Healthy Relationships on the Autism Spectrum: Feasibility and Target Engagement

项目摘要/摘要 自闭症患者容易受到关系欺凌和性暴力等创伤性社会经历的影响 被同龄人。社交焦虑和对同伴关系质量的不满正在损害 许多。通过随机测试的针对自闭症成人的社交技能干预措施太少了 对照试验(RCT)。该项目将测试健康关系的机制参与度和可行性 关于自闭症谱系(心脏)。心脏干预是通过NIMH K18(2020- 2022)，并对来自美国各地的N=55名年龄在18-40岁的自闭症成年人进行了可行性测试。 《红心》是一门在线实时授课的六节课。红心是新奇的，因为它是开发出来的 通过以社区为基础的与自闭症成年人的参与过程，课程由以下人员共同提供 一名自闭症患者和一名非自闭症促进者作为一个团队工作，课程使用神经多样性- 接受立场，而不是赤字模型的方法。具体地说，心灵不会传授这样的社交技能 比如闲聊，眼神交流，话轮转换练习，或其他可能有助于 自闭症患者的“伪装”或伪装。取而代之的是，心脏利用基于证据的暴力预防 编程，并教自闭症参与者识别健康和不健康之间的区别 人际关系，如何结识朋友，开始新的友谊或浪漫关系，如何谈判性 同意，承认界限，在需要的时候结束友谊或约会关系--同时尊重， 而不是寻求最小化或消除自闭症的差异。拟议的临床试验的目标是 证明目标机制可以参与并试验所有方法(例如，随机化、促进者 训练)，为测试心脏有效性的全功率试验做准备。红心计划具有高度的可扩展性 它是故意为在线投递而创建的。在红心K18非实验可行性试验中， 参与与包括社会动机在内的结果的积极变化有关。在建议的 RCT我们将测试心脏的可接受性和参与者参与度；主持人对原始文件的忠诚度 手册；提供者对心脏的满意度(N=160)。我们还将测试机制接合。我们 假设心脏受试者的敌意自动思维显著减少， 与参与完成积极的活动相比，减少拒绝敏感性，增加社交动机 控制条件(ACC)。我们还将测试临床影响。我们假设完成任务的参与者 心脏将在统计上显示对同伴关系质量的满意度显著提高 (临床结果)，相对于ACC参与者。我们将招募160名研究参与者，与 阿斯伯格/自闭症网络(AANE)组织，并受益于由5人组成的自闭症咨询委员会。 与IACC自闭症研究战略计划中规定的优先事项一致，拟议的研究 构成了促进自闭症成年人健康和健康的一种新的创新方法。

PROJECT SUMMARY/ABSTRACT Autistic people are vulnerable to traumatic social experiences such as relational bullying and sexual violence by peers. Social anxiety and unhappiness with the quality of peer relationships are impairing problems for many. There are too few social skills interventions for autistic adults that have been tested through randomized controlled trials (RCTs). This project will test mechanism engagement and feasibility of Healthy Relationships on the Autism Spectrum (HEARTS). The HEARTS intervention was developed through a NIMH K18 (2020- 2022) and feasibility tested with a sample of N=55 autistic adults ages 18-40 years old from across the US. HEARTS is a six-session class delivered in real time online. HEARTS is novel because it was developed through a community-based participatory process with autistic adults, the class sessions are co-delivered by one autistic and one non-autistic facilitator who work as a team, and the curriculum uses a neurodiversity- embracing stance instead of a deficit model approach. Specifically, HEARTS does not teach social skills such as small talk, making eye contact, practice at conversational turn-taking, or other skills that may contribute to autistic “masking” or camouflaging. Instead, HEARTS draws on evidence-based violence prevention programming and teaches autistic participants to recognize the differences between healthy and unhealthy relationships, how to meet people and start new friendships or romantic relationships, how to negotiate sexual consent, recognize boundaries, and end friendships or dating relationships when needed—while respecting, rather than seeking to minimize or eliminate, autistic differences. The goal of the proposed clinical trial is to demonstrate that the target mechanism can be engaged and to pilot all methods (e.g., randomization, facilitator training) in preparation for a fully powered trial to test HEARTS’ effectiveness. HEARTS is highly scalable in that it was intentionally created for online delivery. In the HEARTS K18 non-experimental feasibility test, participation was associated with positive changes in outcomes including social motivation. In the proposed RCT we will test HEARTS acceptability and participant engagement; fidelity of the facilitators to the original manual; and provider satisfaction with HEARTS (N=160). We will also test mechanism engagement. We hypothesize that HEARTS participants will demonstrate significant decreases in hostile automatic thoughts, decreased rejection sensitivity, and increased social motivation, relative to participating completing the active control condition (ACC). We will also test clinical impact. We hypothesize that participants who complete HEARTS will demonstrate statistically significant improvement in satisfaction with quality of peer relationships (clinical outcome), relative to ACC participants. We will recruit 160 research participants in partnership with the Asperger/Autism Network (AANE) organization, and benefit from a 5-person autistic Advisory Board. Consistent with stated priorities in the IACC Strategic Plan for autism research, the proposed research constitutes a new and innovative approach to promoting wellness and health for autistic adults.