Change-Sensitive Assessment of Emotion Dysregulation in ASD Across the Lifespan

项目总结 情绪失调(ED)会增加精神和行为问题的风险，并导致服用多种药物， 危机干预和高自杀率。临床上ED升高的比率在以下人群中尤其高 患有自闭症谱系障碍(ASD)的人。有效的ED治疗可以大大降低发病率和成本 并显著提高自闭症患者的生活质量。不幸的是，证据的发展- ASD中基于ED的干预措施一直受到缺乏评估ED的措施的限制，而不是 因智力和语言能力的差异而产生偏见。情绪调节障碍问卷(EDI) (R01HD079512)就是为了解决这一障碍而开发的。EDI是一份护理人员报告，可以快速测量 不断升级的、强烈的、失控的负面情绪和烦躁不安。它在1755年的学校得到了验证- 老年言语和非言语ASD青年以及1000名美国青年代表的样本 人口。EDI已被用于多项临床试验以及筛查和治疗监测 在美国和其他10个国家的住院和门诊环境中。该项目将建立在EDI的基础上 概念和心理测量优势并应用患者报告的结果测量信息 发展EDI-幼儿(2-5岁EDI-YC)和EDI自我报告的系统(PROMIS®)方法 (EDI-SR适用于12岁)。800名自闭症患者和200名其他智力和发育障碍参与者的样本 疾病(IDD)，将从普通社区招募1000人来完成校准和 运用项目反应理论(IRT)和传统心理测量学对各测量进行心理测量学分析 分析。EDI-YC和EDI-SR的变化敏感性将在资助临床的背景下进行评估 审判。EDI-YC的推出将促进儿童早期勃起功能障碍的预防和干预 大脑早期可塑性的关键期。EDI-SR将通过系统的项目细化来开发 确保有效性的过程，即使在认知障碍或情绪意识不佳的情况下也是如此，从而 创造新的机会，纳入患者的观点，包括经常被忽视但正在增长的 在没有照顾者的情况下，在临床试验中患有自闭症或缺碘的成年人群体。最后，翻译 这项研究的价值将通过将ED的特定神经功能联系起来(例如，ED的低激活 ASD患者在挫折和认知缺乏任务中的外侧前额叶皮质(LPFC)至ED 电子数据交换。这将通过收集功能性近红外光谱的神经成像来实现 (FNIRS)和EDI数据在125名4至17岁的ASD儿童样本中。因为艾德的跨诊断 重大影响将从攻击到自杀和其他与以下相关的严重症状 艾德。我们将通过评估候选EDI-EC和EDI-SR来确保EDI电池在人群中的实用性 非ASD IDD样本中的项目，以及通过从大型社区生成一般规范 样本。

PROJECT SUMMARY Emotion dysregulation (ED) increases risk for psychiatric and behavioral problems, and leads to polypharmacy, crisis interventions, and high rates of suicidality. Rates of clinically elevated ED are particularly high among those with autism spectrum disorder (ASD). Effective treatment of ED could greatly reduce morbidity and costs and significantly improve quality of life for individuals with ASD. Unfortunately, the development of evidence- based interventions for ED in ASD has been limited by the absence of measures that assess ED without being biased by differences in intellectual and verbal ability. The Emotion Dysregulation Inventory (EDI) (R01HD079512) was developed to address this obstacle. The EDI is a caregiver report that measures rapidly escalating, intense, and poorly regulated negative emotion and dysphoria. It was validated on 1755 school- aged verbal and nonverbal ASD youth as well as a sample of 1000 youth representative of the general US population. The EDI is already being used in multiple clinical trials and for screening and treatment monitoring in inpatient and outpatient settings across the U.S. and in 10 other countries. This project will build on the EDI's conceptual and psychometric strengths and apply Patient-Reported Outcomes Measurement Information System (PROMIS®) methods to develop the EDI-Young Child (EDI-YC for ages 2-5) and the EDI Self-Report (EDI-SR for ages 12+). Samples of 800 participants with ASD, 200 with other intellectual and developmental disorders (IDD), and 1000 from the general community will be recruited to complete calibration and psychometric analysis of each measure using Item Response Theory (IRT) and traditional psychometric analyses. The change-sensitivity of the EDI-YC and EDI-SR will be evaluated in the context of funded clinical trials. The availability of the EDI-YC will motivate ED prevention and intervention in early childhood during this critical period of early brain plasticity. The EDI-SR will be developed through a systematic item refinement process to ensure validity even in the context of cognitive impairments or poor emotional awareness, thereby creating new opportunities to incorporate patient perspectives and include the often overlooked but growing population of adults with ASD or IDD in clinical trials when no caregiver is available. Finally, the translational value of this research will be supported by linking specific neural features of ED (e.g., hypo-activation of the lateral prefrontal cortex (LPFC) during frustration and cognitive inflexibility tasks) to ED in ASD as assessed by the EDI. This will be accomplished through neuroimaging via collection of functional near-infrared spectroscopy (fNIRS) and EDI data in a sample of 125 4- to 17-year-olds with ASD. Because of ED's transdiagnostic significance, the impact will span outcomes from aggression to suicide and other critical symptoms related to ED. We will ensure the EDI battery's utility across populations by evaluating the candidate EDI-EC and EDI-SR items in non-ASD IDD samples, as well as through the generation of general norms from large community samples.