Physiological mechanisms of action relating to immediate and long-term therapeutic horseback riding intervention effects in a psychiatric population of youth with autism spectrum disorder

项目总结/摘要 自闭症谱系障碍（ASD）是一个严重的公共卫生问题，因为它的生活质量很差 影响，不断增加的患病率和高医疗保健使用成本。三分之二的自闭症患者 同时患有精神疾病这些人需要密集的干预措施，以解决 精神病学相关的异常行为（例如，易怒和多动），这是许多 这一人群的残疾和成本。这个项目的目标是评估生理机制 潜在的治疗骑马（THR）以前观察到显着的积极影响， ASD青年，特别是那些同时发生精神疾病的人，并进一步评估 干预的持久性、剂量和亚群体效应。目标1：检验假设， 唾液皮质醇、心血管和皮肤电活动的生理反应模式解释了我们的 先前观察到的显著结果（即，减少易怒和多动，改善社交和 沟通）和其他结果（情绪调节和照顾者生活质量），在6-16岁的青少年 多岁ASD和合并精神病诊断的患者随机接受10周手动THR干预 与无马谷仓活动（BA）对照相比。我们的初步研究结果表明， 挑战ASD大多数可能更有可能从THR中受益，特别是如果结果由以下因素介导： 生理上的兴奋目标2：评价THR组与BA组相比目标1结局的耐久性 对照组在干预期后6个月，给予我们初步的证据，维持初步的 在6个月的随访中取得的结果。目的3：探讨THR和BA的剂量效应和亚群效应 通过比较THR和BA组的效应量差异进行干预：（1）10周等待列表对照 组;（2）混合干预组（5周BA，随后5周THR）;以及（3） THR研究人群在精神病住院后随机化。 我们的初步结果，在两个路径国际首演认可的骑马中心， 本申请证明了ASD外周生理唤醒数据收集是可行的 年轻人在从事THR。我们还部分复制了我们以前的结果，并证明， 皮质醇是THR对ASD青少年异常行为影响的一个可行的靶介体，值得进一步研究。 调查我们的建议有可能推进人类与动物相互作用（HAI）领域，特别是 THR，用于ASD和合并精神疾病的个体。它也将指导未来的研究人员 有兴趣更好地了解与HAI相关的生理机制。我们的长远目标是 从经验上将THR确立为一种生态有效的转诊断干预措施， 心理生理唤醒状态的青年与各种心理健康问题，促进收购， 长期保持关键的生活技能，提高个人及其照顾者的生活质量。

Project Summary/Abstract Autism Spectrum Disorder (ASD) is a critical public health concern, given its negative quality of life impacts, increasing prevalence rates, and high health care utilization costs. Two-thirds of the ASD population have co-occurring psychiatric disorders. These individuals require intensive interventions to address psychiatrically related aberrant behaviors (e.g., irritability and hyperactivity), which are the source of much of the disability and cost for this population. The goal of this project is to assess physiological mechanisms underlying Therapeutic Horseback Riding’s (THR) previously observed significant positive effects on ASD youth, particularly those with co-occurring psychiatric disorders, and to further evaluate durability, dose, and sub-population effects of the intervention. Aim 1: Test the hypothesis that physiological response patterns of salivary cortisol, cardiovascular, and electrodermal activity account for our previously observed significant outcomes (i.e., reduced irritability and hyperactivity, and improved social and communication), and additional outcomes (emotion regulation and caregiver quality of life), in youth ages 6-16 yrs. with ASD and co-occurring psychiatric diagnoses randomized to a 10-week manualized THR intervention compared to a no-horse Barn Activity (BA) control. Our preliminary findings suggest the psychiatrically challenged ASD majority may be more likely to benefit from THR, particularly if outcomes are mediated by physiological arousal. Aim 2: Evaluate the durability of Aim 1 outcomes in the THR group compared to the BA control group six-months after the intervention period, given our preliminary evidence for maintenance of initial outcome gains in a six-month follow-up. Aim 3: Explore dose and sub-population effects of THR and BA interventions by comparing effect size differences in THR and BA groups to a: (1) 10-week wait-list control group; (2) Hybrid intervention group (five weeks BA followed by five weeks THR); and (3) subsample of the THR study population randomized following psychiatric hospitalization. Our preliminary results, obtained at both PATH international premiere accredited riding centers proposed in the current application demonstrate that peripheral physiological arousal data collection is feasible with ASD youth while engaged in THR. We have also partially replicated our previous results and demonstrated that cortisol is a viable target mediator of THR effects on aberrant behaviors in ASD youth that merits further investigation. Our proposal has the potential to advance the field of human-animal interaction (HAI), specifically THR, for individuals with ASD and co-occurring psychiatric disorders. It also stands to guide future researchers interested in better understanding the physiological mechanisms associated with HAI. Our long-range goal is to empirically establish THR as an ecologically valid, transdiagnostic intervention that targets underlying psychophysiological arousal states in youth with a variety of mental health issues, facilitating acquisition and long-term maintenance of critical life skills that enhance quality of life for individuals and their caregivers.