■自闭症女性经常被诊断不足,误诊,和/或在以后的生活中被诊断出来。限制性和重复行为(RRB)对诊断越来越重要,但在女性中通常被评为较低。这是否反映了这些特征的真正较低水平,或者女性典型的RRB是否具有不同的表型表现,这可能无法在当前的定量测量工具上注册,目前尚不清楚。
■21名自闭症女性和21名自闭症男性在实际年龄上匹配,FSIQ完成了AQ,ADOS-2和ADI-R从ADOS-2和ADI-R中选择与自闭症的DSM-5诊断标准中限制和重复行为的四个领域相关的项目。使用混合方法分析方法,在不同性别之间比较了这些指标的评分和评论,以更好地表征自闭症女性的RRB.
■AQ上没有性别差异,广泛评估自闭症特征。当按照DSM-5的四个RRB标准进行分析时,当使用传统算法评分时,ADI-R没有性别差异,传统算法将问题缩小到在男性比例高的研究样本中捕获自闭症时更敏感和更特异的问题.当纳入与DSM-5相关的其他项目以识别更广泛的项目池中的性别变化时,女性在刻板的动作和言语上得分较高。在ADOS-2期间,女性也参与了更多的感官行为。定性分析表明,女性更有可能进行刻板的身体摇摆和旋转,焦虑时的刻板行为,对变化表现出重大反应,重复的语言,包括列表和计数,和感官行为,尤其是在触觉领域。
■探索性发现强调了RRB的性别差异,这可能有助于提高女性的诊断清晰度。女性较高的触觉感觉行为表明,更新的DSM-5现在将感觉成分作为诊断标准的一部分,女性的诊断灵敏度可能会提高。
UNASSIGNED: Autistic females are frequently underdiagnosed, misdiagnosed, and/or diagnosed later in life. Restricted and Repetitive Behaviors (
RRBs) are increasingly critical for diagnosis and yet are commonly rated lower in females. Whether this reflects genuinely lower levels of these traits, or if female-typical
RRBs have a different phenotypic presentation that may not register on current quantitative measurement tools is unclear.
UNASSIGNED: Twenty-one autistic females and 21 autistic males matched on chronological age and FSIQ completed the AQ, ADOS-2, and ADI-R. Items from the ADOS-2 and ADI-R were selected that were relevant to the four areas of restricted and repetitive behavior in the DSM-5 diagnostic criteria of autism. Using a mixed-methods analytical approach, scores and comments on these measures were compared between sexes to better characterize
RRBs in autistic females.
UNASSIGNED: There were no sex differences on the AQ, which broadly assesses autistic traits. When analyzed by the four DSM-5 RRB criteria, there were no sex differences on the ADI-R when using traditional algorithm scoring that narrows questions down to those that are more sensitive and specific in capturing autism in research samples with a high proportion of males. When incorporating additional items relevant to the DSM-5 to identify sex changes in a broader pool of items, females scored higher on stereotyped movements and speech. Females also engaged in more sensory behaviors during the ADOS-2. Qualitative analyses indicated that females were more likely to engage in stereotyped body rocking and spinning, stereotyped behaviors when anxious, to show major reactions to changes, repetitive language including listing and counting, and sensory behaviors, especially in the tactile domain.
UNASSIGNED: Exploratory findings highlight sex differences in
RRBs that may help enhance diagnostic clarity for females. Higher tactile sensory behaviors in females suggests there may be increased diagnostic sensitivity for females with the updated DSM-5 that now includes sensory components as part of the diagnostic criteria.