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摘要
孤独症谱系障碍(ASD)儿童常共患情绪行为问题,包括焦虑、强迫症、抑郁症、失眠等,这些情绪行为问题将加重ASD患儿的核心损害,严重影响其社交和身心健康.现有研究表明认知行为治疗(CBT)能通过改变负面认知、抑制不良情绪及减少负面行为进而改善ASD儿童的情绪行为问题.本文针对国内外开展的CBT在改善ASD的情绪行为方面的治疗研究展开综述,旨在为ASD的综合治疗提供新的方向.
Abstract
Children with autism spectrum disorder (ASD) often suffer from comorbid emotional and behavioral problems, including anxiety, obsessive-compulsive disorder, depression, insomnia, etc, which will aggravate the core damage of children with ASD and seriously affect their social and physical and mental health. Existing studies have shown that cognitive behavioral therapy (CBT) can improve emotional and behavioral problems in children with ASD by changing negative cognitions, suppressing negative emotions, and reducing negative behaviors. This article reviewed the therapeutic research on CBT in improving the emotional behavior of ASD at home and abroad, aiming to provide a new direction for the comprehensive treatment of ASD.
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许旭,田甜,胡幼芳.
认知行为治疗对孤独症谱系障碍儿童情绪行为干预的研究进展[J].
中国妇幼健康研究, 2024, 35(9): 94-98 DOI:10.3969/j.issn.1673-5293.2024.09.015
| [1] |
Lord C, Brugha T S, Charman T, et al. Autism spectrum disorder[J]. Nat Rev Dis Primers, 2020, 6(1): 1-23.
|
| [2] |
Mottron L, Bzdok D. Autism spectrum heterogeneity: fact or artifact? [J]. Mol Psychiatry, 2020, 25(12): 3178-3185.
|
| [3] |
Zhou H, Xu X, Yan W, et al. Prevalence of autism spectrum disorder in China: a nationwide multi-center population-based study among children aged 6 to 12 years[J]. Neurosci Bull, 2020, 36(9): 961-971.
|
| [4] |
Enright S J. Cognitive behaviour therapy-clinical applications[J]. BMJ, 1997, 314(7097): 1811-1816.
|
| [5] |
韦晴, 胡晓毅. 孤独症儿童的认知行为干预研究[J]. 应用心理学, 2018, 24(3): 234-242.
|
| [6] |
Van Steensel F J, Bögels S M, Perrin S. Anxiety disorders in children and adolescents with autistic spectrum disorders: a meta-analysis[J]. Clin Child Fam Psycho Rev, 2011, 14(3): 302-317.
|
| [7] |
Kim J A, Szatmari P, Bryson S E, et al. The prevalence of anxiety and mood problems among children with autism and asperger syndrome[J]. Autism, 2000, 4(2): 117-132.
|
| [8] |
Perihan C, Burke M, Bowman-Perrott L, et al. Effects of cognitive behavioral therapy for reducing anxiety in children with high functioning ASD: a systematic review and meta-analysis[J]. J Autism Dev Disord, 2020, 50(6): 1958-1972.
|
| [9] |
Wood J J, Kendall P C, Wood K S, et al. Cognitive behavioral treatments for anxiety in children with autism spectrum disorder: a randomized clinical trial[J]. JAMA Psychiatry, 2020, 77(5): 474-483.
|
| [10] |
Sharma S, Hucker A, Matthews T, et al. Cognitive behavioural therapy for anxiety in children and young people on the autism spectrum: a systematic review and meta-analysis[J]. BMC Psychol, 2021, 9(1): 151.
|
| [11] |
Wise J M, Cepeda S L, Ordaz D L, et al. Open trial of modular cognitive-behavioral therapy in the treatment of anxiety among late adolescents with autism spectrum disorder[J]. Child Psychiatry Hum Dev, 2019, 50(1): 27-34.
|
| [12] |
Oerbeck B, Overgaard K R, Attwood T, et al. “Less stress”: a pilot study on a cognitive behavioral treatment program for anxiety in children with autism spectrum disorders[J]. Scand J Child Adolesc Psychiatr Psychol, 2021, 9: 30-40.
|
| [13] |
Lord C, Elsabbagh M, Baird G, et al. Autism spectrum disorder[J]. Lancet, 2018, 392(10146): 508-520.
|
| [14] |
Driscoll K, Schonberg M, Stark M F, et al. Family-centered cognitive behavioral therapy for anxiety in very young children with autism spectrum disorder[J]. J Autism Dev Disord, 2020, 50(11): 3905-3920.
|
| [15] |
Clark C, Hill V, Charman T. School based cognitive behavioural therapy targeting anxiety in children with autistic spectrum disorder: a quasi-experimental randomised controlled trail incorporating a mixed methods approach[J]. J Autism Dev Disord, 2017, 47(12): 3883-3895.
|
| [16] |
Luxford S, Hadwin J A, Kovshoff H. Evaluating the effectiveness of a school-based cognitive behavioural therapy intervention for anxiety in adolescents diagnosed with autism spectrum disorder[J]. J Autism Dev Diord, 2017, 47(12): 3896-3908.
|
| [17] |
Vigerland S, Serlachius E, Thulin U, et al. Long-term outcomes and predictors of internet-delivered cognitive behavioral therapy for childhood anxiety disorders[J]. Behav Res Ther, 2017, 90: 67-75.
|
| [18] |
Guzick A G, Schneider S C, Kendall P C, et al. Change during cognitive and exposure phases of cognitive-behavioral therapy for autistic youth with anxiety disorders[J]. J Consult Clin Psychol, 2022, 90(9): 709-714.
|
| [19] |
Vause T, Jaksic H, Neil N, et al. Functional behavior-based cognitive-behavioral therapy for obsessive compulsive behavior in children with autism spectrum disorder: a randomized controlled trial[J]. J Autism Dev Disord, 2020, 50(7): 2375-2388.
|
| [20] |
Meier S M, Petersen L, Schendel D E, et al. Obsessive-compulsive disorder and autism spectrum disorders: longitudinal and offspring risk[J]. PLoS One, 2015, 10(11): e0141703.
|
| [21] |
Kose L K, Fox L, Storch E A. Effectiveness of cognitive behavioral therapy for individuals with autism spectrum disorders and comorbid obsessive-compulsive disorder: a review of the research[J]. J Dev Phys Disabil, 2018, 30(1): 69-87.
|
| [22] |
Jassi A, Fernandez de la Cruz L, Russell A, et al. An evaluation of a new autism-adapted cognitive behaviour therapy manual for adolescents with obsessive-compulsive disorder[J]. Child Psychiatry Hum Dev, 2021, 52(5): 916-927.
|
| [23] |
Flygare O, Andersson E, Ringberg H, et al. Adapted cognitive behavior therapy for obsessive-compulsive disorder with co-occurring autism spectrum disorder: a clinical effectiveness study[J]. Autism, 2020, 24(1): 190-199.
|
| [24] |
Iniesta-Sepulveda M, Nadeau J M, Ramos A, et al. An initial case series of intensive cognitive-behavioral therapy for obsessive-compulsive disorder in adolescents with autism spectrum disorder[J]. Child Psychiatry Hum Dev, 2018, 49(1): 9-19.
|
| [25] |
Wickberg F, Lenhard F, Aspvall K, et al. Feasibility of internet-delivered cognitive-behavior therapy for obsessive-compulsive disorder in youth with autism spectrum disorder: a clinical benchmark study[J]. Internet Interv, 2022, 28: 100520.
|
| [26] |
Hudson C C, Hall L, Harkness K L. Prevalence of depressive disorders in individuals with autism spectrum disorder: a meta-analysis[J]. J Abnorm Child Psychol, 2019, 47(1): 165-175.
|
| [27] |
Mazzone L, Ruta L, Reale L. Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges[J]. Ann Gen Psychiatry, 2012, 11(1): 16.
|
| [28] |
Stewart M E, Barnard L, Pearson J, et al. Presentation of depression in autism and asperger syndrome: a review[J]. Autism, 2006, 10(1): 103-116.
|
| [29] |
Cassidy S, Bradley P, Robinson J, et al. Suicidal ideation and suicide plans or attempts in adults with asperger's syndrome attending a specialist diagnostic clinic: a clinical cohort study[J]. Lancet Psychiatry, 2014, 1(2): 142-147.
|
| [30] |
Santomauro D, Sheffield J, Sofronoff K. Depression in adolescents with ASD: a pilot RCT of a group intervention[J]. J Autism Dev Disord, 2016, 46(2): 572-588.
|
| [31] |
McGillivray J A, Evert H T. Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD[J]. J Autism Dev Disord, 2014, 44(8): 2041-2051.
|
| [32] |
Bemmer E R, Boulton K A, Thomas E E, et al. Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder[J]. Mol Autism, 2021, 12(1): 11.
|
| [33] |
Elliott S J, Marshall D, Morley K, et al. Behavioural and cognitive behavioural therapy for obsessive compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD)[J]. Cochrane Database Syst Rev, 2021, 9(9): CD013173.
|
| [34] |
McCrae C S, Chan W S, Curtis A F, et al. Telehealth cognitive behavioral therapy for insomnia in children with autism spectrum disorder: a pilot examining feasibility, satisfaction, and preliminary findings[J]. Autism, 2021, 25(3): 667-680.
|
| [35] |
Dike I C, Onyishi C N, Adimora D E, et al. Yoga complemented cognitive behavioral therapy on job burnout among teachers of children with autism spectrum disorders[J]. Medicine (Baltimore), 2021, 100(22): e25801.
|
| [36] |
刘钊泉, 赵珠瑞, 冯经彩. 认知行为训练对孤独症儿童家长应对方式研究[J]. 数据, 2023,(1): 17-18.
|
| [37] |
黄永. 父母团体认知行为干预对孤独症患儿治疗依从性及生活自理能力的影响[J]. 护理实践与研究, 2021, 18(22): 3420-3423.
|
| [38] |
Maskey M, Rodgers J, Grahame V, et al. A randomised controlled feasibility trial of immersive virtual reality treatment with cognitive behaviour therapy for specific phobias in young people with autism spectrum disorder[J]. J Autism Dev Disord, 2019, 49(5): 1912-1927.
|
| [39] |
梁增红. 认知行为疗法联合推拿对孤独症谱系障碍伴异常饮食患儿营养状态的影响观察[J]. 山西卫生健康职业学院学报, 2021, 31(5): 63-65.
|
| [40] |
Kuroda M, Kawakubo Y, Kamio Y, et al. Preliminary efficacy of cognitive-behavioral therapy on emotion regulation in adults with autism spectrum disorder: a pilot randomized waitlist-controlled study [J]. PLoS One, 2022, 17(11): e0277398.
|
| [41] |
Reyes N M, Pickard K, Reaven J. Emotion regulation: a treatment target for autism spectrum disorder[J]. Bull Menninger Clin, 2019, 83(3): 205-234.
|
| [42] |
Maddox B B, Miyazaki Y, White S W. Long-term effects of CBT on social impairment in adolescents with ASD[J]. J Autism Dev Disord, 2017, 47(12): 3872-3882.
|
基金资助
国家自然科学基金项目(82101618)
江苏省妇幼健康重点学科(FXK201705)
江苏省妇幼健康科研面上重点资助项目(F201804)