Depression Surge in Adolescence & Gender Differences: Biocognitive Mechanisms

描述（由申请人提供）：为什么抑郁症在青春期急剧增加，尤其是对女性？尽管这个问题具有重大的科学和公共卫生意义，但青春期抑郁症激增和性别差异出现的机制仍然难以捉摸。这一应用与NIMH的使命有关，即了解青少年抑郁症的原因，少数民族和性别地位在抑郁症中的作用，以及早期干预的目标。本应用程序的目的是检查非裔美国人抑郁症激增和性别差异出现的普遍性，以及从创新的遗传-认知脆弱性X交易压力模型的角度检查这些发展现象背后的机制，嵌入在规范的青少年大脑和认知发展背景中。为此，将对600名12岁社区青年（男女平均，白种人和非裔美国人）及其父母进行大规模的前瞻性纵向研究。评估儿童的认知和遗传（血清素转运体基因多态性；仅二年级）脆弱性，规范认知发展，种族认同和精神诊断将在第一次和以后每年进行。每6个月对精神症状、消极生活事件、绝望、情感虐待和同伴受害、感知歧视、身体形象和青春期状态进行评估。此外，将从Ps的母亲在时间1中获得父母精神病理和父母认知脆弱性的评估。最后，在时间1和每年从p的母亲那里获得关于养育方式和父母推理反馈的信息。研究结果将对预防抑郁症有非常重要的意义。了解青少年抑郁症激增背后的机制，可以建议采取干预措施，使其短路，并对年轻的成年期造成巨大损害。具体而言，研究结果将提示青少年抑郁症预防干预的最佳特征：目标青少年的识别、时间、目标心理或生物过程，以及女孩与男孩、非洲裔美国人与高加索人的干预。公共卫生相关性：这项应用的独特之处在于，它将从认知易感性-压力/遗传易感性-压力综合模型的角度，对不同种族青少年抑郁症激增的普遍性和性别差异的出现，以及这两种发展现象背后的测试机制进行重大前瞻性研究。此外，执行功能的发展轨迹，相关的认知脆弱性对抑郁症的成因，告知规范的青少年大脑和认知发展的知识，将进行检查。通过分离青少年抑郁症发展的风险因素和机制，该项目的研究结果将对抑郁症的预防具有重要意义，特别是在最佳时间和目标（即，高认知和/或遗传风险）干预的领域，可以适当地定制以解决性别和种族差异。

DESCRIPTION (provided by applicant): Why does depression surge so dramatically in adolescence, especially for females? Despite the great scientific and public health significance of this question, the mechanisms underlying the surge in depression and emergence of gender differences in depression during adolescence remain elusive. This application is relevant to NIMH's mission to understand the causes of depression in youth, role of minority and gender status in depression, and targets for early intervention. The aims of this application are to examine the generality to African-Americans of this surge in depression and emergence of gender differences as well as to examine the mechanisms underlying these developmental phenomena from the perspective of an innovative genetic-cognitive vulnerability X transactional stress model, embedded within a normative adolescent brain and cognitive development context. To this end, a large-scale prospective, longitudinal study of 600 12-year old community youth (evenly divided between males and females and Caucasians and African-Americans) and their parents will be conducted. Assessments of children's cognitive and genetic (serotonin transporter gene polymorphism; Year 2 only) vulnerability, normative cognitive development, racial identity, and psychiatric diagnoses will be conducted at Time 1 and yearly thereafter. Assessments of psychiatric symptoms, negative life events, hopelessness, emotional abuse and peer victimization, perceived discrimination, body image, and pubertal status will occur every 6 months. In addition, assessments of parental psychopathology and parental cognitive vulnerability will be obtained from Ps' mothers at Time 1. Finally, information about parenting styles and parental inferential feedback will be obtained from Ps' mothers at Time 1 and yearly. Results will have very significant implications for prevention of depression. Knowledge of mechanisms underlying the adolescent surge in depression would suggest interventions for short-circuiting it and the great impairment it portends for young adulthood. Specifically, results will suggest optimal features of preventive interventions for depression in youth regarding: identification of youth to target, timing, psychological or biological processes to target, and interventions for girls vs. boys and African-Americans vs. Caucasians. PUBLIC HEALTH RELEVANCE: This application is unique in that it will provide a major prospective study of the generality across ethnic groups of the adolescent surge in depression and emergence of gender differences and test mechanisms underlying these two developmental phenomena from the perspective of an integrated cognitive vulnerability-stress/genetic vulnerability- stress model. In addition, developmental trajectories of executive functions relevant to the genesis of cognitive vulnerability to depression, informed by knowledge of normative adolescent brain and cognitive development, will be examined. By isolating the risk factors and mechanisms underlying the development of depression in adolescence, the project's findings will have significant implications for the prevention of depression, particularly in the area of optimal timing and targeting (i.e., high cognitive and/or genetic risk) of interventions that could be tailored appropriately to address gender and ethnic differences.