Validity of the social responsiveness scale to differentiate between autism spectrum disorders and disruptive behaviour disorders
Validity of the social responsiveness scale to differentiate between autism spectrum disorders and disruptive behaviour disorders
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DOI：
10.1007/s00787-013-0427-5
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发表时间：
2014-02-01
影响因子：
6.4
通讯作者：
Freitag, Christine M.
中科院分区：
文献类型：
--
作者：
Cholemkery, Hannah;Kitzerow, Janina;Freitag, Christine M.
自闭症谱系障碍（ASD）以及对立违抗（ODD）和行为障碍（CD）的特征是与同龄人的社会互动困难。社会反应量表（SRS）测量儿童和青少年的互惠社会行为，最初是作为自闭症特征的定量测量而开发的。在本研究中，我们比较了ODD，CD和ASD儿童的父母评定SRS评分，并单独检查SRS的诊断有效性，并结合额外的问卷调查来区分各组。我们假设，SRS更好地区分ASD和典型的发展控制（TD）比ASD和破坏性行为障碍ODD和CD。样本由三个临床组组成：ASD无共病智力延迟（N = 55），ODD/CD（N = 55）和TD（N = 55），年龄在6至18岁之间。两组受试者的年龄、性别和智商相匹配。比较三组的SRS评分。通过受试者工作特征（ROC）分析检查SRS总分和分项评分的敏感性和特异性。Logistic回归分析计算估计正确指定的个人的比率。SRS在ASD和TD之间具有很好的区分性（ROC AUC = 1.00），但ASD与ODD/CD相比的敏感性和特异性显著降低（ROC AUC = 0.82）。三个家长评定的问卷的组合导致了提高的有效性，以区分ASD和ODD/CD。对于可疑ASD和/或ODD/CD儿童的临床筛查目的，SRS应与其他疾病特异性问卷结合使用，以提高两种疾病的正确分类率。
Autism spectrum disorder (ASD) as well as oppositional defiant (ODD) and conduct disorder (CD) is characterised by difficulties in social interaction with peers. The Social Responsiveness Scale (SRS) measures reciprocal social behaviour in children and adolescents and was originally developed as a quantitative measure of autistic traits. In the present study, we compare parent-rated SRS scores in children with ODD, CD, and ASD and examine the diagnostic validity of the SRS alone and in combination with additional questionnaires to differentiate between groups. We hypothesize that the SRS better differentiates ASD and typically developing controls (TD) than ASD and the disruptive behaviour disorders ODD and CD. The sample consists of three clinical groups: ASD without comorbid intellectual delay (N = 55), ODD/CD (N = 55), and TD (N = 55), between 6 and 18 years. The groups were matched by age, sex, and IQ. SRS scores were compared for the three groups. Sensitivity and specificity of the SRS total and sub-scores were examined by receiver operating characteristics (ROC) analyses. Logistic regression analyses were calculated for estimating the rate of correctly specified individuals. The SRS differentiated excellently between ASD and TD (ROC-AUC = 1.00), but sensitivity and specificity were considerably lower when ASD was compared with ODD/CD (ROC-AUC = 0.82). A combination of three parent-rated questionnaires resulted in an improved validity to differentiate ASD and ODD/CD. For clinical screening purposes in children suspicious of ASD and/or ODD/CD, the SRS should be used in combination with additional disorder-specific questionnaires to improve the rate of correct classification of both disorders.