Mental Health in Autistic Adults: An RDoC Approach

成人自闭症患者的心理健康：RDoC 方法

• 批准号: 10523163
• 负责人: Carla A Mazefsky
• 金额: $ 232.56万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-06 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10523163
• 关键词: Address; Adult; Age; Aggressive behavior; Aging; Ally; Area; Behavior; Behavioral; Biological; Biological Factors; Biological Markers; Brain imaging; Child; Clinical; Communities; Computer Models; Control Groups; Data; Diagnosis; Dimensions; Disease; Distress; Ecological momentary assessment; Emotional; Emotions; Ensure; Equipment and supply inventories; Feeling suicidal; Female; Functional Magnetic Resonance Imaging; Funding; Future; Heterogeneity; Home; Impulsivity; Individual; Information Dissemination; International; Intervention; Life; Light; Measurement; Measures; Mental Health; Methods; Mission; Modeling; Nature; Outcome; Patient Self-Report; Pattern; Pharmaceutical Preparations; Phenotype; Physiological; Physiology; Play; Premature Mortality; Prevalence; Prevention; Process; Psychiatric Diagnosis; Psychophysiology; Psychosocial Factor; Quality of life; Questionnaires; Race; Regulation; Reporting; Reproducibility; Research; Research Domain Criteria; Research Methodology; Research Personnel; Resources; Rest; Rewards; Risk; Role; Safety; Sampling; Source; Speed; Stimulus; Structure; Subgroup; Suicide; Testing; Time; Translations; Trauma; Universities; Work; adult with autism spectrum disorder; affective neuroscience; autism spectrum disorder; autistic; base; clinical care; cohort; community engagement; comparison group; design; emotion dysregulation; emotion regulation; emotional experience; emotional stimulus; ethnic identity; experience; high risk; human old age (65+); improved; indexing; innovation; longitudinal design; neural circuit; non-suicidal self injury; novel; personalized care; primary outcome; prospective; recruit; reducing suicide; relating to nervous system; response; self reported behavior; sensory stimulus; sex; statistics; suicidal; suicidal morbidity; suicidal risk; synergism; theories; therapy development

Center Overview Abstract The University of Pittsburgh Autism Center of Excellence (ACE) directly addresses the Interagency Autism Coordinating Committee’s call for research on adult mental health to improve safety and quality of life, and to reduce premature mortality. We do so by generating the measures and mechanistic targets needed to improve mental health and reduce suicide risk in autistic adults. We address this understudied and critical topic in authentic partnership with autistic adults and their allies. We emphasize mechanistic translation, bring new researchers to work on autism, and provide an academic home for junior researchers getting started in this area. We will assemble a Pittsburgh ACE cohort of 200 autistic and 100 non-autistic 18- to 65-year-old adults (≥ 50 with recent suicidality in each group) who will complete three projects that are focused on different units of analysis (self-report, behavior and ambulatory physiology, and neural circuits), time scales, and primary outcomes, all related to adult mental health. Project 1 will provide the first dimensional self-report questionnaire of suicidality developed for ASD and the first longitudinal characterization of suicidality in autistic adults. Project 2’s innovative physiologically-triggered ecological momentary design will characterize proximal risk processes for suicidal ideation, non-suicidal self-injury, and impulsive aggression in a temporally sensitive manner to allow for future interventions prior to escalation of emotion dysregulation and harmful outcomes. Project 3 tests a neural mechanistic model of early neural hyper-reactivity to stimuli followed by decreased recruitment of regulatory resources and consequent physiological, subjective, and behavioral hypo-reactivity. Our Clinical Core provides data to all of the projects to characterize the sample, including novel phenotypic measures (e.g., a biomarker of aging based on structural brain images). Our Center structure enables us to integrate data from all sources to enhance the impact of individual projects. For example, we will speed translation by connecting a biological causal mechanism to lived experience and longitudinal outcomes. We will pool all data to identify the most salient predictors of suicidality trajectories, providing a significant advance over approaches that consider small sets of predictors and enabling determination of relative contributions to risk. We will shed light on heterogeneity in outcomes by connecting subgroups based on daily dynamics of emotion and physiological reactivity and regulation to neural reactivity and suicidality. Our age range and transdiagnostic, suicidal comparison group allows us to determine what is unique about mental health in ASD and how aging may play a role. We will employ novel means to disseminate this critical information to the community with the help of our team of autistic partners from diverse backgrounds. This process will ensure that our Center will not only engage individuals from groups that have been marginalized, but will also create and maintain mutually beneficial and rewarding relationships that will enhance and enrich our research sample, outcomes, and overall impact.

中心概述摘要 匹兹堡大学自闭症卓越中心（ACE）直接解决机构间自闭症 协调委员会呼吁成人心理健康研究以提高安全和生活质量的呼吁，并 减少过早死亡率。我们通过产生改进所需的措施和机械目标来做到这一点 心理健康并降低加速成年人的自杀风险。我们在这个理解和关键的话题中解决 与加速成年人及其盟友的真实伙伴关系。我们强调机械翻译，带来新的 研究人员从事自闭症的工作，并为初级研究人员提供学术住所 区域。我们将组装一个由200个自闭症和100个非自闭症的匹兹堡王牌队列组成的18至65岁的成年人 （≥50，每组最近自杀）将完成三个专注于不同单位的项目 分析（自我报告，行为和门诊生理学以及神经回路），时间尺度和主要 结果，都与成人心理健康有关。项目1将提供第一维自我报告问卷 为ASD开发的自杀性和加速成年人自杀性的第一个纵向表征。项目 2的创新物理触发的生态瞬时设计将表征代理风险过程 以自杀的构想，非自杀的自我伤害和暂时敏感的冲动侵略性 在情绪失调和有害结果升级之前，允许将来进行干预。项目3测试 早期神经元高反应性的神经元机械模型，然后先进 监管资源以及随之而来的身体，主观和行为性低反应性。我们的临床 Core为所有项目提供了数据以表征样本的数据，包括新的表型措施（例如， 基于结构大脑图像的衰老的生物标志物）。我们的中心结构使我们能够整合来自 所有来源以增强单个项目的影响。例如，我们将通过连接一个 生物因果关系机制，实现了现场经验和纵向结果。我们将汇总所有数据以识别 自杀轨迹的大多数显着预测指标，为考虑的方法提供了重大进步 一小部分预测因素和确定对风险的相对贡献。我们会亮着 通过基于情绪和生理动态的亚组连接子组的异质性 对神经反应性和自杀的反应性和调节。我们的年龄范围和经诊断，自杀 比较小组允许我们确定ASD心理健康的独特之处以及衰老的发挥 角色。我们将采用新颖的手段将这些关键信息传播给社区 我们来自潜水员背景的令人印象深刻的合作伙伴团队。这个过程将确保我们的中心不仅将 吸引被边缘化的团体的个人，但也将创建和维护 有益和有益的关系将增强和丰富我们的研究样本，结果以及 总体影响。