孤独症谱系障碍儿童情绪失调现状、评估方法及干预策略的研究进展

doi:10.13481/j.1671-587X.20250630

摘要/Abstract

摘要：

情绪失调（ED）是孤独症谱系障碍（ASD）儿童的常见问题，对社交、学业成就、亲子关系和整体功能会产生不良影响。ASD儿童共患的ED容易与其核心症状混淆或被忽视，从多个角度评估ASD儿童的情绪调节（ER）问题有助于早期识别和诊断ED，可为制订改善ASD儿童ED甚至整体预后的干预方法提供参考。探讨ASD儿童ED的非药物及药物治疗方法的应用，有助于为不同亚群ASD儿童的ED选择合适的干预策略，也可为更适用于幼儿和学龄前期ASD儿童ED的干预方法提供依据。现结合国内外相关研究成果，从ED的现状、评估方法和干预策略等方面介绍ASD儿童共患ED的研究进展，以期为ASD儿童ED的早期识别、诊断及有效干预提供更多科学依据。

关键词: 情绪调节, 情绪失调, 孤独症谱系障碍, 非药物干预, 早期识别

Abstract:

Emotional dysregulation （ED） is a common problem in the children with autism spectrum disorder （ASD） and has adverse effects on social interaction， academic achievement， parent-child relationships， and overall functioning. The comorbid ED in the children with ASD is easily confused with or overlooked due to its core symptoms. Assessing the emotional regulation （ER） problems in the children with ASD from multiple perspectives is helpful for the early identification and diagnosis of ED， and can provide the reference for developing intervention methods to improve ED and even the overall prognosis of the children with ASD. Discussing the application of non-pharmacological and pharmacological treatment methods for ED in the children with ASD is helpful for selecting appropriate intervention strategies for ED in different subgroups of the children with ASD， and can also provide the basis for intervention methods more suitable for ED in toddler and preschool-aged children with ASD. Based on relevant research results at home and abroad， this article introduces the research progress in comorbid ED in the children with ASD from the aspects of the current status of emotional dysregulation， assessment methods， and intervention strategies， in order to provide more scientific basis for the early identification， diagnosis， and effective intervention of ED in children with ASD.

Key words: Emotional regulation, Emotional dysregulation, Autism spectrum disorder, Non-pharmacological intervention, Early identification

中图分类号:

R749.94

刘万霞,苗春越,董涵宇,薛洋,刘宇默,贾飞勇. 孤独症谱系障碍儿童情绪失调现状、评估方法及干预策略的研究进展[J]. 吉林大学学报(医学版), 2025, 51(6): 1728-1735.

Wanxia LIU,Chunyue MIAO,Hanyu DONG,Yang XUE,Yumo LIU,Feiyong JIA. Research progress in emotional dysregulation, assessment, and intervention in children with autism spectrum disorder[J]. Journal of Jilin University(Medicine Edition), 2025, 51(6): 1728-1735.

参考文献 51

[1]	LAI M C， LOMBARDO M V， BARON-COHEN S. Autism［J］. Lancet， 2014， 383（9920）： 896-910.
[2]	SHAW K A， WILLIAMS S， PATRICK M E， et al. Prevalence and early identification of autism spectrum disorder among children aged 4 and 8 years - autism and developmental disabilities monitoring network， 16 sites， United States， 2022［J］. MMWR Surveill Summ， 2025， 74（2）： 1-22.
[3]	SHAFFER R C， SCHMITT L M， REISINGER D L， et al. Regulating together： emotion dysregulation group treatment for ASD youth and their caregivers［J］. J Autism Dev Disord， 2023， 53（5）： 1942-1962.
[4]	JAISLE E M， GROVES N B， BLACK K E， et al. Linking ADHD and ASD symptomatology with social impairment： the role of emotion dysregulation［J］. Res Child Adolesc Psychopathol， 2023， 51（1）： 3-16.
[5]	TOTSIKA V， HASTINGS R P， EMERSON E， et al. A population-based investigation of behavioural and emotional problems and maternal mental health： associations with autism spectrum disorder and intellectual disability［J］. J Child Psychol Psychiatry， 2011， 52（1）： 91-99.
[6]	VOGEL A C， JACKSON J J， BARCH D M， et al. Excitability and irritability in preschoolers predicts later psychopathology： The importance of positive and negative emotion dysregulation［J］. Dev Psychopathol， 2019， 31（3）： 1067-1083.
[7]	BRINKE L WTE， SCHUIRINGA H D， MATTHYS W. Emotion regulation and angry mood among adolescents with externalizing problems and intellectual disabilities［J］. Res Dev Disabil， 2021， 109： 103833.
[8]	THOMPSON R A. Emotion regulation： a theme in search of definition［J］. Monographs Society Res Child， 1994， 59（2/3）： 25-52.
[9]	SANCHIS-SANCHIS A， GRAU M D， MOLINER A R， et al. Effects of age and gender in emotion regulation of children and adolescents［J］. Front Psychol， 2020， 11： 946.
[10]	SAMSON J L， ROCHAT L， CHANAL J， et al. The effects of cognitive-affective switching with unpredictable cues in adults and adolescents and their relation to “cool” executive functioning and emotion regulation［J］. Front Psychol， 2022， 13： 757213.
[11]	VAN RIJN S， KUIPER K， BOUW N， et al. Neurocognitive and behavioral development in young children （1-7 years） with sex chromosome trisomy［J］. Endocr Connect， 2023， 12（5）： e220494.
[12]	GOERLICH K S， VOTINOV M. Hormonal abnormalities in alexithymia［J］. Front Psychiatry， 2023， 13： 1070066.
[13]	SUNDSTRÖM-POROMAA I. The menstrual cycle influences emotion but has limited effect on cognitive function［J］. Vitam Horm， 2018， 107： 349-376.
[14]	OLSSON A， KOPSIDA E， SORJONEN K， et al. Testosterone and estrogen impact social evaluations and vicarious emotions： a double-blind placebo-controlled study［J］. Emotion， 2016， 16（4）： 515-523.
[15]	BERKOVITS L， EISENHOWER A， BLACHER J. Emotion regulation in young children with autism spectrum disorders［J］. J Autism Dev Disord， 2017， 47（1）： 68-79.
[16]	SÁEZ-SUANES G P， GARCÍA-VILLAMISAR D， DEL POZO ARMENTIA A. The role of intellectual disability and emotional regulation in the autism-depression relationship［J］. Autism， 2023， 27（7）： 1960-1967.
[17]	SALAZAR DE PABLO G， PASTOR JORDÁ C， VAQUERIZO-SERRANO J， et al. Systematic review and meta-analysis： efficacy of pharmacological interventions for irritability and emotional dysregulation in autism spectrum disorder and predictors of response［J］. J Am Acad Child Adolesc Psychiatry， 2023， 62（2）： 151-168.
[18]	CIBRALIC S， KOHLHOFF J， WALLACE N， et al. A systematic review of emotion regulation in children with Autism Spectrum Disorder［J］. Res Autism Spectr Disord， 2019， 68： 101422.
[19]	JAHROMI L B， MEEK S E， OBER-REYNOLDS S. Emotion regulation in the context of frustration in children with high functioning autism and their typical peers［J］. J Child Psychol Psychiatry， 2012， 53（12）： 1250-1258.
[20]	DELUCIA E A， MCKENNA M P， ANDRZEJEWSKI T M， et al. A pilot study of self-regulation and behavior problems in preschoolers with ASD： parent broader autism phenotype traits relate to child emotion regulation and inhibitory control［J］. J Autism Dev Disord， 2022， 52（10）： 4397-4411.
[21]	SUNG Y S， LIN C Y， CHU S Y， et al. Emotion dysregulation mediates the relationship between sensory processing and behavior problems in young children with autism spectrum disorder： a preliminary study［J］. J Autism Dev Disord， 2024， 54（2）： 738-748.
[22]	WEISS J A， THOMSON K， CHAN L S. A systematic literature review of emotion regulation measurement in individuals with autism spectrum disorder［J］. Autism Res， 2014， 7（6）： 629-648.
[23]	BECK K B， CONNER C M， BREITENFELDT K E， et al. Assessment and treatment of emotion regulation impairment in autism spectrum disorder across the life span current state of the science and future directions［J］. Psychiatr Clin N Am， 2021， 44（1）： 95-110.
[24]	MAZEFSKY C A， WHITE S W. Emotion regulation： concepts & practice in autism spectrum disorder［J］. Child Adolesc Psychiatr Clin N Am， 2014， 23（1）： 15-24.
[25]	FENNING R M， BAKER J K， MOFFITT J. Intrinsic and extrinsic predictors of emotion regulation in children with autism spectrum disorder［J］. J Autism Dev Disord， 2018， 48（11）： 3858-3870.
[26]	中华医学会儿科学分会发育行为学组，中国医师协会儿科分会儿童保健专业委员会，儿童孤独症诊断与防治技术和标准研究项目专家组. 孤独症谱系障碍患儿常见共患问题的识别与处理原则［J］. 中华儿科杂志， 2018， 56（3）： 174-178.
[27]	MAZEFSKY C A， HERRINGTON J， SIEGEL M， et al. The role of emotion regulation in autism spectrum disorder［J］. J Am Acad Child Adolesc Psychiatry， 2013， 52（7）： 679-688.
[28]	STODDARD J， ZIK J， MAZEFSKY C A， et al. The internal structure of the aberrant behavior checklist irritability subscale： implications for studies of irritability in treatment-seeking youth with autism spectrum disorders［J］. Behav Ther， 2020， 51（2）： 310-319.
[29]	FAVOLE I， DAVICO C， MARCOTULLI D， et al. Sleep disturbances and emotional dysregulation in young children with autism spectrum， intellectual disability， or global developmental delay［J］. Sleep Med， 2023， 105： 45-52.
[30]	MCGUIRE K， FUNG L K， HAGOPIAN L， et al. Irritability and problem behavior in autism spectrum disorder： a practice pathway for pediatric primary care［J］. Pediatrics， 2016， 137（）： S136-S148.
[31]	谢加阳，牛国辉. 维生素D在神经发育障碍性疾病中的作用研究进展［J］. 解放军医学杂志， 2024， 49（5）： 586-593.
[32]	NUSKE H J， YOUNG A V， KHAN F Y， et al. Systematic review： emotion dysregulation and challenging behavior interventions for children and adolescents on the autism spectrum with graded key evidence-based strategy recommendations［J］. Eur Child Adolesc Psychiatry， 2024， 33（6）： 1963-1976.
[33]	BAUMINGER N. The facilitation of social-emotional understanding and social interaction in high-functioning children with autism： intervention outcomes［J］. J Autism Dev Disord， 2002， 32（4）： 283-298.
[34]	SCARPA A， REYES N M. Improving emotion regulation with CBT in young children with high functioning autism spectrum disorders： a pilot study［J］. Behav Cogn Psychother， 2011， 39（4）： 495-500.
[35]	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.
[36]	SALEM-GUIRGIS S， ALBAUM C， TABLON P， et al. MYmind： a concurrent group-based mindfulness intervention for youth with autism and their parents［J］. Mindfulness， 2019， 10（9）： 1730-1743.
[37]	HENDRIX N M， PICKARD K E， BINION G E， et al. A systematic review of emotion regulation in parent-mediated interventions for autism spectrum disorder［J］. Front Psychiatry， 2022， 13： 846286.
[38]	CASAGRANDE K A， INGERSOLL B R. Parent-mediated interventions for social communication in young children with ASD［M］//Handbook of Social Skills and Autism Spectrum Disorder： Assessment， Curricula， and Intervention. Cham： Springer International Publishing， 2017： 285-312.
[39]	SALAZAR DE PABLO G， STUDERUS E， VAQUERIZO-SERRANO J， et al. Implementing precision psychiatry： a systematic review of individualized prediction models for clinical practice［J］. Schizophr Bull， 2021， 47（2）： 284-297.
[40]	FUSAR-POLI L， BRONDINO N， ROCCHETTI M， et al. Prevalence and predictors of psychotropic medication use in adolescents and adults with autism spectrum disorder in Italy： a cross-sectional study［J］. Psychiatry Res， 2019， 276： 203-209.
[41]	DEVANE C L， CHARLES J M， ABRAMSON R K， et al. Pharmacotherapy of autism spectrum disorder： results from the randomized BAART clinical trial［J］. Pharmacotherapy， 2019， 39（6）： 626-635.
[42]	POLITTE L C， HENRY C A， MCDOUGLE C J. Psychopharmacological interventions in autism spectrum disorder［J］. Harv Rev Psychiatry， 2014， 22（2）： 76-92.
[43]	HOLLANDER E， CHAPLIN W， SOORYA L， et al. Divalproex sodium vs placebo for the treatment of irritability in children and adolescents with autism spectrum disorders［J］. Neuropsychopharmacology， 2010， 35（4）： 990-998.
[44]	HELLINGS J A， WECKBAUGH M， NICKEL E J， et al. A double-blind， placebo-controlled study of valproate for aggression in youth with pervasive developmental disorders［J］. J Child Adolesc Psychopharmacol， 2005， 15（4）： 682-692.
[45]	WASSERMAN S， IYENGAR R， CHAPLIN W F， et al. Levetiracetam versus placebo in childhood and adolescent autism： a double-blind placebo-controlled study［J］. Int Clin Psychopharmacol， 2006， 21（6）： 363-367.
[46]	RUGINO T A， SAMSOCK T C. Levetiracetam in autistic children： an open-label study［J］. J Dev Behav Pediatr， 2002， 23（4）： 225-230.
[47]	BELSITO K M， LAW P A， KIRK K S， et al. Lamotrigine therapy for autistic disorder： a randomized， double-blind， placebo-controlled trial［J］. J Autism Dev Disord， 2001， 31（2）： 175-181.
[48]	AISHWORIYA R， VALICA T， HAGERMAN R， et al. An update on psychopharmacological treatment of autism spectrum disorder［J］. Neurotherapeutics， 2022， 19（1）： 248-262.
[49]	GENOVESE A， BUTLER M G. Clinical assessment， genetics， and treatment approaches in autism spectrum disorder （ASD）［J］. Int J Mol Sci， 2020， 21（13）： 4726.
[50]	ARNOLD L E， AMAN M G， COOK A M， et al. Atomoxetine for hyperactivity in autism spectrum disorders： placebo-controlled crossover pilot trial［J］. J Am Acad Child Adolesc Psychiatry， 2006， 45（10）： 1196-1205.
[51]	HANDEN B L， JOHNSON C R， LUBETSKY M. Efficacy of methylphenidate among children with autism and symptoms of attention-deficit hyperactivity disorder［J］. J Autism Dev Disord， 2000， 30（3）： 245-255.