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

项目摘要/摘要 自闭症谱系障碍(ASD)是一个严重的公共卫生问题，因为它的负面生活质量 影响、不断增加的患病率和高昂的医疗保健利用成本。三分之二的自闭症患者 有共同发生的精神障碍。这些人需要密集的干预措施来解决 精神相关的异常行为(例如，易怒和多动)，这是许多 这些人口的残疾和成本。这个项目的目标是评估生理机制。 基础治疗骑马(THR)先前观察到显著的积极作用 自闭症青少年，特别是患有共病精神障碍的青少年，并进一步评估 干预措施的持久性、剂量和亚群效应。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 以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岁的青年中 几年前。将ASD和同时出现的精神疾病诊断随机分为10周的人工THR干预 与没有马棚活动(BA)的对照组相比。我们的初步发现表明，在精神上 受到挑战的ASD大多数可能更有可能从THR中受益，特别是如果结果是通过 生理唤醒。目标2：评估THR组与BA组的AIM 1结果的持久性 对照组在干预期结束6个月后，给予我们初步的维持证据 在六个月的随访中结果有所改善。目的3：探讨苏氨酸和苯丁酸的剂量效应和亚群效应 通过比较Thr和BA组与A组的效果大小差异进行干预：(1)10周等待名单对照 (2)混合干预组(5周BA和5周THR)；和(3) 精神科住院后随机抽样的研究人群。 我们的初步结果，在两个路径国际首屈一指的认可骑马中心，建议在 目前应用表明，利用ASD采集周围生理唤醒数据是可行的 在从事THR的同时保持青春。我们还部分复制了我们之前的结果，并证明了 皮质醇是苏氨酸对青少年ASD患者异常行为影响的有效靶标，值得进一步研究 调查。我们的建议有可能推动人-动物相互作用(HAI)领域的发展，特别是 THR，适用于患有自闭症和共生精神障碍的个人。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。我们的长期目标是 经验性地确定THR是一种生态有效的跨诊断干预措施，针对潜在的 有各种心理健康问题的青少年的心理生理唤醒状态，促进获得和 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.