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

项目摘要/摘要 精神病理学的发展起源可以追溯到子宫经历。然而， 对早期精神问题的产前和新生儿标记物的研究有限。一个 一项有希望的调查表明，在怀孕期间暴露在母亲的痛苦中可能会 对儿童健康和疾病易感性的持久影响。但是，关联的机制 产妇风险因素与儿童结局的关系仍然知之甚少。情绪失调(ED) 是一个跨诊断的脆弱性因素，它是许多破坏性和代价高昂的精神疾病的基础 诊断，包括人格障碍、焦虑、抑郁和自杀风险。因此，艾德 可作为成人复杂精神病理学的一个可行指标。在儿童中，早期症状是 ED可能先于正式的精神诊断，如焦虑、注意力缺陷/多动症 无序，冲动或脾气调节困难。然而，这方面的研究很少 研究ED或ED轨迹在母亲及其子女之间的代际传播 从创新研究领域标准(RDoC)的角度研究儿童。这样做的目的是 建议通过以下方式促进当前对ED的了解：(1) 孕妇有全方位的情绪困扰，以及(2)检查有希望的临床 以及他们孩子的精神病理风险的发育指数。通过添加到现有的、 NIMH资助的队列，拟议的研究将从怀孕开始跟踪N=324个母子二元 通过18个月，儿童行为问题开始表现出等级的发展阶段- 订单稳定性。与RDoC的观点一致，母亲们将被招募来满足制服 分配ED分数，并将完成全面的产前成套实验室评估 行为、心理生理学和自我报告的勃起功能障碍、压力和精神病理学测量。 胎儿的生理反应也将在产前被记录下来，作为ED的早期风险指标。 在出生的24小时内，婴儿将接受可靠和有效的新生儿神经行为检查 旨在检测新出现的失调迹象(例如，高度唤醒和低自我调节)。在… 7个月和18个月的母婴配对将返回实验室，从事 可靠地引发共同监管和/或监管失调。行为和心理生理反应 将使用动力系统方法评估母亲和孩子的模式，这些方法是 适合于捕捉复杂的发育过程。这一创新和严格的 设计性研究将复杂的临床样本与成熟的开发设计相结合 以及先进的统计方法，以更好地了解早期心理健康轨迹。什么时候 这个项目的目标实现了，我们将对母亲的勃起功能障碍有更好的了解 和他们的孩子处于关键阶段，为以后的健康、发育、 和幸福感。这项纵向研究将为儿童时期的继续研究奠定基础 并将推进一条致力于了解失控女性的方案调查路线 并加强对儿童的早期干预，防止精神病的发生。

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.