Improving Brain-Behavior Markers of Preschool Executive Function through aGroup-Based Parenting Intervention for Low-Income Families

点击翻译按钮获取中文摘要

PROJECT ABSTRACT Impairments in executive functioning (EF), cognitive processes that support self-regulation, disproportionately impact children living in poverty and increase vulnerability for childhood disruptive behavior disorders (DBDs; oppositional defiant disorder, conduct disorder), which trigger a cascade of mental health problems and psychosocial difficulties across the lifespan. Poverty-related stress and maladaptive parenting styles have been linked to alterations of neural and behavioral EF markers in children; despite this, no studies have studied if parenting prevention programs can directly target childhood EF, and through improving EF, reduce disruptive behaviors in at-risk children. This K23 Mentored Patient-Oriented Research Career Development Award application seeks to conduct a mechanistic randomized clinical trial to determine whether neural-behavioral indices of childhood EF is an experimental therapeutic target that can be modified via caregiver participation in the Chicago Parent Program (CPP; Aim 1). Consistent with the NIMH Research Domain Criteria framework, childhood EF will be assessed across multiple levels of analysis (electroencephalogram [EEG], behavior, survey). The project also seeks to evaluate whether increases in childhood neural-behavioral EF mediate the effects of CPP in reducing disruptive behavior problems over a short-term follow-up (Aim 2). The project will also explore whether increases in specific parenting practices (discipline, scaffolding), previously linked to individual differences in EF, mediate the effects of CPP in predicting change in childhood neural-behavioral EF (Aim 3). The sample will include 90 Medicaid eligible parent-child (ages 4-5 years old) dyads; and will employ a novel recruitment approach where the target child will have moderate-to-severe EF delays at baseline but does not meet diagnostic criteria for a DBD. Consistent with the candidate's translational clinical scientist career goals, the candidate seeks crucial training in: community-based research and dissemination and implementation science, advanced EEG methods to evaluate neural-behavioral EF targets of preventive interventions, and statistical skills to design and evaluate clinical trials. Training will occur in an outstanding interdisciplinary environment at the University of Illinois at Chicago, in the Department of Psychiatry and leverage the department's established strengths in community mental health services research, dissemination and implementation science, and affective neuroscience. Mentors Drs. Atkins, Fitzgerald and Bhaumik and consultants Drs. Klumpp, Wakschlag, Gross, and Handley have expertise in the training areas and extensive histories of early career mentorship, and will work together to ensure the candidate's successful transition to research independence. Study findings will support an R01 application to validate the results on a larger scale and launch the candidate's academic career as a preventive intervention scientist. Findings have significant potential to identify whether CPP, a cost-efficient parenting intervention, modifies neural-behavioral EF indices in urban poor children, a theorized etiological risk mechanism of DBDs, and therefore prevent DBDs.