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

自闭症谱系障碍患者整个生命周期情绪失调的变化敏感评估

• 批准号: 10158534
• 负责人: Carla A Mazefsky
• 金额: $ 65.45万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-10 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10158534
• 关键词: 17 year old; 5 year old; Address; Admission activity; Adolescent; Adult; Age; Aggressive behavior; Awareness; Brain; Calibration; Caregivers; Censuses; Characteristics; Child; Clinical; Clinical Trials; Cognitive; Collection; Communities; Comprehension; Country; Crisis Intervention; Data; Data Reporting; Development; Developmental Delay Disorders; Diagnosis; Emotional; Emotions; Enrollment; Ensure; Equipment and supply inventories; Evaluation; Evidence based intervention; Frustration; Funding; Future; Gender; Generations; Impaired cognition; Impairment; Information Systems; Inpatients; Intellectual functioning disability; Intervention; Investigational Therapies; Lateral; Life; Link; Longevity; Longitudinal Studies; Measurement; Measures; Mental disorders; Methods; Monitor; Morbidity - disease rate; Near-Infrared Spectroscopy; Nursery Schools; Outcome; Outpatients; Painless; Parents; Participant; Patient Outcomes Assessments; Patient Self-Report; Patients; Performance; Polypharmacy; Population; Prefrontal Cortex; Prevention; Problem behavior; Process; Property; Proxy; Psychometrics; Quality of life; Reporting; Research; Risk; Sampling; School-Age Population; Structure; Suicide; Symptoms; Testing; Validation; Validity of Self Report; Variant; Youth; adult with autism spectrum disorder; autism spectrum disorder; autistic children; base; clinically significant; cognitive ability; cognitive interview; cost; critical period; developmental disease; dysphoria; early childhood; effective therapy; emotion dysregulation; experience; flexibility; follow up assessment; improved; individuals with autism spectrum disorder; neuroimaging; recruit; relating to nervous system; response; screening; theories

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.

项目概要 情绪失调 (ED) 会增加精神和行为问题的风险，并导致多重用药、 危机干预和高自杀率。临床上 ED 升高的比率在以下人群中特别高： 患有自闭症谱系障碍 (ASD) 的人。有效治疗 ED 可以大大降低发病率和费用 并显着改善自闭症谱系障碍患者的生活质量。不幸的是，证据的发展—— 对自闭症谱系障碍 (ASD) 的 ED 的干预措施受到限制，因为缺乏评估 ED 的措施 由于智力和语言能力的差异而产生偏见。情绪失调量表 (EDI) (R01HD079512) 的开发就是为了解决这个障碍。 EDI 是一份快速衡量的护理人员报告 不断升级、强烈且调节不良的负面情绪和烦躁不安。它在 1755 学校得到了验证- 老年语言和非语言 ASD 青少年以及美国 1000 名青少年代表样本 人口。 EDI 已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 开发 EDI-幼儿 (EDI-YC for 2-5 岁) 和 EDI 自我报告的系统 (PROMIS®) 方法 （EDI-SR 适合 12 岁以上）。样本包括 800 名患有自闭症谱系障碍 (ASD) 的参与者，以及 200 名患有其他智力和发育障碍的参与者 疾病（IDD），并将从普通社区招募 1000 名来完成校准和 使用项目反应理论 (IRT) 和传统心理测量对每项测量进行心理测量分析 分析。 EDI-YC 和 EDI-SR 的变化敏感性将在资助的临床背景下进行评估 试验。 EDI-YC 的推出将推动这一时期幼儿期的 ED 预防和干预 早期大脑可塑性的关键时期。 EDI-SR 将通过系统的项目细化来开发 即使在认知障碍或情绪意识较差的情况下也能确保有效性的过程，从而 创造新的机会来纳入患者的观点，并包括经常被忽视但不断增长的观点 临床试验中没有护理人员的情况下患有 ASD 或 IDD 的成人人群。最后，翻译 这项研究的价值将通过联系 ED 的特定神经特征（例如， 受挫和认知不灵活任务期间的外侧前额叶皮层（LPFC））与自闭症谱系障碍（ASD）中的 ED 的评估 电子数据交换。这将通过收集功能性近红外光谱进行神经成像来实现 (fNIRS) 和 EDI 数据，样本来自 125 名 4 至 17 岁自闭症谱系障碍 (ASD) 患者。由于 ED 的跨诊断 意义重大，其影响将涵盖从攻击到自杀以及与其他相关的其他严重症状的结果 埃德。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，以及通过大型社区生成通用规范 样品。