Evaluating a novel approach-avoidance model of repetitive behaviors in autistic adolescents: A multi-method study

评估自闭症青少年重复行为的新型接近-回避模型：一项多方法研究

• 批准号: 10612091
• 负责人: BENJAMIN YERYS
• 金额: $ 23.71万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10612091
• 关键词: Accounting; Address; Adolescence; Age; Amygdaloid structure; Anxiety; Behavior; Behavioral; Brain; Caregivers; Child; Childhood; Clinical; Data; Decision Making; Development; Diagnosis; Diagnostic; Dimensions; Disparate; Distress; Education; Emotional; Emotions; Exposure to; General Population; Goals; Grant; Hobbies; Individual; Intervention; Knowledge; Lateral; Link; Literature; Longevity; Measures; Medial; Methods; Modeling; Motivation; Movement; National Institute of Mental Health; Negative Valence; Neurocognitive; Nucleus Accumbens; Outcome; Pathway interactions; Patient Self-Report; Performance; Persons; Positioning Attribute; Positive Valence; Prefrontal Cortex; Protocols documentation; Proxy; Punishment; Quality of life; Questionnaires; Reporting; Research; Research Domain Criteria; Rewards; Sensory; Speech; Stereotyping; Stimulus; Strategic Planning; Stress; Symptoms; System; Teenagers; Testing; Time; Work; adolescent with autism spectrum disorder; adult with autism spectrum disorder; autism spectrum disorder; autistic; comparison group; emotional experience; experience; improved; individuals with autism spectrum disorder; interest; neural; neural correlate; neuroimaging; novel; novel strategies; recruit; repetitive behavior; resilience; reward circuitry; sensory input; social

ABSTRACT Repetitive behaviors comprise one of the two core domains of symptoms for an autism spectrum disorder diagnosis (hereafter ‘autism’), and the lived experience of autistic individuals suggests that these behaviors serve important functions that are largely misunderstood and poorly addressed clinically. Autistic individuals report engaging in repetitive behaviors for reasons related to enjoyment and reasons related to distress (i.e., to decrease stress and anxiety). The field lacks a validated model that encompasses these seemingly polarized lived experiences, which negatively impacts our ability to provide appropriate supports, and educate the public to better accommodate autistic individuals. The guiding scientific premise of this R21 is that autistic individuals are driven to engage in repetitive behaviors via both approach (enjoyment) and avoidance (avoiding/easing exposure to negative stimuli) mechanisms. The approach component of the model is supported by a burgeoning literature and our preliminary work demonstrating that measures from the Research Domain Criteria’s Positive Valence System are implicated for special interest repetitive behaviors. The avoidance component of the model is supported by a robust literature and our preliminary data associating sensory reactivity and insistence on sameness repetitive behaviors with measures from the Research Domain Criteria’s Negative Valence System. The objective of this project is to take the first step in evaluating the approach-avoidance model of repetitive behaviors in a study with autistic adolescents. Adolescence is a developmental period when many autistic youth can reflect on the drivers of their repetitive behaviors. Aim 1 will recruit 250 autistic adolescents between the ages of 13 and 17 and a caregiver to provide ratings on the type of repetitive behaviors they engage in, approach and/or avoidance motivations for engaging in the behavior(s), and the intensity of the emotional valence associated with each repetitive behavior. We will derive latent profiles of repetitive behaviors as a novel method for parsing the heterogeneous clinical presentations of repetitive behaviors. Aim 2 will recruit 60 teens from Aim 1 to complete neuroimaging and behavioral protocols associated with the Research Domain Criteria’s Positive Valence (approach), and Negative Valence systems (avoidance); the goal is to link these dimensional assessments of approach and avoidance mechanisms with self-report of valence direction and intensity of repetitive behaviors. We hypothesize that Aim 1 will yield 3 unique latent profiles—Predominantly Approach, Predominantly Avoidant, and Mixed Approach/Avoidant—and that Aim 2’s canonical correlation analyses will show the Positive Valence System to be associated with approach repetitive behaviors and Negative Valence System to be associated with avoidance repetitive behaviors. This line of research has the potential to redefine models of repetitive behavior to align with the autistic lived experience, and to enhance clinical supports through identifying novel target mechanisms that are malleable or through education to the general public to better accommodate the needs of autistic people.

抽象的 重复行为包括自闭症谱系障碍症状的两个核心领域之一 诊断（以后的“自闭症”）和加速个人的现场经验表明这些行为有效 重要的功能在很大程度上是误解并且在临床上解决的问题很差。自闭症患者报告 出于与享受和与苦难有关的原因（即 减轻压力和焦虑）。该领域缺乏涵盖这些看似两极分化的经过验证的模型 现场体验，对我们提供适当支持的能力产生负面影响，并教育公众 更好地适应准确的个人。该R21的指导科学前提是准确的个体 被驱使通过方法（享受）和回避（避免/放松）从事重复行为 暴露于负面刺激）机制。模型的方法组成部分由新兴 文学和我们的初步工作，证明了研究领域标准的积极措施 价系统是为了特殊的重复行为。模型的回避组件 由强大的文献和我们的初步数据支持感官反应性和坚持 与研究域标准负面价系统的措施相同的重复行为。 该项目的目的是迈出第一步，以评估重复性的避免进近模型 与青少年的研究中的行为。青少年是许多令人印象深刻的青年的发展时期 可以反思其重复行为的驱动力。 AIM 1将招募250个加速器 年龄在13岁和17岁之间，以及一名护理人员，以提供有关其参与重复行为的类型的评级 和/或避免参与行为的动机以及情感价的强度 与每个重复行为相关联。我们将作为一种新方法得出重复行为的潜在概况 解析重复行为的异质临床表现。 AIM 2将从AIM招募60名青少年 1完成与研究域标准相关的神经影像学和行为方案 价（方法）和负价系统（避免）；目标是将这些维度联系起来 评估方法和避免机制的价值方向和强度的自我报告 重复行为。我们假设AIM 1将产生3个独特的潜在剖面，即敏锐的方法， 主要避免避免和混合方法/避免 - AIM 2的规范相关分析将会 显示与方法重复行为和负相关的正价系统 与回避重复行为相关的系统。这项研究有可能重新定义 重复行为模型，以与加速的实时体验保持一致，并通过 识别可延展或通过向公众教育的新型目标机制以更好 满足自闭症患者的需求。