PDF(Pubmed)
Abstract：
It has been suggested that the sequelae of trauma are under-recognized in youth on the autism spectrum. We aimed to generate expert consensus regarding important trauma indicators, including but not limited to traumatic stress symptoms, in autistic youth.
We recruited 72 experts in autism and/or childhood trauma. Via a 2-round Delphi survey, experts commented on and rated the importance of 48 potential indicators, drawn from PTSD criteria and a broader literature on traumatic sequelae in autism. A revised list of 51 indicators, 18 clinical guidelines developed from expert comments, and summaries of expert qualifications and ratings from Round 1 were submitted to a second round (n = 66; 92% retention) of expert review and rating.
Twenty-two indicators reached consensus (>75% round 2 endorsement). Many, but not all, reflected PTSD criteria, including intrusions (e.g., trauma re-enactments in perseverative play/speech), avoidance of trauma-reminders, and negative alterations in mood/cognition (e.g., diminished interest in activities) and in arousal/reactivity (e.g., exaggerated startle). Experts also identified increased reliance on others, adaptive and language regressions, self-injurious behavior, and non-suicidal self-injury as important indicators. Consensus guidelines emphasized the need for tailored measures, developmentally informed criteria, and multiple informants to increase diagnostic accuracy.
Expert consensus emphasizes and informs a need for tailored diagnostic guidelines and measures to more sensitively assess traumatic reactions in autistic youth.
We recruited 72 experts in autism and/or childhood trauma. Via a 2-round Delphi survey, experts commented on and rated the importance of 48 potential indicators, drawn from PTSD criteria and a broader literature on traumatic sequelae in autism. A revised list of 51 indicators, 18 clinical guidelines developed from expert comments, and summaries of expert qualifications and ratings from Round 1 were submitted to a second round (n = 66; 92% retention) of expert review and rating.
Twenty-two indicators reached consensus (>75% round 2 endorsement). Many, but not all, reflected PTSD criteria, including intrusions (e.g., trauma re-enactments in perseverative play/speech), avoidance of trauma-reminders, and negative alterations in mood/cognition (e.g., diminished interest in activities) and in arousal/reactivity (e.g., exaggerated startle). Experts also identified increased reliance on others, adaptive and language regressions, self-injurious behavior, and non-suicidal self-injury as important indicators. Consensus guidelines emphasized the need for tailored measures, developmentally informed criteria, and multiple informants to increase diagnostic accuracy.
Expert consensus emphasizes and informs a need for tailored diagnostic guidelines and measures to more sensitively assess traumatic reactions in autistic youth.
摘要：
目的：有人认为，在自闭症谱系中，青少年对创伤后遗症的认识不足。我们旨在就重要的创伤指标达成专家共识，包括但不限于创伤应激症状，在自闭症青年。
方法：我们招募了72名自闭症和/或儿童创伤方面的专家。通过两轮德尔福调查，专家对48项潜在指标的重要性进行了评论和评级，来自创伤后应激障碍标准和更广泛的自闭症创伤后遗症文献。修订后的51项指标清单，根据专家意见制定的18个临床指南，第1轮的专家资格和评级摘要已提交给第二轮（n=66；保留率92％）的专家审查和评级。
结果：22项指标达成共识（>75%的第2轮认可）。许多,但不是全部,反映了创伤后应激障碍标准，包括侵入(例如，坚持不懈的游戏/演讲中的创伤重演)，避免创伤提醒，和情绪/认知的负面改变(例如，对活动的兴趣减弱)和对唤醒/反应性(例如，夸张的惊吓）。专家们还发现对他人的依赖增加，自适应和语言回归，自我伤害的行为，并将非自杀自我伤害作为重要指标。共识准则强调需要采取量身定制的措施，发展知情标准，和多个线人，以提高诊断的准确性。
结论：专家共识强调并告知需要量身定制的诊断指南和措施，以更敏感地评估自闭症青年的创伤反应。
方法：我们招募了72名自闭症和/或儿童创伤方面的专家。通过两轮德尔福调查，专家对48项潜在指标的重要性进行了评论和评级，来自创伤后应激障碍标准和更广泛的自闭症创伤后遗症文献。修订后的51项指标清单，根据专家意见制定的18个临床指南，第1轮的专家资格和评级摘要已提交给第二轮（n=66；保留率92％）的专家审查和评级。
结果：22项指标达成共识（>75%的第2轮认可）。许多,但不是全部,反映了创伤后应激障碍标准，包括侵入(例如，坚持不懈的游戏/演讲中的创伤重演)，避免创伤提醒，和情绪/认知的负面改变(例如，对活动的兴趣减弱)和对唤醒/反应性(例如，夸张的惊吓）。专家们还发现对他人的依赖增加，自适应和语言回归，自我伤害的行为，并将非自杀自我伤害作为重要指标。共识准则强调需要采取量身定制的措施，发展知情标准，和多个线人，以提高诊断的准确性。
结论：专家共识强调并告知需要量身定制的诊断指南和措施，以更敏感地评估自闭症青年的创伤反应。
