Risk for Child Psychopathology: A Twin-Study Perspective

描述（由申请人提供）：利用流行病学定义的资源，纵向双胞胎研究，我们研究儿童精神病理学的发展过程和生物心理社会风险。在2岁和7岁现有筛查的基础上，我们描述了2岁、7岁和12岁时与内化（焦虑和抑郁）、外化（对立和行为障碍）和ADHD发展相关的风险因素。我们的大多数高危病例符合DSM-IV诊断，但我们包括具有亚阈值症状的个体和一个大型对照组。具体目标包括风险因素的特征，遗传和环境影响的分析，并改善儿童疾病的测量和分类。“基于儿童的”风险因素包括早期症状、气质和应激反应、基础和反应性皮质醇、睾酮和脱氢表雄酮、认知能力和归因方式以及认知情感处理技能。家庭和其他心理社会风险因素包括父母的诊断和精神病理学家族史，双胞胎和双胞胎父母的社会互动方式，家庭压力的多个方面，以及消极的养育方式。我们采用的研究方法包括与照顾者和儿童的结构化诊断访谈，医疗记录，观察员评级，儿童自我报告和父母报告问卷，录像家庭行为电池和基于计算机的测试（主要是反应时间任务）。这项研究的意义在于了解已知的风险因素如何相互作用和/或介导彼此对儿童精神病理学的影响，在遗传信息，纵向设计。双胞胎方法允许我们解析表型方差和协方差的措施，遗传和环境的组成部分，和组件进行了研究。这些结果也将增强我们对共病、疾病内异质性以及疾病与特征之间的关联的理解。该项目与公共卫生的相关性在于它确定了常见儿童疾病的风险因素，并调查了这些因素在遗传和环境因素的背景下如何相互作用。所获得的知识应该为早期发现、改进干预措施和更好地分类儿童疾病的努力提供信息。

DESCRIPTION (provided by applicant): Using the resources of an epidemiologically defined, longitudinal twin study, we examine developmental course and biopsychosocial risks for childhood psychopathology. Building on existing screening at ages 2 and 7 years, we characterize risk factors at ages 2, 7, and 12 relevant to the development of internalizing (anxiety and depression), externalizing (oppositional and conduct disorder), and ADHD. Most of our at-risk cases qualify for a DSM-IV diagnosis, yet we include individuals with sub-threshold symptoms and a large control group. Specific aims include characterization of risk factors, analysis of genetic and environmental effects, and improved measurement and classification of childhood disorders. "Child-based" risk factors include earlier symptoms, temperament and stress reactivity, basal and reactive cortisol, testosterone and DHEA, cognitive abilities and attributional styles, and cognitive-affective processing skills. Family and other psychosocial risk factors include parental diagnosis and family history of psychopathology, twin-twin and twin-parent social interaction styles, multiple facets of family stress, and negative parenting. The research methods that we employ include structured diagnostic interviews with caregivers and children, medical records, observer ratings, child self-report and parent-report questionnaires, videotaped home-based behavioral batteries, and computer-based testing (mostly reaction time tasks). The study's significance lies in understanding how known risk factors interact and/or mediate each other's effects on child psychopathology in a genetically informative, longitudinal design. Twin methodology allows us to parse phenotypic variance and covariance among measures into genetic and environmental components, and the components are studied developmentally. The results should also enhance our understanding of comorbidity, heterogeneity within disorders, and the association of disorders with traits. The project's public health relevance lies in its identification of risk factors for common childhood disorders and its investigation of how they interact in the context of genetic and environmental factors. The knowledge gained should inform efforts toward early detection, improved interventions, and better classification of childhood disorders.