MENTORED PATIENT-ORIENTED RESEARCH CAREER DEVELOPMENT AWARD

描述(由申请人提供)： 申请者是一名儿童和青少年精神病学家，在国家儿童医学中心(CNMC)和乔治华盛顿大学医学院(GWUSM)有初级预约。托马斯博士在幼儿精神病学方面拥有丰富的临床经验。这一奖项将使她获得培训和指导，成为一名专注于幼儿破坏性障碍的独立临床调查员。教育计划包括教学课程，涵盖临床研究、统计学、生物信息学、研究设计和儿童早期方法学的原理和实践。本提案的目标是研究儿童早期破坏性障碍和其他障碍之间的共病情况。首席研究员将专注于两种类型的共病：具有情感失调的破坏性障碍和具有神经发育障碍(认知、语言、运动和神经行为)的破坏性障碍。这项建议的目的是迈出第一步，用横断面数据区分这两种破坏性行为的发展模式。首先，PI计划探索症状模式，以验证患者可以可靠地归类为两种形式的破坏性障碍：情感/破坏性和神经发育/破坏性。其次，她将测试这两组蹒跚学步的儿童和具有父母和亲子关系特征的健康对照组之间的关联。这项研究的数据将为一项前瞻性队列研究提供信息，该研究将检查早期破坏性障碍的发展途径和病因，并指导干预和预防策略。这些研究很重要，因为早期有破坏性困难的儿童面临着更高的风险，即持续外向性困难、内在化和学习困难，以及成人精神病理学。 这项研究将在附属于乔治敦大学临床研究中心(GCRC)的CNMC儿科临床研究中心(PCRC)进行，需要大量使用PCRC的三个观察室，以及PCRC的生物统计学/生物信息学和行为表型/仪器核心。

DESCRIPTION (provided by applicant): The applicant is a child and adolescent psychiatrist with primary appointments at Children's National Medical Center (CNMC) and at The George Washington University School of Medicine (GWUSM). Dr. Thomas has extensive clinical experience in toddler psychiatry. This award will allow her to obtain the training and mentoring to become an independent clinical investigator focusing on disruptive disorders in toddlers. The educational plan includes didactic courses covering the principles and practice of clinical research, statistics, bioinfomatics, research design, and early childhood methodology. The goal of the present proposal is to examine the comorbidity between disruptive and other disorders in early childhood. The principal investigator will focus on two types of comorbidity: disruptive disorders with affective dysregulation, and disruptive disorders with neurodevelopmental difficulties (cognitive, language, motor, and neurobehavioral). The aim of this proposal is to take a first step in distinguishing these two developmental patterns of disruptive behavior with cross-sectional data. First, the PI plans to explore patterns of symptoms to verify that patients can be reliably classified into two forms of disruptive disorders: Affective/Disruptive and Neurodevelopmental/Disruptive. Second, she will test the association between these two groups of toddlers and healthy controls with characteristics of the parent and the parent-child relationship. Data from this study will inform a prospective cohort study that will examine developmental pathways to, and etiology of, early disruptive disorders, and guide strategies for intervention and prevention. These studies are important because children with early disruptive difficulties are at increased risk for continuing extemalizing difficulties, for internalizing and academic difficulties, and for adult psychopathology. This study will be conducted at the Pediatric Clinical Research Center (PCRC) at CNMC, affiliated with the Georgetown University Clinical Research Center (GCRC), and requires heavy use of the three PCRC observation rooms, and the PCRC Biostatistics/Bioinfomatics and Behavioral Phenotyping/Instrument Cores.