Behavioral Studies of Mental Retardation and Depression

描述（由申请人提供）：人们越来越认识到，精神发育迟滞的人容易出现神经精神问题。然而，尚待确定的是，DSM-4中规定的所有标准是否都能有效地适用于这一人群。拟议项目的最终重点是精神发育迟滞和语言有限的人的临床抑郁症。抑郁症的某些特征（体重变化，睡眠问题，精神激动等）可以通过行为观察技术很容易地检测到。然而，其他标志（例如，动机减弱，行为不持久等）不太容易操作。后一个问题的出现是因为（1）患有严重精神发育迟滞的人无法有意义地参与临床访谈，（2）第三方报告在操作这些更具挑战性的结构时可能具有值得怀疑的价值。为了解决这两个问题，我们已经组装了一套行为测试，可以评估动机，注意力，记忆力和执行功能的儿童有限的语言。提出了两条平行的研究轨道。在第一个轨道中，我们将评估在何种程度上选择的电池方面可以告诉我们的认知功能的儿童与精神发育迟滞和抑郁症的双重诊断表现出很少或根本没有沟通的语言。将与功能匹配的非抑郁对照受试者进行潜在的信息比较。在第二个轨道，电池将管理到更高的功能，口头更有能力的儿童与智力迟钝，并有或没有抑郁症。这项平行工作不仅将系统地复制第一轨道的研究，而且还将使我们能够评估测试组合分数与传统神经心理学测试（NEPSY）分数之间的相关性。拟议的项目响应了最近由NICHD和NIMH联合宣布的一个优先领域，即精神发育迟滞的精神病理学（PA-01-028）。

DESCRIPTION (provided by applicant): It is increasingly being recognized that people with mental retardation are prone to neuropsychiatric problems. Yet to be determined, however, is whether all of the criteria specified in the DSM-IV can be effectively operationalized for this population. The ultimate focus of the proposed project is clinical depression in people with mental retardation and limited language. Certain hallmarks of depression (changes in body weight, sleep problems, psychomotor agitation, etc.) can be detected readily via behavioral observation techniques. However, other hallmarks (e.g., diminished motivation, behavioral impersistence, etc.) are less readily operationalized. The latter problem arises because (1) people with significant mental retardation cannot participate meaningfully in clinical interviews and (2) third-party reports may be of questionable value in operationalizing these more challenging constructs. To address these two problems, we have assembled a battery of behavioral tests that can assess motivation, attention, memory, and executive functioning in children with limited language. Two parallel tracks of research are proposed. In the first track, we will evaluate the degree to which selected aspects of the battery can inform us about the cognitive functioning of children with dual diagnoses of mental retardation and depression who exhibit little or no communicative language. Potentially informative comparisons will be made with functionally matched, nondepressed contrast participants. In the second track, the battery will be administered to higher functioning, verbally more capable children with mental retardation and with or without depression. This parallel work will not only replicate systematically studies of the first track but will also allow us to assess the correlation between test-battery scores and scores from a conventional neuropsychological instnunent (the NEPSY). The proposed project responds to a priority area recently announced jointly by NICHD and NIMH, the psychopathology of mental retardation (PA-01-028).