National Comorbidity Survey - Replication (NCS-R)

点击翻译按钮获取中文摘要

During the past year, we have investigated the structure of depression observed in adults (NCS-R) and adolescents (NCS-A) and found highly similar classes and probabilities across adults and youth, with greater complexity in structure among adults than in adolescents. The subtypes identified in these analyses suggest that both symptom patterns and severity of depressive symptoms are sources of heterogeneity in major depressive disorder. We have also examined the associations between both maternal and paternal psychopathology and subtypes of neglect, assessed the associations between subtypes of neglect subtypes and lifetime DSM-IV disorders in adults, and evaluated the independent associations between neglect and psychopathology after adjustment for parental psychopathology, other adverse experiences, recall bias, and social and demographic correlates. We found that childhood supervisory neglect is associated with negative mental health outcomes among exposed youth, independent of other demographic and familial risk factors. Furthermore, both paternal and maternal psychopathology demonstrated significant associations with neglect subtypes. These findings highlight the importance of neglect in characterizing childhood adversity, and demonstrate the importance of a broader conceptualization of childhood risk factors for adult psychopathology (Heaton et al, under review). Public Health Impact: These findings have provided novel knowledge on comparability of the structure of major depressive disorder in adults and adolescents. The central importance of symptoms that are somatic in quality (such as changes in appetite, weight, sleep and fatigue) in discriminating depressive subtypes has major implications for our understanding of the biologic pathways, treatment and opportunities for prevention of the consequences of this major public health problem in American youth. The findings have also made contribution to the nosology of depression, and provided support for retention of atypical specifier in the new DSM-5 by demonstrating its distinct biological correlates and treatment response. The strong links we found between neglect and long standing psychiatric disorders have provided insights on importance of early intervention. Expansion of empirical inquiry into the associations between paternal, as well as maternal, risk factors and neglect in population based samples may provide advancements in both etiology and prevention. Future Plans: Our efforts on the NCS-R as an independent project have been significantly reduced over the past year, since the analyses of the most relevant topics to our research programs have been completed. However, we plan to keep using this rich nationally representative sample to conduct comparative analyses of symptom patterns, correlates and consequences of disorders shown in our parallel adolescent sample.