Understanding Pathways from Environmental Risk to Internalising Problems for Autistic Young People

了解自闭症年轻人从环境风险到内化问题的途径

• 批准号: ES/X014207/1
• 负责人: William Mandy
• 金额: $ 72.2万
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FX014207%2F1
• 关键词: Understanding; Pathways; Environmental; Risk; Internalising

Autism is characterised by differences in social relating, communication, flexibility and sensory processing. Autistic people experience very high rates of mental health difficulties: they are at least three times more likely to have internalising difficulties (i.e., anxiety and/or depression) compared to non-autistic people. These mental health difficulties often become established in childhood and adolescence and can have devastating effects on autistic people's lives. Despite this, currently, effective treatments for the internalising problems of autistic people are lacking; and most have to struggle on without the help they need. To develop better interventions for autistic internalising problems, we need a much more comprehensive understanding of why they first develop, why they persist and what can help reduce them.We aim to make new discoveries about what drives the development of internalising problems in autistic young people (AYP), thereby contributing new insights to inform prevention and treatment. We will focus on features of the social and physical environment, and how these contribute to AYP's internalising problems. We take this approach because: (i) it is highly likely that environmental factors, not just individual characteristics, influence autistic mental health, but research in this area has been lacking; (ii) it reflects the new, community-driven 'neurodiversity paradigm' that highlights the need to understand autistic lives in context; (iii) many potential environmental risk factors (e.g., parenting, school characteristics, noise) are amenable to modification, and so could become targets for future interventions to prevent or treat autistic internalising difficulties.Our project has the following phases:Phase 1 - Qualitative Study.At the start of the project, we will interview AYP and parents of AYP to develop understanding, based on lived experience, of autistic internalising problems, generating ideas about their nature, course, causes, maintaining factors, mitigators and impacts. Bridging Phase.Towards the end of the Phase 1 study, we will hold a process of consultation and collaboration with AYP and other stakeholders (e.g., parents, autistic adults, clinicians, policy makers), so that our Phase 1 discoveries shape the rest of our project. This will involve researchers and stakeholders working together to derive focused research questions that can feasibly be addressed in the quantitative Phase 2 of the project. We already have a detailed plan for Phase 2, but the Bridging Phase will enhance and extend this.Phase 2 - Quantitative Study.We will conduct the largest-ever investigation of environmental influences on autistic mental health, using data from two UK birth cohort studies, the Millennium Cohort Study (MCS) and the Avon Longitudinal Study of Parents and Children (ALSPAC). In MCS and ALSPAC, we will investigate the trajectories of AYP's internalising problems and diverse environmental factors associated with better and worse outcomes. Our sophisticated analyses of longitudinal data will allow us to model processes that unfold over time to identify ways in which environments shape AYPs and, conversely, how AYPs shape their environment. We can also identify critical periods of risk and test for cascades, whereby an environmental factor influences development/behaviour in a way that subsequently influences internalising symptoms. Crucial to our project is collaboration amongst researchers, AYP, autistic adults, parents and other stakeholders, to shape all elements of the research. To this end we will establish advisory panels (one of AYP, one of adult stakeholders) who will meet regularly; and we will also consult a wider community of autistic people throughout the project. We will share our findings within and outside academia, via academic papers, conferences, blogs, social media and graphical materials co-produced with an artist and AYP.

自闭症的特点是在社会关系，沟通，灵活性和感觉处理方面的差异。自闭症患者的心理健康问题发生率非常高：他们至少有三倍的可能性有内化困难（即，焦虑和/或抑郁）。这些心理健康问题往往在儿童和青少年时期就已经形成，并可能对自闭症患者的生活产生毁灭性的影响。尽管如此，目前，自闭症患者的内在问题缺乏有效的治疗方法;大多数人不得不在没有帮助的情况下挣扎。为了开发更好的自闭症内化问题干预措施，我们需要更全面地了解自闭症内化问题最初产生的原因、持续存在的原因以及如何帮助减少自闭症内化问题。我们的目标是对自闭症青少年（AYP）内化问题发展的驱动因素做出新的发现，从而为预防和治疗提供新的见解。我们将集中在社会和物理环境的特点，以及如何这些有助于AYP的内化问题。我们采取这种方法是因为：（i）环境因素，而不仅仅是个人特征，很可能影响自闭症的心理健康，但这方面的研究一直缺乏;（ii）它反映了新的，社区驱动的“神经多样性范式”，强调需要了解自闭症的生活背景;（iii）许多潜在的环境风险因素（例如，我们的计划分为以下阶段：第一阶段-质性研究在计划开始时，我们会与青少年学生及青少年学生家长会面，以亲身经历为基础，加深他们对自闭症内在化问题的认识，并就问题的性质、过程、成因、维持因素、缓解因素及影响提出意见。过渡阶段。在第一阶段研究结束时，我们将与AYP和其他利益相关者（例如，父母、自闭症成年人、临床医生、政策制定者），因此我们的第一阶段发现塑造了我们项目的其余部分。这将涉及研究人员和利益相关者共同努力，以得出重点研究问题，这些问题可以在项目的定量阶段2中得到可行的解决。我们已经有了第二阶段的详细计划，但过渡阶段将加强和扩展这一计划。第二阶段-定量研究我们将进行有史以来规模最大的环境对自闭症心理健康影响的调查，使用来自两项英国出生队列研究的数据，千禧队列研究（MCS）和雅芳父母和儿童纵向研究（ALSPAC）。在MCS和ALSPAC中，我们将研究AYP的内在化问题的轨迹以及与更好和更坏结果相关的各种环境因素。我们对纵向数据的复杂分析将使我们能够对随着时间的推移而展开的过程进行建模，以确定环境塑造AYP的方式，以及相反，AYP如何塑造他们的环境。我们还可以确定风险的关键时期，并测试级联，即环境因素影响发育/行为的方式，随后影响内化症状。对我们的项目至关重要的是研究人员，AYP，自闭症成年人，父母和其他利益相关者之间的合作，以塑造研究的所有元素。为此，我们将建立咨询小组（AYP的一个，成人利益相关者之一），他们将定期开会;我们还将在整个项目中咨询更广泛的自闭症患者社区。我们将通过学术论文、会议、博客、社交媒体和与艺术家和AYP共同制作的图形材料，在学术界内外分享我们的发现。