Developmental patterning of irritability enhances prediction of psychopathology in preadolescence: Improving RDoC with developmental science.
Developmental patterning of irritability enhances prediction of psychopathology in preadolescence: Improving RDoC with developmental science.
复制标题
DOI：
10.1037/abn0000655
复制
发表时间：
2022-08
期刊：
影响因子：
--
通讯作者：
Mittal, Vijay A
中科院分区：
文献类型：
--
作者：
Damme, Katherine S F;Norton, Elizabeth S;Briggs-Gowan, Margaret J;Wakschlag, Lauren S;Mittal, Vijay A
易激惹在精神病理学中的转诊重要性已经得到证实。然而，发展展开的易怒模式的具体临床和神经结果的贡献仍然是一个重要的和未回答的问题。为了解决文献中的这一空白，在学龄前和学龄早期（约2.5年后）对来自一个大型多样化队列的110名青少年的易怒模式进行了评估，并采用了旨在捕获正常：异常频谱的维度易怒量表。在青春期前（约6年后），评估了来自半结构化临床访谈的临床结局（内化/外化症状）和神经结局（表征为灰质体积异常）。对于临床结果，学龄前儿童易怒是青春期前内化和外化症状的跨诊断预测因子。然而，在一个模型，包括学龄前和早期的学龄，易怒提供了更大的特异性，这表明，较高的易怒在早期的学龄与升高的青春期前外化，但不内化症状。在神经结果方面，学龄前易怒并不能预测青春期前灰质体积异常;然而，学龄早期的易怒表现出区域间的相互作用，青春期前情感区域的体积减少（例如，杏仁核，内侧眶额皮质）和其它区域的体积增加（例如，小脑）。这些复杂的模式突出了一个发展知情的方法，国家心理健康研究所的研究领域标准（RDoC）的方法，产生transdiagnosis表型和多个单元的分析的贡献。捕捉这些个体差异和发展的异质性，可以提供关键的洞察新兴的精神病理学的基础机制的展开。这项研究利用了三个重要发展时期（学前，学龄早期和青春期早期）的数据，以确定早期易怒如何预测后期的临床和神经结果。本研究表明，占发展模式增强预测，并进一步强调了显着的潜力，有意义地将发展纳入精神病理学的维度研究。
The transdiagnostic importance of irritability in psychopathologyhas been demonstrated. However, the contribution of developmentally-unfolding irritability patterns to specific clinical and neural outcomes remains an important and unanswered question. To address this gap in the literature, irritability patterns of 110 youth from a large, diverse cohort were assessed at preschool age and again at early school age (~2.5 years later) with a dimensional irritability scale designed to capture the normal:abnormal spectrum. At pre-adolescence (~6-years later), clinical outcomes (internalizing/externalizing symptoms) derived from a semi-structured clinical interview and neural outcomes (characterized as gray matter volume abnormalities) were assessed. For clinical outcomes, preschool age irritability alone was a transdiagnostic predictor of internalizing and externalizing symptoms at pre-adolescence. However, in a model including both preschool- and early school age, irritability provided greater specificity, suggesting that higher irritability at early school age related to elevated pre-adolescent externalizing, but not internalizing symptoms. In terms of neural outcomes, elevated preschool irritability did not predict pre-adolescent gray matter volume abnormality; however, irritability at early school age demonstrated an interactive effect among regions, with reduced volume in pre-adolescence emotional regions (e.g., amygdala, medial orbitofrontal cortex) and increased volume in other regions (e.g., cerebellum). These complex patterns highlight the contribution of a developmentally informed approach, the National Institute of Mental Health’s Research Domain Criteria (RDoC) approach, to yield transdiagnostic phenotypes and multiple units of analysis. Capturing these individual differences and developmental heterogeneity can provide critical insight into the unfolding of mechanisms underlying emerging psychopathology. This study leverages data from three important developmental periods (the pre-school, early school age and early adolescence) to identify how early irritability predicts later clinical and neural outcomes. The present study demonstrates that accounting for developmental patterning enhances prediction and further, emphasizes the significant potential that comes with meaningfully incorporating development into dimensional studies of psychopathology.