Intervening Early with Neglected Children: Key Behavioral and Neurobiological Outcomes in Adolescence

项目摘要/摘要 父母为年幼的孩子充当共同调节者，帮助他们调节行为、情绪和 生理学和支持健康的大脑回路的发展。忽视父母往往不能起到 共同调节，这对幼儿的自我调节能力和大脑发育有影响。 随着孩子年龄的增长，这些自我调节方面的困难可能会变得更加明显。青春期 代表了一段特别容易出现心理健康问题的时期，因为 对情绪和行为调节的需求与日俱增，再加上神经的不断发展 支持情绪和行为调节的回路。在这场竞争性的更新中，我们建议遵循 进入青春期的儿童最初参与了一项关于依恋和 作为婴儿的生物行为追赶(ABC)，使我们能够通过实验评估可塑性和对 早期干预的结果是大脑回路和自我调节。美国广播公司的干预旨在 帮助父母学会以反应灵敏的方式互动，期望孩子们表现出 增强了调节行为、情绪和生理的能力。我们评估了ABC的疗效 参与儿童保护服务(CPS)的父母的干预。父母被随机分配到ABC或 进行控制干预。儿童在T1(1-4岁)和T2(8-10岁)进行跟踪。在T1，更多的 ABC组的儿童比DEF组的儿童发展出安全和有组织的依恋，并且 ABC的儿童表现出更规范的皮质醇产生，更少的负面情绪表达，以及 DEF儿童的抑制性控制能力强于儿童。ABC父母更敏感，表现出更好的选择 神经活动比DEF父母更多。在T2，ABC儿童表现出更大的前额叶皮质激活作为反应 对恐怖面孔的照片比DEF儿童更好，这表明在大脑水平上对威胁有更好的监管 激活。同样在T2，ABC组的孩子报告说与父母的关系更安全，并显示出 比DEF产生更标准的皮质醇和更优化的自主神经系统功能 孩子们。在青春期，ABC的干预预计会导致大脑回路增强，甚至更多 与控制干预相关的最佳功能。在拟议的研究中，我们将评估行为和 由父母介绍的13、14和15岁青少年的神经生物学发展 在婴儿期(n=120)和从中期开始跟踪的低风险青少年中进行CPS随机临床试验 儿童期(n=80)。在每一次年度评估中，主要结构，抑制控制，情绪调节， 生理调节和依恋/联系将在大脑激活和回路的水平上进行评估， 在行为层面上。

PROJECT SUMMARY/ ABSTRACT Parents serve as co-regulators for their young children, helping them regulate behaviors, emotions, and physiology and supporting the development of healthy brain circuitry. Neglecting parents often fail to serve as co-regulators, which has implications for young children’s self-regulatory capabilities and brain development. As children become older, these difficulties with self-regulation may become more pronounced. Adolescence represents a period of particular vulnerability for the emergence of mental health problems because of increasing demands for regulation of emotions and behaviors, coupled with on-going development of neural circuits that support emotional and behavioral regulation. In this competing renewal, we propose to follow children into adolescence who initially participated in a randomized clinical trial design of Attachment and Biobehavioral Catch-up (ABC) as infants, allowing us to experimentally assess plasticity and modification of brain circuits and self-regulation as the result of an early intervention. The ABC intervention was designed to help parents learn to interact in responsive and sensitive ways, with the expectation that children would show enhanced ability to regulate behavior, emotions, and physiology. We assessed the efficacy of the ABC intervention among parents involved with Child Protective Services (CPS). Parents were randomized to ABC or to a control intervention. Children were followed at T1 (ages 1-4) and T2 (ages 8-10). At T1, more of the children in the ABC group developed secure and organized attachments than children in the DEF group, and children in ABC showed more normative production of cortisol, less expression of negative emotions, and stronger inhibitory control than children in DEF. ABC parents were more sensitive and showed more optimal neural activity than DEF parents. At T2, ABC children showed greater prefrontal cortex activation in response to photographs of fearful faces than DEF children, suggesting better regulation to threat at the level of brain activation. Also at T2, children in the ABC group reported more secure relationships with parents, and showed more normative cortisol production and more optimal autonomic nervous system functioning than DEF children. In adolescence, the ABC intervention is expected to result in enhanced brain circuitry and more optimal functioning relative to the control intervention. In the proposed study, we will assess behavioral and neurobiological development among 13-, 14- and 15-year-old adolescents whose parents were referred by CPS to a randomized clinical trial in infancy (n=120), and among low-risk adolescents followed since middle childhood (n=80). At each annual assessment, the primary constructs, inhibitory control, emotion regulation, physiological regulation, and attachment/affiliation, will be assessed at the level of brain activation and circuitry, and at the behavioral level.