Transdiagnostic Mechanisms of Youth Externalizing Psychopathology from Childhood to Adolescence: A Longitudinal Person-Centered Approach

项目概要/摘要 青年外化精神病理学，如注意力缺陷/多动障碍（ADHD），对立 违抗性障碍（ODD）和行为障碍（CD）彼此高度共病， 带来了很多负面的结果。更多的病因学知识（例如，认知、情感或动机 机制）可以改善干预措施或促进预防。然而，高合并症率和 研究个别疾病的流行掩盖了症状和潜在的 病因学虽然认识到这一问题激发了更多的研究机制的并发症， 现存的文学作品有两个重要的局限性。第一，许多研究隐含地将诊断实体视为 通过在基于组的分析中比较疾病或通过利用单独的因素， 每一种紊乱这些方法通常会删除有意义的共享方差，并将诊断视为 单一的，不考虑异质性在共病中的作用（即，疾病内的异质性可 导致更高的跨疾病共病率）。第二，横向研究破坏了我们对 从童年到青春期的外化途径是否代表了独特的 疾病或它是否代表同一疾病实体的不同表现。人为本 纵向方法，如潜在转移分析，克服了这两个限制。目标1将 建立在三个时间点出现的外化症状的潜在类别以及 跨时间点上课。目标2将检查潜在类别的认知，情感和动机预测 每个时间点的状态以及跨时间点在潜在类别之间转换的概率。 探索性目标3将评估潜在类别与功能障碍的相关程度， 为了检查某些机制是否有助于预测成员资格，或过渡到， 班影响陈述：这项工作将说明关键机制如何与外部化相关 随着时间的推移，无论DSM诊断如何。这将为更大的病因学铺平道路 了解，告知如何利用病因学知识来完善我们的疾病分类学， 识别.拟议的奖学金允许申请人建立在她的基础知识在认知 调查其他过程，如情绪和动机（培训目标1）;提高她的理解力 的理论和方法的方法来检查comorbance（培训目标2）;并扩大她 将潜在方法和纵向方法纳入统计库（培训目标3）。最后，研究金将 提供职业发展和道德培训的机会（培训目标4）。PI史密斯是一个博士 佛罗里达国际大学儿童和青少年心理学临床科学专业学生。的 奖学金旨在为申请人的独立研究生涯做好准备。

PROJECT SUMMARY/ABSTRACT Youth externalizing psychopathology, such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD), are highly comorbid with one another and are associated with many negative outcomes. Greater knowledge of etiology (e.g., cognitive, emotional, or motivational mechanisms) may improve interventions or facilitate prevention. However, the high rate of comorbidity and the popularity of investigating individual disorders has obscured relationships between symptoms and potential etiologies. While recognition of this problem has inspired more research on mechanisms of comorbidity, the extant literature suffers from two critical limitations. One, many studies implicitly treat diagnostic entities as distinct and independent by comparing disorders in group-based analyses or by utilizing separate factors for each disorder. These approaches often remove meaningful shared variance, and by treating diagnoses as unitary, do not account for the role of heterogeneity in comorbidity (i.e., heterogeneity within disorders may lead to higher comorbidity across disorders). Two, cross-sectional studies undermine our understanding of whether the externalizing pathway from childhood to adolescence represents the development of unique disorders or whether it represents different presentations of the same disease entity. Person-centered longitudinal approaches, such as Latent Transition Analysis, overcome both of these limitations. Aim 1 will establish the latent classes of externalizing symptoms present at three time points and the transitions between classes across time points. Aim 2 will examine cognitive, emotional, and motivational predictors of latent class status at each time point as well as the probability of transitioning between latent classes across time points. Exploratory aim 3 will evaluate the extent to which latent classes are correlated with functional impairments in order to examine if certain mechanisms are useful in predicting membership in, or transitions to, more impaired classes. Impact statement: This work will illustrate how key mechanisms are related to externalizing symptomatology over time, irrespective of DSM diagnosis. This will pave the way for greater etiological understanding, inform how knowledge of etiology can be utilized to refine our nosology, and improve risk identification. The proposed fellowship allows the applicant to build upon her foundational expertise in cognition to investigate other processes, such as emotion and motivation (training goal 1); advance her understanding of the theoretical and methodological approaches to examining comorbidity (training goal 2); and expand her statistical repertoire to include latent and longitudinal approaches (training goal 3). Lastly, the fellowship will provide opportunities for professional development and ethical training (training goal 4). PI Smith is a doctoral student in Clinical Science in Child and Adolescent Psychology at Florida International University. The fellowship is designed to prepare the applicant for an independent research career.