Change-Sensitive Assessment of Emotion Dysregulation in ASD Across the Lifespan

自闭症谱系障碍患者整个生命周期情绪失调的变化敏感评估

基本信息

批准号：
10158534
负责人：
Carla A Mazefsky
金额：
$ 65.45万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-10 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10158534
关键词：
17 year old 5 year old Address Admission activity Adolescent Adult Age Aggressive behavior Awareness Brain Calibration Caregivers Censuses Characteristics Child Clinical Clinical Trials Cognitive Collection Communities Comprehension Country Crisis Intervention Data Data Reporting Development Developmental Delay Disorders Diagnosis Emotional Emotions Enrollment Ensure Equipment and supply inventories Evaluation Evidence based intervention Frustration Funding Future Gender Generations Impaired cognition Impairment Information Systems Inpatients Intellectual functioning disability Intervention Investigational Therapies Lateral Life Link Longevity Longitudinal Studies Measurement Measures Mental disorders Methods Monitor Morbidity - disease rate Near-Infrared Spectroscopy Nursery Schools Outcome Outpatients Painless Parents Participant Patient Outcomes Assessments Patient Self-Report Patients Performance Polypharmacy Population Prefrontal Cortex Prevention Problem behavior Process Property Proxy Psychometrics Quality of life Reporting Research Risk Sampling School-Age Population Structure Suicide Symptoms Testing Validation Validity of Self Report Variant Youth adult with autism spectrum disorder autism spectrum disorder autistic children base clinically significant cognitive ability cognitive interview cost critical period developmental disease dysphoria early childhood effective therapy emotion dysregulation experience flexibility follow up assessment improved individuals with autism spectrum disorder neuroimaging recruit relating to nervous system response screening theories

项目摘要

PROJECT SUMMARY Emotion dysregulation (ED) increases risk for psychiatric and behavioral problems, and leads to polypharmacy, crisis interventions, and high rates of suicidality. Rates of clinically elevated ED are particularly high among those with autism spectrum disorder (ASD). Effective treatment of ED could greatly reduce morbidity and costs and significantly improve quality of life for individuals with ASD. Unfortunately, the development of evidence- based interventions for ED in ASD has been limited by the absence of measures that assess ED without being biased by differences in intellectual and verbal ability. The Emotion Dysregulation Inventory (EDI) (R01HD079512) was developed to address this obstacle. The EDI is a caregiver report that measures rapidly escalating, intense, and poorly regulated negative emotion and dysphoria. It was validated on 1755 school- aged verbal and nonverbal ASD youth as well as a sample of 1000 youth representative of the general US population. The EDI is already being used in multiple clinical trials and for screening and treatment monitoring in inpatient and outpatient settings across the U.S. and in 10 other countries. This project will build on the EDI's conceptual and psychometric strengths and apply Patient-Reported Outcomes Measurement Information System (PROMIS®) methods to develop the EDI-Young Child (EDI-YC for ages 2-5) and the EDI Self-Report (EDI-SR for ages 12+). Samples of 800 participants with ASD, 200 with other intellectual and developmental disorders (IDD), and 1000 from the general community will be recruited to complete calibration and psychometric analysis of each measure using Item Response Theory (IRT) and traditional psychometric analyses. The change-sensitivity of the EDI-YC and EDI-SR will be evaluated in the context of funded clinical trials. The availability of the EDI-YC will motivate ED prevention and intervention in early childhood during this critical period of early brain plasticity. The EDI-SR will be developed through a systematic item refinement process to ensure validity even in the context of cognitive impairments or poor emotional awareness, thereby creating new opportunities to incorporate patient perspectives and include the often overlooked but growing population of adults with ASD or IDD in clinical trials when no caregiver is available. Finally, the translational value of this research will be supported by linking specific neural features of ED (e.g., hypo-activation of the lateral prefrontal cortex (LPFC) during frustration and cognitive inflexibility tasks) to ED in ASD as assessed by the EDI. This will be accomplished through neuroimaging via collection of functional near-infrared spectroscopy (fNIRS) and EDI data in a sample of 125 4- to 17-year-olds with ASD. Because of ED's transdiagnostic significance, the impact will span outcomes from aggression to suicide and other critical symptoms related to ED. We will ensure the EDI battery's utility across populations by evaluating the candidate EDI-EC and EDI-SR items in non-ASD IDD samples, as well as through the generation of general norms from large community samples.

项目摘要情绪失调（ED）增加了精神病和行为问题的风险，并导致多药，危机干预措施和自杀率高。临床上升高的ED率在患有自闭症谱系障碍的人（ASD）。 ED的有效治疗可以大大降低发病率和成本并显着改善ASD患者的生活质量。不幸的是，证据的发展 - 基于ASD中的ED的干预措施受到评估而没有进行的措施的限制因智力和言语能力的差异而偏见。情绪失调库存（EDI）（R01HD079512）的开发是为了解决这一障碍。 EDI是一份护理人员报告，可快速衡量升级，激烈且受到调节的负面情绪和烦躁不安。它在1755年的学校进行了验证 - 老年语和非语言ASD青年以及代表美国将军的1000名青年样本人口。 EDI已经用于多个临床试验和筛查和治疗监测在美国和其他10个国家 /地区的住院和门诊环境中。这个项目将建立在EDI的基础上概念和心理测量强度，并应用患者报告的结果测量信息系统（Promis®）开发Edi-Young儿童（2-5岁）和EDI自我报告的方法（EDI-YC）（12岁以上的EDI-SR）。 800名ASD的样本，有200个智力和发展的样本将招募疾病（IDD）和一般社区的1000个，以完成校准和使用项目响应理论（IRT）和传统心理测量学对每种措施进行心理测量分析分析。 EDI-YC和EDI-SR的变化敏感性将在基本临床的背景下进行评估试验。在此期间，EDI-YC的可用性将激发幼儿期ED ED预防和干预早期脑可塑性的关键时期。 EDI-SR将通过系统的项目进行开发即使在认知障碍或情绪意识不佳的背景下，可以确保有效性的过程，从而创造新的机会来融合患者的观点，并包括经常被忽视但不断增长的当没有护理人员可用时，在临床试验中患有ASD或IDD的成年人的人群。最后，翻译这项研究的价值将通过连接ED的特定神经特征来支持（例如在挫折和认知僵化任务期间的外侧前额叶皮层（LPFC）在ASD中进行了ED EDI。通过收集功能性近红外光谱法来实现这一点（FNIRS）和EDI数据在125 4至17岁的ASD样本中。由于埃德的转诊意义上，影响将涵盖从侵略性到自杀的结果以及与 ed。我们将通过评估候选人EDI-EC和EDI-SR来确保EDI电池的实用性非ASD IDD样本中的项目以及大型社区的一般规范的产生样品。