从自闭症到复数“自闭症”:来自不同病因、发育轨迹和症状强度组合的证据

Paul Whiteley, Kevin Carr, Paul Shattock, Malcolm Hooper, Carol Stott, Karl Hardy, Ben Marlow
{"title":"从自闭症到复数“自闭症”:来自不同病因、发育轨迹和症状强度组合的证据","authors":"Paul Whiteley, Kevin Carr, Paul Shattock, Malcolm Hooper, Carol Stott, Karl Hardy, Ben Marlow","doi":"10.1192/bjp.2024.281","DOIUrl":null,"url":null,"abstract":"<p>Autism spectrum disorder is defined by the presence of sustained problems in areas of social cognition and social understanding alongside repetitive and/or restricted patterns of behaviour. Behavioural presentations and developmental trajectories in autism are highly heterogeneous. For most, characteristics variably continue across the lifespan, and, for many, they overlap with numerous overrepresented comorbid combinations spanning behavioural, psychiatric and somatic domains. The current autism diagnostic systems (DSM-5, ICD-11) reflect this heterogeneity, focusing on discerning different assistance needs and symptom severity combinations. An emerging view on the pluralisation of autism – ‘the autisms’ – based on different severity levels and different developmental trajectories is gaining popularity, bolstered by the introduction of the grouping ‘profound autism’ and observations of non-persistence of autism for some. We advance the case for expanding the definition of the plural autisms based also on the numerous different aetiological routes that can lead to autism. Various genetic conditions, susceptibility to infectious agents, non-infectious environmental exposures and immune-mediated occurrences have all been observed to culminate in a diagnosis of autism. As a triad, aetiology, presentation intensity and developmental trajectory offer new ways to classify the autisms, with potentially important implications for research and practice.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"93 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"From autism to the plural ‘autisms’: evidence from differing aetiologies, developmental trajectories and symptom intensity combinations\",\"authors\":\"Paul Whiteley, Kevin Carr, Paul Shattock, Malcolm Hooper, Carol Stott, Karl Hardy, Ben Marlow\",\"doi\":\"10.1192/bjp.2024.281\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Autism spectrum disorder is defined by the presence of sustained problems in areas of social cognition and social understanding alongside repetitive and/or restricted patterns of behaviour. Behavioural presentations and developmental trajectories in autism are highly heterogeneous. For most, characteristics variably continue across the lifespan, and, for many, they overlap with numerous overrepresented comorbid combinations spanning behavioural, psychiatric and somatic domains. The current autism diagnostic systems (DSM-5, ICD-11) reflect this heterogeneity, focusing on discerning different assistance needs and symptom severity combinations. An emerging view on the pluralisation of autism – ‘the autisms’ – based on different severity levels and different developmental trajectories is gaining popularity, bolstered by the introduction of the grouping ‘profound autism’ and observations of non-persistence of autism for some. We advance the case for expanding the definition of the plural autisms based also on the numerous different aetiological routes that can lead to autism. Various genetic conditions, susceptibility to infectious agents, non-infectious environmental exposures and immune-mediated occurrences have all been observed to culminate in a diagnosis of autism. As a triad, aetiology, presentation intensity and developmental trajectory offer new ways to classify the autisms, with potentially important implications for research and practice.</p>\",\"PeriodicalId\":22495,\"journal\":{\"name\":\"The British Journal of Psychiatry\",\"volume\":\"93 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The British Journal of Psychiatry\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1192/bjp.2024.281\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The British Journal of Psychiatry","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1192/bjp.2024.281","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

自闭症谱系障碍的定义是在社会认知和社会理解方面持续存在问题,同时行为模式重复和/或受限。自闭症患者的行为表现和发育轨迹差异很大。对于大多数患者来说,其特征在整个生命周期中都会不同程度地持续存在,对于许多患者来说,这些特征与行为、精神和躯体领域的许多高比例合并症重叠。目前的自闭症诊断系统(DSM-5、ICD-11)反映了这种异质性,重点在于辨别不同的援助需求和症状严重程度组合。基于不同严重程度和不同发展轨迹的自闭症多元化--"自闭症"--的新观点正日益流行,"深度自闭症 "分组的引入以及对某些自闭症患者不存在自闭症的观察也为这一观点提供了支持。我们还根据可能导致自闭症的多种不同病因,提出了扩大多元自闭症定义的理由。据观察,各种遗传条件、对感染性病原体的易感性、非感染性环境暴露和免疫介导的事件都会最终导致自闭症的诊断。作为三要素,病因、表现强度和发育轨迹为自闭症的分类提供了新的方法,对研究和实践具有潜在的重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
From autism to the plural ‘autisms’: evidence from differing aetiologies, developmental trajectories and symptom intensity combinations

Autism spectrum disorder is defined by the presence of sustained problems in areas of social cognition and social understanding alongside repetitive and/or restricted patterns of behaviour. Behavioural presentations and developmental trajectories in autism are highly heterogeneous. For most, characteristics variably continue across the lifespan, and, for many, they overlap with numerous overrepresented comorbid combinations spanning behavioural, psychiatric and somatic domains. The current autism diagnostic systems (DSM-5, ICD-11) reflect this heterogeneity, focusing on discerning different assistance needs and symptom severity combinations. An emerging view on the pluralisation of autism – ‘the autisms’ – based on different severity levels and different developmental trajectories is gaining popularity, bolstered by the introduction of the grouping ‘profound autism’ and observations of non-persistence of autism for some. We advance the case for expanding the definition of the plural autisms based also on the numerous different aetiological routes that can lead to autism. Various genetic conditions, susceptibility to infectious agents, non-infectious environmental exposures and immune-mediated occurrences have all been observed to culminate in a diagnosis of autism. As a triad, aetiology, presentation intensity and developmental trajectory offer new ways to classify the autisms, with potentially important implications for research and practice.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信