Mental Health in Autistic Adults: An RDoC Approach

自杀意念和行为、非自杀性自残和冲动攻击在自闭症患者中非常普遍。 成年人。这些困难被认为是由情绪失调(ED)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， 在自闭症成人中，关于ED的先前研究有限。之前对情绪的研究很少 自闭症的反应性和调节性是混合的，包括高和低两种模式的证据. 跨多个响应系统的反应性(即，生理、行为和自我报告)，这可能随 个体差异和背景的作用。尽管ED对自闭症成人具有临床意义，但如何以及 自闭症成人为什么表现为勃起功能障碍以及高反应性或低反应性对现实生活功能的意义 人们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ED 持续动态监测副交感和交感神经的瞬时评估方案 200名自闭症成年人和100名非自闭症成年人(两组)的神经系统活动 因自杀而过度抽样)。具体地说，我们将描述ED是如何在各种不同的背景下出现的 日常生活中的反应系统(即主观、行为、生理)，以及ED组件如何 动态地增加随后的自杀意念、自我伤害和冲动性攻击的近期风险 自闭症和自杀史的共同作用。研究结果将揭示自闭症独有的勃起功能障碍 与有自杀风险的自闭症和非自闭症患者的情况相比，这种情况很常见。我们的交叉项目 综合目标将确定具有不同风险特征的ED过程的个人和子组模式 组。使用生理触发将ED组件与具有临床意义的真实世界结果联系起来 EMA将使我们能够表征和评估不同类型的ED的功能意义 并以对时间敏感的方式确定近期风险和复原力进程。发现 将导致新的治疗目标和在ED发病或升级之前的及时干预策略 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.