Behavioral, Neural Markers, and Trajectories of Nonsuicidal Self-Injury in Autistic Adults

About This Grant

PROJECT SUMMARY At least half of autistic adults report a history of nonsuicidal self-injury (NSSI), or intentional destruction of one’s own body tissue without suicidal intent. This is concerning as NSSI has a strong link with suicide attempts in general and autistic samples. Despite this precedence and the increasing spotlight on suicidal thoughts in autism, there is limited research which explicitly examines NSSI in autism. Considering the precursory role NSSI has on suicide attempts, there is a critical gap in our understanding of NSSI in autism. In the limited work, there is evidence to suggest that compulsivity, the tendency to engage in repetitive, often maladaptive, thoughts or actions, which is characterized by reduced goal-directed behavior, may be linked to NSSI. The current proposal seeks to address this gap by integrating self-report, clinical interviews, fMRI task, and longitudinal data collection to examine behavioral and neural markers of compulsivity with NSSI, and trajectories of NSSI in of autistic adults ages 18-45 years (N=90, 50% oversampled for recent NSSI in the past 4-months). The central hypothesis of this proposal is that behavioral and neural markers of compulsivity during decision-making relates to NSSI, including a persistent trajectory of NSSI. Characterizing NSSI associations with behavioral markers of compulsivity (Aim 1), and neural markers of compulsivity (Aim 2), and identification of NSSI trajectories (Aim 3) in autistic adults has the potential to aid in targeted NSSI prevention and intervention programs for autism. This project will be the first in a larger program of research that is aligned with RDoC, and will contribute to NIMH’s Strategic Priorities 1.3 (“Identify and characterize neural circuit mechanisms contributing to human behavior and their disruption in mental illness”), 2.1 (“Characterize the trajectories of [..] behavioral development across the lifespan), and 2.2 (“Identify and understand risk factors, biomarkers, and behavioral indicators of mental illnesses [..] across the lifespan”), and with the Interagency Autism Coordinating Committee (IACC) Strategic Plan 2.2 (“to understand the underlying biology of co-occurring conditions in autism [..]”) and 6.2 (“improve [..] mental health outcomes across the lifespan, with the goal of improving safety, reducing premature mortality [..]). This application details a comprehensive research and training plan which allows the candidate to address these questions and develop the skills necessary to become an independent investigator. Specifically, this candidate will receive training in 1) NSSI and by proxy suicidality; 2) behavioral and neural markers of compulsivity; and 3) longitudinal methodology and analysis. Training will occur within the rich scientific environment offered through the University of Pittsburgh and with the support of an exceptional mentoring team (Mazefsky, Scott, Price, and Brown) and expert statistical consultant (Yu) who together possess a strong track record of training early career scientists and supporting their transition into highly successful independent investigators. The proposed K23 activities will lead the candidate to establish a successful and independent program of research focused on using translational neuroscience approaches to identify and target neurobehavioral compulsivity as it relates to NSSI in autism.