Behavioral Studies of Mental Retardation and Depression

描述(申请人提供)：越来越多的人认识到，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-IV中规定的所有标准是否都能有效地适用于这一群体。拟议项目的最终焦点是智力发育迟滞和语言受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、精神运动激动等)可以通过行为观察技术很容易地检测到。然而，其他特征(例如，动力减弱、行为不持久等)不太容易实施。后一个问题的出现是因为(1)有严重智力障碍的人不能有意义地参与临床访谈，(2)第三方报告在实施这些更具挑战性的结构方面可能有可疑的价值。为了解决这两个问题，我们组织了一系列行为测试，可以评估语言受限儿童的动机、注意力、记忆力和执行功能。提出了两条平行的研究轨道。在第一个跟踪中，我们将评估该组合的选定方面在多大程度上可以告诉我们患有智力低下和抑郁症的双重诊断儿童的认知功能，这些儿童很少表现出或没有表现出沟通语言。潜在的信息量比较将与功能匹配的、非抑郁的对比参与者进行。在第二个轨道上，电池将被用来治疗功能更强、语言能力更强的智力障碍儿童，无论他们是否患有抑郁症。这项平行的工作不仅将系统地复制对第一个轨道的研究，而且还将使我们能够评估测试电池分数与传统神经心理学仪器(NEPSY)分数之间的相关性。拟议的项目响应了NICHD和NIMH最近联合宣布的一个优先领域--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).