Neural pathways linking early adversity and preschool psychopathology to adolescent mental health

项目摘要/摘要 学龄前焦虑虽然普遍存在，但对未来结果的预测并不完美。例如, 纵向数据表明，学龄前焦虑症不仅预示着未来的焦虑，而且还预示着其他 青春期的内在化障碍和并存的破坏性行为。同样，早期的逆境也会增加 这对许多形式的青少年精神病来说都是危险的。使用我们目前的方法，我们不能确定 学龄前儿童在青春期会继续患上哪种障碍。这部分是因为大多数车型 主要关注诊断内的连续性，而不是跨诊断风险因素，在以下情况下 逆境，取决于童年经历的数量而不是性格。目前的提案测试了一个 新的概念模型侧重于不良暴露的类型，区分了两个主要维度 多种形式的逆境背后的经验：剥夺和威胁。人际暴力或威胁 认知和社会输入的减少或剥夺是由儿童的经历来区分的 这些经历对神经和认知功能的影响。因此，这种逆境模式 将重点放在跨诊断风险因素上。重要的是，与剥夺和威胁有关的神经通路 与已知的在早期焦虑症中被破坏的神经回路相同。鉴于这种共同的神经风险，我们 预计早期的逆境和焦虑会相互作用，增加青春期患精神病的风险。我们 此外，预计其他学龄前诊断(例如，ODD、ADHD)会进一步缓解。这些神经通路可能 成为学龄前焦虑症和青少年精神病之间的“缺失环节”。要解决这一知识 GAP，我们建议跟踪一组青少年(现在15-17岁；N=502)，他们在 学龄前儿童(2-5岁)这些儿童中的一个亚样本(N=93)接受了结构和功能成像 在5-10岁之间，最多3次。这一创新的、经济高效的提案将提供无与伦比的 有机会回答有关连接早期风险的神经发育过程轨迹的核心问题 在高度脆弱的人群中对特定形式的青少年精神病理学的关注。拟议的研究 直接针对NIMH战略计划的目标1和2。

Project Summary/Abstract Preschool anxiety, while prevalent and impairing, is an imperfect predictor of future outcomes. For example, longitudinal data suggest that anxiety disorders in preschool predict not just future anxiety but also other internalizing disorders and comorbid disruptive behavior in adolescence. Similarly, early adversity increases risk for many forms of adolescent psychopathology. Using our current methods we cannot identify which preschool children will go on to acquire which disorders in adolescence. This is in part because most models focus primarily on continuity within diagnoses as opposed to transdiagnostic risk factors and in the case of adversity, on the number rather than character of adverse childhood experiences. The current proposal tests a novel conceptual model focused on the type of adverse exposure, which differentiates two primary dimensions of experience underlying multiple forms of adversity: deprivation and threat. Interpersonal violence or threat and decreased cognitive and social inputs or deprivation are differentiated by the kind of experiences children have and by the impact of those experiences on neural and cognitive function. Thus, this model of adversity allows a focus on transdiagnostic risk factors. Importantly, the neural pathways linked to deprivation and threat are the same neural circuits known to be disrupted in early anxiety disorders. Given this shared neural risk we expect that early adversity and anxiety will interact to increase risk for psychopathology in adolescence. We also expect further moderation by other preschool diagnoses (e.g., ODD, ADHD). These neural pathways may be the ‘missing link’ between preschool anxiety and adolescent psychopathology. To address this knowledge gap, we propose following a group of adolescents (now aged 15-17 years; N=502) who were first assessed in preschool (ages 2–5 years). A subsample of these children (N=93) underwent structural and functional imaging up to 3 times between 5-10 years of age. This innovative, cost-effective proposal will provide an unparalleled opportunity to answer central questions about the trajectory of neurodevelopmental processes linking early risk to specific forms of adolescent psychopathology in a highly vulnerable population. The proposed research directly addresses Objectives 1 and 2 of the NIMH strategic plan.