Etiology Of Anxiety, Mood And Distruptive Behavior Disor

这是一项关于情绪在青春期精神病理学发展中的作用的生物行为纵向调查。重点是(A)负面情绪(愤怒、焦虑、悲伤)的多种成分在精神病理学演变中的作用，以及(B)导致情绪失调和紊乱的社会化经历和生物过程。情绪的失调体验和表达与外化(反社会模式)和内化(焦虑、抑郁情绪)障碍有关。青春期是这些疾病发展的关键时刻。在此期间，精神病理的发生率增加，临床问题在性别上变得更加分化，即男性更多的反社会行为，女性更多的焦虑和抑郁。我们研究了四组年轻人：(1)外在性和内在性问题共存，(2)外在性问题，(3)内在性问题，和(4)无症状。青少年的年龄从11岁到16岁不等，在两个时间点上学习，间隔两年。对同等数量的男性和女性进行研究，以检查症状、情绪调节和疾病表现方式的性别差异的病因学。下面总结了当前四个项目的结果，这些项目侧重于青年在第一次数据收集时的功能预测因素。(1)男性和女性在神经激素模式与精神病理的关系上存在差异。有更多焦虑-抑郁问题和注意力问题的男孩，睾酮水平较低，他们的睾酮水平在一天中下降得更慢。有更多破坏性行为问题的女孩表现出一天中睾丸素水平的急剧下降。(2)性别缓和了精神病理学(内在化和外在化问题)与情感和心脏反应性之间的许多重要联系。女孩的内在性问题(焦虑和抑郁)与更强的血压反应性有关。外在性问题与收缩压反应性降低有关，尤其是对男孩来说。(3)男性和女性在情绪和自我概念上的差异分别有助于解释他们外在化和内在化问题的不同风险。男性在整体自我价值、运动能力、外表和浪漫魅力上比女性更看好自己，尽管他们认为自己表现不太好。女性比男性表现出更多的内疚和羞愧，她们会进行更多的反省应对。反省是指个体S执着地专注于抑郁症状，没有采取任何行动减轻痛苦，从而助长了抑郁情绪的延续和自尊的降低。(4)基于性别的精神病理学模式可以与性别角色和情绪社会化经验联系起来。年轻时的男子气概与较少的内化问题有关，而女性气质与较少的外在问题有关。在反应青少年中，性别角色与父母的惩罚、忽视和情绪性(以及缺乏讨论、同理心和分心)一起是精神症状的有力预测因素。这些研究强调了研究影响青春期男性和女性精神病理学表现形式的生物因素和社会化经历的重要性。

This is a biobehavioral, longitudinal investigation of the role of emotion in the development of psychopathology in adolescence. The focus is on (a) the role of multiple components of negative emotions (anger, anxiety, sadness) in the evolution of psychopathology, and (b) socialization experiences and biological processes that contribute to emotion dysregulation and disorder. The dysregulated experience and expression of emotion is implicated in both externalizing (antisocial patterns) and internalizing (anxiety, depressed mood) disorders. Adolescence is a critical juncture in the development of these disorders. The incidence of psychopathology increases during this time period, and clinical problems become more differentiated along gender lines, i.e. more antisocial behavior in males and more anxiety and depression in females.Four groups of youths are studied: (1) comorbid externalizing and internalizing problems, (2) externalizing problems, (3) internalizing problems, and (4) asymptomatic. Youth range in age from 11 to 16 years and are studied at two time points, spaced two years apart. Equal numbers of males and females are studied in order to examine etiology of sex differences in symptoms, emotion regulation, and developmental changes in how disorders manifested. Findings from four current projects that focus on predictors of functioning of youth at the first time point of data collection are summarized next. (1) Males and females differ in relations between neurohormonal patterns and psychopathology. Boys with more anxiety-depression problems, and attention problems, have lower levels of testosterone, and their testosterone levels decreased more slowly across the day. Girls with more disruptive behavior problems display a steep decline in testosterone production across the day. (2) Gender moderates many significant associations between psychopathology (internalizing and externalizing problems) and affective and cardiac reactivity. Internalizing problems (anxiety and depression) in girls are associated with greater blood pressure reactivity. Externalizing problems are associated with less systolic blood pressure reactivity, especially for boys. (3) Differences in emotions and self-concepts of males and females help to explain their differential risk for externalizing and internalizing problems, respectively. Males view themselves more favorably than females on global self-worth, athletic competence, physical appearance, and romantic appeal despite rating themselves as less well behaved. Females show more guilt and shame than males, and they engage in more ruminative coping. Rumination refers to the individual’s persistent focus on depressive symptoms, without taking any action to reduce the distress, thereby contributing to continuation of depressed mood and diminished self-esteem. (4) Gender-based patterns of psychopathology can be linked to sex-roles and emotion socialization experiences. Masculinity in youth is associated with few internalizing problems, and femininity is associated with few externalizing problems. Sex roles in conjunction with parental punishment, neglect, and emotionality (as well as lack of discussion, empathy, and distraction) in response adolescents’ negative emotions are powerful predictors of psychiatric symptoms. These studies highlight the importance of studying both biological factors and socialization experiences that influence the form of expression of psychopathology in adolescent males and females.