Objective

Despite the high prevalence of mental health difficulties in autistic youth, little is known about the patterns of developmental continuity and change in psychiatric symptoms between childhood and adolescence. Using a stratified community-derived sample of autistic youth (n = 101; 57 males, 44 females), within (homotypic) and between (heterotypic) domain associations between psychiatric symptoms in childhood to adolescence were tested as well as whether any continuities were moderated by sex, IQ, autism symptom severity, social economic status, or parental mental health.

Method

Autistic youth were assessed for emotional, behavioral, and attention-deficit/hyperactivity disorder (ADHD) symptoms in childhood (age 4-9 years) and adolescence (age 13-17 years) using parental diagnostic interview. Unadjusted and adjusted (accounting for the co-occurrence of psychiatric symptoms in childhood) weighted models tested homotypic and heterotypic associations between symptoms in childhood and adolescence. Moderation of significant pathways was tested using multigroup analysis.

Results

Adolescent psychiatric symptoms all were predicted by symptoms of their childhood counterparts (emotional symptoms incidence rate ratio [IRR] = 1.06, 95% CI = 1.02-1.10, p < .01; behavioral symptoms IRR = 1.38, 95% CI = 1.21-1.59, p < .01; ADHD symptoms IRR = 1.11, 95% CI = 1.05-1.19, p < .01); the only heterotypic pathway that remained significant in adjusted analyses was from childhood emotional symptoms to adolescent ADHD symptoms (IRR = 1.04, 95% CI = 1.01-1.07, p = .02). Sex moderated the homotypic ADHD symptoms pathway; associations were significant in female participants only. Child IQ moderated the homotypic behavioral symptoms pathway; the association was stronger in youth with IQ <70.

Conclusion

Results from this community-based sample suggest that psychiatric symptoms in autistic youth exhibit substantial developmental continuity and thus highlight the importance of early screening and intervention. Sex and IQ may be important factors to consider when predicting likelihood of stability of ADHD and behavioral symptoms.

中文翻译：

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自闭症青少年从童年到青春期的精神症状的同型和异型连续性

客观的

尽管自闭症青年中心理健康问题的发生率很高，但人们对儿童和青春期之间的发展连续性和精神症状变化的模式知之甚少。使用来自自闭症青年的分层社区样本（n = 101；57 名男性，44 名女性），测试了童年到青春期精神症状之间（同型）和（异型）域之间的关联，以及是否有任何连续性被缓和按性别、智商、自闭症症状严重程度、社会经济状况或父母心理健康状况分类。

方法

使用父母诊断访谈，评估自闭症青少年在童年（4-9 岁）和青春期（13-17 岁）的情绪、行为和注意力缺陷/多动障碍 (ADHD) 症状。未调整和调整（考虑到儿童时期精神症状的共同出现）加权模型测试了儿童和青春期症状之间的同型和异型关联。使用多组分析测试重要途径的调节。

结果

青少年精神症状均由其童年对应物的症状预测（情绪症状发生率比 [IRR] = 1.06，95% CI = 1.02-1.10，p  < .01；行为症状 IRR = 1.38，95% CI = 1.21-1.59 , p  < .01；ADHD 症状 IRR = 1.11，95% CI = 1.05-1.19，p  < .01）；在调整后的分析中唯一保持显着的异型途径是从儿童情绪症状到青少年 ADHD 症状（IRR = 1.04，95% CI = 1.01-1.07，p  = .02）。性别调节了同型多动症症状通路；关联仅在女性参与者中显着。儿童智商调节同型行为症状通路；这种关联在智商 <70 的年轻人中更强。

结论

这个基于社区的样本的结果表明，自闭症青少年的精神症状表现出显着的发展连续性，从而突出了早期筛查和干预的重要性。在预测 ADHD 和行为症状稳定的可能性时，性别和智商可能是需要考虑的重要因素。