Objective:To investigate the differences in electroencephalographic (EEG) microstate characteristics between children with autism spectrum disorder (ASD) and typically developing (TD) children, and to explore the correlation between irritability and EEG microstate features in ASD children.Methods:A total of 104 children with ASD [ASD group, 83 boys, 21 girls; aged 4-13 years, mean age (9.47±1.74)years] from the Autism Cohort of Nanjing Medical University and 60 TD children [TD group; 50 boys, 10 girls; aged 5-13 years, mean age(9.86±1.78) years ]from the IEEE Dataport database were enrolled. Irritability severity was assessed using the Affective Reactivity Index-Parent (ARI-P). Resting-state EEG data with eyes closed were recorded using a 24-channel dry-electrode EEG cap. Group-level EEG microstate topographic maps and microstate parameters, including mean duration, frequency, and time coverage, were extracted and compared between groups using nonparametric tests. In the ASD group, Spearman correlation analysis was used to examine the associations between microstate features and ARI-P in ASD children. Multiple linear regression was used to identify predictors of irritability.Results:Four group-level microstates (A, B, C, D) were identified in both groups. Compared to TD children, ASD children exhibited significantly longer mean duration for all microstates, in microstates A[ M(Q1, Q3)]: 0.060 (0.054,0.070) vs 0.091 (0.0530, 0.155) s, microstate B: 0.059 (0.050, 0.066) vs 0.087 (0.057,0.149) s, microstate C: 0.059 (0.050, 0.066) vs 0.095 (0.056, 0.183) s and microstate D: 0.055 (0.049,0.075) vs 0.095 (0.053,0.162) s ( Z=-3.51, -4.89, -4.71, -4.21; all P<0.001); However, microstate occurrence frequencies were significantly lower in the ASD group: A: 5.423 (3.640,21.024) vs 1.834 (1.327,3.395) Hz, microstate B: 4.949 (3.439,20.038) vs 2.146 (1.314,3.834) Hz, microstate C: 5.888 (3.998,22.078) vs 2.234 (1.441,3.768) Hz and microstate D: 5.371 (3.170,15.208) vs 2.074 (1.147,3.582) Hz ( Z=-7.72, -6.41, -7.85, -6.60; all P<0.001). In the ASD group, ARI-P scores were positively correlated with the mean duration of microstates B, C, and D ( r=0.28, 0.26, 0.33; all P<0.05) and negatively correlated with the occurrence frequency of microstates A, C, and D ( r=-0.26, -0.27, -0.21; all P<0.05). Multiple linear regression analysis revealed that the mean duration of microstate B was a significant predictor of irritability severity ( β=0.436, 95% CI: 1.260-4.202, P<0.001). Conclusion:Resting-state EEG microstate characteristics in Children with ASD differ from those in TD children and are associated with the severity of irritability. Prolonged duration of microstate B may serve as a risk factor for increased irritability in children with ASD.

Objective:To analyze and validate the reliability and validity of the social skills improvement system-rating scales Chinese version (parent version) (SSIS-RS-C) in middle school students.Method:A total of 1 486 parents of middle school students were recruited according to the cluster sampling method.The social responsiveness scale and strengths and difficulties questionnaire were used as criterion validity tools.A retest was conducted one month later.SPSS 27.0 was used for descriptive statistics, item analysis, internal consistency test, test-retest reliability test and criterion validity test. AMOS 24.0 was used to perform confirmatory factor analysis .Results:Item analysis indicated significant positive correlations between each item and the subscales ( r=0.293-0.782, all P<0.01), with significant differences in scores between high and low groups ( t=10.079-37.038, all P<0.01).Confirmatory factor analysis supported a seven-factor structure for the social skills subscale(communication, cooperation, assertion, responsibility, empathy, engagement and self control) and a five-factor structure for the problem behavior subscale (externalizing, bullying, hyperactivity/inattention, internalizing and autism spectrum) of the SSIS-RS-C.There was a positive correlation between the social skills subscale and prosocial behavior ( r=0.637, P<0.001), and between the problem behavior subscale and social impairments and difficult behaviors ( r=0.765, 0.688, both P<0.001).The Cronbach's α coefficients for the total scale, social skills subscale and problem behavior subscale were 0.934, 0.972 and 0.963, respectively.The test-retest correlation coefficients for the total score and the two subscales were 0.665, 0.871 and 0.598, respectively (all P<0.001). Conclusion:The SSIS-RS-C demonstrated good reliability and validity in the Chinese adolescent population.

Objective:To analyze and validate the reliability and validity of the social skills improvement system-rating scales Chinese version (parent version) (SSIS-RS-C) in middle school students.Method:A total of 1 486 parents of middle school students were recruited according to the cluster sampling method.The social responsiveness scale and strengths and difficulties questionnaire were used as criterion validity tools.A retest was conducted one month later.SPSS 27.0 was used for descriptive statistics, item analysis, internal consistency test, test-retest reliability test and criterion validity test. AMOS 24.0 was used to perform confirmatory factor analysis .Results:Item analysis indicated significant positive correlations between each item and the subscales ( r=0.293-0.782, all P<0.01), with significant differences in scores between high and low groups ( t=10.079-37.038, all P<0.01).Confirmatory factor analysis supported a seven-factor structure for the social skills subscale(communication, cooperation, assertion, responsibility, empathy, engagement and self control) and a five-factor structure for the problem behavior subscale (externalizing, bullying, hyperactivity/inattention, internalizing and autism spectrum) of the SSIS-RS-C.There was a positive correlation between the social skills subscale and prosocial behavior ( r=0.637, P<0.001), and between the problem behavior subscale and social impairments and difficult behaviors ( r=0.765, 0.688, both P<0.001).The Cronbach's α coefficients for the total scale, social skills subscale and problem behavior subscale were 0.934, 0.972 and 0.963, respectively.The test-retest correlation coefficients for the total score and the two subscales were 0.665, 0.871 and 0.598, respectively (all P<0.001). Conclusion:The SSIS-RS-C demonstrated good reliability and validity in the Chinese adolescent population.

Objective:To investigate the differences in electroencephalographic (EEG) microstate characteristics between children with autism spectrum disorder (ASD) and typically developing (TD) children, and to explore the correlation between irritability and EEG microstate features in ASD children.Methods:A total of 104 children with ASD [ASD group, 83 boys, 21 girls; aged 4-13 years, mean age (9.47±1.74)years] from the Autism Cohort of Nanjing Medical University and 60 TD children [TD group; 50 boys, 10 girls; aged 5-13 years, mean age(9.86±1.78) years ]from the IEEE Dataport database were enrolled. Irritability severity was assessed using the Affective Reactivity Index-Parent (ARI-P). Resting-state EEG data with eyes closed were recorded using a 24-channel dry-electrode EEG cap. Group-level EEG microstate topographic maps and microstate parameters, including mean duration, frequency, and time coverage, were extracted and compared between groups using nonparametric tests. In the ASD group, Spearman correlation analysis was used to examine the associations between microstate features and ARI-P in ASD children. Multiple linear regression was used to identify predictors of irritability.Results:Four group-level microstates (A, B, C, D) were identified in both groups. Compared to TD children, ASD children exhibited significantly longer mean duration for all microstates, in microstates A[ M(Q1, Q3)]: 0.060 (0.054,0.070) vs 0.091 (0.0530, 0.155) s, microstate B: 0.059 (0.050, 0.066) vs 0.087 (0.057,0.149) s, microstate C: 0.059 (0.050, 0.066) vs 0.095 (0.056, 0.183) s and microstate D: 0.055 (0.049,0.075) vs 0.095 (0.053,0.162) s ( Z=-3.51, -4.89, -4.71, -4.21; all P<0.001); However, microstate occurrence frequencies were significantly lower in the ASD group: A: 5.423 (3.640,21.024) vs 1.834 (1.327,3.395) Hz, microstate B: 4.949 (3.439,20.038) vs 2.146 (1.314,3.834) Hz, microstate C: 5.888 (3.998,22.078) vs 2.234 (1.441,3.768) Hz and microstate D: 5.371 (3.170,15.208) vs 2.074 (1.147,3.582) Hz ( Z=-7.72, -6.41, -7.85, -6.60; all P<0.001). In the ASD group, ARI-P scores were positively correlated with the mean duration of microstates B, C, and D ( r=0.28, 0.26, 0.33; all P<0.05) and negatively correlated with the occurrence frequency of microstates A, C, and D ( r=-0.26, -0.27, -0.21; all P<0.05). Multiple linear regression analysis revealed that the mean duration of microstate B was a significant predictor of irritability severity ( β=0.436, 95% CI: 1.260-4.202, P<0.001). Conclusion:Resting-state EEG microstate characteristics in Children with ASD differ from those in TD children and are associated with the severity of irritability. Prolonged duration of microstate B may serve as a risk factor for increased irritability in children with ASD.

Objective:To investigate the characteristic of social ability in children and adolescents with attention deficit hyperactivity disorder (ADHD) and its relationship with core symptoms, emotional and behavioral problems.Methods:Fifty-nine children with ADHD aged 6-13 for outpatient department from June 2019 to June 2021 were selected as the ADHD group, and 62 normal children matched in age and sex were recruited as the typical development group(TD group). The social responsiveness scale (SRS), SNAP-Ⅳ rating scale and strengths and difficulties questionnaire (SDQ) were used to evaluate the social ability, core symptoms and emotional and behavioral problems of the subjects.SPSS 26.0 was used for statistical analysis.Non parametric test was used to compare and analyze the differences in social ability, emotional and behavioral problems between the two groups.Spearman correlation analysis was used to analyze the relationship between social ability and core symptoms, emotional and behavioral problems of ADHD group.Generalized linear regression was used to analyze the impact of gender, age, IQ, core symptoms, emotional and behavioral problems of ADHD group on social ability.Results:In the ADHD group, the total score of SRS (65(42, 83)), social perception (10 (8, 13)), social cognition (13 (9, 19)), social communication (19 (11, 29)), and autism like behavior (9 (5, 14)) were significantly higher than those of TD group(38 (27.5, 59.5), 7 (4, 12.5), 8 (6, 15), 12 (6.5, 20), 4 (2, 11)) ( Z=-2.97, -2.75, -2.41, -3.01, -2.64, all P<0.05) .The total score of SDQ difficulty, influence factors, mood, hyperactivity, conduct and peer interaction were significantly higher than those of TD group ( Z=-5.80, -6.89, -2.82, -8.59, -2.52, -3.81, all P<0.05). The total score of SRS and the scores of each subscale in ADHD group were positively correlated with the total score of SNAP -Ⅳ and the scores of each subscale ( r=0.33-0.71, all P<0.05). The total score of SRS and the score of social communication scale were positively correlated with the total score of SDQ difficulty, influencing factors, emotion, hyperactivity, conduct and peer interaction subscale ( r=0.29-0.65, all P<0.05). Social perception was positively correlated with the total score of difficulty, hyperactivity and the scores of peer interaction subscale ( r=0.56, 0.32, 0.45, all P<0.05). The scores of social cognition and autism like behavior subscale were positively correlated with the total scores of difficulty, influencing factors, emotion and peer interaction subscale ( r=0.27-0.55, all P<0.05). The scores of social motivation subscale were positively correlated with the total scores of difficulty, emotion, hyperactivity, conduct and peer interaction subscale ( r=0.29-0.55, all P<0.05). The total score of SRS and the scores of each subscale were negatively correlated with the scores of prosocial behavior subscale ( r=-0.63--0.49, all P<0.05). The total score of SRS was positively affected by gender, age, opposites and disobedience, emotion, hyperactivity and peer interaction ( B=0.05-0.23, all P<0.05), and negatively affected by the prosocial behavior subscale ( B=-0.07, P<0.05). Conclusion:ADHD children often have obvious social ability defects, which are clearly related to core symptoms, emotional and behavioral problems.The risk factors are opposition and disobedience, emotions and peer relationships, and the protective factor is prosocial behaviors.

Objective:To explore the differences between impaired perspective-taking and executive function in children with attention deficit hyperactivity disorder(ADHD).Methods:From January 2019 to December 2020, according to DSM-5 diagnostic criteria, thirty-two cases of ADHD children aged 6 to 16(ADHD group) and twenty-six cases of typical development children and adolescents matched with age and intelligence (TD Group) were included. The response time and accuracy rate in dilemma stage and probe stage to self-oriented, maternal perspective-taking and other perspective-taking were measured using perspective-shifting task, and the executive function was evaluated by the behavior rating inventory of executive function (BRIEF). Repeated measurement analysis of variance was used to compare the difference of response time and accuracy rate between the two groups. Pearson correlation analysis was used to explore the correlation between the perspective-taking behavior characteristics and the BRIEF total score and subscale scores of ADHD group.Results:The total score and subscale scores of BRIEF scale in ADHD group were significantly higher than those in TD group (all P<0.01). The interaction between group and task type was significant during the task dilemma stage of perspective-shifting task ( F(2, 106)=4.365, P<0.05). Simple effect analysis showed that in other-perspective-taking task, the response time of ADHD group ((2 305.48±464.27)ms) was significantly longer than that of TD group ((1 971.13±462.95)ms) and the difference was statistically significant ( t=2.870, P<0.01). Pearson correlation analysis showed that the response time of ADHD group to other perspective-taking in dilemma stage was positively correlated with working memory, organization and inhibition index in EF ( r=0.401, 0.432, 0.342, all P<0.01). Conclusion:The ability of the perspective taking is closely related to impaired executive function, which seem to share a common neuropsychological basis.

Objective:To study the distribution and related factors of aggressive behavior among school aged children in Nanjing.Methods:Totally 4678 primary school students in Nanjing were sampled by cluster random sampling in this study.The General questionnaire and Achenbach's child Behavior Checklist were used to investi gate the general situation and aggressive behavior.Results:The rate of aggressive behavior of school-age children in Nanjing was 3.6 ％ (167/4678).Multivariate logistic regression analysis indicated that democratic parenting style [other parenting styles (OR =1.94,95％ CI =1.10-3.42),mixed parenting style(OR =1.96,95％ CI =1.35-2.85)],and genetic screening before birth (OR =0.71,95％ CI =0.52-0.99) were protective factors for children's aggressive behavior.The factor figures of aggressive behavior were positively correlated with that of oth er behavior problems in Pearson correlation analysis (r =0.52-0.80,Ps ＜0.01).Conclusion:About 3.6％ of the school aged children in Nanjing have aggressive behavior.It is more likely to have aggressive behaviors for children who is in other parenting styles except the democratic style and never have the genetic screening before birth.And children who with aggressive behavior may co-occur with other behavior problems.

Objective　The purpose of this study was to explore the distinctive alterations and tendency in symptomatology of childhood schizophrenia in recent ten years. Methods　234 cases with schizophrenia, who were hospitalized in Brain Hospital Affiliated to Nanjing Medical University (group 1, 118 cases in 1986-1989; group 2, 116 cases in 1996-1999) were reexamined in a retrospective study. According to the age of onset, the cases were divided into four groups, as under 6 years, 6-9 years, 10-12 years and 13-15 years. The age of onset, alternations of symptomatology and its tendency in the four age groups were compared. Results　It was observed some tendency that the average age of onset in Group 2 ［（11.6±1.6）years］ was 1.6 years earlier than that in Group 1［（13.2±2.0）years］（P<0.05）. Visual hallucinations in 10-12 years (66.7%) in Group 2 were more than that in the similar age group in Group 1（38.5%, P<0.01）. In comparison with Group 1, delusion of love was more observed in each age group except those aged under 6 years in Group 2（P<0.01,0.05,0.01）. The symptoms of schizophrenia concerning sexual problem, martial exercise, terror, superstition, fantasy, learning disability were more than ten years ago （P<0.01，0.05）. Conclusions　It indicates that the age of onset of childhood schizophrenia become earlier in recent ten years, and delusions, especially that concerning sexual problem are more occurred.

Objective　The purpose of this study was to explore the distinctive alterations and tendency in symptomatology of childhood schizophrenia in recent ten years. Methods　234 cases with schizophrenia, who were hospitalized in Brain Hospital Affiliated to Nanjing Medical University (group 1, 118 cases in 1986-1989; group 2, 116 cases in 1996-1999) were reexamined in a retrospective study. According to the age of onset, the cases were divided into four groups, as under 6 years, 6-9 years, 10-12 years and 13-15 years. The age of onset, alternations of symptomatology and its tendency in the four age groups were compared. Results　It was observed some tendency that the average age of onset in Group 2 ［（11.6±1.6）years］ was 1.6 years earlier than that in Group 1［（13.2±2.0）years］（P<0.05）. Visual hallucinations in 10-12 years (66.7%) in Group 2 were more than that in the similar age group in Group 1（38.5%, P<0.01）. In comparison with Group 1, delusion of love was more observed in each age group except those aged under 6 years in Group 2（P<0.01,0.05,0.01）. The symptoms of schizophrenia concerning sexual problem, martial exercise, terror, superstition, fantasy, learning disability were more than ten years ago （P<0.01，0.05）. Conclusions　It indicates that the age of onset of childhood schizophrenia become earlier in recent ten years, and delusions, especially that concerning sexual problem are more occurred.