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Investigating the Phenomenology and Physiologic Underpinnings of Decreased Sound Tolerance in Adults with Autism Spectrum Disorder

调查患有自闭症谱系障碍的成人声音耐受性下降的现象学和生理学基础

基本信息

批准号：
10658844
负责人：
Zachary James Williams
金额：
$ 5.06万
依托单位：
VANDERBILT UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10658844
关键词：
Acoustics Address Adult Adverse reactions Affect American Anxiety Auditory Auditory Perception Auditory Physiology Auditory area Auditory system Behavior Behavioral Brain Stem Caregiver Burden Caregivers Characteristics Child Classification Clinical Communities Data Development Diagnostic Dimensions Disease Distress Emotional Etiology Event-Related Potentials Evidence based treatment Exhibits Family Family member Foundations Frequencies Fright Functional disorder Future General Population Growth Hyperacusis Individual Individual Differences Intervention Knowledge Loudness Loudness Perception Mastication Measures Mental disorders Meta-Analysis Pain Participant Patient Self-Report Perception Peripheral Persons Phenotype Physiological Physiology Population Prevalence Process Psychoacoustics Psychometrics Psychophysics Psychophysiology Pure-Tone Audiometry Questionnaires Reporting Research Research Personnel Safety Sampling Schools Self Administration Sensory Sensory Manifestations Severities Source Stimulus Subgroup Surveys Symptoms Syndrome Testing Tympanometry Ultrasonography United States Variant Work Workplace acoustic reflex adult with autism spectrum disorder associated symptom auditory processing autism spectrum disorder autistic children avoidance behavior behavioral impairment clinically significant comorbidity coping disabling symptom effective intervention emotional reaction experience functional disability improved indexing individuals with autism spectrum disorder insight meetings middle ear neural neurophysiology novel otoacoustic emission phenomenological models psychologic recruit repetitive behavior research clinical testing response sensory stimulus social sound symptom cluster symptomatology verbal

项目摘要

Project Summary Individuals with autism spectrum disorder (ASD) exhibit multiple differences in sensory perception, which have now been recognized as a core feature of the condition. Among these sensory differences, decreased sound tolerance (DST; i.e., an inability to cope with everyday sounds) is particularly salient, with a lifetime prevalence of 50–70% in the ASD population. Despite both first-person accounts and empirical studies indicating that DST is a major source of distress and functional impairment in ASD, little is known about the phenomenology or physiologic underpinnings of this symptom cluster, and no evidence-based treatments for DST in ASD are currently available. Some researchers have suggested that the adverse reactions seen in ASD are manifestations of hyperacusis, reflecting disordered loudness perception. However, others contend that exaggerated emotional responses to specific acoustic stimuli underlie these behaviors, indicating that DST in ASD could be a form of misophonia, a psychiatric disorder characterized by excessive emotional reactions to specific “trigger” sounds. To date, little empirical work has tested these hypotheses against one another, and it remains an open question whether DST in ASD reflects hyperacusis, misophonia, or a combination of the two. Furthermore, it remains unknown whether these symptoms are associated with alterations in the peripheral or central auditory system. The proposed study aims to answer these questions using a two-stage approach. In stage 1, we will construct a novel self-report questionnaire that assesses a wide range of DST symptoms spanning the four theoretical domains of loudness, pain, annoyance (i.e., misophonia), and fear. Available measures of DST typically assess only the loudness (hyperacusis) or annoyance (misophonia) dimensions, failing to address a number of other clinically significant symptoms. Utilizing large online samples of adults with and without ASD, we will refine and psychometrically validate our questionnaire for use as a quantitative measure of transdiagnostic DST symptoms. In stage 2, we will recruit adults with ASD (both with and without DST) and healthy controls from the community, characterizing their auditory function using a battery of psychoacoustic and physiological tests. Auditory perception will be assessed using pure tone audiometry, loudness discomfort level testing, and categorical loudness scaling. Underlying auditory physiology will be assessed from the middle ear to auditory cortex using a combination of tympanometry, acoustic reflex testing, otoacoustic emission suppression, brainstem/cortical auditory event-related potentials, and auditory steady-state responses. Objective auditory measures will be compared between diagnostic groups, and relationships between these measures and subjective DST symptomatology (based on established surveys and the novel self-report developed in stage 1) will be explored across the full stage 2 sample. This project will answer the fundamental question of whether DST in ASD represents a variant of hyperacusis, misophonia, or a combination of the two. Furthermore, by relating DST symptoms to underlying physiology, we will determine whether different dimensions of DST can be separated based on their physiologic correlates. Findings from this study are expected to elucidate the psychological and physiological mechanisms of DST in ASD, improving our understanding of this disabling symptom and guiding the development of targeted interventions for the ASD population.

项目总结