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

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.