Emotion dysregulation across generations: Identifying early developmental and clinical indicators of risk

项目总结/摘要 精神病理学的发展起源可以追溯到子宫内的经历。然而，在这方面， 对产前和新生儿早期精神问题的标志物的研究有限。一 一项有希望的调查表明，在怀孕期间暴露于母亲的痛苦， 对儿童健康和疾病易感性的持久影响。然而，机制关联 产妇风险因素与儿童结局的关系仍然知之甚少。情绪失调（艾德） 是一个跨诊断的脆弱性因素，是许多破坏性和昂贵的精神病治疗的基础。 诊断，包括人格障碍，焦虑，抑郁和自杀风险。因此，艾德 作为成年人复杂精神病理学的可行指标。在儿童中， 艾德可能先于正式的精神病诊断，如焦虑、注意力缺陷/多动症 紊乱，以及冲动或脾气调节困难。然而，很少有研究 检查母亲及其子女之间艾德或艾德轨迹的代际传递 从创新的研究领域标准（RDoC）的角度来看儿童。的目的 建议是通过（1）招募 孕妇与全方位的情绪困扰，（2）检查有前途的临床 和儿童精神病理学风险的发育指数。通过添加到现有的， NIMH资助的队列，拟议的研究将随访N=324例妊娠期母子二人组 到18个月，这是一个儿童行为问题开始表现出严重性的发展阶段， 秩序稳定性与RDoC的观点一致，母亲将被招募，以满足统一的 分布的艾德分数，并将完成全面的产前实验室电池，以评估 行为、心理生理和自我报告的艾德、压力和精神病理学测量。 还将在产前记录胎儿生理反应，作为ED风险的早期指标。 在出生后24小时内，婴儿将接受可靠有效的新生儿神经行为检查 设计用于检测出现的失调迹象（例如，高唤醒和低自我调节）。在 7-18个月大的时候，母亲和孩子会回到实验室， 可靠地引起共调节和/或失调。行为和心理生理反应 模式将在母亲和孩子使用动力系统的方法， 适合捕捉复杂的发育过程。这种创新和严格 设计研究将复杂的临床样本与完善的开发设计相结合 和先进的统计方法，以更好地了解早期心理健康轨迹。当 该项目的目标得以实现，我们将对母亲的艾德有更好的了解 和他们的孩子在一个关键阶段，奠定了基石，为以后的健康，发展， 和幸福这项纵向研究将为研究儿童期奠定基础 并将推进一个致力于了解失调女性的项目调查路线， 改善早期干预和预防精神病理学。

PROJECT SUMMARY/ABSTRACT The developmental origins of psychopathology can be traced to in utero experiences. However, there is limited research into prenatal and newborn markers of early psychiatric problems. A promising line of inquiry suggests that exposure to maternal distress during pregnancy can have a lasting effect on child health and disease susceptibility. However, mechanisms associating maternal risk factors with child outcomes remain poorly understood. Emotion dysregulation (ED) is a transdiagnostic vulnerability factor that underlies many devastating and costly psychiatric diagnoses, including personality disorders, anxiety, depression, and suicide risk. Therefore, ED serves as a viable index of complex psychopathology among adults. In children, early signs of ED likely precede formal psychiatric diagnoses, such as anxiety, attention deficit/hyperactivity disorder, and difficulties with impulse or temper regulation. However, there have been few studies examining intergenerational transmission of ED or ED trajectories among mothers and their young children from an innovative Research Domain Criteria (RDoC) perspective. The objective of this proposal is to advance current understanding of ED across generations by (1) enrolling pregnant women with the full range of emotional distress, and (2) examining promising clinical and developmental indices of risk for psychopathology in their children. By adding to an existing, NIMH-funded cohort, the proposed study will follow N=324 mother-child dyads from pregnancy through 18 months, a developmental stage when child behavior problems begin to show rank- order stability. Consistent with the RDoC perspective, mothers will be recruited to meet a uniform distribution of ED scores and will complete a comprehensive prenatal laboratory battery to assess behavioral, psychophysiological, and self-reported measures of ED, stress, and psychopathology. Fetal physiological responses will also be recorded prenatally, as early indices of risk for ED. Within 24 hours of birth, babies will undergo a reliable and valid newborn neurobehavioral exam designed to detect emerging signs of dysregulation (e.g., high arousal and low self-regulation). At 7- and 18-months, mother-child pairs will return to the laboratory to engage in dyadic tasks that reliably elicit co-regulation and/or dysregulation. Behavioral and psychophysiological response patterns will be assessed in mother and child using dynamical systems methods that are appropriate for capturing complex developmental processes. This innovative and rigorously designed study unites a complex clinical sample with a well-established developmental design and advanced statistical approaches to better understand early mental health trajectories. When the aims of this project are realized, we will have an improved understanding of ED in mothers and their children during a critical stage that lays the building blocks for later health, development, and wellbeing. This longitudinal study will lay a foundation for research continuing into childhood and will advance a programmatic line of inquiry devoted to understanding dysregulated women and children to improve early intervention and prevent psychopathology.