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 重复行为是自闭症谱系障碍症状的两个核心领域之一 诊断（以下简称“自闭症”），自闭症患者的生活经历表明这些行为有助于 自闭症患者报告的重要功能在很大程度上被误解和未得到很好的解决。 出于与享受相关的原因和与痛苦相关的原因（即，为了 该领域缺乏包含这些看似两极分化的经过验证的模型。 生活经历，这会对我们提供适当支持和教育公众的能力产生负面影响 更好地适应自闭症患者 R21 的指导科学前提是自闭症患者。 被驱使通过接近（享受）和回避（避免/放松 该模型的方法部分得到了新兴的机制的支持。 文献和我们的初步工作表明，研究领域标准的积极措施 效价系统涉及特殊兴趣重复行为模型的回避部分。 得到了可靠的文献和我们与感官反应和坚持相关的初步数据的支持 通过研究领域标准的负价系统测量相同的重复行为。 该项目的目标是迈出评估重复性的接近-回避模型的第一步。 一项针对自闭症青少年的研究显示，青春期是许多自闭症青少年的发育时期。 可以反思他们重复行为的驱动因素，目标 1 将招募 250 名自闭症青少年。 13 岁和 17 岁的看护者对他们所从事的重复行为类型、方法进行评级 和/或参与行为的回避动机，以及情绪效价的强度 作为一种新颖的方法，我们将得出重复行为的潜在特征。 为了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 完成与研究领域标准的积极相关的神经影像和行为协议 价（接近）和负价系统（避免）的目标是将这些维度联系起来； 通过自我报告化合价方向和强度来评估接近和回避机制 我们认为目标 1 将产生 3 种独特的潜在特征——主要方法、 以回避为主，以及混合方法/回避——目标 2 的典型相关分析将 显示正价系统与接近重复行为和负价系统相关 与避免重复行为相关的系统有可能重新定义。 重复行为模型，以符合自闭症患者的生活经历，并通过以下方式增强临床支持 确定可塑性的新目标机制或通过对公众进行教育来更好地 满足自闭症患者的需求。