自闭症谱系障碍社交动机理论：机制及干预探索

自闭症谱系障碍(Autism Spectrum Disorder, ASD)表现为社会交往困难以及重复刻板兴趣或行为。社交动机理论提出ASD个体是由于社交动机缺乏导致的社交障碍。目前该理论缺乏理论元素及结构关系的系统论证, 及基于此理论的低龄ASD儿童群体的研究证据。本研究拟采用心理实验法、眼动及近红外脑成像技术, 探索低龄ASD儿童早期社交奖赏、社交定向异常眼动标记及眶额叶脑区活动的神经机制。此外, 通过音乐奖赏强化学习的干预方式改善该理论的核心元素(社交奖赏), 观测能否改善ASD儿童的社交动机。本研究的开展有望对该理论进行系统验证, 并形成改善社交行为的潜在干预方案。     

Parents' perceptions of the quality of infant sleep behaviours and practices: A qualitative systematic review

A systematic review of qualitative studies was conducted to explore how parents perceive sleep quality in their infants aged 0–24 months and the factors that influence these perceptions. A systematic search of the databases Scopus, Embase, Cinahl, PsycInfo and MEDLINE, was undertaken to identify eligible peer-reviewed studies published between 2006–2021. Ten papers met inclusion criteria and were subsequently included in the review. Evaluation of papers with the Critical Appraisal Skills Programme qualitative checklist classified papers as weak, moderate or strong, with half considered strong. Thematic synthesis identified one superordinate theme, culture, and five interrelated subordinate themes regarding how parents perceive their infant's sleep and the factors that may influence these perceptions. These themes were: (1) Infants physical and emotional comfort; (2) Beliefs regarding safety; (3) Parental and familial wellbeing; (4) Perceived degree of infant agency; (5) Influence of external beliefs and opinions. The findings from this review may assist practitioners in providing parents with personalized and culturally sensitive information regarding infant sleep and may also inform antenatal and early intervention practices, subsequently minimizing parental distress regarding infant sleep patterns.     

Modified Comprehensive Behavioral Intervention for Tics: Treating Children With Tic Disorders,Co-Occurring ADHD,and Psychosocial Impairment

Our objective was to evaluate the feasibility and acceptability, and preliminary efficacy of a modified comprehensive behavioral intervention for tics (MCBIT) therapy for youth with chronic tic disorders (CTDs), co-occurring attention-deficit hyperactivity disorder (ADHD), and associated psychosocial impairment. Seventeen youth ages 10–17 with CTD and co-occurring ADHD were randomly assigned to the MCBIT group (n = 9) or to a control group where they received traditional comprehensive behavioral intervention for tics (CBIT) therapy (n = 8). Both groups received ten 55-minute weekly treatment sessions, and two 55-minute biweekly relapse prevention sessions. Sixteen of the 17 participants completed the study, and acceptability ratings in both treatment groups were high with no significant differences in expectation of improvement. The MCBIT and CBIT groups in combination showed significant improvement in tic severity, ADHD symptom severity, and tic-related impairment. Group differences were not significant. The results indicate that MCBIT treatment is feasible and acceptable for youth with CTD and ADHD, and is similarly well tolerated relative to traditional CBIT. Results were not sufficiently superior to recommend MCBIT over CBIT for this population. However, given the demonstrated benefit of behavioral treatments that target co-occurring conditions concurrently, continuing to examine novel behavioral approaches that can target tics and related conditions simultaneously and successfully is recommended.     

Examining Safety Behavior Subtypes Across Distinct Social Contexts in Social Anxiety Disorder and Major Depression

People with social anxiety disorder (SAD) use different types of safety behaviors that have been classified as avoidance vs. impression management. The current study investigated differences in safety behavior subtype use in 132 individuals with principal diagnoses of social anxiety disorder (SAD, n = 69), major depressive disorder (MDD, n = 30), and nonpatient controls (n = 33) across two social contexts: an interpersonal relationship-building task (social affiliation) and a speech task (social performance). We examined whether diagnostic groups differed in safety behavior subtype use and whether group differences varied by social context. We also explored relationships between avoidance and impression management safety behaviors, respectively, and positive and negative valence affective and behavioral outcomes within the social affiliation and social performance contexts. Safety behavior use varied by diagnosis (SAD > MDD > nonpatient controls). The effect of diagnosis on impression management safety behavior use depended on social context: use was comparable for the principal SAD and MDD groups in the social performance context, whereas the SAD group used more impression management safety behaviors than the MDD group in the social affiliation context. Greater use of avoidance safety behaviors related to higher negative affect and anxious behaviors, and lower positive affect and approach behaviors across contexts. Impression management safety behaviors were most strongly associated with higher positive affect and approach behaviors within the social performance context. These findings underscore the potential value of assessing safety behavior subtypes across different contexts and within major depression, in addition to SAD.     

Behavioral Parent Training Engagement Among Young Children With Autism Spectrum Disorder

The purpose of the current study was to examine engagement with Behavioral Parent Training (BPT) for families of children with Autism Spectrum Disorder (ASD) and assess openness to novel delivery formats for BPT (e.g., telehealth, group). Participants were caregivers of 501 children with ASD (ages 2–6) enrolled in the SPARK (Simons Foundation Powering Autism Research for Knowledge) online national registry. The study assessed: (1) rates of child disruptive behavior diagnoses, (2) engagement and satisfaction with BPT, (3) parent and child factors (e.g., diagnostic history), and (4) openness to novel delivery formats. Almost 25% of young children with ASD in this sample had disruptive behavior problems rising to the level of a diagnosis of ADHD or ODD and thus would benefit from BPT. However, only one third of these families had actually been referred to BPT. Families indicated high level of interest in participating in BPT, with a particular interest in Parent Child Interaction Therapy (PCIT) as well as novel delivery formats such as telehealth and group. Specific components of the therapy and delivery formats were indicative of parent satisfaction (e.g. groups, longer treatment sessions, longer treatment length). Specific parent and child characteristics were predictive of openness to novel formats (e.g. parental depression, more severe behavioral challenges, lower verbal skills). Results underscore the need for increased referrals and access to BPT programs the ASD population. Both parent and child characteristics are important for determining appropriate delivery formats.     

Cross-Lagged Analyses of Prolonged Grief and Depression Symptoms With Insomnia Symptoms

Prolonged grief disorder, characterized by severe, persistent and disabling grief, has recently been added to the DSM-5-TR and ICD-11. Treatment for prolonged grief symptoms shows limited effectiveness. It has been suggested that prolonged grief symptoms exacerbate insomnia symptoms, whereas insomnia symptoms, in turn, may fuel prolonged grief symptoms. To help clarify if treating sleep disturbances may be a viable treatment option for prolonged grief disorder, we examined the proposed reciprocal relationship between symptoms of prolonged grief and insomnia. On three time points across 6-month intervals, 343 bereaved adults (88% female) completed questionnaires to assess prolonged grief, depression, and insomnia symptoms. We applied random intercept cross-lagged panel models (RICLPMs) to assess reciprocal within-person effects between prolonged grief and insomnia symptoms and, as a secondary aim, between depression and insomnia symptoms. Changes in insomnia symptoms predicted changes in prolonged grief symptoms but not vice versa. Additionally, changes in depression and insomnia symptoms showed a reciprocal relationship. Our results suggest that targeting insomnia symptoms after bereavement is a viable option for improving current treatments for prolonged grief disorder.     

Information processing,neuropsychological function,and the inherited predisposition to alcoholism

Sons of male alcoholics are at particularly heightened risk for the development of alcoholism. This heightened risk frequently appears in association with increased incidence of conduct disorder or hyperactivity, with deficits in abstract thinking and poor school performance, with abnormalities in cued psychophysiological response, and with increased sensitivity to the putatively stress-response-dampening effects of alcohol intoxication. This risk and its associated features are discussed within the context of a neuropsychological theory, predicated on the notions (1) that deficits in cognitive functions theoretically dependent upon the intact functioning of the prefrontal cortex could underlie manifestation of the idiosyncracies commonly attributed to sons of male alcoholics, and (2) that acute alcohol intoxication could relieve the subjective discomfort associated with the consequences of such deficits.     

Prevalence of personality disorders among bulimics,nonbulimic binge eaters,and normal controls

We examined the comorbidity of bulimia and personality pathology among college women. Subjects included women (n=23) meeting DSM-III-R criteria for bulimia nervosa (bulimics), women (n=23) who reported binge eating but did not fulfill the criteria for bulimia nervosa (binge eaters), and women (n=23) who did not binge eat (normals). The subjects completed an assessment battery consisting of the Personality Disorders Examination and the SCID as well as the Beck Depression Inventory, the Rosenberg Self-Esteem Index, and measures of impulsivity and self-defeating tendencies. Fourteen of 23 bulimics (61%) met criterion for a personality disorder using DSM-III-R Axis II criteria. In comparison, 3 of 23 (13%) binge eaters and 1 of 23 (4%) normal subjects received an Axis II diagnosis. Borderline and self-defeating diagnoses were the predominant personality disorders in 96% of the bulimics exhibiting clinically significant personality pathology. Bulimics also exhibited significantly more depression, impulsivity, and self-defeating behavior and lower self-esteem than binge eaters and normals. The findings are discussed within a conceptual framework that posits an interaction between personality pathology and restrained eating.     

Validity of the DSM-III-R personality disorder Clusters

This study assessed the validity of the DSM-III-R personality disorder clusters (i.e., odd-eccentric, dramatic-emotional-erratic, and anxious-fearful) by examining the relationships between self-report measures that tap the core features shared by disorders from each cluster and Cluster scores established via a semistructured interview in a sample of 57 outpatients. Results indicated a high degree of correlation among the DSM-III-R personality disorder Cluster scores. In addition, a series of regression analyses revealed that self-report scores did not account for a significant amount of variance in their respective Cluster scores over and above that accounted for by other self-report measures and other Cluster scores. These results suggest that the current DSM-III-R cluster classification scheme may not be appropriate, and it is recommended that a more empirically justifiable classification of the personality disorders be adopted in DSM-IV.