pervasive developmental disorder

广泛性发育障碍
  • 文章类型: Journal Article
    这篇文献综述旨在探讨宗教信仰,信仰,以及自闭症青少年的相关信念。宗教一词与各种相关概念互换使用,如信仰,灵性,和宗教信仰,和更广泛的,包含认知的多方面方法,主观,社会,文化,在这个人口亚组中分析了宗教的情感领域。与神经多样性范式一致,这篇综述努力对自闭症谱系疾病采用包容性的镜头,欣赏认知和行为差异的频谱,并强调认识到优势和挑战的重要性,反映了围绕神经多样性和自闭症谱系疾病的细微差别的话语。然而,“高功能自闭症”和“障碍”等术语用于必要的地方,以反映评论中包含的期刊。通过访问APAPsycInfo等学术搜索引擎进行了系统的搜索,APAPsycarticles,APA心理测验,和PubMed。使用严格的纳入和排除标准,仅纳入以英语撰写并对人类受试者进行的同行评审文章。在对相关性和质量进行审查后选出的13篇文章中,确定了几个反复出现的主题。最重要的发现是在探索自闭症的宗教信仰时,不同术语和特征的关联。“确定了39个关键主题,分为六个主要主题。这些是宗教信仰,灵性,及其在自闭症青少年中的表达;自闭症青少年的宗教行为和做法;自闭症青少年的认知和宗教;社会和文化对自闭症青少年宗教信仰的影响;父母和照顾者的影响,观点,关于自闭症青少年的信仰和灵性的经验;以及信仰对自闭症青少年的益处:父母和青少年观点。从整个宗教和灵性的概念来看,从这篇综述中包含的现有研究可以推断,宗教信仰(认知能力,行为,和经验)与神经典型的青少年相比,自闭症青少年(高功能自闭症)的一部分可能不会显着减弱。然而,对于自闭症青少年来说,没有足够的研究得出相同或相反的结论。当被发现时,保留的宗教信仰可以归因于太多的因素,心智能力或心智能力下降,同理心,或想象力似乎不是宗教的唯一或主要预测因素或贡献者。文化的作用,父母,看护者,和宗教信仰是重要的,并且可能比其他先前争论的预测因素(如心理化)更有助于宗教信仰及其表达。许多自闭症青少年和他们的照顾者将宗教信仰和灵性视为他们和他们孩子生活中必不可少的领域,希望他们的孩子有机会成为宗教团体和派别的一部分,期待政府,宗教,和医疗当局在这一领域积极支持他们。调查结果呼吁决策者,宗教领袖,和利益攸关方制定包容和支持自闭症青少年的战略。宗教作为这些儿童及其家庭的资源和应对策略的可能作用值得探索。
    This literature review aims to explore religiosity, faith, and related beliefs in autistic adolescents. The term religiosity was used interchangeably with various related concepts such as faith, spirituality, and religious beliefs, and a broader, multifaceted approach encompassing the cognitive, subjective, social, cultural, and emotional domains of religiosity is analyzed in this population subgroup. In alignment with the neurodiversity paradigm, this review endeavors to adopt an inclusive lens toward autism spectrum conditions, appreciating the spectrum of cognitive and behavioral differences and highlighting the importance of recognizing strengths and challenges alike, reflecting the nuanced discourse surrounding neurodiversity and autism spectrum conditions. However, terms such as \"high-functioning autism\" and \"disorder\" were used where needed to reflect the journals included in the review. A systematic search was conducted by accessing academic search engines such as APA PsycInfo, APA PsycArticles, APA PsycTests, and PubMed. Only peer-reviewed articles written in English and performed on human subjects were included using strict inclusion and exclusion criteria. Several recurring themes were identified from the 13 articles selected after review for relevance and quality. The most important finding was the association of different terminologies and features while exploring \"religiosity in autism.\" Thirty-nine key themes were identified, which were grouped into six major themes. These were religious faith, spirituality, and its expression in autistic adolescents; religious behaviors and practices of autistic adolescents; cognition and religion in autistic teens; social and cultural influences on religiosity in autistic young ones; parents\' and carers\' influence, perspectives, and experiences about faith and spirituality on autistic adolescents; and perceived benefits of faith to autistic teens: parents and adolescent perspectives. Looking at the concept of religiosity and spirituality as a whole, it can be inferred from the available research included in this review that religiosity (cognitive abilities, behaviors, and experiences) in a subset of autistic adolescents (high-functioning autism) might not be significantly subdued as compared to neurotypical adolescents. However, there is not enough research to conclude the same or the opposite for autistic adolescents in general. When found, reserved religiosity could be attributed to a plethora of factors, and decreased mental ability or mentalization, empathy, or imagination did not seem to be the sole or primary predictors or contributors to religiosity. The role of culture, parents, carers, and religious affiliations was significant and might be a stronger contributor to religiosity and its expression than other previously argued predictors like mentalization. Many autistic teens and their carers regard religiosity and spirituality as essential domains in their and their children\'s lives, want their children to be given opportunities to be a part of religious groups and affiliations, and look forward to government, religious, and healthcare authorities actively supporting them in this domain. The findings call for policymakers, religious leaders, and stakeholders to devise strategies for inclusion and support for autistic adolescents. The possible role of religion as a resource and coping strategy for these children and their families is worth exploring.
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  • 文章类型: Journal Article
    目的:自1990年代以来,美国自闭症谱系障碍(ASD)患病率的种族差异已经发生了变化。这篇综述阐述了这种转变的性质和背景,并讨论了潜在的影响因素和未来研究的领域。
    方法:本综述纳入了美国ASD患病率的17项基于人群的流行病学出生队列研究,将种族作为变量。研究是通过PubMed上的关键字搜索确定的。要包括在内,研究需要在患病率估计中包括种族或族裔作为变量,包括至少1000例自闭症患者,并在6月3日之前以英文出版,2023年。
    结果:结果表明,在2010年之前的几乎所有出生队列中,白人儿童的ASD患病率最高。黑人的ASD患病率,西班牙裔,在2010年出生队列中,亚洲/太平洋岛民(API)儿童(分别为22.3,22.5和22.2/1000)的患病率超过了白人儿童(21.2/1000)的患病率,并且在2012年出生队列中继续增加.
    结论:美国ASD患病率存在持续的种族差异,这些差异在2010年后被颠倒了,当时黑人的ASD患病率,西班牙裔,&API儿童超过了白人儿童中的ASD患病率。这种ASD患病率的种族重组的可能驱动因素包括ASD筛查和诊断的变化,健康保险政策的变化,移民政策的变化,和提高少数群体的教育程度。
    OBJECTIVE: Racial differences in prevalence rates of autism spectrum disorder (ASD) have shifted in the United States (US) since the 1990s. This review addresses the nature and context of this shift and discusses potential contributing factors and areas for future research.
    METHODS: Seventeen population-based epidemiological birth cohort studies on ASD prevalence in the US that included race as a variable are included in the review. Studies were identified via a keyword search on PubMed. To be included, studies were required to include race or ethnicity as a variable in the prevalence estimates, include at least 1000 cases with autism, and be published in English by June 3rd, 2023.
    RESULTS: Results suggest that in nearly all birth cohorts prior to 2010, ASD prevalence rates were highest among White children. ASD prevalence rates among Black, Hispanic, and Asian/Pacific Islander (API) children (22.3, 22.5, and 22.2 per 1000, respectively) surpassed prevalence rates among White children (21.2 per 1000) in the 2010 birth cohort and continued to increase in the 2012 birth cohorts.
    CONCLUSIONS: There are persistent racial differences in ASD prevalence in the US, and these differences were inverted after 2010, when ASD prevalence among Black, Hispanic, & API children surpassed ASD prevalence among White children. Possible drivers of this racial repatterning of ASD prevalence include changes in ASD screening and diagnosis, changes to health insurance policy, changes to immigration policy, and increased education attainment by minority groups.
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  • 文章类型: Journal Article
    自闭症谱系障碍(ASD)的诊断在典型形式中是相对自愿的。光谱的边缘及其扩展程度,然而,有争议。这具有深远的影响,这超出了理论考虑:首先,周围形式的自闭症比中枢形式更普遍;第二,我们不知道非典型表格的典型针对性建议有多相关。在DSM-IV-TR中,自闭症的这些边缘在广泛性发育障碍-未指明(PDD-NOS)类别中进行了研究。尽管可靠性低,这个以前的诊断对于阐明边缘的灰色区域特别有意义.因此,该系统的目的是与孤独症相比,研究PDD-NOS的临床特征。
    通过搜索PubMed和WebOfScience数据库进行了逐步系统的PRISMA文献综述,以选择相应的研究。
    系统评价包括81项研究,包括6,644名患有PDD-NOS的儿童。比较PDD-NOS和AD的横断面和纵向研究表明,PDD-NOS对应于较温和形式的自闭症,影响较小,相关疾病较少,除了精神分裂症和情绪障碍.
    我们的评论挑战PDD-NOS的最初观点,并显示了这种诊断在处理自闭症边缘时的临床相关性,以及频谱中包含的事实上的多样性。然而,鉴于PDD-NOS的许多局限性(低可靠性,时间的不稳定性,可接受性低),我们建议DSM-5的分类学变化:我们基于与社会化障碍相关的三个主要维度引入一个新的类别,情绪不稳定和精神病症状。
    我们的评论认为AD和PDD-NOS在临床特征上有区别,因此强调了研究自闭症边缘的必要性。虽然PDD-NOS类别的局限性使得从研究的角度研究这些边缘无关紧要,我们认为,对于心理健康专业人员来说,采用多维度的方法来记录社会化,情绪不稳定和精神病症状会很有趣。因此,我们的审查鼓励未来的研究来测试新类别的相关标准,并可能确定发育轨迹,具体的干预措施和治疗。
    UNASSIGNED: Autism Spectrum Disorder (ASD) diagnosis is relatively consensual in typical forms. The margins of the spectrum and their degree of extension, however, are controversial. This has far-reaching implications, which extend beyond theoretical considerations: first, peripheral forms of autism are more prevalent than central forms; second, we do not know how relevant typical-targeted recommendations are for atypical forms. In DSM-IV-TR, these margins of autism were studied within the category of Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS). In spite of its low reliability, this former diagnosis was of particular interest to shed light on the gray area of margins. The aim of this systematic is therefore to investigate the clinical characteristics of PDD-NOS in comparison with Autistic Disorder.
    UNASSIGNED: A stepwise systematic PRISMA literature review was conducted by searching PubMed and Web Of Science databases to select corresponding studies.
    UNASSIGNED: The systematic review included 81 studies comprising 6,644 children with PDD-NOS. Cross-sectional and longitudinal studies comparing PDD-NOS and AD showed that PDD-NOS corresponds to milder form of autism with less impact and less associated disorder, with the exception of schizophrenia and mood disorder.
    UNASSIGNED: Our review challenges initial views of PDD-NOS, and shows the clinical relevance of this diagnosis when dealing with the margins of autism, and the de facto diversity included in the spectrum. However, in view of the many limitations of PDD-NOS (low reliability, instability through time, low acceptability), we suggest taxonomic changes in DSM-5: we introduce a new category based on three main dimensions related to socialization impairment, emotional lability and psychotic symptoms.
    UNASSIGNED: Our review argues for a distinction between AD and PDD-NOS on clinical characteristics and thus highlights the need to study the margins of autism. While the limitations of the PDD-NOS category made it irrelevant to investigate these margins from a research perspective, we believe that a multidimensional approach for mental health professionals taping socialization, emotion lability and psychotic symptoms would be interesting. Our review therefore encourage future studies to test relevant criteria for a new category and possibly identify developmental trajectories, specific interventions and treatments.
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  • 文章类型: Case Reports
    越来越多的证据表明,某些自闭症谱系障碍的病因涉及免疫功能障碍。免疫疾病与自闭症谱系障碍之间的确切关系尚不清楚。在这里,我们报告了一名14岁的男性患有无丙种球蛋白血症,他被诊断出患有自闭症谱系障碍,他一生中经常接受外源性免疫球蛋白。该案例研究支持当前的理论,这些理论涉及某些自闭症谱系障碍患者的抗体缺乏。我们的案例将增加越来越多的文献,以了解自闭症发病机制中免疫缺陷之间的联系。
    A growing evidence base has implicated immune dysfunction in the etiology of some cases of autism spectrum disorder. The precise relationship between immune disorders and autism spectrum disorder remains unclear. Herein we report a 14-year-old-male with agammaglobulinemia, who was diagnosed with autism spectrum disorder, and who has received exogenous immunoglobulins regularly for most of his life. This case study supports current theories implicating antibody deficiencies in some individuals with an autism spectrum disorder. Our case will add to the growing literature of understanding the connection between immune deficiencies in the pathogenesis of autism.
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  • 文章类型: Journal Article
    自闭症谱系障碍(ASD)的病理生理学尚未完全了解;然而,已经报道了炎症反应和谷氨酸信号的改变,导致研究针对ASD治疗中免疫谷氨酸能系统的分子。棕榈酰乙醇胺(PEA)是一种天然存在的饱和N-酰基乙醇胺,已被证明可有效控制炎症,抑郁症,癫痫,和痛苦,可能通过对谷氨酸毒性的神经保护作用。这里,我们系统回顾了所有在ASD中检查PEA及其生物行为相关性的人类和动物研究。研究表明ASD中PEA和其他内源性大麻素(ECB)/酰基乙醇胺(AE)的血清/脑水平改变。改变PEA信号对社会暴露的反应和改变的酶的表达/活性负责ECBs/AEs的合成和催化,以及下调过氧化物酶体增殖物激活受体-α(PPAR-α)和大麻素受体靶GPR55mRNA的脑表达,已被报道。应激和暴露于外源性大麻素可能会调节ECBs/AE水平和神经精神疾病候选基因的表达,对ASD有影响。有限的研究表明,补充PEA可以通过改善语言,社会和非社会行为来降低整体自闭症的严重程度。潜在的神经生物学基础包括调节免疫反应,神经炎症,神经营养,凋亡,神经发生,神经可塑性,神经变性,线粒体功能,和微生物群的活动,可能通过过氧化物酶体增殖物激活受体-α(PPAR-α)激活。
    Autism spectrum disorder (ASD) pathophysiology is not completely understood; however, altered inflammatory response and glutamate signaling have been reported, leading to the investigation of molecules targeting the immune-glutamatergic system in ASD treatment. Palmitoylethanolamide (PEA) is a naturally occurring saturated N-acylethanolamine that has proven to be effective in controlling inflammation, depression, epilepsy, and pain, possibly through a neuroprotective role against glutamate toxicity. Here, we systematically reviewed all human and animal studies examining PEA and its biobehavioral correlates in ASD. Studies indicate altered serum/brain levels of PEA and other endocannabinoids (ECBs)/acylethanolamines (AEs) in ASD. Altered PEA signaling response to social exposure and altered expression/activity of enzymes responsible for the synthesis and catalysis of ECBs/AEs, as well as downregulation of the peroxisome proliferator activated receptor-α (PPAR-α) and cannabinoid receptor target GPR55 mRNA brain expression, have been reported. Stress and exposure to exogenous cannabinoids may modulate ECBs/AEs levels and expression of candidate genes for neuropsychiatric disorders, with implications for ASD. Limited research suggests that PEA supplementation reduces overall autism severity by improving language and social and nonsocial behaviors. Potential neurobiological underpinnings include modulation of immune response, neuroinflammation, neurotrophy, apoptosis, neurogenesis, neuroplasticity, neurodegeneration, mitochondrial function, and microbiota activity, possibly through peroxisome proliferator-activated receptor-α (PPAR-α) activation.
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  • 文章类型: Journal Article
    UNASSIGNED: Among the many intervention programs for children with autism spectrum disorder (ASD), the Early Start Denver Model (ESDM) is one of the few approaches that has succeeded in demonstrating clinical efficacy in randomized control trials. Here, we inves-tigate the clinical efficacy of ESDM intervention in young children with ASD in a community setting within Japan.
    UNASSIGNED: All subjects were children with ASD who received ESDM intervention during the study period. Each ESDM session lasted 75 min and occurred once per week for at least 12 weeks. The outcome measures consisted of the Kyoto Scale of Psychological Develop-ment (K-test), Aberrant Behavior Checklist-Japanese version (ABC-J), and the Clinical Global Impression-Severity scale (CGI-S).
    UNASSIGNED: Twenty-seven subjects (29.4±6.4 months old) received ESDM intervention that lasted for 8.0±2.6 months on average. The score on Language and Social developmental quotient on the K-test increased significantly after the intervention. The total scores on the ABC-J and CGI-S significantly decreased after completion of the ESDM intervention.
    UNASSIGNED: Our results suggest that ESDM intervention could reduce the severity of distinct clinical features of ASD, such as impair-ments in social interaction and communication assessed by the K-test, and maladaptive behavior rated by the ABC-J and CGI-S. We be-lieve that the ESDM adapted to each institution might become one of the standard options for children with ASD in Japan.
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  • 文章类型: Journal Article
    It is challenging to treat symptoms of autism spectrum disorder (ASD), comorbid psychiatric disorders and ASD-associated symptoms. Some of the commonly used medications to treat these can, and frequently do have serious adverse side effects. Therefore, it is important to identify medications that are effective and with fewer side effects and negative outcomes. In this review, we looked at current evidence available for using the serotonin and norepinephrine reuptake inhibitors (SNRIs) class of medications in treating some of these often difficult to treat symptoms and behaviors. An extensive literature search was conducted using EBSCO.host. Our search algorithm identified 130 articles, 6 of which were deemed to meet criteria for the purpose of this review. Each of these six articles was independently reviewed and critically appraised. As a prototype of the SNRIs family, venlafaxine was found to be a useful adjuvant in children and adults with ASD for the treatment of self-injurious behaviors, aggression, and ADHD symptoms when used in doses lower than its antidepressant dosage. However, duloxetine was not found to show any added benefit in treatment of any of the comorbid symptoms and behaviors in ASD when compared to other antidepressants. On the other hand, milnacipran was reported to produce improvements in impulsivity, hyperactivity symptoms, and social functioning through reduction of inattention of ADHD when comorbid with ASD. Overall, SNRIs were shown variable effectiveness in treatment of these comorbid symptoms and behaviors in ASD.
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  • 文章类型: Journal Article
    UNASSIGNED: There is limited research on the type and quantity of actions (activities) occupational therapy practitioners utilize when providing sensory integration treatment to children with Autism Spectrum Disorders (ASD).
    UNASSIGNED: A coding scheme identifying specific aspects of sensory integration treatment was developed and used to analyze 34 videos of 9 children with ASD, aged between 18 and 56 months, treated by 8 occupational therapists. Occupational therapists providing sensory integration treatment to children with ASD were behaviorally coded and rated using Observer XT, a software package designed for analysis of behavioral processes.
    UNASSIGNED: Verbal communications, including offers, positive commands, and feedback, to facilitate engagement were the most frequent actions enacted by therapists. Proprioceptive activities were the most frequent sensory opportunities presented. Therapists received high ratings for sensitivity qualities.
    UNASSIGNED: The number of sensory opportunities and interactions the therapists provided suggest concordance with sensory integration treatment components in the clinical setting. General impression ratings indicate engagement between child and therapist may be an important aspect of sensory integration treatment for young children with ASD. Quantification of therapists\' actions can provide insight into the moment-to-moment decision-making and relationships between therapist and child during daily practice of sensory integration treatment.
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  • 文章类型: Journal Article
    Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects social interaction and communication, with restricted interests, activity and behaviors. ASD is highly familial, indicating that genetic background strongly contributes to the development of this condition. However, only a fraction of the total number of genes thought to be associated with the condition have been discovered. Moreover, other factors may play an important role in ASD onset. In fact, it has been shown that parental conditions and in utero and perinatal factors may contribute to ASD etiology. More recently, epigenetic changes, including DNA methylation and micro RNA alterations, have been associated with ASD and proposed as potential biomarkers. This review aims to provide a summary of the literature regarding ASD candidate genes, mainly focusing on synapse formation and functionality and relevant epigenetic and environmental aspects acting in concert to determine ASD onset.
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  • 文章类型: Journal Article
    Clinically significant attention-deficit/hyperactivity disorder (ADHD) symptoms are common and impairing in children and youth with autism spectrum disorder(ASD). The aim of this systematic review and meta-analysis was to (a) evaluate the efficacy and safety of pharmacotherapy for the treatment of ADHD symptoms in ASD and (b) distil findings for clinical translation.
    We searched electronic databases and clinical trial registries (1992 onwards). We selected randomized controlled trials conducted in participants <25 years of age, diagnosed with ASD that evaluated ADHD outcomes (hyperactivity/impulsivity and inattention) following treatment with stimulants (methylphenidate or amphetamines), atomoxetine, alpha-2 adrenergic receptor agonists, antipsychotics, tricyclic antidepressants, bupropion, modafinil, venlafaxine, or a combination, in comparison with placebo, any of the listed medications, or behavioral therapies. Data were pooled using a random-effects model.
    Twenty-five studies (4 methylphenidate, 4 atomoxetine, 1 guanfacine, 14 antipsychotic, 1 venlafaxine, and 1 tianeptine) were included. Methylphenidate reduced hyperactivity (parent-rated: standardized mean difference [SMD] = -.63, 95%CI = -.95,-.30; teacher-rated: SMD = -.81, 95%CI = -1.43,-.19) and inattention (parent-rated: SMD = -.36, 95%CI = -.64,-.07; teacher-rated: SMD = -.30, 95%CI = -.49,-.11). Atomoxetine reduced inattention (parent-rated: SMD = -.54, 95%CI = -.98,-.09; teacher/investigator-rated: SMD = -0.38, 95%CI = -0.75, -0.01) and parent-rated hyperactivity (parent-rated: SMD = -.49, 95%CI = -.76,-.23; teacher-rated: SMD = -.43, 95%CI = -.92, .06). Indirect evidence for significant reductions in hyperactivity with second-generation antipsychotics was also found. Quality of evidence for all interventions was low/very low. Methylphenidate was associated with a nonsignificant elevated risk of dropout due to adverse events.
    Direct pooled evidence supports the efficacy and tolerability of methylphenidate or atomoxetine for treatment of ADHD symptoms in children and youth with ASD. The current review highlights the efficacy of standard ADHD pharmacotherapy for treatment of ADHD symptoms in children and youth with ASD. Consideration of the benefits weighed against the limitations of safety/efficacy data and lack of data evaluating long-term continuation is undertaken to help guide clinical decision-making regarding treatment of co-occurring ADHD symptoms in children and youth with ASD.
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