A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children.
A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children.
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DOI：
10.1017/s0033291723001599
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发表时间：
2023-12
影响因子：
6.9
通讯作者：
Elsabbagh, M.
中科院分区：
文献类型：
--
作者：
Wright, N.;Courchesne, V.;Pickles, A.;Bedford, R.;Duku, E.;Kerns, C. M.;Bennett, T.;Georgiades, S.;Hill, J.;Richard, A.;Sharp, H.;Smith, I. M.;Vaillancourt, T.;Zaidman-Zait, A.;Zwaigenbaum, L.;Szatmari, P.;Elsabbagh, M.
自闭症患者的心理健康问题增加，但关于儿童时期问题的发展过程的证据有限。我们比较了自闭症和典型发展（TD）队列中焦虑抑郁、行为和注意力问题的水平和增长。潜在生长曲线模型应用于2-10岁自闭症儿童初始队列（Pathways, N = 397； 84%男孩）和一般人群TD队列（Wirral儿童健康与发展研究；WCHADS, N = 884, 49%男孩）中重复父母报告的儿童行为检查表数据。生成百分位数图来量化自闭症儿童和TD儿童之间的差异。自闭症儿童表现出较高的心理健康问题水平，但考虑到自闭症和自闭症样本之间的智商和性别差异，这一水平大大降低了。在生长模式上有微小的差异；焦虑抑郁问题在学龄前和儿童后期的注意力问题尤其突出。家庭收入越高，三个维度的基础水平越低，但焦虑抑郁问题的增加幅度越大。智商越高，儿童时期注意力问题水平越低，衰退速度越快。女性的焦虑抑郁水平更高，行为问题下降得更快。社会影响型自闭症症状严重程度预示着注意力问题水平的提高。自闭症女孩的问题相对于非自闭症的同性同龄人来说尤其严重。与自闭症儿童相比，自闭症儿童，尤其是女孩，表现出更高的心理健康问题，而且在预测指标上存在一些差异。应将心理健康评估纳入自闭症儿童的临床实践。
Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2–10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.