自闭症儿童和年轻人的内化问题中的性别/性别差异:系统性审查和元分析
Elna H Suominen1, Calliope A Chen1, Andrew Dunlop1
1University College London, London, United Kingdom.
Journal of the American Academy of Child and Adolescent Psychiatry
|October 22, 2025
概括
自闭症女孩比男孩更容易感到焦虑,尤其是那些智商较高的年长女孩. 虽然整体内化问题和抑郁症症状没有显示出明显的性别差异,但高异质性需要谨慎.
科学领域:
- 神经发育障碍 神经发育障碍
- 儿童和青少年精神病学 儿童和青少年精神病学
- 性别和性别在健康方面的差异
背景情况:
- 自闭症谱系障碍 (ASD) 影响着全球儿童和青少年 (CYP).
- 关于自闭症CYP内部化问题的性别/性别差异存在不一致的发现.
- 内化问题,包括焦虑和抑郁,在自闭症患者中很常见.
研究的目的:
- 系统地审查和综合关于性别/性别差异的证据,以内化自闭症CYP中的问题严重程度.
- 调查自闭症女孩是否与自闭症男孩相比表现出不同程度的内化问题.
- 检查这些差异的潜在调节因素,如年龄,智商和研究方法.
主要方法:
- 在主要数据库 (Medline,Embase,PsycINFO,ASSIA,Web of Science) 进行系统的文献搜索.
- 包括使用验证措施对自闭症男孩和女孩内化问题进行比较的研究.
- 随机效应元分析以估计整体内化,焦虑和抑郁症状的效应大小.
- 超回归来探索年龄,智商和研究设计的适度效应.
主要成果:
- 包括56项研究 (N=13,410个自闭症CYP).
- 自闭症女孩的焦虑症状明显高于男孩 (g=0.13,p=0.015).
- 这种焦虑差异在社区样本,年龄较大的儿童和智商较高的儿童中更为明显.
- 在整体内化或抑郁症状方面没有发现显著差异,尽管趋势有利于女孩.
- 在所有聚合的性别/性别差异中观察到高异质性.
结论:
- 自闭症女孩比自闭症男孩表现出更多的焦虑症状,尤其是那些智商较高的老年女孩.
- 关于自闭症CYP中整体内化问题和抑郁症状的性别/性别差异的证据有限.
- 包含的研究中高异质性要求在解释研究结果时谨慎.
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