Understanding Mental Health in Neurodevelopmental Conditions: A Hidden Talents Approach

神经发育疾病(NDC)，如自闭症、ADHD和发育性协调障碍，是终生疾病，影响大约10%的人口(Emerging Minds，2021)。自闭症本身的成本比癌症、中风和心脏病加在一起更高(Buescher等人，JAMA)，但相对于其他疾病，在NDC上的研究支出很少(例如，每个自闭症成年人6.60 GB，而每个癌症患者295 GB(Autistica，2014))。这种资金不足，包括博士培训，在理解NDCs方面留下了两个特别的空白，这将在本项目中得到解决。首先，尽管神经发育特征在人群中重叠并持续分布，但对NDCs的研究过度集中在单一条件上(塔帕尔等人，《柳叶刀精神病学》)。研究表明，患有NDC的人更常见的是患有一种以上的疾病，而不是“纯粹的”障碍(Rutter，2008)。因此，人们呼吁研究人员在研究NDC时开发跨诊断方法，而不是专注于离散的类别(Astle等人，2021；Emerging Minds，2021)。第二，假设NDC相关的症状和逆境(例如，欺凌)预示着认知和心理健康不良。然而，以前的研究忽略了考虑适应性发展过程有时是如何增强认知，从而减少精神疾病的。这一方法最近被正式确定为“隐藏人才”方法(Frankenuis等人，2020年，TICS)。利用基于人群的数据和认知基础隐藏人才的方法，这一跨学科项目将确定国家发展中心的隐藏人才，从而为了解和干预国家发展中心改善心理健康提供信息。研究1-在线定性调查研究，调查患有国家发展中心的青少年和成年人的生活经历，重点是他们的才华和应对方式。主题和研究结果将为研究2-4中的变量选择和建模提供信息。研究2-4-利用青少年大脑认知发展队列中的遗传、神经成像和认知数据进行的三项研究；abcdStudy.org。这是美国最大的基于人群的神经认知和健康研究(N~12K)，有几个重叠的NDC和心理健康的衡量标准。分析将集中于发现隐藏的人才，即与NDDC和相关逆境正相关的神经和认知标记。然后，我们将使用遗传敏感的纵向分析，测试这些隐藏的人才是否缓和了NDC、相关逆境和后来的精神健康结果之间的关联。在发现国家发展中心隐藏的人才方面，这些发现将能够为了解和干预改善神经发育状况下的心理健康提供信息。大多数关于国家发展中心的研究都集中在单一的条件下，因此这个项目将提供对条件之间重叠的洞察。结果将提交给临床医生和慈善合作伙伴，从而增加研究结果为临床实践和国家政策提供信息的可能性。这项研究与GW4 BioMed MRC战略研究主题“人口健康”相关。

Neurodevelopmental conditions (NDCs) such as Autism, ADHD and Developmental Coordination Disorder are lifelong conditions which affect around 10% of the population (Emerging Minds, 2021). They have high co-occurrence with various mental health difficulties (Emerging Minds 2021).Autism alone is more costly than cancer, stroke, and heart disease, combined (Buescher et al., JAMA), yet there is little research spending on NDCs relative to other conditions (for example £6.60 per autistic adult vs £295 per cancer patient (Autistica, 2014)). Such underfunding, including PhD training, has left two particular gaps in understanding NDCs, which will be addressed in this project.First, research on NDCs is overly focussed on single conditions even though neurodevelopmental traits are overlapping and continuously distributed in the population (Thapar et al., Lancet Psychiatry). Research suggests that it is more common for individuals with NDCs to have more than one condition rather than a 'pure' disorder (Rutter, 2008). Consequently there are calls for researchers to develop transdiagnostic approaches when researching NDCs rather than focusing on discrete categories (Astle et al., 2021; Emerging Minds, 2021).Second, it is assumed that NDC related symptoms and adversities (e.g., bullying) are predictive of poor cognition and mental health. However, previous research has neglected to consider how adaptive developmental processes sometimes enhance cognition and thereby could reduce mental illness. This has recently been formalised as the 'hidden talents' approach (Frankenhuis et al., 2020, TiCS). Drawing on population-based data and the cognitively grounded hidden talents approach, this cross-disciplinary project will identify hidden talents in NDCs and thereby inform understanding of and interventions for improving mental health in NDCs.Study 1-An online qualitative survey study to investigate the lived experience of adolescents and adults with NDCs focusing on their talents and coping. Themes and findings will inform variable selection and modelling in Studies 2-4. Studies 2-4-Three studies drawing on genetic, neuroimaging, and cognitive data in the Adolescent Brain Cognitive Development cohort; abcdstudy.org. This is the largest population-based study of neurocognition and health in the US (N~12K), with several measures of overlapping NDCs and mental health. Analyses will focus on uncovering hidden talents, i.e., neural and cognitive markers positively associated with NDCs and related adversities. We will then test if these hidden talents moderate the association between NDCs, related adversities, and later mental health outcomes, using genetically sensitive longitudinal analyses. In identifying hidden talents in NDCs, the findings will be able to inform understanding of and interventions for improving mental health in neurodevelopmental conditions. Most research on NDCs focuses on single conditions, and so this project will provide insight into overlaps between conditions. The results will be presented to clinicians and charity partners, thereby increasing the potential for the findings to inform clinical practice and national policy. This research is relevant to the GW4 BioMed MRC strategic research theme of 'population health'.