Mental Health in Autistic Adults: And RDoC Approach

摘要-项目1 在最近的研究中，自闭症成年人的自杀率高得惊人; 4- 72%的人赞同自杀意念 4-33%的人有自杀行为或企图。科学和倡导团体都支持 研究有效的自杀评估和识别危险因素。然而，现有的自杀倾向 筛查措施似乎对自闭症成年人的作用并不相同，迄今为止，还没有研究表明， 使用的是自杀风险的衡量标准，而不是即将发生的风险的筛选。对现有自杀筛查的调整 可能是不够的，因为有证据表明，自闭症成年人可能有独特的风险因素，如 自闭症特征和自闭症倦怠。本研究将发展一套适合于自闭症成年人的自杀倾向测量工具， 自杀倾向量表，它将记录自杀风险的连续性。自闭症成年人和他们的盟友将完善一个 项目池，25名自闭症成年人（其中至少10名有自杀倾向）将完成认知访谈的 起草项目，以确保清晰和理解。1000名自闭症和非自闭症成年人的样本将 完成草拟的调查表和一套相关的在线措施，以评估 项目池，进行项目反应理论校准，并将现有的自杀措施与 通过IRT协同校准提出的问卷。300名自闭症和非自闭症参与者的子样本（ ACE核心样本）将在一年内每两个月重复一次测量，跨项目分析将 检查那些报告更多自杀基线的人是否也报告更多日常生活中的自杀意念， 通过潜在增长模型对自杀风险随时间的变化进行建模，并确定与自杀风险最密切相关的因素 有自杀倾向孤独症自杀倾向量表将是第一个有效的自杀倾向 为ASD开发的测量，设计了自闭症成年人的输入，并通过 强调与风险有关的过程。这种措施的可用性对于知情干预至关重要 发展，以提高安全和生活质量。

ABSTRACT- Project 1 Suicide rates in autistic adults are alarming high in recent research; 4- 72% have endorsed suicidal ideation and 4-33% have engaged in suicidal behavior or attempts. Both scientific and advocacy groups have endorsed research for effective suicidality assessment and identification of risk factors. However, existing suicidality screening measures do not seem to function in the same way for autistic adults, and to date, no research has used a measure of suicide risk rather than a screen of imminent risk. Adaptation of existing suicide screens may be insufficient, given evidence that autistic adults may have unique risk factors, such as camouflaging of autistic traits and autistic burnout. This study will develop a suicidality measure for autistic adults, the Autism Suicidality Inventory, that will capture a continuum of suicide risk. Autistic adults and their allies will refine an item pool, and 25 autistic adults (at least 10 of which with suicidality) will complete cognitive interviews of the drafted items to ensure clarity and comprehension. A sample of 1000 autistic and non-autistic adults will complete the drafted questionnaire and a related online battery of measures to evaluate the dimensionality of the item pool, conduct Item Response Theory calibration, and compare existing suicide measures to the proposed questionnaire via IRT co-calibration. A subsample of 300 autistic and non-autistic participants (the ACE core sample) will repeat the measure every two months for a year, and cross-project analyses will examine whether those who report more suicidality baseline also report more suicidal ideation in daily life, model suicide risk over time via latent growth models, and identify factors that are most strongly associated with suicidality trajectories. The Autism Suicidality Inventory will be the first validated suicide propensity measure developed for ASD, designed with input from autistic adults and capturing a continuum of risk via an emphasis on processes that relate to risk. The availability of such a measure is essential to inform intervention development to improve safety and quality of life.