There is evidence to suggest that sensory processing differences (SPDs) to external stimuli are a plausible underlying mechanism for mental health problems among autistic people. In the current systematic review, we examined the associations between, on the one hand, eleven types of SPDs and, on the other hand, internalising and externalising problems. The literature search was conducted on five databases (MEDLINE, PsycINFO, Web of Science, EMBASE, and CINAHL) between 1990 and August 2024. Studies with autistic people aged under 65 years-old that reported correlations between SPDs and internalising/externalising problems were included. Three-level and random-effects meta-analyses and narrative synthesis were conducted. In total, we included 63 articles (11,659 participants) in the current review. Overall, higher levels of all SPD subtypes were found to be associated with greater internalising/externalising problems. Hypersensitivity, visual, auditory, and tactile sensitivities were strongly associated with internalising/externalising problems, while smaller effects were observed for unusual processing of smell and taste. Sensation seeking was highly linked with externalising problems, whereas it was the least associated sensory subtype with internalising problems. Future studies could address the limitations in the extant literature (e.g., heterogeneity in the estimates of associations, a lack of externalising problem investigations and longitudinal studies) to further advance our understanding of the role of SPDs in the aetiology, development, and treatment of internalising/externalising problems in autism.

中文翻译：

---

自闭症感觉处理差异与内化/外化问题之间关系的系统评价和荟萃分析


有证据表明，对外部刺激的感觉处理差异 （SPD） 是自闭症患者心理健康问题的合理潜在机制。在当前的系统评价中，我们一方面研究了 11 种类型的 SPD 之间的关联，另一方面研究了内化和外化问题之间的关联。1990 年至 2024 年 8 月期间，在五个数据库 （MEDLINE、PsycINFO、Web of Science、EMBASE 和 CINAHL） 上进行了文献检索。纳入了针对 65 岁以下自闭症患者的研究，这些研究报告了 SPD 与内化/外化问题之间的相关性。进行了三水平和随机效应荟萃分析和叙述综合。在当前的综述中，我们总共纳入了 63 篇文章（11,659 名受试者）。总体而言，发现所有 SPD 亚型的较高水平的内容与更大的内化/外化问题相关。超敏反应、视觉、听觉和触觉敏感性与内化/外化问题密切相关，而观察到对嗅觉和味觉异常处理的影响较小。寻求感觉与外化问题高度相关，而它是与内化问题最不相关的感觉亚型。未来的研究可以解决现有文献中的局限性（例如，关联估计的异质性，缺乏外化问题调查和纵向研究），以进一步推进我们对 SPDs 在自闭症内化/外化问题病因学、发展和治疗中的作用的理解。