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: 10698097
• 负责人: Lauren M Bylsma
• 金额: $ 42.68万
• 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/10698097
• 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; Elderly; Emotional; Emotions; Event; Feeling suicidal; Hour; Impairment; Impulsivity; Individual; Individual Differences; Intervention; Life; Link; Literature; Mental Health; Modeling; Motivation; Negative Valence; Outcome; Parasympathetic Nervous System; 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; 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; neural; neuroimaging; non-suicidal self injury; novel; resilience; respiratory; response; social; suicidal; suicidal behavior; suicidal risk; verbal

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.

自杀的构想和行为，非自杀的自我伤害和冲动侵略在自闭症中非常普遍 成年人。这些困难是由情绪失调（ED）引起的，包括灵活的问题 - 调节或维持正价系统或下调负价系统。然而， 自闭症成年人中的ED研究的先前研究有限。从缺乏情感的先前研究中得出的结果 自闭症中的反应性和调节性混合在一起，包括表明超级和低功能的模式 多个反应系统（即生理学，行为和自我报告）之间的反应性，可能会随着 个体差异和上下文的功能。尽管ED对自闭症成年人的临床意义，但如何和 为什么ED在自闭症成年人中表现出来以及对现实生活的高反应性或性能的重要性 结果仍然很少了解。为了解决这些差距，我们将使用14天的生态评估ED 瞬时评估方案，并通过副交感神经和交感 在200名自闭症成年人和100名非自动成年人的样本中的神经系统活动（两组 为自杀而过采样）。具体而言，我们将表征ED在各种环境中的出现 日常生活中的响应系统（即主观，行为，生理）以及ED组件如何 动态地有助于随后的自杀念头，自我伤害和冲动侵略的近端风险 自闭症和自杀历史的功能。调查结果将揭示自闭症独有的ED方面 与那些在自闭症和非自闭症患者中遇到自杀风险的人相比。我们的横向项目 综合目标将确定ED流程的单独和子组模式，这些模式表征了独特的风险 组。将ED组件与使用生理触发的临床意义的现实结果联系 EMA将使我们能够表征和评估ED不同模式的功能意义 组件并以时间敏感的方式确定近期风险和弹性过程。发现 将导致新的治疗目标和及时的干预策略在发作或升级之前 以及相关的有害结果。