Mental Health in Autistic Adults: An RDoC Approach

成人自闭症患者的心理健康：RDoC 方法

基本信息

批准号：
10523168
负责人：
Lauren M Bylsma
金额：
$ 43.5万
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：
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/10523168
关键词：
Acute Address Adult Affect Aggressive behavior Ambulatory Monitoring Anger Arousal Autism Diagnosis Behavior Buffers Chronic Clinical Communities Complement Complex Data Detection Development Dimensions Ecological momentary assessment Emotional Emotions Event Feeling suicidal Hour Impairment Impulsivity Individual Individual Differences Intervention Life Link Literature Mental Health Modeling Motivation Negative Valence Outcome Patient Self-Report Pattern Physiological Physiology Positive Valence Process Protocols documentation Psychophysiology Recording of previous events Recovery Regulation Reporting Research Research Domain Criteria Risk Sample Size Sampling Self-Injurious Behavior Sensory Severities Sinus Arrhythmia Subgroup Suicide Sympathetic Nervous System System Time Work adult with autism spectrum disorder autism spectrum disorder autistic clinical phenotype clinically significant cohort design dysphoria emotion dysregulation emotion regulation emotional behavior emotional experience flexibility functional outcomes graph theory human old age (65+)individuals with autism spectrum disorder innovation multimodality negative affect neuroimaging non-suicidal self injury novel relating to nervous system resilience respiratory response social suicidal behavior suicidal risk

项目摘要

Suicidal ideation and behavior, non-suicidal self-injury, and impulsive aggression are highly prevalent in autistic adults. These difficulties are proposed to arise from emotion dysregulation (ED), including problems flexibly up- regulating or sustaining positive valence systems or down-regulating negative valence systems. However, there is limited prior research on ED among autistic adults. Findings from the scant prior studies on emotional reactivity and regulation in autism have been mixed, including evidence of patterns of both hyper- and hypo- reactivity across multiple response systems (i.e., physiology, behavior, and self-report), which may vary as a function of individual differences and context. Despite the clinical significance of ED for autistic adults, how and why ED manifests in autistic adults and the significance of either hyper- or hypo-reactivity for real-life functional outcomes remain poorly understood. To address these gaps, we will assess ED using a 14-day ecological momentary assessment protocol with continuous ambulatory monitoring of parasympathetic and sympathetic nervous system activity in a sample of 200 autistic adults and 100 non-autistic adults (both groups oversampled for suicidality). Specifically, we will characterize how ED emerges in a variety of contexts across response systems (i.e., subjective, behavior, physiology) in daily life, and how ED components may dynamically contribute to proximal risk for subsequent suicide ideation, self-injury, and impulsive aggression as a function of both autism and suicidality history. Findings will reveal aspects of ED that are unique to autism versus those that are common across autistic and non-autistic individuals at risk for suicide. Our cross-project integrative aim will identify individual and subgroup patterns of ED processes that characterize distinctive risk groups. Linking ED components to real-world outcomes of clinical significance using physiologically-triggered EMA will allow us to characterize and evaluate the functional significance of different patterns of ED components and identify near-term risk and resilience processes in a temporally sensitive manner. Findings will lead to novel treatment targets and just-in-time intervention strategies prior to onset or escalation of ED and associated deleterious outcomes.

自杀意念和行为、非自杀性自残和冲动攻击在自闭症患者中非常普遍成年人。这些困难被认为是由情绪失调（ED）引起的，包括灵活向上的问题调节或维持正价系统或下调负价系统。然而，先前对成人自闭症 ED 的研究有限。先前关于情绪的研究很少自闭症的反应性和调节性是混合的，包括高和低的模式的证据。跨多个反应系统（即生理、行为和自我报告）的反应性，这些系统可能会因个体差异和环境的作用。尽管 ED 对于成人自闭症患者具有临床意义，但如何以及为什么 ED 在自闭症成人中表现出来以及反应过度或反应低下对现实生活功能的重要性结果仍然知之甚少。为了弥补这些差距，我们将使用 14 天的生态评估 ED 副交感神经和交感神经持续动态监测的瞬时评估方案 200 名自闭症成人和 100 名非自闭症成人样本（两组）的神经系统活动对自杀进行过采样）。具体来说，我们将描述 ED 在各种背景下如何出现日常生活中的反应系统（即主观、行为、生理），以及 ED 成分如何发挥作用动态地导致随后的自杀意念、自残和冲动攻击的近端风险自闭症和自杀史的函数。研究结果将揭示自闭症特有的 ED 方面与有自杀风险的自闭症和非自闭症患者中常见的那些相比。我们的跨项目综合目标将确定具有独特风险特征的 ED 流程的个体和亚组模式组。使用生理触发将 ED 成分与具有临床意义的现实结果联系起来 EMA 将使我们能够表征和评估不同 ED 模式的功能意义组件并以时间敏感的方式识别近期风险和弹性过程。发现将在 ED 发作或升级之前制定新的治疗目标和及时干预策略以及相关的有害结果。