2021 Volume 61 Issue 1 Pages 64-74
Objectives : Recently, subthreshold autism spectrum disorder, which is noticed only after complaints of physical and mental disorders in adolescence and adulthood, has become a focus of attention. Early assessment of ASD characteristics presenting in the background of comorbidity is most important to provide appropriate support depending on the characteristics. Although P-F study is originally a personality test based on the reaction tendency to frustration scenes, it is easy to reflect problems in interpersonal situations, and its possible usefulness has been shown as a means to specifically grasp the characteristics of interpersonal interaction in ASD. In this study, it is a purpose to examine the possibility of assessment towards adolescents and adults with subthreshold ASD using quantitative and qualitative analyses of P-F study.
Subjects and method : The subjects were 31 patients who visited a psychiatric unit. They were divided into two groups according to the presence or absence of subthreshold ASD. The group with subthreshold ASD fell under one or more of the diagnostic criteria A or B in DSM-5 (11 patients). The control group was a clinical group without ASD (20 patients). We conducted P-F study for adults, and performed quantitative and qualitative analyses.
Results : As a result of quantitative analysis of the P-F study, unscorable responses were more abundant in the subthreshold ASD group than in non-ASD clinical group. In the qualitative analysis of the unscorable responses of the subthreshold ASD group, four characteristics of “difficult to cope”, “situation approval”, “self-oriented”, and “misidentification of situation” were recognized. The qualitative analysis of responses for 24 scenes also showed four characteristics “excessive displacement of responsibility”, “self-assertion with less empathy”, “inappropriate remarks to situation” and “using words with discomfort”. In the subthreshold ASD group, “misidentification of the situation” in the unscorable responses, and “inappropriate remarks to situation” and “using words with discomfort” in the responses of 24 scenes, were recognized more frequently than in non-ASD clinical group.
Conclusion : The P-F study is likely to reflect interpersonal interaction issues that are difficult to recognize at first glance, and there is a possibility of being able to distinguish subthreshold ASD in the background of comorbidity.
