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Correction: Associations between academic achievement and internalizing disorders in Swedish students aged 16 years between 1990 and 2018. 更正:1990至2018年间瑞典16岁学生学习成绩与内化障碍之间的关系。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-11-20 DOI: 10.1007/s00787-024-02617-1
Björn Högberg, Mattias Strandh, Solveig Petersen, Karina Nilsson
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引用次数: 0
A nomogram for predicting non-suicide self-injury in youth depression patients: a longitudinal analysis. 预测青少年抑郁症患者非自杀性自伤的提名图:纵向分析。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-11-18 DOI: 10.1007/s00787-024-02603-7
Yingwen Li, Yarong Ma, Bin Sun, Robert Rosenheck, Jie Zhang, Hongbo He

Non-suicidal self-injury (NSSI) behavior is a common issue in youth with depression while lacks a prognostic prediction model. This study aims to develop a nomogram for NSSI in youth with depression. A total of 701 patients were included in the analysis based a youth depression cohort. They were further divided into a training set and a validation set. The Lasso regression and binary logistic regression were used to select variables for the nomogram. The nomogram's discrimination, calibration, accuracy, clinical applicability, and generalization involved the use of metrics such as the area under the receiver operating characteristic curve (ROC), Hosmer-Lemeshow (HL) test, Brier score, calibration curve, decision curve analysis (DCA), and internal validation. The Delong test was employed to compare the ROC performance between the two models. These patients had an average age of 19.3+/-3.3 years, and 101 (20.6%) individuals reported NSSI. Five risk factors for NSSI were identified: age, age at first medication, previous instances of NSSI, academic stress score in the Adolescent Self-rating Life Events Check List (ASLEC), and somatic anxiety of the 14 item Hamilton Anxiety Rating Scale (HAMA-14). The training set and validation set of binary logistic regression-based model showed good discrimination (area under the curve (AUC) 0.781, 95% CI: 0.735 ~ 0.827; and 0.757, 95% CI: 0.682 ~ 0.831, respectively), calibration (P = 0.421 and 0.175, respectively), and accuracy (Brier score 0.119 to 0.155 and 0.109 to 0.168, respectively). A prognostic nomogram was developed and validated to assist clinicians in predicting NSSI of youth with depression.

非自杀性自伤(NSSI)行为是青少年抑郁症患者的常见问题,但缺乏预后预测模型。本研究旨在为青少年抑郁症患者的 NSSI 行为建立一个提名图。在青少年抑郁症队列的基础上,共有 701 名患者被纳入分析。他们被进一步分为训练集和验证集。采用拉索回归和二元逻辑回归来选择提名图的变量。对提名图的区分度、校准、准确性、临床适用性和普适性的评估采用了接收者工作特征曲线下面积(ROC)、Hosmer-Lemeshow(HL)检验、Brier 评分、校准曲线、决策曲线分析(DCA)和内部验证等指标。德隆检验用于比较两种模型的 ROC 性能。这些患者的平均年龄为 19.3+/-3.3 岁,101 人(20.6%)报告了 NSSI。确定了 NSSI 的五个风险因素:年龄、首次服药年龄、以前的 NSSI 事件、青少年生活事件自评量表 (ASLEC) 中的学习压力得分以及汉密尔顿焦虑评定量表 (HAMA-14) 14 个项目中的躯体焦虑。基于二元逻辑回归模型的训练集和验证集显示出良好的区分度(曲线下面积(AUC)分别为 0.781,95% CI:0.735 ~ 0.827;0.757,95% CI:0.682 ~ 0.831)、校准度(P = 0.421)和准确度(Brier 评分分别为 0.119 ~ 0.155 和 0.109 ~ 0.168)。开发并验证了一种预后提名图,以帮助临床医生预测抑郁症青少年的 NSSI。
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引用次数: 0
The patient and the family: investigating parental mental health problems, family functioning, and parent involvement in child and adolescent mental health services (CAMHS). 病人与家庭:调查父母的心理健康问题、家庭功能以及父母参与儿童和青少年心理健康服务(CAMHS)的情况。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-11-18 DOI: 10.1007/s00787-024-02607-3
Emme-Lina Wirehag Nordh, Karin Grip, Ulf Axberg

Parental mental health problems can impact child mental health, as well as treatment of child mental health problems. The aim of this study was to investigate self-reported mental health problems in parents of children referred to outpatient child and adolescent mental health services (CAMHS) and to compare child mental health problems, family variables, treatment received and parent participation in treatment planning between parents above and below the cut-off for elevated mental health problems. The sample included N = 111 parents of N = 98 children. Parental reports covering their own and their children's mental health problems, family functioning, adult relationship satisfaction, and previous treatment for mental health problems were collected at the time of the child's intake appointment. Questions concerning contact with CAMHS were completed one year later. At the time of the intake appointment, 44% of the children had a parent who reported elevated mental health problems. In these families, children reportedly had significantly more mental health problems and problematic family functioning was more common than in families where parent mental health problems were not elevated. Parents with elevated mental health problems received group-based parent support/education to a greater extent during the first year of contact with CAHMS and reported less participation in treatment planning compared to parents without elevated mental health problems. To conclude, findings indicate that co-occurring mental health problems are common in parents when their child is referred to CAMHS, and in these families, it is reported that children have more symptoms, and more families experience problematic functioning. These factors merit consideration in assessment and treatment planning, indicating increased treatment needs in this group of families.

父母的心理健康问题会影响儿童的心理健康以及儿童心理健康问题的治疗。本研究旨在调查儿童和青少年心理健康门诊服务(CAMHS)转诊儿童的父母自我报告的心理健康问题,并比较高于和低于心理健康问题升高临界值的父母的儿童心理健康问题、家庭变量、接受的治疗和父母参与治疗计划的情况。样本包括 N = 111 名家长和 N = 98 名儿童。在儿童就诊时收集了家长的报告,内容包括家长本人及其子女的心理健康问题、家庭功能、成人关系满意度以及之前的心理健康问题治疗情况。有关与儿童心理健康服务机构联系的问题则在一年后完成。在预约入院时,44% 的儿童的父母有严重的心理健康问题。据报告,在这些家庭中,儿童的心理健康问题明显增多,家庭功能出现问题的情况也比父母心理健康问题不严重的家庭更常见。与没有精神健康问题的家长相比,有严重精神健康问题的家长在与 CAHMS 接触的第一年中接受了更多的以小组为基础的家长支持/教育,并报告说参与治疗计划的程度较低。总之,研究结果表明,当孩子被转介到儿童及青少年保健服务机构时,家长普遍会有并发的精神健康问题,据报告,在这些家庭中,孩子有更多的症状,更多的家庭功能出现问题。这些因素值得在评估和治疗计划中加以考虑,表明这类家庭对治疗的需求增加了。
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引用次数: 0
Mental health, risk behaviors, and social life factors in relation to adolescents' suicide ideation, plans and attempt. 心理健康、危险行为和社会生活因素与青少年自杀意念、计划和企图自杀的关系。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-11-15 DOI: 10.1007/s00787-024-02616-2
Stine Danielsen, Katrine Strandberg-Larsen, Massimiliano Orri, Merete Nordentoft, Annette Erlangsen, Trine Madsen

Objective: This study investigated differences in mental health and well-being, risk behaviors, and social life factors among adolescents who experienced different forms of suicidality.

Methods: We examined 18-years-olds in the Danish National Birth Cohort (N = 47,852). Suicidality was defined with mutually exclusive categories ranging from no suicidality, self-reported suicide ideation, plans, and attempt as well as hospital-recorded suicide attempt. The proportion of adolescents with self-reported poor mental health and well-being, risk behaviors, and social life factors were compared across forms of suicidality. Sample weights were applied.

Results: Depressive symptoms were reported by 14% (95% CI 13%;14%) of girls with no suicidality, 44% (95% CI 43%;45%) of girls with suicide ideation, and 68% (95% CI 65%;72%) 66% (95% CI 60%;72%) of girls with self-reported suicide attempt or hospital-recorded suicide attempt respectively. Among boys, depressive symptoms were reported by 5% (95% CI 4%;5%) of those with no suicidality, 27% (95% CI 26%;28%) of those with suicide ideation, and 51% (95% CI 45%;57%) and 40% (95% CI 22%;58%) of those with self-reported suicide attempt or hospital-recorded suicide attempt respectively. Likewise, other aspects of poor mental health and well-being gradually increased relative with more severe forms of suicidality, while no notable differences were identified between adolescents with self-reported and hospital-recorded suicide attempt. Similar tendencies were observed for risk behaviors and social life factors.

Conclusion: These findings suggest that adolescents with suicidality, including the large proportion with suicide ideation only, faces challenges across several parameters of mental health and well-being, risk behavior, and social life factors. This emphasizes the need for community-based interventions to identify and support the large group of adolescents experiencing both more and less severe forms of suicidality. Clinicians should prioritize comprehensive psychiatric intervention to address the complex needs of suicidal adolescents effectively.

研究目的本研究调查了经历过不同形式自杀的青少年在心理健康和幸福感、风险行为和社会生活因素方面的差异:我们调查了丹麦全国出生队列(N = 47,852)中的 18 岁青少年。自杀倾向的定义包括无自杀倾向、自我报告的自杀意念、自杀计划和自杀未遂以及医院记录的自杀未遂等相互排斥的类别。研究人员比较了不同自杀倾向的青少年自我报告的不良心理健康和幸福感、危险行为和社会生活因素的比例。结果显示14%(95% CI 13%;14%)无自杀倾向的女孩、44%(95% CI 43%;45%)有自杀意念的女孩、68%(95% CI 65%;72%)66%(95% CI 60%;72%)有自我报告自杀未遂或医院记录自杀未遂的女孩分别报告了抑郁症状。在男生中,无自杀倾向者占 5%(95% CI 4%;5%),有自杀倾向者占 27%(95% CI 26%;28%),自我报告有自杀企图或医院记录有自杀企图者分别占 51%(95% CI 45%;57%)和 40%(95% CI 22%;58%),有抑郁症状者分别占 5%(95% CI 4%;5%)、27%(95% CI 26%;28%)、51%(95% CI 45%;57%)和 40%(95% CI 22%;58%)。同样,相对于更严重的自杀倾向,其他方面的不良心理健康和幸福感也在逐渐增加,而自我报告有自杀企图的青少年和医院记录有自杀企图的青少年之间并无明显差异。在危险行为和社会生活因素方面也观察到类似的趋势:这些研究结果表明,有自杀倾向的青少年,包括大部分仅有自杀意念的青少年,在心理健康和幸福感、危险行为和社会生活因素等多个方面都面临着挑战。这就强调了以社区为基础的干预措施的必要性,以识别和支持一大批有较严重和较轻微自杀倾向的青少年。临床医生应优先考虑综合精神干预,以有效解决有自杀倾向青少年的复杂需求。
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引用次数: 0
Acceptance and commitment therapy as a transdiagnostic approach to adolescents with different anxiety disorders: study protocol. 将接纳与承诺疗法作为一种跨诊断方法,用于治疗患有不同焦虑症的青少年:研究方案。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-11-14 DOI: 10.1007/s00787-024-02608-2
Diana Vieira Figueiredo, Maria do Céu Salvador, Daniel Rijo, Paula Vagos

Adolescence increases vulnerability to mental ill-health, particularly anxiety disorders like Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD). Still, the understanding of Psychological Flexibility/Inflexibility (PF/PI) as a transdiagnostic framework relevant to explaining these difficulties and the efficacy of Acceptance and Commitment Therapy (ACT) in addressing adolescent SAD and GAD remains limited. Hence, this study has two aims: examining the role of PI/PF on adolescents' mental health and assessing ACT's efficacy for adolescent SAD and GAD. We will collect data from 400 community adolescents and employ network analysis to explore connections between PI/PF processes, anxiety, and flourishing. We will also investigate pathways linking PI/PF processes with flourishing and anxiety across samples (clinical SAD, clinical GAD, and mentally healthy groups), expecting to find similar patterns. Furthermore, a Randomized Controlled Trial with three groups (control, SAD experimental and GAD experimental), each comprising 29 participants, and four assessment moments (pre- and post-intervention and 3- and 6-months follow-up) will be conducted. Similar improvements are anticipated in both experimental groups, driven by changes in PI/PF processes. Findings from this work will provide valuable evidence to PI/PF as accurate conceptualizations of human suffering and expand the transdiagnostic application of ACT to adolescents with anxiety disorders.

青春期是心理疾病的高发期,尤其是社交焦虑症(SAD)和广泛性焦虑症(GAD)等焦虑症。尽管如此,人们对心理弹性/灵活性(PF/PI)作为一种跨诊断框架来解释这些困难以及接受与承诺疗法(ACT)在解决青少年社交焦虑症(SAD)和广泛性焦虑症(GAD)方面的疗效的理解仍然有限。因此,本研究有两个目的:研究 PI/PF 对青少年心理健康的作用,以及评估 ACT 对青少年 SAD 和 GAD 的疗效。我们将收集 400 名社区青少年的数据,并采用网络分析来探索 PI/PF 过程、焦虑和蓬勃发展之间的联系。我们还将研究不同样本(临床 SAD、临床 GAD 和心理健康组)中 PI/PF 过程与蓬勃发展和焦虑之间的联系途径,希望能发现类似的模式。此外,我们还将进行一项随机对照试验,分为三组(对照组、SAD 实验组和 GAD 实验组),每组 29 人,并进行四次评估(干预前和干预后以及 3 个月和 6 个月的随访)。预计在 PI/PF 过程变化的推动下,两个实验组都会有类似的改善。这项工作的结果将为 PI/PF 作为人类痛苦的准确概念化提供有价值的证据,并将 ACT 的跨诊断应用扩展到患有焦虑症的青少年。
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引用次数: 0
Addressing the mental health of families living with autism spectrum disorder: insights and future directions. 解决自闭症谱系障碍患者家庭的心理健康问题:见解与未来方向。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-11-14 DOI: 10.1007/s00787-024-02611-7
Lizhen Huang, Mingbang Wang, Wenxian Huang, Minyu Zhang, Wei He
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引用次数: 0
Stimulant medication and symptom interrelations in children, adolescents and adults with attention-deficit/hyperactivity disorder. 患有注意力缺陷/多动症的儿童、青少年和成人的兴奋剂药物治疗与症状之间的相互关系。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-11-11 DOI: 10.1007/s00787-024-02610-8
Zarah van der Pal, Hilde M Geurts, Jonas M B Haslbeck, Alex van Keeken, Anne Marijn Bruijn, Linda Douw, Daan van Rooij, Barbara Franke, Jan Buitelaar, Nanda Lambregts-Rommelse, Catharina Hartman, Jaap Oosterlaan, Marjolein Luman, Liesbeth Reneman, Pieter J Hoekstra, Tessa F Blanken, Anouk Schrantee

Stimulant medication is effective in alleviating overall symptom severity of attention-deficit/hyperactivity disorder (ADHD), yet interindividual variability in treatment response and tolerability still exists. While network analysis has identified differences in ADHD symptom relations, the impact of stimulant medication remains unexplored. Increased understanding of this association could provide valuable insights for optimizing treatment approaches for individuals with ADHD. In this study, we compared and characterized ADHD symptom networks (including 18 ADHD symptoms) between stimulant-treated (n = 348) and untreated (n = 70) individuals with ADHD and non-ADHD controls (NACs; n = 444). Moreover, we compared symptom networks between subgroups defined by their stimulant treatment trajectory (early-and-intense use, late-and-moderate use). Stimulant-treated individuals with ADHD showed stronger associations between symptoms, compared with untreated individuals with ADHD and NACs. We found no differences in symptom networks between the stimulant treatment trajectory subgroups. Prospective longitudinal studies are needed to disentangle whether the identified differences stem from treatment or pre-existing factors.

兴奋剂药物能有效减轻注意力缺陷/多动障碍(ADHD)的总体症状严重程度,但治疗反应和耐受性方面的个体差异仍然存在。虽然网络分析发现了注意力缺陷/多动障碍症状关系的差异,但兴奋剂药物的影响仍未得到探讨。加深对这一关联的了解,可以为优化多动症患者的治疗方法提供有价值的见解。在这项研究中,我们比较并描述了接受过兴奋剂治疗(348 人)和未接受过兴奋剂治疗(70 人)的多动症患者与非多动症对照组(444 人)之间的多动症症状网络(包括 18 种多动症症状)。此外,我们还比较了根据兴奋剂治疗轨迹(早期和密集使用、晚期和中度使用)定义的亚组之间的症状网络。与未经治疗的 ADHD 患者和 NACs 相比,接受过兴奋剂治疗的 ADHD 患者症状之间的关联性更强。我们发现,兴奋剂治疗轨迹亚组之间的症状网络没有差异。我们需要进行前瞻性纵向研究,以厘清所发现的差异是源于治疗还是原有因素。
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引用次数: 0
Capturing complexity: cultural and demographic nuances in suicidal tendencies research among chinese students. 把握复杂性:中国学生自杀倾向研究中的文化和人口细微差别。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-11-09 DOI: 10.1007/s00787-024-02613-5
Mahindra Bandari, Cindy Osei, Manisha Bandari, Uzay Cagatay, Warren Chan
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引用次数: 0
Electrophysiological indices of reward anticipation as ADHD risk and prognostic biomarkers. 作为多动症风险和预后生物标志物的奖赏预期电生理指标。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-11-08 DOI: 10.1007/s00787-024-02606-4
Nóra Bunford, Kristóf Ágrez, György Hámori, Júlia Koller, Attila Pulay, Zsófia Nemoda, János M Réthelyi

The attention-deficit/hyperactivity disorder (ADHD) clinical phenotype has limitations for deciphering ADHD etiology and predicting prognosis. Although relative to the clinical phenotype, intermediate phenotypes may have better explanatory and prognostic power, the extent to which ADHD intermediate phenotypes are associated with ADHD risk and prognosis is unknown. The aim of this study was to evaluate evidence for event-related potential (ERP) measures of reward anticipation as ADHD risk and prognostic biomarkers. We examined, whether (1) in a sample of adolescents (N = 304; Mage = 15.78 years, SD = 1.08; 39.5% female), accounting for the effects of age, sex, ADHD severity and depression, ERPs are associated with ADHD polygenic risk scores (PRSs) (ADHD risk) and (2) in a sample of adolescents at-risk for ADHD (n = 99; Mage = 15.78 years, SD = 1.08; 39.5% female), accounting for the effects of age, sex, ADHD severity, depression, and baseline outcome values, ERPs are associated, prospectively, with alcohol misuse (ADHD prognosis). In adolescents, greater ADHD PRSs were associated with lower electrophysiological anticipatory attention to motivationally relevant feedback (b = -0.115, p = .046 95%CI [-0.228; -0.002]). The predictors accounted for 5% of the variance in the outcome. In adolescents at-risk for ADHD, at 18-month follow-up, lower electrophysiological anticipatory attention to motivationally relevant feedback was associated with greater alcohol consumption (b = -7.454, p = .007, 95%CI [-12.873; -2.034]). The predictors accounted for 31% of the variance in this outcome. These findings were replicated in sensitivity analyses with behavioral performance variables added as covariates. The current findings support the hypothesis that ERP amplitudes of reward anticipation may be ADHD risk and prognostic biomarkers and suggest that intermediate phenotypes may confer advantages over the ADHD clinical phenotype in delineating etiology and predicting prognosis.

注意缺陷/多动障碍(ADHD)的临床表型在解读ADHD病因和预测预后方面存在局限性。虽然相对于临床表型,中间表型可能具有更好的解释力和预后力,但ADHD中间表型与ADHD风险和预后的关联程度尚不清楚。本研究旨在评估奖励预期的事件相关电位(ERP)测量作为多动症风险和预后生物标志物的证据。我们研究了:(1) 在青少年样本中(样本数 = 304;年龄 = 15.78 岁,SD = 1.08;39.5% 为女性),考虑到年龄、性别、多动症严重程度和抑郁的影响,ERP 是否与多动症多基因风险评分(PRSs)(多动症风险)相关;(2) 在多动症高危青少年样本中(样本数 = 99;年龄 = 15.78 岁,SD = 1.08;39.5% 为女性),ERP 是否与多动症多基因风险评分(PRSs)(多动症风险)相关。78 岁,SD = 1.08;39.5% 为女性)中,考虑到年龄、性别、多动症严重程度、抑郁和基线结果值的影响,ERPs 与酗酒(多动症预后)相关。在青少年中,ADHD PRS越大,对动机相关反馈的电生理预期注意越低(b = -0.115,p = .046,95%CI [-0.228; -0.002])。预测因素占结果变异的 5%。对于有多动症风险的青少年,在18个月的随访中,对动机相关反馈的电生理预期注意力较低与饮酒量较高有关(b = -7.454,p = .007,95%CI [-12.873; -2.034])。预测因素占这一结果变异的 31%。在将行为表现变量作为协变量加入的敏感性分析中,这些结果得到了验证。目前的研究结果支持奖励预期的ERP振幅可能是ADHD风险和预后生物标志物的假设,并表明在确定病因和预测预后方面,中间表型可能比ADHD临床表型更具优势。
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引用次数: 0
Neuroanatomical basis of language ability in an autism subgroup with moderate language deficits. 具有中度语言障碍的自闭症亚群语言能力的神经解剖学基础。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-11-08 DOI: 10.1007/s00787-024-02605-5
Yaqiong Xiao, Ningxuan Zhang, Kaiyu Huang, Shuiqun Zhang, Jin Xin, Qingshan Huang, Aiwen Yi

Children with autism spectrum disorder (ASD) are highly heterogenous in their language abilities. A number of studies have shown neural correlates of language deficits in children with ASD, but the underlying neuroanatomical foundation of early language deficits in ASD remains largely elusive. In this study, we analyzed MRI data from a cohort of Chinese children with ASD (n = 67) and typical development (TD, n = 37) aged 1.5 to 6.5 years. The ASD sample was classified into two subgroups based on the median of the language scores: ASD with moderate language deficits (ASDmoderate, n = 34) and ASD with severe language deficits (ASDsevere, n = 34). We tested the group differences in the brain volumes between TD and two ASD subgroups, and also examined the associations between cortical grey matter volume and language abilities in TD and ASD subgroups, separately. We observed significant group differences in grey matter and white matter volume, with post-hoc analyses specifically indicating significant differences between TD and ASDmoderate subgroup. Significant correlations between grey matter volume and language scores were observed exclusively within the ASDmoderate subgroup, including positive associations in the bilateral superior temporal gyrus, hippocampus, and left inferior parietal lobe, and negative correlations in the bilateral precuneus. These findings provide novel evidence for the neuroanatomical basis related to language ability in an ASD subgroup with moderate language deficits, and offer new insights into the heterogeneity of language deficits in children with ASD.

自闭症谱系障碍(ASD)儿童的语言能力存在很大差异。许多研究显示了自闭症谱系障碍儿童语言障碍的神经相关性,但自闭症谱系障碍儿童早期语言障碍的潜在神经解剖学基础在很大程度上仍然难以捉摸。在本研究中,我们分析了一组年龄在1.5至6.5岁的中国ASD(67人)和典型发育(TD,37人)儿童的核磁共振成像数据。根据语言得分的中位数,ASD样本被分为两个亚组:中度语言障碍 ASD(ASDmoderate,n = 34)和重度语言障碍 ASD(ASDsevere,n = 34)。我们检测了 TD 和两个 ASD 亚组之间大脑体积的群体差异,还分别检测了 TD 和 ASD 亚组大脑皮层灰质体积与语言能力之间的关联。我们观察到灰质和白质体积存在明显的组间差异,事后分析特别表明 TD 和 ASD 中度亚组之间存在明显差异。只有在中度自闭症亚组中观察到灰质体积与语言分数之间存在显著相关性,包括双侧颞上回、海马和左侧下顶叶的正相关性,以及双侧楔前叶的负相关性。这些发现为具有中度语言障碍的ASD亚组中与语言能力相关的神经解剖学基础提供了新的证据,并为了解ASD儿童语言障碍的异质性提供了新的视角。
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引用次数: 0
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European Child & Adolescent Psychiatry
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