Change-sensitive Measurement of Emotion Dysregulation in ASD

ASD 情绪失调的变化敏感测量

• 批准号: 8925119
• 负责人: Carla A Mazefsky
• 金额: $ 49.11万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-10 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8925119
• 关键词: Achievement; Address; Admission activity; Affect; Aggressive behavior; Anxiety; Area; Attention; Autistic Disorder; Award; Behavior; Behavioral; Calibration; Caregiver Burden; Caregivers; Child; Clinical; Clinical Trials; Cognitive; Communities; Comorbidity; Data Collection; Data Set; Depressed mood; Development; Dimensions; Emotional; Emotions; Equipment and supply inventories; Evaluation; Evidence based treatment; FDA approved; Factor Analysis; Genetic; Gold; Guidelines; Health; Heterogeneity; Hospitalization; Hyperactive behavior; Individual; Information Systems; Inpatients; Interview; Lead; Life; Measurement; Measures; Mental Depression; Mental disorders; Modeling; Online Systems; Outcome Measure; Outcome Study; Outpatients; Output; Parents; Participant; Patient Outcomes Assessments; Persons; Pharmaceutical Preparations; Phenotype; Population; Population Study; Problem behavior; Process; Property; Provider; Psychiatric Diagnosis; Psychiatric therapeutic procedure; Psychometrics; Psychopathology; Recording of previous events; Regulation; Research; Sampling; Severities; Source; Structure; Symptoms; Testing; Time; autism spectrum disorder; base; emotion dysregulation; emotion regulation; emotional distress; externalizing behavior; innovation; instrument; literacy; neuroimaging; primary outcome; response; stereotypy; theories; treatment effect; treatment planning; user-friendly; young adult

DESCRIPTION (provided by applicant): Individuals with autism spectrum disorder (ASD) are often in need of psychiatric care due to poor emotion regulation and emotional distress. Only two psychotropic medications have been approved for use in ASD, both to treat irritability expressed as tantrums, outbursts, and aggression. However, the underlying deficits in emotion regulation that lead to these problem behaviors are poorly understood and rarely measured or targeted in treatment. Evidence-based treatment approaches for the full range of emotion dysregulation (e.g. depression, outbursts, meltdowns, etc.) present in ASD do not exist. A major barrier to progress in this area is a lack of validated, treatment sensitive measures of emotional distress for individuals with ASD. This project proposes to refine and validate a new measure of emotional distress and emotion regulation for ASD, called the Emotion Dysregulation Inventory (EDI). Guidelines from the Patient-Reported Outcome Measurement Information System (PROMIS) Project and gold-standard statistical approaches will be utilized to complete calibration and psychometric analysis of the EDI. The primary sample will include caregivers of 1000 children and young adults with ASD from community, outpatient, and psychiatric inpatient settings. Data collection will occur through an online system. Analyses will focus on establishing the EDI's factor structure/dimensionality, developing a less than 10-item short form, establishing convergent and divergent validity, comparing EDI scores among groups whose scores would be expected to differ (e.g. inpatients versus community sample; ASD versus healthy controls), and comparing EDI scores to observational counts of emotion dysregulation episodes displayed by children who are inpatients on two specialized psychiatric units. A subset of the sample will complete the EDI twice to establish test-retest reliability. The EDI's ability to detect treatment change will be determined by comparing both caregiver- and provider-rated EDI scores at admission and discharge across two psychiatric inpatient units that specialize in ASD and 4-week change scores in a stable community sample. The primary outcome of this study will be a user-friendly (e.g. available online, brief), validated, treatment sensitive outcome measure for clinical trials in ASD that is independent of verbal ability. In addition, this study will produce he largest existing dataset on emotion dysregulation in ASD, which will be used to identify emotional profiles and treatment needs in this population. Additional time-course questions in the EDI that tap the individual's history of emotion dysregulation will be useful for clinical conceptualization and helping to understand the boundaries between emotion dysregulation that is inherent in ASD and comorbid psychiatric disorders. Finally, having a sensitive measure of emotion dysregulation in ASD will aid in understanding heterogeneity in genetic and neuroimaging research and will enable cross-population studies

描述（由申请人提供）：患有自闭症谱系障碍（ASD）的个体通常由于情绪调节不良和情绪困扰而需要精神护理。只有两种精神药物被批准用于ASD，都是用于治疗表现为发脾气，爆发和攻击的易怒。然而，导致这些问题行为的情绪调节的潜在缺陷知之甚少，很少在治疗中测量或针对。针对各种情绪失调（如抑郁、情绪爆发、情绪崩溃等）的循证治疗方法ASD中存在的不存在。在这一领域取得进展的一个主要障碍是缺乏有效的，对ASD患者情绪困扰的治疗敏感措施。该项目建议完善和验证一种新的测量ASD的情绪困扰和情绪调节的方法，称为情绪调节障碍量表（EDI）。患者报告结局测量信息系统（PROMIS）项目的指南和金标准统计方法将用于完成EDI的校准和心理测量分析。主要样本将包括来自社区，门诊和精神病住院设置的1000名ASD儿童和年轻人的照顾者。数据收集将通过在线系统进行。分析的重点是建立EDI的因素结构/维度，开发一个少于10个项目的简短表格，建立收敛和发散效度，比较预期得分不同的组之间的EDI得分（例如住院病人与社区样本; ASD与健康对照），并将EDI分数与两个专门精神科住院儿童的情绪失调发作的观察计数进行比较。样本的一个子集将完成EDI两次，以建立重测信度。EDI检测治疗变化的能力将通过比较两个精神科住院单位（专门研究ASD）入院和出院时护理人员和提供者评定的EDI评分以及稳定社区样本中的4周变化评分来确定。本研究的主要结局将是ASD临床试验的用户友好（例如，在线提供，简短），经验证的治疗敏感结局指标，与语言能力无关。此外，这项研究将产生关于ASD情绪失调的现有最大数据集，该数据集将用于确定该人群的情绪特征和治疗需求。EDI中的其他时间过程问题挖掘了个体的情绪失调史，这将有助于临床概念化，并有助于理解ASD和共病精神疾病中固有的情绪失调之间的界限。最后，对ASD患者的情绪失调进行敏感的测量将有助于理解遗传和神经影像学研究的异质性，并将使跨人群研究成为可能