Often Asked but Rarely Answered: Can Asians Meet DSM-5/ICD-10 Autism Spectrum Disorder Criteria?
Often Asked but Rarely Answered: Can Asians Meet DSM-5/ICD-10 Autism Spectrum Disorder Criteria?
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DOI：
10.1089/cap.2016.0021
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发表时间：
2016-11-01
影响因子：
1.9
通讯作者：
Leventhal, Bennett L.
中科院分区：
文献类型：
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作者：
Kim, So Hyun;Kim, Young Shin;Leventhal, Bennett L.
目的：为了评估亚洲人是否使用基于西方的诊断工具和基于精神障碍诊断和统计手册第5版（DSM-5）的标准，可以有效地诊断（韩国儿童）人群患有自闭症谱系障碍（ASD）。参与者包括来自一项更大的流行病学研究（N = 55，266）的流行病学确定的7-14岁（N = 292）韩国队列。主要结果是基于西方为基础的诊断方法，韩国儿童使用金标准工具，自闭症诊断访谈修订版，自闭症诊断观察时间表。进行因素分析和方差分析，以检查自闭症症状的因素结构，并确定与ASD和非ASD diagnosis.Results韩国儿童之间的表型差异：使用西方为基础的诊断方法，韩国ASD儿童被成功地确定了中高诊断效度（灵敏度/特异性范围64%-93%），强内部一致性，收敛/并发效度。韩国人群中的自闭症表型模式与西方人群中观察到的两个症状域（社会沟通和限制和重复行为因素）相似。在使用社会可接受的沟通行为方面存在统计学显著差异（例如，直接凝视，面部表情的范围）之间出现的ASD与非ASD的情况下（大多数p < 0.001），确保这些可以是一个类似的有效部分的ASD表型在亚洲和西方population.Conclusions：尽管神话，偏见和刻板印象的亚洲人的社会行为，亚洲人（至少韩国儿童）通常使用的互惠社会互动的元素类似于那些在西方。因此，在西方文化中广泛用于ASD的标准化诊断方法可以有效地用作韩国人和其他亚洲人的评估过程和研究的一部分。
Objectives: To evaluate whether Asian (Korean children) populations can be validly diagnosed with autism spectrum disorder (ASD) using Western-based diagnostic instruments and criteria based on Diagnostic and Statistical Manual on Mental Disorders, 5th edition (DSM-5).Methods: Participants included an epidemiologically ascertained 7-14-year-old (N = 292) South Korean cohort from a larger prevalence study (N = 55,266). Main outcomes were based on Western-based diagnostic methods for Korean children using gold standard instruments, Autism Diagnostic Interview-Revised, and Autism Diagnostic Observation Schedule. Factor analysis and ANOVAs were performed to examine factor structure of autism symptoms and identify phenotypic differences between Korean children with ASD and non-ASD diagnoses.Results: Using Western-based diagnostic methods, Korean children with ASD were successfully identified with moderate-to-high diagnostic validity (sensitivities/specificities ranging 64%-93%), strong internal consistency, and convergent/concurrent validity. The patterns of autism phenotypes in a Korean population were similar to those observed in a Western population with two symptom domains (social communication and restricted and repetitive behavior factors). Statistically significant differences in the use of socially acceptable communicative behaviors (e.g., direct gaze, range of facial expressions) emerged between ASD versus non-ASD cases (mostly p < 0.001), ensuring that these can be a similarly valid part of the ASD phenotype in both Asian and Western populations.Conclusions: Despite myths, biases, and stereotypes about Asian social behavior, Asians (at least Korean children) typically use elements of reciprocal social interactions similar to those in the West. Therefore, standardized diagnostic methods widely used for ASD in Western culture can be validly used as part of the assessment process and research with Koreans and, possibly, other Asians.