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

摘要 孤独，或伴随着感知到的社会脱节而产生的痛苦感，会带来重大的风险。 负面的身体和心理健康结果，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）的青少年表现出比典型的孤独症患者更高的孤独感。 这使他们特别容易受到这些负面结果的影响。虽然发展研究 在典型的发展中（TD）人群中，将同伴关系确定为风险和保护因素， 我们对同伴关系如何与自闭症孤独症的发展有关的理解。因此，理解 在青春期孤独发展中赋予风险和保护的机制，以及是否 他们在高风险人群中有所不同，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 与孤独和社会联系相关：社会认知系统，社会奖励系统， 与其他人不同。这些大脑机制在ASD中也是非典型的，并被认为与非典型的 社会互动目前的建议将测试一种新的生物心理社会模型的发展， 孤独，其中这些假定的神经机制作为孤独发展的预测因子， 对社会经验的影响。在我们的模型中，同伴关系可能同时赋予风险因素和保护因素 社会经验和孤独感的发展之间的关系。我们将用一个前瞻性的- 纵向设计，随访75名ASD和120名TD青少年，年龄和智商平均匹配， 每四个月一次，持续了二十个月。重要的是，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， 孤独在TD和ASD青少年中的发展出现，并检查这些是否 不同群体的机制不同。目前的建议是创新的，在其使用生态有效， 自然主义和社会互动的功能磁共振成像方法，PI博士。此夕h 建议建立在现有的工作，从共同是博士Shackman和Lemay和顾问博士丝绸使用 生态瞬时评估（EMA），以获得现实世界的，在社会的时刻评估 体验及其对情绪和孤独感的影响。这些贡献将对科学界产生重大影响。 现场和相关的战略使命的NIMH，因为他们将提供新的，关键的缺失信息 自闭症孤独症的发展轨迹，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 干预措施，以减轻孤独的经验和相关的负面结果，在高风险 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.