Mental Health in Autistic Adults: An RDoC Approach

中心概述摘要 匹兹堡大学自闭症卓越中心(ACE)直接针对跨部门自闭症 协调委员会呼吁对成人精神健康进行研究，以提高安全和生活质量，并 降低过早死亡率。我们通过制定改进所需的措施和机制目标来做到这一点。 心理健康和降低自闭症成年人的自杀风险。我们讨论了这个未被充分研究的重要话题。 与患有自闭症的成年人及其盟友建立真正的伙伴关系。我们强调机械化翻译，创新 研究人员致力于自闭症的研究，并为初级研究人员提供一个学术家园 区域。我们将汇集匹兹堡ACE队列，其中包括200名自闭症患者和100名18至65岁的非自闭症成年人 (≥50，每组最近自杀)谁将完成三个专注于不同单位的项目 分析(自我报告、行为和活动生理学、神经回路)、时间尺度和主要 结果，所有这些都与成年人的心理健康有关。项目1将提供第一个维度的自我报告问卷 对自闭症患者自杀倾向的研究以及首次对自闭症成人的自杀倾向进行纵向描述。项目 2‘S创新的生理触发生态瞬间设计将表征近端风险过程 对于自杀意念，非自杀性自伤，以及对时间敏感的冲动攻击， 允许在情绪失调和有害后果升级之前进行未来的干预。项目3测试 早期神经对刺激的高反应和随后减少的募集的神经机制模型 调节资源和随之而来的生理、主观和行为低反应。我们的临床 CORE向所有项目提供数据以表征样本，包括新颖的表型测量(例如， 基于结构脑图像的衰老生物标记物)。我们的中心结构使我们能够从 所有来源都要增强个别项目的影响力。例如，我们将通过将 生活体验和纵向结果的生物因果机制。我们将汇集所有数据以确定 最显著的自杀轨迹预测指标，提供了比考虑到 预测因素的小集合，并能够确定对风险的相对贡献。我们将阐明 基于情绪和生理日常动态的连接亚组结果的异质性 对神经反应性和自杀性的反应性和调节。我们的年龄范围和跨诊断、自杀 对照小组让我们确定自闭症患者心理健康的独特之处以及衰老可能起到的作用 一个角色。我们会透过新的方法，向社会人士发放这些重要的资讯。 我们的自闭症伙伴团队来自不同的背景。这一过程将确保我们的中心不仅将 吸引来自被边缘化群体的个人，但也将创建和维护相互 有益和有益的关系，将增强和丰富我们的研究样本、结果和 整体影响。

Center Overview Abstract The University of Pittsburgh Autism Center of Excellence (ACE) directly addresses the Interagency Autism Coordinating Committee’s call for research on adult mental health to improve safety and quality of life, and to reduce premature mortality. We do so by generating the measures and mechanistic targets needed to improve mental health and reduce suicide risk in autistic adults. We address this understudied and critical topic in authentic partnership with autistic adults and their allies. We emphasize mechanistic translation, bring new researchers to work on autism, and provide an academic home for junior researchers getting started in this area. We will assemble a Pittsburgh ACE cohort of 200 autistic and 100 non-autistic 18- to 65-year-old adults (≥ 50 with recent suicidality in each group) who will complete three projects that are focused on different units of analysis (self-report, behavior and ambulatory physiology, and neural circuits), time scales, and primary outcomes, all related to adult mental health. Project 1 will provide the first dimensional self-report questionnaire of suicidality developed for ASD and the first longitudinal characterization of suicidality in autistic adults. Project 2’s innovative physiologically-triggered ecological momentary design will characterize proximal risk processes for suicidal ideation, non-suicidal self-injury, and impulsive aggression in a temporally sensitive manner to allow for future interventions prior to escalation of emotion dysregulation and harmful outcomes. Project 3 tests a neural mechanistic model of early neural hyper-reactivity to stimuli followed by decreased recruitment of regulatory resources and consequent physiological, subjective, and behavioral hypo-reactivity. Our Clinical Core provides data to all of the projects to characterize the sample, including novel phenotypic measures (e.g., a biomarker of aging based on structural brain images). Our Center structure enables us to integrate data from all sources to enhance the impact of individual projects. For example, we will speed translation by connecting a biological causal mechanism to lived experience and longitudinal outcomes. We will pool all data to identify the most salient predictors of suicidality trajectories, providing a significant advance over approaches that consider small sets of predictors and enabling determination of relative contributions to risk. We will shed light on heterogeneity in outcomes by connecting subgroups based on daily dynamics of emotion and physiological reactivity and regulation to neural reactivity and suicidality. Our age range and transdiagnostic, suicidal comparison group allows us to determine what is unique about mental health in ASD and how aging may play a role. We will employ novel means to disseminate this critical information to the community with the help of our team of autistic partners from diverse backgrounds. This process will ensure that our Center will not only engage individuals from groups that have been marginalized, but will also create and maintain mutually beneficial and rewarding relationships that will enhance and enrich our research sample, outcomes, and overall impact.