Leveraging Mobile Tools to Investigate Emotion Dynamics and Behavior in Autistic Youth with Depression - ABSTRACT: Autism spectrum disorder is a common neurodevelopmental condition associated with elevated risk for depression beginning in childhood. Depression is linked to poorer outcomes for autistic youth, including suicidality, yet traditional treatments for depression are often less effective for this population. The current prevalence of depression is approximately four times higher in autistic than non-autistic youth, underscoring the urgent need for research identifying mechanisms that can guide tailored intervention strategies. A major gap exists in our knowledge about how key aspects of depression unfold in the lives of autistic adolescents in the flow of daily life, including daily positive and negative emotional experiences, and how those experiences reciprocally relate to adolescents’ behavioral, social, and environmental contexts. Understanding these processes is essential for identifying modifiable, real-world targets for prevention and treatment. This project will use a smartphone-based research platform with ecological momentary assessment (EMA) and passive mobile sensing capabilities to characterize daily positive and negative emotions and their contextual predictors and sequelae among 300 adolescents aged 13–17 (autistic and non-autistic youth with and without major depressive disorder [MDD]; 75/group). Mobile sensing (e.g., accelerometer, GPS, phone use) and EMA data will be collected over six months using a measurement burst design. Informed by the process model of emotion regulation, which conceptualizes emotion as dynamically shaped by transactions between individuals and their environments, this study will (1) characterize daily positive and negative emotion, behavior, and social context across groups, (2) identify behavioral, social, and environmental predictors of emotion, and (3) examine how daily emotion predicts subsequent engagement with these contexts. We hypothesize that autistic adolescents with MDD will show the highest daily negative emotion, lowest positive emotion, and lowest social interaction quality and frequency, and that emotion–context associations will be stronger and more sensitive in this group. These project aims are aligned with the current NICHD priority of improving the transition to adulthood among individuals with developmental disabilities. This project represents the first large-scale study to apply mobile sensing and EMA to understanding daily emotion and behavior in autism. Further, this project reflects the applicant’s new research program using mobile devices to investigate the development of internalizing problems in autistic youth. The applicant is supported in this endeavor by an interdisciplinary team of investigators with complementary areas of expertise. The feasibility of the proposed project is supported by this team’s history recruiting and retaining youth for longitudinal studies, their expertise with digital research tools and intensive longitudinal modeling, and their clinical skills with autistic youth. Findings arising from this project will identify modifiable daily-life mechanisms linking emotion and context in autistic youth, providing a foundation for personalized, digital interventions that deliver just-in-time support to prevent and treat depression in autistic adolescents.
