Repetitive and stereotyped behaviours in pervasive developmental disorders
Repetitive and stereotyped behaviours in pervasive developmental disorders
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DOI：
10.1111/j.1469-7610.2005.01565.x
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发表时间：
2006-06-01
影响因子：
7.6
通讯作者：
Santosh, Paramala J.
中科院分区：
文献类型：
--
作者：
Carcani-Rathwell, Iris;Rabe-Hesketh, Sophia;Santosh, Paramala J.
背景：重复和刻板行为是一组异质性的行为，存在于许多神经精神疾病。尽管它们在PDD中具有核心意义，但尚不清楚这些行为是否有不同的群体对自闭症具有不同的特异性。研究方法：重复行为的两因素模型，即感觉/运动（低阶）和认知刚性（高阶），被概念化。该模型的拟合优度的数据进行了检查，在临床人口的PDD儿童，有和没有精神发育迟滞，和那些只有精神发育迟滞（MR）。结果：PDD受试者的所有重复行为发生率均高于仅MR受试者。两个独立的“低阶”和“高阶”子组的重复行为的存在被证实只有在MR组。低阶行为似乎更多地与全球发展问题相关，而高阶行为则与PDD组的反刍显著相关。结论：这项研究表明，重复行为可能有两个不同的亚组，其中感觉和运动重复行为通常与较低的发育年龄和较低的特定自闭症综合征，而“高阶”行为可能是一个更“自闭症特异性”的功能。PDD中低阶和高阶行为的共同出现可能反映了这些疾病中弥漫性改变的神经网络的最终结果，因此是PDD的一个具体特征。有必要对这些行为进行更系统的研究，不仅在自闭症障碍中，而且在其他神经精神障碍中。
Background: Repetitive and stereotyped behaviours are a heterogeneous group of behaviours present in many neuropsychiatric disorders. Despite their core significance in PDD, it is not clear whether there are distinct groups of these behaviours with different specificity to autism. Methods: A two-factor model of the repetitive behaviours, namely sensory/motor (lower-order) and cognitive rigidity (higher-order), was conceptualised. The model's goodness of fit to the data was examined in a clinic population of children with PDD, with and without mental retardation, and of those with only mental retardation (MR). Results: Subjects with PDD had higher rates of all repetitive behaviours compared to those with MR only. The existence of two independent 'lower-order' and 'higher-order' sub-groups of the repetitive behaviours was confirmed only in the MR group. The lower-order behaviours appear to be associated more with global developmental problems, whereas the higher-order behaviours were significantly associated with ruminations in the PDD group. Conclusions: This study suggests that there may be two distinct sub-groups of repetitive behaviours whereby the sensory and motor repetitive behaviours are generally associated with lower developmental age and less specific to the autistic syndrome whereas the 'higher-order' behaviours may be a more 'autism-specific' feature. The co-occurrence of the lower- and higher-order behaviours in PDD might reflect the end result of diffuse altered neural networks in these disorders thus being a specific feature of PDD. There is a need for more systematic studies of these behaviours not only in autistic disorders but also in other neuropsychiatric disorders.