Mental Health in Autistic Adults: An RDoC Approach

自杀意念和行为、非自杀性自伤和冲动性攻击在自闭症患者中非常普遍， 成年人了这些困难被认为是由情绪失调（艾德）引起的，包括灵活向上的问题。 调节或维持正价系统或下调负价系统。然而，在这方面， 关于成人孤独症患者中的艾德的先前研究有限。之前关于情绪的研究很少， 自闭症的反应和调节是混合的，包括高和低的模式的证据， 跨多个响应系统的反应性（即，生理学、行为和自我报告），这可能会随着年龄的增长而变化。 个体差异和背景的作用。尽管艾德对自闭症成人的临床意义， 为什么艾德表现在自闭症成年人和现实生活中的功能性高或低反应的意义 对结果仍然知之甚少。为了解决这些差距，我们将使用14天的生态评估艾德 对副交感神经和交感神经进行持续动态监测的瞬时评估方案 在200名自闭症成年人和100名非自闭症成年人（两组）的样本中， 自杀倾向的过度采样）。具体来说，我们将描述艾德如何出现在各种背景下， 响应系统（即，主观的、行为的、生理学的），以及艾德成分如何可以 动态地有助于随后的自杀意念，自我伤害和冲动性攻击的近端风险， 自闭症和自杀史的共同作用研究结果将揭示自闭症特有的艾德方面 与那些在有自杀风险的孤独症和非孤独症个体中常见的差异。我们的跨项目 综合目标将确定个体和亚组模式的艾德过程的特点独特的风险 组将艾德成分与具有临床意义的真实世界结局联系起来， EMA将使我们能够表征和评估不同模式的艾德的功能意义 我们的目标是以时间敏感的方式识别短期风险和复原力过程。结果 在艾德发作或恶化之前， 以及相关的有害后果。

Suicidal ideation and behavior, non-suicidal self-injury, and impulsive aggression are highly prevalent in autistic adults. These difficulties are proposed to arise from emotion dysregulation (ED), including problems flexibly up- regulating or sustaining positive valence systems or down-regulating negative valence systems. However, there is limited prior research on ED among autistic adults. Findings from the scant prior studies on emotional reactivity and regulation in autism have been mixed, including evidence of patterns of both hyper- and hypo- reactivity across multiple response systems (i.e., physiology, behavior, and self-report), which may vary as a function of individual differences and context. Despite the clinical significance of ED for autistic adults, how and why ED manifests in autistic adults and the significance of either hyper- or hypo-reactivity for real-life functional outcomes remain poorly understood. To address these gaps, we will assess ED using a 14-day ecological momentary assessment protocol with continuous ambulatory monitoring of parasympathetic and sympathetic nervous system activity in a sample of 200 autistic adults and 100 non-autistic adults (both groups oversampled for suicidality). Specifically, we will characterize how ED emerges in a variety of contexts across response systems (i.e., subjective, behavior, physiology) in daily life, and how ED components may dynamically contribute to proximal risk for subsequent suicide ideation, self-injury, and impulsive aggression as a function of both autism and suicidality history. Findings will reveal aspects of ED that are unique to autism versus those that are common across autistic and non-autistic individuals at risk for suicide. Our cross-project integrative aim will identify individual and subgroup patterns of ED processes that characterize distinctive risk groups. Linking ED components to real-world outcomes of clinical significance using physiologically-triggered EMA will allow us to characterize and evaluate the functional significance of different patterns of ED components and identify near-term risk and resilience processes in a temporally sensitive manner. Findings will lead to novel treatment targets and just-in-time intervention strategies prior to onset or escalation of ED and associated deleterious outcomes.