Mental Health in Autistic Adults: An RDoC Approach

中心概况摘要 匹兹堡大学自闭症卓越中心（ACE）直接解决机构间自闭症 协调委员会呼吁对成人心理健康进行研究，以提高生活安全和质量， 降低过早死亡率。我们通过制定改进所需的措施和机械目标来做到这一点。 心理健康和降低自杀风险。我们解决这个不足和关键的话题， 与自闭症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， 研究人员致力于自闭症，并为初级研究人员提供一个学术之家， 区我们将收集匹兹堡ACE队列的200名自闭症和100名非自闭症18至65岁的成年人 （每组中≥ 50名最近有自杀倾向的人），他们将完成三个侧重于不同单元的项目 分析（自我报告、行为和动态生理学以及神经回路）、时间尺度和主要 结果，都与成人心理健康有关。项目1将提供第一个维度的自我报告问卷 这是自闭症患者自杀倾向的第一个纵向特征，也是自闭症成人自杀倾向的第一个纵向特征。项目 2的创新生理触发生态瞬间设计将表征近端风险过程 自杀意念，非自杀性自伤，和冲动性攻击在时间敏感的方式， 允许在情绪失调和有害结果升级之前进行未来干预。项目3测试 早期神经对刺激的高反应性，随后减少招募的神经机制模型 调节资源和随后的生理、主观和行为低反应性。我们的临床 Core为所有项目提供数据以表征样品，包括新的表型测量（例如， 基于结构脑图像的衰老生物标志物）。我们的中心结构使我们能够整合来自 所有来源，以提高个别项目的影响。例如，我们将通过连接 生活经验和纵向结果的生物因果机制。我们将汇集所有数据， 自杀轨迹的最突出的预测因素，提供了一个显着的进步，考虑的方法， 小规模的预测指标，并能够确定相对风险贡献。我们将阐明 通过基于情绪和生理的日常动态连接子组， 神经反应性和自杀倾向的反应性和调节。我们的年龄范围和跨诊断，自杀 对照组使我们能够确定ASD患者心理健康的独特之处以及衰老可能如何发挥作用 角色我们会采用新的方法，透过 我们的自闭症合作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 让被边缘化的群体中的个人参与进来，但也将创造和维持相互之间的关系， 有益的和有益的关系，这将提高和丰富我们的研究样本，成果， 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.