A Prospective-Longitudinal Investigation of the Biopsychosocial Predictors of Loneliness Across Adolescence in Autism and Typical Development

摘要 孤独，或伴随着感觉到的社交脱节而产生的苦恼，会带来巨大的风险 对于消极的身心健康结果，如慢性病、抑郁症和自我伤害。 青春期是孤独感增加的时期，因此是确定风险和保护因素的关键时期。 患有自闭症谱系障碍(ASD)的青少年表现出比一般人更高的孤独感 人口，使他们特别容易受到这些负面结果的影响。虽然发展研究已经 在典型的发展中(TD)人群中，同伴关系被确定为风险和保护因素，差距仍然存在 我们对同伴关系如何与自闭症患者孤独感的发展有关的理解。因此，理解 在青春期孤独的发展中提供风险和保护的机制，以及是否 他们在高危人群中的不同，对于有效干预和改善孤独感至关重要 出现严重的有害后果。对成年人的研究指出了几个认知和神经因素 与孤独和社会关系相关的：社会认知系统、社会奖励系统和 与其他人不同。这些脑机制在ASD中也是非典型的，并被认为与非典型的 社交互动。目前的提案将测试一种新的生物心理社会发展模式 孤独感这些假定的神经机制在孤独感的发展中起到预测作用 它们对社会体验的影响。在我们的模型中，同伴关系可能会同时带来风险和保护因素 在社会经历和孤独的发展之间。我们将使用预期的-测试模型- 追踪年龄和智商平均匹配的75名自闭症青少年和120名TD青少年的纵向设计 每四个月一次，持续二十个月。重要是，这个项目将是第一个整合这些神经， 认知/情感和行为水平的分析，以调查风险和保护机制 在患有TD和ASD的青少年中，孤独的发育性出现，并检验这些 不同群体之间的机制不同。目前的提案在使用生态上有效的、 PI Redcay博士开发的自然主义和社交互动的功能磁共振成像方法。此外， 该提案建立在Shackman博士和Lemay博士以及Silk博士顾问的现有工作基础上，以使用 生态瞬时评估(EMA)，以获得对社会环境的真实、即时的评估 体验及其对情绪和孤独的影响。这些贡献将对科学研究具有重大意义 并与NIMH的战略任务相关，因为它们将提供新的、关键的缺失信息 关于孤独感在ASD中的发展轨迹，并将确定风险和保护机制 对抗孤独的结果。从这个项目中获得的知识对治疗有直接的影响 缓解高危人群孤独感及其相关负面后果的干预措施 患有ASD和TD的青少年。

ABSTRACT Loneliness, or the feeling of distress that accompanies perceived social disconnection, confers significant risk for negative physical and mental health outcomes, such as chronic disease, depression, and self-harm. Adolescence is a period of increasing loneliness and thus a critical time to identify risk and protective factors. Adolescents with autism spectrum disorder (ASD) demonstrate higher rates of loneliness than the typical population, making them especially vulnerable to these negative outcomes. While developmental research has identified peer relations as risk and protective factors in typically developing (TD) populations, gaps remain in our understanding of how peer relations relate to the development of loneliness in ASD. Thus, understanding the mechanisms that confer risk and protection in the development of loneliness in adolescence, and whether they differ in high-risk populations, is critical to effectively intervening and ameliorating loneliness before the onset of significant deleterious consequences. Research in adults points to several cognitive and neural factors associated with loneliness and social connection: social-cognitive systems, social reward systems, and dissimilarity from others. These brain mechanisms are also atypical in ASD and posited to relate to atypical social interaction. The current proposal will test a novel biopsychosocial model of the development of loneliness in which these posited neural mechanisms serve as predictors in the development of loneliness via their effects on social experiences. In our model, peer relations may confer both risk and protective factors between social experience and the development of loneliness. We will test this model using a prospective- longitudinal design to follow 75 ASD and 120 TD adolescents mean-matched in age and IQ, and followed every four months for twenty months. Importantly, this project will be the first to integrate across these neural, cognitive/affective, and behavioral levels of analysis to investigate risk and protective mechanisms in the developmental emergence of loneliness in adolescents with TD and ASD, and to examine whether these mechanisms differ between groups. The current proposal is innovative in its use of ecologically valid, naturalistic, and social-interactive fMRI approaches that the PI Dr. Redcay has developed. Further, the proposal builds on existing work from co-Is Drs. Shackman and Lemay and Consultant Dr. Silk to use ecological momentary assessment (EMA) to obtain real-world, in-the-moment assessments of social experiences and their effects on mood and loneliness. These contributions will be significant to the scientific field and relevant to the strategic mission of NIMH because they will provide novel, critical missing information on the developmental trajectory of loneliness in ASD and will identify mechanisms of risk for and protection against loneliness outcomes. Knowledge gained from this project has direct implications for treatment interventions to mitigate the experience of loneliness and associated negative outcomes in high-risk adolescents with ASD and TD.