Reward responsivity and depression in autism spectrum disorder: A multimethod approach

项目总结 患有自闭症谱系障碍的青少年患抑郁症的比例几乎是其神经症患者的两倍 同行(20%对11%)。未经治疗的抑郁症与不良的短期(例如，拒绝上学)和长期的抑郁有关 影响生活质量的后果(例如，身体健康状况不佳、就业率较低)。患有自闭症的青少年也 自杀导致过早死亡的风险是神经型同龄人的10倍。风险因素 自闭症中的抑郁还没有得到很好的理解，测量工作可能会因社会原因而复杂化。 沟通困难(即自闭症症状)，使青少年识别和 向提供者和家庭成员解释情感体验。因此，更客观的措施(例如， 脑电[EEG]，特别是事件相关电位[ERPs])可能提供更好的理解 自闭症青少年抑郁的危险因素。改变奖励响应性(研究领域标准 [RDoC]积极价值)和被破坏的社会过程(RDoC从属关系和依恋)是关键的风险因素 对神经型青少年抑郁症的研究，但尚未在自闭症中进行研究。临床和神经科 社会和非社会奖励响应性的测量以及与抑郁症状的关联没有 在自闭症中进行了检查，这可能提供关于发育轨迹的有意义的信息。 与NIMH战略计划、战略目标2相一致，“以识别和了解风险因素、生物标志物 和精神疾病的行为指标，这个K23应用程序旨在检查临床和神经标记物 自闭症青少年的社会和非社会奖励反应及其与抑郁症状的关系 包括纵向调查。在各种自闭症、抑郁症专家团队的指导下， 奖励响应性，心理生理学方法，以及纵向和统计方法，这项建议 我将考察这些RDoC结构对14-17岁青少年抑郁的预测影响 患有自闭症。根据青春期的特点，青春期是早期发现和干预的关键发展期 由于抑郁症患病率的激增和同伴关系的日益重要。具体地说，这个提案 将使用EEG/ERP技术和临床医生评级的访谈来衡量社会和非社会奖励响应性 在患有自闭症的青少年中，测试与抑郁症状的关系。青少年将被评估一次 一年后，研究临床和神经指标如何随着时间的推移预测抑郁症状，这将 告知这些RDoC结构在这一弱势群体中的发展历程。申请人的长- 学期目标是了解自闭症和自闭症患者奖赏反应的神经生物学和行为发展 青春期至成年期抑郁症与筛查方法及干预的关系 发展。有指导的培训将允许申请者获得多方法测量(例如，ERP)方面的专业知识 方法学、临床医生评定的访谈)和纵向设计和分析，重点是评估 自闭症患者抑郁的发病、维持和治疗机制。

PROJECT SUMMARY Adolescents with Autism Spectrum Disorder experience depression at rates nearly twice that of their neurotypical peers (20% vs. 11%). Untreated depression is associated with adverse short (e.g., school refusal) and long-term outcomes (e.g., poor physical health, lower employment) that impair quality of life. Adolescents with autism also face a 10x increase in the risk for premature death by suicide than their neurotypical peers. Risk factors to depression in autism are not well understood and measurement efforts may be complicated by social communication difficulties (i.e., autism symptomatology) that complicate adolescents’ efforts to identify and explain emotional experiences to providers and family members. Therefore, more objective measures (e.g., electroencephalogram [EEG], specifically event-related potentials [ERPs]) may provide a better understanding of risk factors to depression in adolescents with autism. Altered reward responsivity (Research Domain Criteria [RDoC] Positive Valence) and disrupted social processes (RDoC Affiliation and Attachment) are key risk factors to depression for neurotypical adolescents, but have not been investigated in autism. Clinical and neural measures of social and nonsocial reward responsivity and associations with depression symptoms have not been examined in autism, which may provide meaningful information about developmental trajectories. Consistent with the NIMH Strategic Plan, Strategic Goal 2, “to identify and understand risk factors, biomarkers and behavioral indicators of mental illness,” this K23 application aims to examine clinical and neural markers of social and nonsocial reward responsivity and associations with depression symptoms in adolescents with autism, including longitudinal investigations. Under the mentorship of a diverse team of experts in autism, depression, reward responsivity, psychophysiological methods, and longitudinal and statistical methodologies, this proposal will examine the predictive influences of these RDoC constructs to depression in adolescents 14-17 years old with autism. Adolescence is a key developmental period for early detection and intervention as it is characterized by spikes in depression prevalence and an increasing importance of peer relationships. Specifically, this proposal will use EEG/ERP techniques and clinician-rated interviews to measure social and nonsocial reward responsivity in adolescents with autism and test relationships with depression symptoms. Adolescents will be assessed one year later to investigate how clinical and neural measures predict depression symptoms over time, which will inform the developmental course of these RDoC constructs in this vulnerable population. The applicant’s long- term goal is to understand the neurobiological and behavioral development of reward responsivity in autism and associations with depression from adolescence to adulthood so as to inform screening methods and intervention development. Mentored training will allow the applicant to gain expertise in multimethod measures (e.g., ERP methodologies, clinician-rated interviews) and longitudinal design and analysis, with an emphasis on assessing mechanisms associated with the onset, maintenance, and treatment of depression in autism.