青少年及成年孤独症谱系障碍患者社交技能训练的疗效

目的:探讨社交技能训练对青少年和成人孤独症谱系障碍(ASD)患者社会交往障碍的疗效。方法:入组符合美国精神障碍诊断与统计手册第5版(DSM-5)ASD诊断标准的12~30岁被试44例,分为训练组(n=22)和对照组(n=22)。对训练组进行为期14周的社交技能训练,训练前(基线)和训练结束(终点)时,对两组患者进行异常行为量表(ABC)和社交反应量表(SRS)的评定以及心理推理任务和执行功能测查任务的评估。结果:训练组终点的ABC总分和社会退缩因子分,SRS总分和社交知觉、社交认知、社交沟通因子分均低于基线(均P<0.05),心理推理的二级错误信念任务的通过率高于基线(P<0.05),执行功能的Rey复杂图形记忆任务中的延迟记忆结构分、延迟记忆细节分高于基线,连线测验中的数字字母连线时间、B测验完成时-A测验完成时短于基线(均P<0.05)。而对照组在终点时,除ABC社会退缩因子外,其余上述项目与基线时相比差异均无统计学意义(均P>0.05)。结论:社交技能训练能够有效改善青少年和成年ASD患者的整体症状和社会交往障碍,还能有效提高青少年和成年ASD患者的心理推理能力和执行功能。

Effect of social skills training for adolescence and adult with autism spectrum disorder

Objective:To explore the effect of social skills training on social deficits in adolescents and adults with autism spectrum disorder(ASD).Methods:Forty-four subjects aged 12-30 years and meeting the ASD criteria of Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5) were recruited(22 in training group and 22 in control group).The social skills training composed of 14 sessions which were held once a week for 14 weeks was performed in training group.The subjects in both groups were assessed with the Aberrant Behavior Checklist(ABC),Social Responsiveness Scale(SRS),theory of mind(ToM) tasks and executive function tasks at baseline and the end of training program.Results:In training group,ABC total scores,scores of lethargy factor,SRS total scores,scores of social awareness,social cognition,social communication factors were lower at the end of training than at baseline(Ps<0.05).The pass rate of second-order false belief task of ToM was higher at the end of training than at baseline(Ps<0.05).For executive function tasks,the delay recalling structure scores and delay recalling detail scores of Rey complex figure test were higher at the end of training than at baseline,and the alphanumeric connection time and the complete time of test B minus the complete time of test A of trail-making test were shorter at the end of training than at baseline(Ps<0.05).There was no significant difference between the baseline and end point in control group in above mentioned tests except for scores of lethargy factor(Ps>0.05).Conclusion:It suggests that the social skills training could improve the overall symptoms and the social deficits of adolescents and adults with ASD,as well as their theory of mind and executive function.