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.

中心概况摘要 匹兹堡大学自闭症卓越中心 (ACE) 直接解决机构间自闭症问题 协调委员会呼吁对成人心理健康进行研究，以提高安全和生活质量，并 我们通过制定改进所需的措施和机制目标来降低过早死亡率。 我们在《自闭症成人》中讨论了这个尚未得到充分研究的关键话题。 我们强调与自闭症成年人及其盟友建立真正的伙伴关系，带来新的东西。 研究人员致力于研究自闭症，并为初级研究人员提供一个学术家园 我们将召集 200 名自闭症患者和 100 名非自闭症 18 至 65 岁成年人组成的匹兹堡 ACE 队列。 （每组中≥ 50 名最近有自杀倾向的人）将完成三个针对不同单位的项目 分析（自我报告、行为和动态生理学以及神经回路）、时间尺度和主要 项目1将提供第一维自我报告问卷。 为自闭症谱系障碍（ASD）制定的自杀倾向和自闭症成人自杀倾向的第一个纵向特征项目。 2 创新的生理触发生态瞬时设计将表征近端风险过程 对于自杀意念、非自杀性自残和对时间敏感的冲动攻击 允许在情绪失调和有害结果升级之前进行未来的干预。 早期神经对刺激过度反应，随后招募神经元减少的神经机制模型 监管资源以及随之而来的生理、主观和行为反应低下。 Core 向所有项目提供数据来表征样本，包括新颖的表型测量（例如， 基于大脑结构图像的衰老生物标志物）我们的中心结构使我们能够整合来自的数据。 例如，我们将通过连接一个项目来加快翻译速度。 我们将汇集所有数据来确定生活经验和纵向结果的生物因果机制。 自杀轨迹最显着的预测因子，比考虑自杀倾向的方法取得了重大进步 我们将阐明一小组预测因素并确定对风险的相对贡献。 根据情绪和生理的日常动态连接亚组，从而得出结果的异质性 对神经反应和自杀的反应和调节。我们的年龄范围和跨诊断、自杀倾向。 对照组使我们能够确定自闭症谱系障碍患者心理健康的独特之处以及衰老的影响 我们将在以下人员的帮助下采用新颖的方式向社区传播这一重要信息。 我们的团队由来自不同背景的自闭症合作伙伴组成，这个过程将确保我们的中心不仅能够。 让来自被边缘化群体的个人参与进来，但也将创造和维持相互 有益且有益的关系将增强和丰富我们的研究样本、成果和 整体影响。