Change-sensitive Measurement of Emotion Dysregulation in ASD

ASD 情绪失调的变化敏感测量

基本信息

批准号：
9276754
负责人：
Carla A Mazefsky
金额：
$ 44.95万
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 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9276754
关键词：
Achievement Address Admission activity Affect Aggressive behavior Anxiety Area Attention Autistic Disorder Award Behavior Calibration Caregiver Burden Caregivers Child Clinical Clinical Trials Cognitive Communities Comorbidity Data Collection Data Set Depressed mood Development Dimensions Emotional Emotions Equipment and supply inventories Evaluation Evidence based treatment FDA approved Factor Analysis Genetic Gold Guidelines Heterogeneity Hospitalization Hyperactive behavior Impairment Individual Information Systems Inpatients Interview Lead Life Measurement Measures Mental Depression Mental disorders Modeling Online Systems Outcome Measure Outcome Study Outpatients Output Parents Participant Patient Outcomes Assessments Persons Pharmaceutical Preparations Phenotype Population Population Study Problem behavior Process Property Provider Psychiatric Diagnosis Psychiatric therapeutic procedure Psychometrics Psychopathology Recording of previous events Regulation Research Sampling Severities Source Structure Symptoms Testing Time autism spectrum disorder base behavior observation emotion dysregulation emotion regulation emotional distress externalizing behavior innovation instrument literacy neuroimaging primary outcome psychiatric symptom public health relevance response stereotypy theories treatment effect treatment planning user-friendly young adult

项目摘要

DESCRIPTION (provided by applicant): Individuals with autism spectrum disorder (ASD) are often in need of psychiatric care due to poor emotion regulation and emotional distress. Only two psychotropic medications have been approved for use in ASD, both to treat irritability expressed as tantrums, outbursts, and aggression. However, the underlying deficits in emotion regulation that lead to these problem behaviors are poorly understood and rarely measured or targeted in treatment. Evidence-based treatment approaches for the full range of emotion dysregulation (e.g. depression, outbursts, meltdowns, etc.) present in ASD do not exist. A major barrier to progress in this area is a lack of validated, treatment sensitive measures of emotional distress for individuals with ASD. This project proposes to refine and validate a new measure of emotional distress and emotion regulation for ASD, called the Emotion Dysregulation Inventory (EDI). Guidelines from the Patient-Reported Outcome Measurement Information System (PROMIS) Project and gold-standard statistical approaches will be utilized to complete calibration and psychometric analysis of the EDI. The primary sample will include caregivers of 1000 children and young adults with ASD from community, outpatient, and psychiatric inpatient settings. Data collection will occur through an online system. Analyses will focus on establishing the EDI's factor structure/dimensionality, developing a less than 10-item short form, establishing convergent and divergent validity, comparing EDI scores among groups whose scores would be expected to differ (e.g. inpatients versus community sample; ASD versus healthy controls), and comparing EDI scores to observational counts of emotion dysregulation episodes displayed by children who are inpatients on two specialized psychiatric units. A subset of the sample will complete the EDI twice to establish test-retest reliability. The EDI's ability to detect treatment change will be determined by comparing both caregiver- and provider-rated EDI scores at admission and discharge across two psychiatric inpatient units that specialize in ASD and 4-week change scores in a stable community sample. The primary outcome of this study will be a user-friendly (e.g. available online, brief), validated, treatment sensitive outcome measure for clinical trials in ASD that is independent of verbal ability. In addition, this study will produce he largest existing dataset on emotion dysregulation in ASD, which will be used to identify emotional profiles and treatment needs in this population. Additional time-course questions in the EDI that tap the individual's history of emotion dysregulation will be useful for clinical conceptualization and helping to understand the boundaries between emotion dysregulation that is inherent in ASD and comorbid psychiatric disorders. Finally, having a sensitive measure of emotion dysregulation in ASD will aid in understanding heterogeneity in genetic and neuroimaging research and will enable cross-population studies

描述（由申请人提供）：患有自闭症谱系障碍（ASD）的人通常由于情绪调节不良和情绪困扰而需要精神科护理。只有两种精神药物被批准用于治疗自闭症谱系障碍（ASD），两者都用于治疗表现为发脾气、爆发和攻击性的烦躁情绪。然而，人们对导致这些问题行为的情绪调节的潜在缺陷知之甚少，并且很少在治疗中进行测量或针对性治疗。针对自闭症谱系障碍中存在的各种情绪失调（例如抑郁、爆发、崩溃等）的循证治疗方法尚不存在。该领域取得进展的一个主要障碍是缺乏有效的、对治疗敏感的自闭症患者情绪困扰测量方法。该项目旨在完善和验证一种新的自闭症谱系障碍情绪困扰和情绪调节测量方法，称为情绪失调量表（EDI）。来自患者报告结果测量信息系统 (PROMIS) 项目的指南和黄金标准统计方法将用于完成 EDI 的校准和心理测量分析。主要样本将包括来自社区、门诊和精神科住院机构的 1000 名患有自闭症谱系障碍 (ASD) 儿童和年轻人的护理人员。数据收集将通过在线系统进行。分析将侧重于建立 EDI 的因素结构/维度、开发少于 10 项的简短表格、建立收敛和发散的有效性、比较预期分数不同的群体之间的 EDI 分数（例如住院患者与社区样本；自闭症谱系障碍与健康人群）对照），并将 EDI 评分与两个专门精神病科住院患者表现出的情绪失调发作的观察计数进行比较。样本的子集将完成 EDI 两次，以建立重测可靠性。 EDI 检测治疗变化的能力将通过比较两个专门治疗 ASD 的精神科住院病房的护理人员和提供者在入院和出院时评定的 EDI 分数以及稳定社区样本中的 4 周变化分数来确定。这项研究的主要成果将是一个用户友好的（例如，在线提供的、简短的）、经过验证的、治疗敏感的结果测量，用于自闭症谱系障碍的临床试验，且与语言能力无关。此外，这项研究将产生关于自闭症谱系障碍情绪失调的现有最大数据集，该数据集将用于识别该人群的情绪概况和治疗需求。 EDI 中挖掘个人情绪失调历史的其他时程问题将有助于临床概念化，并有助于理解自闭症谱系障碍固有的情绪失调与共病精神疾病之间的界限。最后，对自闭症谱系障碍患者的情绪失调进行敏感测量将有助于理解遗传和神经影像研究中的异质性，并使跨人群研究成为可能