Neurobehavioral assessments of RDoC domains to detect preschool mood disorders

描述（由申请人提供）：儿童情绪障碍是一个重要的公共卫生问题，有6 - 11%的人口患有症状。在受影响的人中，70%将在儿童和/或青春期复发，50%将在成年后继续出现症状。这些慢性模式表明，在生命后期观察到的心理健康问题往往在儿童早期就有可识别的标志。因此，早期识别和干预至关重要。美国国立卫生研究院提出了研究领域标准（RDoC），该标准通过建议对几个基于行为和生物学的过程进行调查，作为一种启发式方法来检查精神疾病的机制。尽管RDoC提供了一个有价值的理论框架，但RDoC在发展精神病理学研究中的适用性受到限制，主要是由于缺乏有效的、可行的、标准化的评估方法来检查幼儿的RDoC域。我们的目标是为幼儿创建和验证行为和神经生物学评估，以检查RDoC域，正效价和负效价与儿童抑郁和焦虑的相关性，这些抑郁和焦虑通常先于儿童抑郁和焦虑或与儿童抑郁和焦虑并存。具体来说，我们将研究奖励评价（正效价）和急性威胁（负效价）的构念，使用这些构念的行为和神经生理学相关性，并测试与4-6岁儿童临床评估的抑郁和焦虑的关联。通过密歇根大学精神病学系的婴儿和幼儿诊所以及我们卫生系统中的普通儿科诊所招募，将确保在我们的研究中，从临床到非临床范围的儿童都有广泛的焦虑和抑郁症状。我们寻求美国国立卫生研究院的试点资金，以调查行为和神经生理学任务的可行性，这些任务将长期1)告知评估程序，将基础科学进步与患者及其家属的可及性相结合；2)完善儿童焦虑和抑郁的潜在机制表征；3)告知后续干预措施，以解决个性化的儿童水平缺陷。由于NIMH认为RDoC标准的研究和未来应用具有高度优先级，因此研究结果将证明具有很高的影响力，然而，很少有实证数据探索幼儿中的此类应用。该建议响应了对验证，可行和标准化的评估单元的迫切需求，以检查幼儿的RDoC域，并且代表了实现有效和基于机制的学龄前儿童抑郁和焦虑识别和治疗策略的长期计划的关键一步。

DESCRIPTION (provided by applicant): Childhood mood disorders represent a significant public health concern, with 6 to 11% of the population suffering from symptomology. Among those affected, 70% will have a recurrence during childhood and/or adolescence, and 50% will continue to experience symptoms in adulthood. These patterns of chronicity suggest that mental health problems observed later in life often have identifiable markers during early childhood. Therefore, early identification and intervention is critical. The NIH has put forth the Research Domain Criteria (RDoC), which acts as a heuristic to examine mechanisms of mental illness by suggesting the investigation of several behaviorally and biologically based processes. Although RDoC provides a valuable theoretical framework, the applicability of RDoC for developmental psychopathology research has been limited, primarily due to a lack of validated, feasible, standardized assessment batteries to examine RDoC domains in young children. Our aim is to create and validate behavioral and neurobiological assessments for young children in order to examine the relevance of RDoC domains, Positive and Negative Valence, for childhood depression and anxiety that often precedes or commingles with it. Specifically, we will study the constructs of reward valuation (Positive Valence) and acute threat (Negative Valence) using behavioral and neurophysiologic correlates of these constructs and test for associations with clinically assessed depression and anxiety in 4-6 year old children. Recruitment through the Infant and Early Childhood Clinic at the University of Michigan's Department of Psychiatry, as well as general pediatrics clinics in our health system, will ensure that a broad spectrum of anxiety and depressive symptoms, across the clinical to non-clinical range are represented in the children in our study. We seek NIH pilot funding to investigate the feasibility of behavioral and neurophysiology tasks that will long-term 1) inform assessment procedures, blending basic science advances with accessibility for patients and their families; 2) improve our characterization of underlying mechanisms of child anxiety and depression; and 3) inform subsequent interventions to address personalized child-level deficits. Findings will prove high impact as the NIMH considers the study and future application of RDoC criteria a high priority, and, yet, there are few empirical data exploring such application among young children. This proposal is responsive to the urgent need for validated, feasible, and standardized assessment batteries to examine RDoC domains in young children, and represents a critical step in a long-term plan to achieve effective and mechanism-based identification and treatment strategies for preschool-age children with depression and anxiety.