Sensory, Emotional and Cognitive Contributions to Anxiety in Autism Spectrum Disorders.
Sensory, Emotional and Cognitive Contributions to Anxiety in Autism Spectrum Disorders.
复制标题
自闭症谱系障碍焦虑的感觉，情感和认知贡献。
DOI：
10.3389/fnhum.2017.00020
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发表时间：
2017
影响因子：
2.9
通讯作者：
Rodgers J
中科院分区：
文献类型：
--
作者：
South M;Rodgers J
严重的焦虑症状给许多被诊断为自闭症谱系障碍（ASD）的个体增加了实质性的额外负担。提高对导致自闭症患者焦虑的具体因素的理解，有助于研究自闭症的原因，也为更有效的干预提供了目标。这篇小型综述文章关注的是三个概念的新证据，这三个概念似乎相互关联，也强烈地预测了自闭症谱系障碍样本的焦虑。非典型感觉功能包括在ASD的诊断标准中，并且可能是焦虑的重要因素。理解和标记情绪的困难（述情障碍）虽然是一种合并症，但可能部分源于非典型的感觉功能，并可能导致如何应对社会和情感情境的混乱和不确定性。不确定性不耐受症（IU）描述的是那些特别难以忍受模棱两可的人，已知这是一些焦虑症的关键机制。虽然将这些概念联系起来的证据到目前为止还不完整，但我们提出了一个包括每个概念的模型，作为未来研究的框架。具体来说，我们提出IU是ASD焦虑的关键中介，并探讨感觉功能、述情障碍和IU之间的关系。我们进一步探讨了内侧前额叶皮层（mPFC）在调节情绪反应中的作用，与边缘和岛基网络有关，并表明这些网络的整合被破坏是适应强烈情绪刺激困难的基础，这导致许多ASD患者对威胁的感知增强。以行为和生物学为基础的ASD焦虑治疗将受益于将这些特定机制作为传统干预措施的辅助手段。
Severe symptoms of anxiety add substantial additional burden to many individuals diagnosed with Autism Spectrum Disorder (ASD). Improved understanding of specific factors that contribute to anxiety in ASD can aid research regarding the causes of autism and also provide targets for more effective intervention. This mini-review article focuses on emerging evidence for three concepts that appear to be related to each other and which also strongly predict anxiety in ASD samples. Atypical sensory function is included in the diagnostic criteria for ASD and is likely an important contributor to anxiety. Difficulties in understanding and labeling emotions (alexithymia), although a co-morbidity, may arise in part from atypical sensory function and can lead to confusion and uncertainty about how to respond to social and emotional situations. Intolerance of uncertainty (IU) describes people who have a particularly hard time with ambiguity and is known to be a key mechanism underlying some anxiety disorders. While evidence for linking these ideas is to date incomplete, we put forward a model including each concept as a framework for future studies. Specifically, we propose that IU is a critical mediator for anxiety in ASD, and explore the relationships between sensory function, alexithymia and IU. We further explore the role of the medial prefrontal cortex (mPFC) in regulating emotional response, in connection with limbic and insula-based networks, and suggest that disrupted integration in these networks underlies difficulties with habituation to strong emotional stimuli, which results in an enhanced perception of threat in many people with ASD. Behavioral and biologically-based treatments for anxiety in ASD will benefit from attending to these specific mechanisms as adjunct to traditional interventions.