Rowan prof delves into autism-depression connection with NIH grant

People with autism spectrum disorder are four times more likely than the general population to experience depression, according to researchers at Queens University in Ontario. Dr. Katherine Gotham, assistant professor in the Department of Psychology at Rowan University, believes that startling statistic may be an underestimate.

“It’s probably a lot more than four times for certain groups,” Gotham said of depression rates across the lifespan. Multiple independent researchers looking at autistic adults in particular have put the overall lifetime depression rate at an astounding 50 to 70 percent.

“It’s a really common, really impactful problem,” said Gotham, who, for the better part of a decade, ran a social group for adults with autism.

“I would see people going in and out of depression,” she recalled. “It kept them from holding jobs and staying in relationships or starting new relationships. And that made them more depressed.”

This experience got Gotham, who initially focused her research on improving assessments used to diagnose autism, interested in the science of depression.

“Why are people with autism getting depressed? What do we have to change to tailor treatment of depression in the autistic population?”

Gotham’s questions are ambitious. She’s starting her search for answers by delving into a largely untapped area of autism research: repetitive thinking. And she has a multimillion-dollar grant from the National Institutes of Health to help her.

A funding grant and a change of scenery

At the time Gotham was first awarded the five-year, $2.1 million grant in 2018, she was an assistant professor at Vanderbilt University Medical Center in Nashville, TN. She had worked there for seven years, along with her husband, Dr. Steven Brunwasser, a fellow academic and psychologist with whom she regularly collaborates on research.

Although Gotham completed the first year of her research at Vanderbilt, the family was ready for a change. “We wanted to get back to the Philadelphia area,” said Gotham, “and we both wanted to work in a university setting that offered a good blend of research and teaching.” At Vanderbilt, virtually 100 percent of Gotham’s time was spent on research.

“Rowan is growing,” Gotham said. “It’s exciting.” Plus, Gotham, who teaches in the College of Science & Mathematics, was able to get in on the ground floor of the Neurodiversity Task Force, part of Rowan’s new Division of Diversity, Equity and Inclusion.

“This allows me to put my research into practice at Rowan and be on the cutting-edge of supporting students and faculty,” she added.

Gotham and Brunwasser started their Rowan careers in September, both as assistant professors in the Department of Psychology. One more advantage of working at Rowan, Gotham noted, is that they will have more opportunities to work together.  

As she embarks on the second year of this NIH-funded project – transferring the remaining $1.65 million of her grant to Rowan with her – Gotham has some big changes in the works.  

“At Vanderbilt, I brought everyone into the lab,” she said. “Here, we’re trying to make it mobile” with portable tools, like an eye-tracking device, that can be used to measure biomarkers associated with thinking patterns.

That mobile component will make a big impact on the demands placed on research participants. With a mobile “lab,” Gotham’s team can go out into the homes of participants in shorter, more frequent blocks of time to obtain reliable data with less hassle for the participant.

When you’re talking about someone who is already coping with the challenges of both autism and depression, Gotham explained, that added convenience matters.

Once the lab is fully up and running, Gotham expects to staff it with two graduate students, four part-time undergraduate students and a post-doctoral fellow, in addition to the project’s full-time study coordinator, Jared Richards.

“I look forward to seeing how our work could impact future research efforts to refine assessments and treatments for mental health conditions,” Richards, a Moorestown resident, said. “I am also excited to see how our study can positively impact the lives of those who participate in it.”

Richards, who graduated from Rowan in 2019 with a Bachelor of Science in Psychological Science, minors in both biology and neuroscience and the Thomas N. Bantivoglio Honors Concentration in the Honors College, said the aims of the study are about so much more than collecting data.

“We will be providing participants a very unique opportunity to learn about themselves and gain support for their mental health that they may not receive otherwise,” he explained.

As a recent graduate himself, Richards emphasized the multi-faceted research opportunities the project offers for students.

“They will be able to learn about the many scientific approaches involved in ASD and emotional health research, as well as gain hands-on experience,” he said. “As a full-time researcher, I will have the capacity to provide lots of support to students who are working in a research setting for their first time.”

These students will handle everything from data entry in the lab to administering assessments in participants’ homes.

Repetition, depression and autism

Repetitive behavior is a hallmark of autism, “but we don’t know much about repetitive thinking, because we have never asked,” Gotham said. “No one has.”

Yet there’s good reason to suspect that repetitive thinking is present, and to suspect that these thinking patterns could play a role in depression, based on the link between depression and rumination.

In general, “when you think repeatedly about negative things, you’re more likely to become depressed,” Gotham said. Yet it’s possible that the repetition itself feeds into depression – even if the subject of those repetitive thoughts is positive, like a favorite topic or hobby.

Before they can untangle what different types of repetitive thought patterns could mean, Gotham and her team must develop reliable tools to measure repetitive thinking.

The future of treating co-occurring depression and autism

“We are moving beyond autism research focused on a ‘cure’ and toward a holistic approach that values quality of life in neurodiverse individuals,” said Gotham. In her research experience working with groups such as the former Interactive Autism Network (IAN) and the research alliance Autistic Adults and other Stakeholders Engaged Together (AASET), that’s what the majority of individuals with autism want: social acceptance and inclusion.

Improving quality of life means finding actionable ways to treat depression in this population.

Treating depression is a complex endeavor even among the general population, Gotham explained. Different individuals need different combinations of pharmaceutical and behavioral interventions. What works for one person does not work for all.

Adding to the mix a condition like autism spectrum disorder, itself still mysterious in many ways, makes intervention that much more complicated.

Gotham’s research could be the start to overcoming these obstacles. The NIH is interested in targeting specific mechanisms of disease, she explained. In the context of her research, that means figuring out what types of repetitive thinking are the biggest risk factors for depression.

“Are some people more likely to develop mood problems based on their type of thinking?” Gotham asked. “If we can understand the mechanisms that cause depression for different subgroups, we can develop precision medicine – interventions tailored toward treating that group.”