Compensatory strategies below the behavioural surface in autism: a qualitative study
Compensatory strategies below the behavioural surface in autism: a qualitative study
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DOI：
10.1016/s2215-0366(19)30224-x
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发表时间：
2019-09-01
影响因子：
64.3
通讯作者：
Happe, Francesca
中科院分区：
文献类型：
--
作者：
Livingston, Lucy Anne;Shah, Punit;Happe, Francesca
背景自闭症的代偿性特征知之甚少;也就是说，自闭症谱系障碍的人在行为表现中表现出很少的症状，尽管继续报告自闭症相关的认知困难或差异。对于这些个体在临床和日常生活中用来在行为表面掩饰自闭症的特定补偿策略，我们所知甚少。目前还不清楚没有正式自闭症诊断但经历类似自闭症困难的人是否会使用类似的补偿策略，从而可能使他们能够低于诊断阈值。本研究旨在探讨社会补偿策略，其对诊断和临床结果的影响，在成年人和非autosity.Methods在这项研究中，个人年龄在18岁或以上谁回应了研究广告，是通过社交媒体和英国全国自闭症协会分布在世界各地形成了一个方便的样本。参与者自我：使用在线平台报告了他们使用补偿策略的情况和经验。新颖的分析，包括定性的主题方法，被用来解释他们的反应，并深入了解自闭症的补偿策略。（58人被临床诊断为自闭症，19人自我认定但未被正式诊断为自闭症，59人未被诊断或自我认定，但仍报告有社交困难）完成了在线学习问题。研究结果表明，在被试中存在着多种具有不同特点的补偿策略，个体和环境因素对补偿策略的使用和成功起着积极的调节作用，（社会关系、独立性、就业）和消极（心理健康状况差，诊断晚）与补偿策略使用相关的结果，没有诊断的个体使用的补偿策略与有诊断的个体在质量上相似。解释增加对补偿策略的认识和测量在自闭症中使用的策略应该指导未来的诊断指南，以提高诊断的准确性，并为自闭症谱系障碍患者提供支持，这些患者的认知困难在可观察到的行为中并不明显。版权所有（C）2019作者。由爱思唯尔有限公司发布
Background Little is known about the compensatory profile in autism; that is, people with autism spectrum disorder who show few symptoms in their behavioural presentation, despite continuing to report autism-related cognitive difficulties or differences. Even less is known about the specific compensatory strategies that these individuals use to disguise autism at the behavioural surface, both in the clinic and everyday life. It is also currently unclear whether individuals without a formal autism diagnosis, but experiencing autistic-like difficulties, use similar compensatory strategies, potentially enabling them to sit below the diagnostic threshold. This study aimed to investigate social compensatory strategies, and their effect on diagnosis and clinical outcome, in adults with and without autism.Methods In this study, individuals aged 18 years or older who responded to a study advert that was distributed worldwide via social media and the UK National Autistic Society formed a convenience sample. Participants self: reported their use and experiences of compensatory strategies using an online platform. Novel analyses, including a qualitative thematic approach, were used to interpret their responses and gain insight into compensatory strategies in autism.Findings Between Oct 19, 2017, and fan 2, 2018, 136 adults (58 had a clinical diagnosis of autism, 19 self-identified but were not formally diagnosed as autistic, and 59 were not diagnosed or self-identified, but nevertheless reported social difficulties) completed the online study questions. The findings suggested that there are multiple compensatory strategies with distinct characteristics, individual and environmental factors that modulate compensatory strategy use and success, positive (social relationships, independence, employment) and negative (poor mental health, late diagnosis) outcomes associated with compensatory strategy use, and that individuals without a diagnosis use compensatory strategies that are qualitatively similar to individuals with a diagnosis.Interpretation Increased awareness and measurement of compensatory strategy use in autism should guide future diagnostic guidelines, towards improved diagnostic accuracy and support for people with autism spectrum disorder whose cognitive difficulties are not immediately evident in observable behaviour. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.