IntroductionThis study examined changes in regional homogeneity (ReHo) following Social Skills Training (SST) and their association with improvements in social deficits in individuals with autism spectrum disorder (ASD).Methods44 adolescents and adults with ASD (aged 12-30) were recruited, 38 participants (20 in training group, 18 in control group, matched for sex, age, and IQ) were retained after quality control of MRI data. The training group underwent magnetic resonance imaging (MRI) scans and assessments of Aberrant Behavior Checklist (ABC) and Social Responsiveness Scale (SRS) before and after a 14-week SST program, while the control group completed the same MRI scans and assessments at the same time point but did not receive SST.ResultsResting-state functional MRI analyses revealed significant group × condition interactions in five social brain regions, including the right medial frontal gyrus, right insula, and left medial superior frontal gyrus. At the endpoint of SST, the training group showed reduced ReHo in these regions alongside significant decreases in scores of ABC total, social withdrawal factor, SRS total, social awareness, social cognition, social communication factors. The control group, in contrast, showed only limited improvements on specific subscales, while the training group demonstrated a broader pattern of behavioral gains. We also found an exploratory association between the decrease in ReHo of the right medial frontal gyrus and the reduction in the ABC total score in training group.DiscussionThese findings indicate that SST may modulate local functional connectivity within the social brain networks, and these connectivity changes may correlate with observed behavioral improvements.

Social skills training (SST) has demonstrated efficacy in improving social deficits in individuals with autism spectrum disorder (ASD), but the underlying neural mechanisms remain unclear. This study investigated alterations in whole-brain white matter network topology after SST in ASD individuals and explored potential correlation with improvements in social interaction deficits. 38 ASD patients aged 12 - 30 years were recruited, including 19 who completed magnetic resonance imaging (MRI) scans and social responsiveness scale (SRS) assessments at both baseline and the endpoint of a 14-week SST (training group) and 19 age-, sex-, and IQ-matched patients who underwent MRI scans and SRS assessment at the same time points but did not receive SST (control group). White matter connectivity matrices were constructed using diffusion tensor imaging (DTI), and graph theory analysis was used to assess global and nodal network properties. Paired t-tests and independent-samples t-tests were used for within- and between-group comparisons, respectively. Pearson's partial correlation was used to examine associations between network changes and SRS scores changes. After SST, four edges showed significant changes in white matter connectivity (FDR-corrected), with three increased and one decreased in the training group. Changes in nodal betweenness were also observed. While SRS scores significantly decreased in the training group, no significant correlations were found between neuroimaging changes and behavioral improvements, possibly due to the limited sample size. These findings suggest that SST may reshape white matter network, offering insights into its neural mechanisms and informing novel ASD intervention strategies.

Background This study aimed to explore the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) on screening of depression among patients with neurological disorders, and to explore factors influencing such patients. Methods In this study, 277 subjects who were admitted to the department of neurology of our hospital due to different neurological disorders completed the PHQ-9 questionnaire. The Mini-International Neuropsychiatric Interview (MINI) and Hamilton Rating Scale for Depression (HAMD) were employed to evaluate the depressive symptoms of patients who completed the PHQ-9 questionnaire. The internal consistency, criterion validity, structural validity, and optimal cut-off values of PHQ-9 were evaluated, and the consistency assessment was conducted between the depression severity as assessed by PHQ-9, HAMD and MINI. Logistic regression analysis was used to calculate the risk factors of depression. Results The Cronbach’s α coefficient of the PHQ-9 was 0.839. The Pearson’s correlation coefficient among the 9 items of the PHQ-9 scale was 0.160 ~ 0.578 ( P < 0.01), and the Pearson’s correlation coefficient between each item and the total score was at the range of 0.608 ~ 0.773. Taking the results of MINI as the gold standard, the area under the receiver operating characteristic (ROC) curve of the PHQ-9 results for all the subjects ( n = 277) was 0.898 (95% confidence interval (CI): 0.859 ~ 0.937, P < 0.01). When the cut-off score was equal to 5, the values of sensitivity, specificity, and the Youden’s index were 91.2, 76.6%, and 0.678, respectively. Multivariate logistic regression analysis showed that the influence of unemployment on the occurrence of depression was statistically significant ( P = 0.027, OR = 3.080, 95%CI: 1.133 ~ 8.374). Conclusions The application of PHQ-9 for screening of depression among Chinese patients with neurological disorders showed a good reliability and validity.

Background Health-related risky behaviors (HRB) generally refer to behaviors that have a negative influence on health and quality of life. HRB in adolescents with autism have not been well understood so far. We aim to explore health-related risky behaviors and their risk factors with autistic adolescents. Methods In this study, 150 adolescents with autism and 150 neurotypical adolescents were enrolled. Participants in both groups completed the Adolescent Health-Related Risky Behavior Inventory (AHRBI). Autism Spectrum Screening Questionnaire (ASSQ), Wechsler Intelligence Scale, Theory of Mind (ToM) Test, Zung Self-rating Anxiety Scale (SAS), Zung Self-rating Depression Scale (SDS), and Self-Esteem Scale (SES) were also assessed in the autism group to explore risk factors. Results The results showed that the total score of AHRBI and scores of "aggression and violence (AV)", "suicide or self-injury (SS)", "health-compromising behavior (HCB)", and "unprotected sex (US)" subscales in the autism group were significantly higher than those in the control group (Z value = − 4.58 ~ − 2.26, all P < 0.05). Anxiety, depression, low self-esteem, low IQ score, low ToM test score, increasing age, and communication disorder were found as risk factors for health-related risky behaviors in autistic adolescents. Conclusions Adolescents with autism have more health-related risky behaviors than neurotypical adolescents. We should pay attention to the emotional state, self-esteem, cognitive function, and verbal communication levels of autistic adolescent with health-related risky behaviors.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:探讨社交技能训练对青少年和成人孤独症谱系障碍（ASD）患者社会交往障碍的疗效。方法:入组符合美国精神障碍诊断与统计手册第5版（DSM-5）ASD诊断标准的12～30岁被试44例,分为训练组（n=22）和对照组（n=22）。对训练组进行为期14周的社交技能训练,训练前（基线）和训练结束（终点）时,对两组患者进行异常行为量表（ABC）和社交反应量表（SRS）的评定以及心理推理任务和执行功能测查任务的评估。结果:训练组终点的ABC总分和社会退缩因子分,SRS总分和社交知觉、社交认知、社交沟通因子分均低于基线（均P&lt;0.05）,心理推理的二级错误信念任务的通过率高于基线（P&lt;0.05）,执行功能的Rey复杂图形记忆任务中的延迟记忆结构分、延迟记忆细节分高于基线,连线测验中的数字字母连线时间、B测验完成时-A测验完成时短于基线（均P&lt;0.05）。而对照组在终点时,除ABC社会退缩因子外,其余上述项目与基线时相比差异均无统计学意义（均P&gt;0.05）。结论:社交技能训练能够有效改善青少年和成年ASD患者的整体症状和社会交往障碍,还能有效提高青少年和成年ASD患者的心理推理能力和执行功能。</span>

BACKGROUND:Health-related risky behaviors generally refer to behaviors that have a negative impact on health and quality of life. Health-related risky behaviors in adolescents with high-functioning autism (HFA) have not been well understood so far. Adolescents with HFA may have more health-related risky behaviors than neurotypical adolescents.AIM:To investigate health-related risky behaviors and their risk factors with HFA.METHODS:This is an observational study. Our study enrolled 110 adolescents aged 12-19-years-old meeting Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria for HFA. They were recruited from Peking University Sixth Hospital. There were also 110 age, sex and nationality matched controls enrolled who came from a public school in Beijing, China. Both groups completed the Adolescents Health-related Risky Behavior Inventory. Nonparametric tests were carried out for comparison of the Adolescents Health-related Risky Behavior Inventory scores between the two groups. Expression recognition, the Inventory of Subjective Life Quality for Child and Adolescent, Chinese Wechsler Intelligence Scale for Children, Wechsler Intelligence Scale for Adult-Chinese Revised, Theory of Mind test and Autism Spectrum Screening Questionnaire were assessed in the autism group to explore factors associated with health-related risky behaviors. Multivariate regression analysis was conducted to explore the risk factors of health-related risky behaviors in the HFA group.RESULTS:The results showed that the total score of the Adolescents Health-related Risky Behavior Inventory and scores of "aggression and violence," "suicide and self-injury," "health compromising behavior" and "unprotected sex" subscales in the HFA group were significantly higher than those in the control group (Z range -4.197 to -2.213, P < 0.05). Among the associated factors, poor emotional experience (B = -0.268, P < 0.001), depression (B = -0.321, P < 0.001), low score of intelligence (B = -0.032, P = 0.042), low score of Theory of Mind test (B = -1.321, P = 0.003) and poor adaptation to school life (B = -0.152, P = 0.006) were risk factors. These risky behaviors may promote the occurrence of health-related risky behaviors in adolescents with HFA.CONCLUSION:This study showed that adolescents with HFA were more likely to be involved in health-related risky behaviors. Different health-related risky behaviors have different reasons.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:探讨高功能孤独症儿童心理推理能力特点及其两种心理推理能力成分之间的关系。方法:采用横断面研究方法,对92例符合DSM-IV孤独症诊断标准的6～18岁高功能孤独症儿童及59例年龄、性别相匹配的正常发育儿童进行心理推理能力社会认知成分任务（显性错误信念、一级错误信念、情绪隐藏和二级错误信念）和社会情感成分任务（表情识别）测查。结果:高功能孤独症组心理推理能力社会认知成分任务的通过率和社会情感成分任务的平均分均低于正常对照组（均P &lt;0.05）;高功能孤独症组一级错误信念、情绪隐藏、二级错误信念任务通过组简单表情识别任务的得分高于未通过组（均P &lt;0.05）;复杂表情任务高分组的显性错误信念任务的通过率高于低分组（P &lt;0.05）。结论:6～18岁高功能孤独症儿童心理推理能力的两种成分均存在缺陷,两成分之间既相互作用又相互独立。</span>