Behavior-Related Autistic Traits and Symptoms (BRATS): Advancing Knowledge About Autistic Characteristics in a General Population of Adults

Diagnosing adult autism remains challenging due to limitations in the current classification system (DSM-5-TR), and emerging HiTOP framework. There are also difficulties distinguishing autism from some other conditions such as ADHD, various types of empathy, personality traits, and other forms of psychopathology.

This study was designed to address important questions raised by the scant literature on adult ASD that currently exists. The study yielded results about the distribution of autistic characteristics as measured by the Autism Quotient (AQ) and Empathy Quotient (EQ), in a general population of 446 adults by employing multiple different quantitative research methods such as questionnaires to collect data, and descriptive, correlational, and factor analysis methods to analyze the data. First, factor analytic methods were utilized to examine the underlying structure of self-report measures of autism (AQ) empathy (EQ), and adult ADHD (ASRS v1.1). Next, correlations among newly derived factors (AQ-Unsociability [AQ-US], AQ Imperceptiveness [AQ-IP], AQ Diffused Focus [AQ-DF], EQ Low Cognitive Empathy [EQ-LCe], EQ Social Sensitivity [EQ-SS], EQ Emotional Insensitivity [EQ-EI], ASRS-Combined [ASRS-C], and ASRS-Hyperactive-Motor [ASRS-HM]), and the Five Factor Model (FFM) of personality were investigated. Further analyses examined relations between the eight factor scales and measures of anxiety, depression, personality traits (in both the adaptive and maladaptive ranges), psychopathy, and aggression. Finally, a hierarchical unfolding analysis was conducted to identify potential latent domains underlying all assessed constructs.

The AQ factors did not effectively distinguish autistic characteristic from other psychological conditions. Similar results were found for the EQ factors. The ASRS v1.1 produced a unique two-factor solution (ASRS-C and ASRS-HM), suggesting a distinct presentation of combined ADHD symptoms. Overall, the factor structures of the AQ, EQ, and ASRS factor scales displayed limitations in specifically measuring their target constructs. The study also investigated relations between the factor scales and personality traits. Different personality traits were associated with all eight factor scales, suggesting potential common underlying mechanisms. A hierarchical structural factor analysis revealed a complex behavior-related autistic traits and symptoms (BRATS) structure encompassing all the measures.

Findings suggest the AQ and EQ are not ideal for diagnosing autism or autistic empathy overall, but may be better suited for measuring specific aspects of social communication and empathy. The ASRSv1.1 identified a unique factor of combined ADHD, warranting further investigation. This study’s discussion highlights the complex interplay between autistic traits (AQ/EQ), ADHD, personality, and other forms of psychopathology. It underscores the need for more refined diagnostic tools and research into the underlying mechanisms of these associations

成人自闭症的诊察因现行分类体系（DSM-5-TR）及新兴的HiTOP框架的局限性而颇具挑战。同时，区分自闭症与其他一些疾病，如注意力缺陷多动障碍（ADHD）、多种形式的同理心、人格特质以及其他心理病理形式亦存在困难。本研究旨在回应现有关于成人自闭症研究文献中提出的诸多重要问题。研究通过运用多种定量研究方法，包括问卷调查收集数据，以及描述性、相关性和因素分析方法来分析数据，对446名成年人的自闭症特质（通过自闭症量表AQ和同理心量表EQ衡量）在普通人群中的分布进行了探究。首先，通过因素分析方法，对自闭症（AQ）、同理心（EQ）及成人ADHD（ASRS v1.1）的自我报告测量进行了潜在结构的检验。随后，对新衍生出的因素（AQ-非社交性[AQ-US]、AQ-感知性[AQ-IP]、AQ-分散注意力[AQ-DF]、EQ低认知同理心[EQ-LCe]、EQ社交敏感性[EQ-SS]、EQ情感不敏感性[EQ-EI]、ASRS-综合[ASRS-C]和ASRS-多动-运动[ASRS-HM]）与人格的五大因素模型（FFM）之间的相关性进行了研究。进一步的分析考察了八个因素量表与焦虑、抑郁、人格特质（在适应性和非适应性范围内）、心理病理学以及攻击性之间的关系。最终，通过层级展开分析，以识别所有评估构念潜在的潜在领域。AQ因素在区分自闭症特质与其他心理疾病方面效果不佳。EQ因素也呈现出类似的结果。ASRS v1.1产生了独特的双因素解决方案（ASRS-C和ASRS-HM），表明合并ADHD症状的独特表现。总体而言，AQ、EQ和ASRS因素量表的因子结构在特定测量目标构念方面显示出局限性。研究还探讨了因素量表与人格特质之间的关系。不同的人格特质与所有八个因素量表相关，表明可能存在潜在的共同作用机制。层级结构因素分析揭示了一个复杂的行为相关自闭症特质和症状（BRATS）结构，包含了所有测量指标。研究发现，AQ和EQ并非理想的自闭症或自闭症同理心诊断工具，但可能更适合测量社会沟通和同理心的特定方面。ASRSv1.1识别出合并ADHD的独特因素，值得进一步研究。本研究的讨论强调了自闭症特质（AQ/EQ）、ADHD、人格以及其他形式心理病理之间的复杂相互作用。它强调了需要更精细的诊断工具和对这些关联潜在机制的研究。