Change-Sensitive Assessment of Emotion Dysregulation in ASD Across the Lifespan

自闭症谱系障碍患者整个生命周期情绪失调的变化敏感评估

• 批准号: 10357604
• 负责人: Carla A Mazefsky
• 金额: $ 66.38万
• 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 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10357604
• 关键词: 17 year old; 5 year old; Address; Admission activity; Adolescent; Adult; Age; Aggressive behavior; Awareness; Brain; Calibration; Caregivers; Censuses; Characteristics; Child; Clinical; Clinical Trials; Cognitive; Collection; Communities; Comprehension; Country; Crisis Intervention; Data; Data Reporting; Development; Developmental Delay Disorders; Diagnosis; Emotional; Emotions; Enrollment; Ensure; Equipment and supply inventories; Evaluation; Evidence based intervention; Frustration; Funding; Future; Gender; Generations; Impaired cognition; Impairment; Information Systems; Inpatients; Intellectual functioning disability; Intervention; Investigational Therapies; Lateral; Life; Link; Longevity; Longitudinal Studies; Measurement; Measures; Mental disorders; Methods; Monitor; Morbidity - disease rate; Nursery Schools; Outcome; Outpatients; Painless; Parents; Participant; Patient Outcomes Assessments; Patient Self-Report; Patients; Performance; Polypharmacy; Population; Prefrontal Cortex; Prevention; Problem behavior; Process; Property; Proxy; Psychometrics; Quality of life; Reporting; Research; Risk; Sampling; School-Age Population; Structure; Suicide; Symptoms; Validation; Validity of Self Report; Variant; Youth; adult with autism spectrum disorder; autism spectrum disorder; autistic children; base; clinically significant; cognitive ability; cognitive interview; cost; critical period; developmental disease; dysphoria; early childhood; effective therapy; emotion dysregulation; experience; flexibility; follow up assessment; functional near infrared spectroscopy; improved; individuals with autism spectrum disorder; neuroimaging; pilot test; recruit; relating to nervous system; response; screening; theories

PROJECT SUMMARY Emotion dysregulation (ED) increases risk for psychiatric and behavioral problems, and leads to polypharmacy, crisis interventions, and high rates of suicidality. Rates of clinically elevated ED are particularly high among those with autism spectrum disorder (ASD). Effective treatment of ED could greatly reduce morbidity and costs and significantly improve quality of life for individuals with ASD. Unfortunately, the development of evidence- based interventions for ED in ASD has been limited by the absence of measures that assess ED without being biased by differences in intellectual and verbal ability. The Emotion Dysregulation Inventory (EDI) (R01HD079512) was developed to address this obstacle. The EDI is a caregiver report that measures rapidly escalating, intense, and poorly regulated negative emotion and dysphoria. It was validated on 1755 school- aged verbal and nonverbal ASD youth as well as a sample of 1000 youth representative of the general US population. The EDI is already being used in multiple clinical trials and for screening and treatment monitoring in inpatient and outpatient settings across the U.S. and in 10 other countries. This project will build on the EDI's conceptual and psychometric strengths and apply Patient-Reported Outcomes Measurement Information System (PROMIS®) methods to develop the EDI-Young Child (EDI-YC for ages 2-5) and the EDI Self-Report (EDI-SR for ages 12+). Samples of 800 participants with ASD, 200 with other intellectual and developmental disorders (IDD), and 1000 from the general community will be recruited to complete calibration and psychometric analysis of each measure using Item Response Theory (IRT) and traditional psychometric analyses. The change-sensitivity of the EDI-YC and EDI-SR will be evaluated in the context of funded clinical trials. The availability of the EDI-YC will motivate ED prevention and intervention in early childhood during this critical period of early brain plasticity. The EDI-SR will be developed through a systematic item refinement process to ensure validity even in the context of cognitive impairments or poor emotional awareness, thereby creating new opportunities to incorporate patient perspectives and include the often overlooked but growing population of adults with ASD or IDD in clinical trials when no caregiver is available. Finally, the translational value of this research will be supported by linking specific neural features of ED (e.g., hypo-activation of the lateral prefrontal cortex (LPFC) during frustration and cognitive inflexibility tasks) to ED in ASD as assessed by the EDI. This will be accomplished through neuroimaging via collection of functional near-infrared spectroscopy (fNIRS) and EDI data in a sample of 125 4- to 17-year-olds with ASD. Because of ED's transdiagnostic significance, the impact will span outcomes from aggression to suicide and other critical symptoms related to ED. We will ensure the EDI battery's utility across populations by evaluating the candidate EDI-EC and EDI-SR items in non-ASD IDD samples, as well as through the generation of general norms from large community samples.

项目摘要 情绪失调（艾德）增加了精神和行为问题的风险，并导致多种药物， 危机干预和高自杀率。临床升高的艾德发生率在以下人群中特别高： 自闭症谱系障碍（ASD）。艾德的有效治疗可以大大降低发病率和费用 并显著改善ASD患者的生活质量。很不幸，证据的发展- ASD患者的艾德基础干预措施受到缺乏评估艾德的措施的限制， 由于智力和语言能力的差异而产生偏见。情绪失调量表（EDI） （R01HD079512）的开发旨在解决这一障碍。EDI是一份护理报告， 不断升级的、强烈的、调节不良的负面情绪和烦躁不安。1755年，学校成立-- 老年语言和非语言ASD青年以及1000名代表美国一般青年的样本 人口EDI已经被用于多个临床试验以及筛查和治疗监测 在美国和其他10个国家的住院病人和门诊病人中。该项目将建立在EDI的基础上， 概念和心理测量优势，并应用患者报告的结局测量信息 系统（PROMIS®）方法，以开发幼儿教育信息系统（EDI-YC，适用于2 - 5岁）和幼儿教育信息系统自我报告 （EDI-SR适用于12岁以上）。800名ASD患者，200名其他智力和发育障碍患者 将从一般社区招募1000人完成校准， 使用项目反应理论（IRT）和传统的心理测量学对每个测量进行心理测量分析。 分析。EDI-YC和EDI-SR的变化敏感性将在受资助的临床试验背景下进行评价。 审判EDI-YC的可用性将激励在此期间对幼儿期的艾德预防和干预。 早期大脑可塑性的关键时期。EDI-SR将通过系统的项目细化来制定 过程，以确保有效性，即使在认知障碍或情绪意识差的情况下， 创造新的机会，纳入病人的观点，包括经常被忽视，但不断增长的 临床试验中没有看护者的ASD或IDD成人人群。最后，翻译 通过将艾德的特定神经特征（例如，低激活的 在挫折和认知能力任务期间的外侧前额叶皮层（LPFC））到ASD中的艾德， EDI。这将通过收集功能性近红外光谱的神经成像来完成 （fNIRS）和EDI数据在125例4至17岁ASD患者的样本中。因为艾德的跨诊断 重要的是，影响将涵盖从攻击到自杀和其他与自杀相关的关键症状的结果。 ed.我们将通过评估候选EDI-EC和EDI-SR来确保EDI电池在人群中的效用 项目在非ASD IDD样本，以及通过产生的一般规范，从大型社区 样品