自闭症谱系障碍儿童焦虑研究综述
|
摘要
焦虑是自闭症谱系障碍儿童常见的精神障碍之一,严重影响自闭症谱系障碍儿童的认知和社会技能发展。文章通过对研究自闭症谱系障碍儿童焦虑的文献进行梳理,总结自闭症谱系障碍儿童焦虑的发生率及表现、成因解释、影响因素和干预方法。研究结果显示,自闭症谱系障碍儿童焦虑发生率在11%-84%,主要表现为特定焦虑症、强迫症和社交焦虑障碍;神经心理学、神经生物学、遗传和环境因素构成成因解释;影响因素主要包括年龄、性别、语言、智力水平和ASD严重程度;干预方法主要涉及行为治疗、认知行为治疗和药物疗法。文章最后对已有研究进行反思,以期为未来研究提供启示。
Anxiety,one of the common mental disorders of children with autism spectrum disorders( ASD),has a significant effect on the development of the cognitive and social skills of these children.This study,based on a review of the research literature involving anxiety in children with ASD,summarized the occurrence rate of anxiety,the cause of anxiety,the influencing factors,and the interventions. The results show the following: Children with ASD showed anxiety at the occurrence rate of 11%-84%,mainly in special anxiety disorders,obsessive-compulsive disorder,and social anxiety disorder; neuropsychology,neurobiology,genetics and environmental factors could be used to interpret the cause of their anxiety; the factors affecting their anxiety mainly included age,sex,language,intelligence and the severity of ASD;the interventions mainly involved the behavioral therapy,the cognitive behavioral therapy,and the drug therapy. In conclusion,based on the reflections on the existing research,this study offered suggestions for the future research.
Anxiety,one of the common mental disorders of children with autism spectrum disorders( ASD),has a significant effect on the development of the cognitive and social skills of these children.This study,based on a review of the research literature involving anxiety in children with ASD,summarized the occurrence rate of anxiety,the cause of anxiety,the influencing factors,and the interventions. The results show the following: Children with ASD showed anxiety at the occurrence rate of 11%-84%,mainly in special anxiety disorders,obsessive-compulsive disorder,and social anxiety disorder; neuropsychology,neurobiology,genetics and environmental factors could be used to interpret the cause of their anxiety; the factors affecting their anxiety mainly included age,sex,language,intelligence and the severity of ASD;the interventions mainly involved the behavioral therapy,the cognitive behavioral therapy,and the drug therapy. In conclusion,based on the reflections on the existing research,this study offered suggestions for the future research.
引文
1卜凡帅,徐胜.自闭症谱系障碍诊断标准:演变、影响与展望.中国特殊教育,2015,(2):41-45
2 CDC.CDC increases estimate of autism's prevalence by 15 percent,to 1 in 59 children.https://www.autismspeaks.org/science-news/cdc-increasesestimate-autisms-prevalence-15-percent-1-59-children
3赵金霞,李振.儿童焦虑的发展及干预研究进展.中国特殊教育,2016,(11):39-43
4 Kanner L.Autistic disturbances of affective contact.Nervous Child.1943,(2):217-250
5 Kreslins A,Robertson A E,Melville C.The effectiveness of psychosocial interventions for anxiety in children and adolescents with autism spectrum disorder:A systematic review and meta-analysis.Child and Adolescent Psychiatry and Mental Health,2015,9(1):1-22
6 Mattila M L,Hurtig T,Haapsamo H,et al.Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism:A communityand clinic-based study.Journal of Autism&Developmental Disorders,2010,40(9):1080-1093
7 White S W,Oswald D,Ollendick T,et al.Anxiety in children and adolescents with autism spectrum disorders.Clinical Psychology Review,2009,29(3):216-229
8 Maskey M,Warnell F,Parr J R,et al.Emotional and behavioural problems in children with autism spectrum disorder.Journal of Autism&Developmental Disorders,2013,43(4):851-859
9 Gotham K,Bishop S L,Hus V,et al.Exploring the relationship between anxiety and insistence on sameness in autism spectrum disorders.Autism Research,2013,6(1):33-41
10 18 Kerns C M,Kendall P C.Autism and anxiety:Overlap,similarities,and differences.Handbook of Autism and Anxiety.Switzerland:Springer International Publishing,2014.77-89
11 42 50 Van Steensel,Francisca J A,Susan M,et al.Anxiety disorders in children and adolescents with autistic spectrum disorders:A meta-analysis.Clinical Child and Family Psychology Review,2011,14(3):302-317
12 Leyfer O T,Folstein S E,Bacalman S,et al.Comorbid psychiatric disorders in children with autism:Interview development and rates of disorders.Journal of Autism&Developmental Disorders,2006,36(7):849-861
13 Mayes S D,Calhoun S L,Aggarwal R,et al.Unusual fears in children with autism.Research in Autism Spectrum Disorders,2013,7(1):151-158
14 Green S A,Ben-Sasson A.Anxiety disorders and sensory over-responsivity in children with autism spectrum disorders:Is there a causal relationship?.Journal of Autism and Developmental Disorders,2010,40(12):1495-1504
15 Gillott A,Furniss F,Walter A.Anxiety in highfunctioning children with autism.Autism the International Journal of Research&Practice,2001,5(3):277
16 40 Kuusikko S,Pollockwurman R,Jussila K,et al.Social anxiety in high-functioning children and adolescents with autism and asperger syndrome.Journal of Autism&Developmental Disorders,2008,38(9):1697-1709
17 Zandt F,Prior M,Kyrios M.Repetitive behavior in children with high functioning autism and obsessive compulsive disorder.Autism Development Disorder,2007,37(2):251-259
19 24 29 35 56 61 Jennett H.,Vasa R.A.,Hagopian L.Anxiety in Children with Autism Spectrum Disorder.In:Vasa R,Roy A(eds)Pediatric Anxiety Disorders.Current Clinical Psychiatry.New York:Humana Press,2013.345-377
20 Frith,U.Autism:Explaining the enigma.Oxford:Blackwell,1989
21 Burnette C P,Mundy P C,Meyer J A,et al.Weak central coherence and its relations to theory of mind and anxiety in autism.Journal of Autism and Developmental Disorders,2005,35(1):63-73
22 Etkin A,Egner T,Kalisch R.Emotional processing in anterior cingulate and medial prefrontal cortex.Trends in Cognitive Sciences,2011,15(2):85-93
23 Dalton K M,Nacewicz B M,Johnstone T,et al.Gaze fixation and the neural circuitry of face processing in autism.Nature Neuroscience,2005,8(4):519-526
25 Juranek J,Filipek P A,Berenji G R,et al.Association between amygdala volume and anxiety level:Magnetic resonance imaging(MRI)study in autistic children.Journal of Child Neurology,2006,21(12):1051-1058
26 Kleinhans NM,Richards T,Weaver K,et al.Association between amygdala response to emotional faces and social anxiety in autism spectrum disorders.Neuropsychologia,2010,48(12):3665-3670
27 Hollocks M J,Howlin P,Papadopoulos A S,et al.Differences in HPA-axis and heart rate responsiveness to psychosocial stress in children with autism spectrum disorders with and without comorbid anxiety.Psychoneuroendocrinology,2014,46(4):32-45
28 Levine T P,Sheinkopf S J,Pescosolido M,et al.Physiologic arousal to social stress in children with autism spectrum disorders:A pilot study.Research in Autism Spectrum Disorders,2012,6(1):177-183
30 Piven J,Chase G A,Landa R,et al.Psychiatric disorders in the parents of autistic individuals.Journal of the American Academy of Child&Adolescent Psychiatry,1991,30(3):471-478
31 Mazefsky C A,Kao J,Oswald D P.Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders.Research in Autism Spectrum Disorders,2011,5(1):164-174
32 Conner C M,Maddox B B,White S W.Parents'state and trait anxiety:Relationships with anxiety severity and treatment response in adolescents with autism spectrum disorders.Journal of Autism&Developmental Disorders,2013,43(8):1811-1818
33 Cohen I L,Tsiouris J A.Maternal recurrent mood disorders and high-functioning autism.Journal of Autism&Developmental Disorders,2006,36(8):1077-1088
34 Vasa R A,Mazurek M O.An update on anxiety in youth with autism spectrum disorders.Current Opinion in Psychiatry,2015,28(2):83-90
36 Adreon,D S,Jennifer.Transition to middle and high school:Increasing the success of students with asperger syndrome.Intervention in School&Clinic,2001,36(5):266-271
37 54 Sukhodolsky D G,Scahill L,Gadow K D,et al.Parent-rated anxiety symptoms in children with pervasive developmental disorders:Frequency and association with core autism symptoms and cognitive functioning.Journal of Abnormal Child Psychology,2008,36(1):117-128
38 55 Strang J F,Kenworthy L,Daniolos P,et al.Depression and anxiety symptoms in children and adolescents with autism spectrum disorders without intellectual disability.Research in Autism Spectrum Disorders,2012,6(1):406-412
39 Gadow K D,Devincent C J,Pomeroy J,et al.Comparison of DSM-IV symptoms in elementary school-age children with PDD versus clinic and community samples.Autism,2005,9(4):392-415
41 Davis T E D,Hess J A,Moree B N,et al.Anxiety symptoms across the lifespan in people diagnosed with autistic disorder.Research in Autism Spectrum Disorders,2011,5(1):112-118
43 Costello E J,Egger H L,Angold A.The Developmental epidemiology of anxiety disorders:Phenomenology,prevalence,and comorbidity.Child&Adolescent Psychiatric Clinics of North America,2005,14(4):631-648
44 Hofvander B,Delorme R,Chaste P,et al.Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders.Bmc Psychiatry,2009,9(1):35-44
45 53 Mazurek M O,Kanne S M.Friendship and internalizing symptoms among children and adolescents with ASD.Journal of Autism&Developmental Disorder,2010,40(12):1512-1520
46 Simonoff E,Pickles A,Charman T,et al.Psychiatric disorders in children with autism spectrum disorders:Prevalence,comorbidity,and associated factors in a population-derived sample.Journal of the American Academy of Child&Adolescent Psychiatry,2008,47(8):921-929
47 Lecavalier L.Behavioral and emotional problems in young people with pervasive developmental disorders:Relative prevalence,effects of subject characteristics,and empirical classification.Journal of Autism&Developmental Disorders,2006,36(8):1101-1114
48 Mayes S D,Calhoun S L,Murray M J,et al.Anxiety,depression,and irritability in children with autism relative to other neuropsychiatric disorders and typical development.Research in Autism Spectrum Disorders,2011,5(1):474-485
49 Hallett V,Ronald A,Colvert E,et al.Exploring anxiety symptoms in a large-scale twin study of children with autism spectrum disorders,their cotwins and controls.Journal of Child Psychology&Psychiatry&Allied Disciplines,2013,54(11):1176-1185
51 Rieske R D,Matson J L,Davis T E.The Moderating effect of autism symptomatology on anxiety symptoms.Journal of Developmental&Physical Disabilities,2013,25(5):517-531
52 Davis T E,Moree B N,Dempsey T,et al.The effect of communication deficits on anxiety symptoms in infants and toddlers with autism spectrum disorders.Behavior Therapy,2012,43(1):142-152
57 58 59 62 Hagopian L,Jennett H.Behavioral assessment and treatment for anxiety for those with autism spectrum disorder.Switzerland:Springer International Publishing,2014:158-168
60 Lang R,Regester A,Lauderdale S,et al.Treatment of anxiety in autism spectrum disorders using cognitive behaviour therapy:A systematic review.Developmental Neurorehabilitation,2010,13(1):53-63
63 White S W,Albano A M,Johnson C R,et al.Development of a Cognitive-Behavioral intervention program to treat anxiety and social deficits in teens with high-functioning autism.Clinical Child&Family Psychology Review,2010,13(1):77-90
64 McConachie H,McLaughlin E,Grahame V,et al.Group therapy for anxiety in children with autism spectrum disorder,Autism,2014,18(6):723-732
65 Posey D J,Guenin K D,Kohn A E,et al.A naturalistic open-label study of mirtazapine in autistic and other pervasive developmental disorders.Journal of Child&Adolescent Psychopharmacology,2001,11(3):267-277
66 Nadeau J,Sulkowski M L,Ung D,et al.Treatment of comorbid anxiety and autism spectrum disorders.Neuropsychiatry,2011,1(6):567-578
67 Marcus R N,Owen R,Kamen L,et al.A placebo-controlled,fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder.Journal of the American Academy of Child&Adolescent Psychiatry,2009,48(11):1110-1119
68 Buitelaar J K,vander Gaag R J,Van d H J.Buspirone in the management of anxiety and irritability in children with pervasive developmental disorders:Results of an open-label study.Journal of Clinical Psychiatry,1998,59(2):56-59
2 CDC.CDC increases estimate of autism's prevalence by 15 percent,to 1 in 59 children.https://www.autismspeaks.org/science-news/cdc-increasesestimate-autisms-prevalence-15-percent-1-59-children
3赵金霞,李振.儿童焦虑的发展及干预研究进展.中国特殊教育,2016,(11):39-43
4 Kanner L.Autistic disturbances of affective contact.Nervous Child.1943,(2):217-250
5 Kreslins A,Robertson A E,Melville C.The effectiveness of psychosocial interventions for anxiety in children and adolescents with autism spectrum disorder:A systematic review and meta-analysis.Child and Adolescent Psychiatry and Mental Health,2015,9(1):1-22
6 Mattila M L,Hurtig T,Haapsamo H,et al.Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism:A communityand clinic-based study.Journal of Autism&Developmental Disorders,2010,40(9):1080-1093
7 White S W,Oswald D,Ollendick T,et al.Anxiety in children and adolescents with autism spectrum disorders.Clinical Psychology Review,2009,29(3):216-229
8 Maskey M,Warnell F,Parr J R,et al.Emotional and behavioural problems in children with autism spectrum disorder.Journal of Autism&Developmental Disorders,2013,43(4):851-859
9 Gotham K,Bishop S L,Hus V,et al.Exploring the relationship between anxiety and insistence on sameness in autism spectrum disorders.Autism Research,2013,6(1):33-41
10 18 Kerns C M,Kendall P C.Autism and anxiety:Overlap,similarities,and differences.Handbook of Autism and Anxiety.Switzerland:Springer International Publishing,2014.77-89
11 42 50 Van Steensel,Francisca J A,Susan M,et al.Anxiety disorders in children and adolescents with autistic spectrum disorders:A meta-analysis.Clinical Child and Family Psychology Review,2011,14(3):302-317
12 Leyfer O T,Folstein S E,Bacalman S,et al.Comorbid psychiatric disorders in children with autism:Interview development and rates of disorders.Journal of Autism&Developmental Disorders,2006,36(7):849-861
13 Mayes S D,Calhoun S L,Aggarwal R,et al.Unusual fears in children with autism.Research in Autism Spectrum Disorders,2013,7(1):151-158
14 Green S A,Ben-Sasson A.Anxiety disorders and sensory over-responsivity in children with autism spectrum disorders:Is there a causal relationship?.Journal of Autism and Developmental Disorders,2010,40(12):1495-1504
15 Gillott A,Furniss F,Walter A.Anxiety in highfunctioning children with autism.Autism the International Journal of Research&Practice,2001,5(3):277
16 40 Kuusikko S,Pollockwurman R,Jussila K,et al.Social anxiety in high-functioning children and adolescents with autism and asperger syndrome.Journal of Autism&Developmental Disorders,2008,38(9):1697-1709
17 Zandt F,Prior M,Kyrios M.Repetitive behavior in children with high functioning autism and obsessive compulsive disorder.Autism Development Disorder,2007,37(2):251-259
19 24 29 35 56 61 Jennett H.,Vasa R.A.,Hagopian L.Anxiety in Children with Autism Spectrum Disorder.In:Vasa R,Roy A(eds)Pediatric Anxiety Disorders.Current Clinical Psychiatry.New York:Humana Press,2013.345-377
20 Frith,U.Autism:Explaining the enigma.Oxford:Blackwell,1989
21 Burnette C P,Mundy P C,Meyer J A,et al.Weak central coherence and its relations to theory of mind and anxiety in autism.Journal of Autism and Developmental Disorders,2005,35(1):63-73
22 Etkin A,Egner T,Kalisch R.Emotional processing in anterior cingulate and medial prefrontal cortex.Trends in Cognitive Sciences,2011,15(2):85-93
23 Dalton K M,Nacewicz B M,Johnstone T,et al.Gaze fixation and the neural circuitry of face processing in autism.Nature Neuroscience,2005,8(4):519-526
25 Juranek J,Filipek P A,Berenji G R,et al.Association between amygdala volume and anxiety level:Magnetic resonance imaging(MRI)study in autistic children.Journal of Child Neurology,2006,21(12):1051-1058
26 Kleinhans NM,Richards T,Weaver K,et al.Association between amygdala response to emotional faces and social anxiety in autism spectrum disorders.Neuropsychologia,2010,48(12):3665-3670
27 Hollocks M J,Howlin P,Papadopoulos A S,et al.Differences in HPA-axis and heart rate responsiveness to psychosocial stress in children with autism spectrum disorders with and without comorbid anxiety.Psychoneuroendocrinology,2014,46(4):32-45
28 Levine T P,Sheinkopf S J,Pescosolido M,et al.Physiologic arousal to social stress in children with autism spectrum disorders:A pilot study.Research in Autism Spectrum Disorders,2012,6(1):177-183
30 Piven J,Chase G A,Landa R,et al.Psychiatric disorders in the parents of autistic individuals.Journal of the American Academy of Child&Adolescent Psychiatry,1991,30(3):471-478
31 Mazefsky C A,Kao J,Oswald D P.Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders.Research in Autism Spectrum Disorders,2011,5(1):164-174
32 Conner C M,Maddox B B,White S W.Parents'state and trait anxiety:Relationships with anxiety severity and treatment response in adolescents with autism spectrum disorders.Journal of Autism&Developmental Disorders,2013,43(8):1811-1818
33 Cohen I L,Tsiouris J A.Maternal recurrent mood disorders and high-functioning autism.Journal of Autism&Developmental Disorders,2006,36(8):1077-1088
34 Vasa R A,Mazurek M O.An update on anxiety in youth with autism spectrum disorders.Current Opinion in Psychiatry,2015,28(2):83-90
36 Adreon,D S,Jennifer.Transition to middle and high school:Increasing the success of students with asperger syndrome.Intervention in School&Clinic,2001,36(5):266-271
37 54 Sukhodolsky D G,Scahill L,Gadow K D,et al.Parent-rated anxiety symptoms in children with pervasive developmental disorders:Frequency and association with core autism symptoms and cognitive functioning.Journal of Abnormal Child Psychology,2008,36(1):117-128
38 55 Strang J F,Kenworthy L,Daniolos P,et al.Depression and anxiety symptoms in children and adolescents with autism spectrum disorders without intellectual disability.Research in Autism Spectrum Disorders,2012,6(1):406-412
39 Gadow K D,Devincent C J,Pomeroy J,et al.Comparison of DSM-IV symptoms in elementary school-age children with PDD versus clinic and community samples.Autism,2005,9(4):392-415
41 Davis T E D,Hess J A,Moree B N,et al.Anxiety symptoms across the lifespan in people diagnosed with autistic disorder.Research in Autism Spectrum Disorders,2011,5(1):112-118
43 Costello E J,Egger H L,Angold A.The Developmental epidemiology of anxiety disorders:Phenomenology,prevalence,and comorbidity.Child&Adolescent Psychiatric Clinics of North America,2005,14(4):631-648
44 Hofvander B,Delorme R,Chaste P,et al.Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders.Bmc Psychiatry,2009,9(1):35-44
45 53 Mazurek M O,Kanne S M.Friendship and internalizing symptoms among children and adolescents with ASD.Journal of Autism&Developmental Disorder,2010,40(12):1512-1520
46 Simonoff E,Pickles A,Charman T,et al.Psychiatric disorders in children with autism spectrum disorders:Prevalence,comorbidity,and associated factors in a population-derived sample.Journal of the American Academy of Child&Adolescent Psychiatry,2008,47(8):921-929
47 Lecavalier L.Behavioral and emotional problems in young people with pervasive developmental disorders:Relative prevalence,effects of subject characteristics,and empirical classification.Journal of Autism&Developmental Disorders,2006,36(8):1101-1114
48 Mayes S D,Calhoun S L,Murray M J,et al.Anxiety,depression,and irritability in children with autism relative to other neuropsychiatric disorders and typical development.Research in Autism Spectrum Disorders,2011,5(1):474-485
49 Hallett V,Ronald A,Colvert E,et al.Exploring anxiety symptoms in a large-scale twin study of children with autism spectrum disorders,their cotwins and controls.Journal of Child Psychology&Psychiatry&Allied Disciplines,2013,54(11):1176-1185
51 Rieske R D,Matson J L,Davis T E.The Moderating effect of autism symptomatology on anxiety symptoms.Journal of Developmental&Physical Disabilities,2013,25(5):517-531
52 Davis T E,Moree B N,Dempsey T,et al.The effect of communication deficits on anxiety symptoms in infants and toddlers with autism spectrum disorders.Behavior Therapy,2012,43(1):142-152
57 58 59 62 Hagopian L,Jennett H.Behavioral assessment and treatment for anxiety for those with autism spectrum disorder.Switzerland:Springer International Publishing,2014:158-168
60 Lang R,Regester A,Lauderdale S,et al.Treatment of anxiety in autism spectrum disorders using cognitive behaviour therapy:A systematic review.Developmental Neurorehabilitation,2010,13(1):53-63
63 White S W,Albano A M,Johnson C R,et al.Development of a Cognitive-Behavioral intervention program to treat anxiety and social deficits in teens with high-functioning autism.Clinical Child&Family Psychology Review,2010,13(1):77-90
64 McConachie H,McLaughlin E,Grahame V,et al.Group therapy for anxiety in children with autism spectrum disorder,Autism,2014,18(6):723-732
65 Posey D J,Guenin K D,Kohn A E,et al.A naturalistic open-label study of mirtazapine in autistic and other pervasive developmental disorders.Journal of Child&Adolescent Psychopharmacology,2001,11(3):267-277
66 Nadeau J,Sulkowski M L,Ung D,et al.Treatment of comorbid anxiety and autism spectrum disorders.Neuropsychiatry,2011,1(6):567-578
67 Marcus R N,Owen R,Kamen L,et al.A placebo-controlled,fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder.Journal of the American Academy of Child&Adolescent Psychiatry,2009,48(11):1110-1119
68 Buitelaar J K,vander Gaag R J,Van d H J.Buspirone in the management of anxiety and irritability in children with pervasive developmental disorders:Results of an open-label study.Journal of Clinical Psychiatry,1998,59(2):56-59