnaire measuring Perceived Social Support.ResultsThe results from hierarchical multiple regression analyses show that the importance that fathers attach to the paternal role predicts positively their caregiving satisfaction and their feeling of self-efficacy. The children’s challenging behaviours predict positively the caregiving burden whereas the assessment of social support predicts it negatively.ConclusionsThe perception of the importance of the paternal role needs to be considered in the support offered to families with a child with ASD. A better understanding of the fathers’ feelings could be of value for the programmes.     

Conceptual clarification of the playful engagement in social interaction of preschool-aged children with autism spectrum disorder (ASD)

Children with autism spectrum disorder (ASD) demonstrate limited playfulness. Their difficulty engaging in meaningful interaction with others renders playful engagement in social interactions a challenge. Although little direct evidence exists regarding the promotion of these children’s playful engagement, links can be established with many traits cited in play and social interaction studies. This paper presents the results of a conceptual clarification exercise regarding the key behaviours associated with the construct of playful engagement in preschool-aged children with ASD. Behaviours were identified based on hallmark deficits in early social interactions and play of children with ASD. The analysis revealed the following behaviours: positive affect, engagement, imitation, joint attention, initiation of social interaction, social responsiveness, flexibility, child’s laughter in funny situations and giving and reading non-verbal cues. In conclusion, a conceptually coherent stage has been set for exploring the literature regarding interventions to promote the playful engagement of preschool-aged children with ASD.