Publikationsserver der Universitätsbibliothek Marburg

Titel:Zur Diagnostik und Differentialdiagnostik der Autismus-Spektrum-Störungen
Autor:Langmann, Anika
Weitere Beteiligte: Christiansen, Hanna (Prof. Dr.)
Veröffentlicht:2018
URI:https://archiv.ub.uni-marburg.de/diss/z2018/0100
URN: urn:nbn:de:hebis:04-z2018-01008
DOI: https://doi.org/10.17192/z2018.0100
DDC:150 Psychologie
Publikationsdatum:2019-04-24
Lizenz:https://rightsstatements.org/vocab/InC-NC/1.0/

Dokument

Schlagwörter:

Zusammenfassung:
Autismus-Spektrum-Störungen (engl. Autism-Spectrum-Disorders, ASD) sind definiert über Auffälligkeiten in der sozialen Interaktion und Kommunikation sowie restriktive und repetitive Verhaltensweisen. ASD sind eine Gruppe komplexer, heterogener Störungen, die mit vielen Komorbiditäten einhergehen und bei deren Diagnostik zahlreiche relevante Differentialdiagnosen zu beachten sind. Die Symptomatik wandelt sich zudem in Bezug auf die Kernsymptome und mögliche Begleitsymptome über die Lebensspanne und in Abhängigkeit von zahlreichen Faktoren. Dies macht die Diagnostik der ASD zu einer großen Herausforderung. Die Verfügbarkeit valider und reliabler diagnostischer Instrumente ist essentiell, um eine möglichst optimale therapeutische Versorgung zu gewährleisten. Der vorliegende Kumulus stellt vier separate Studien zu Aspekten der Diagnostik und Differentialdiagnostik der Autismus-Spektrum-Störungen vor. Die ersten beiden Studien untersuchten die diagnostische Güte der Diagnostischen Beobachtungsskala für Autistische Störungen (ADOS) für die diagnostische Einschätzung von Kindern, Jugendlichen und Erwachsenen mit Verdacht auf ASD unter besonderer Berücksichtigung relevanter Differentialdiagnosen und Geschlechtsunterschiede. Die Ergebnisse sprechen für eine gute Einsetzbarkeit des Instruments in der klinischen Praxis, jedoch mit deutlichen Einschränkungen für bestimmte differentialdiagnostische Subgruppen. Aufgrund dieser Befunde erscheint eine individuelle und institutionelle Spezialisierung dringend angeraten. Die dritte Studie untersuchte die diagnostische Güte der ADOS in der klinischen Alltagspraxis unter Berücksichtigung von Merkmalen der Diagnostizierenden, der Durchführung und individueller Fallcharakteristiken. Die Ergebnisse weisen darauf hin, dass die ADOS in der klinischen Praxis mit sehr unterschiedlichen diagnostischen Ergebnissen assoziiert ist. Zur Sicherung einer ausreichend hohen Reliabilität sind regelmäßige Supervision und Fortbildungen zur Kalibrierung der diagnostischen Entscheidungen zu empfehlen. Die vierte Studie schließlich befasste sich mit Möglichkeiten der Differenzierung von ASD mithilfe der Erfassung von Emotionserkennungsleistungen unter Berücksichtigung von ADHS-Symptomen. Es zeigte sich, dass komorbide ADHS-Symptome, möglicherweise vermittelt über Reaktionszeiten, bei Kindern mit ASD einen Einfluss auf die Emotionserkennungsleistung haben und dass eine Verstärkung der Defizite vor allem bei älteren Kindern zum Tragen kommt. In der Diagnostik der ASD ist daher ein besonderes Augenmerk auf komorbide ADHS-Symptome zu richten, um individuell angepasste therapeutische Interventionen einleiten zu können.

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