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会如此剧烈地激增，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，但导致抑郁症激增和青春期抑郁症出现性别差异的机制仍然难以捉摸。该应用程序与NIMH的使命有关，即了解青年抑郁症的原因，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。这个应用程序的目的是研究的普遍性，以非洲裔美国人的这种激增的抑郁症和出现的性别差异，以及检查这些发展现象的基础机制的角度来看，一个创新的遗传认知脆弱性X交易压力模型，嵌入在一个规范的青少年大脑和认知发展的背景。为此，将对600名12岁社区青年（男女、白人和非洲裔美国人各占一半）及其父母进行大规模前瞻性纵向研究。将在时间1和此后每年评估儿童的认知和遗传（5-羟色胺转运蛋白基因多态性;仅2岁）脆弱性、规范性认知发育、种族认同和精神病诊断。每6个月评估一次精神症状、负面生活事件、绝望、情感虐待和同伴伤害、感知歧视、身体形象和青春期状态。此外，将在时间1从Ps的母亲获得父母精神病理学和父母认知脆弱性的评估。最后，父母的教养方式和父母的推理反馈的信息将获得从Ps的母亲在时间1和每年。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的潜在机制，将建议采取干预措施，使其短路，并对年轻的成年人造成严重损害。具体而言，结果将建议青年抑郁症预防干预措施的最佳特征：确定青年目标，时机，心理或生物过程，目标，以及女孩与男孩和非洲裔美国人与白人的干预措施。公共卫生相关性：该应用程序的独特之处在于，它将提供一个主要的前瞻性研究，从综合认知能力-压力/遗传脆弱性-压力模型的角度，研究青少年抑郁症激增和性别差异的出现以及这两种发展现象背后的测试机制。此外，执行功能的发展轨迹有关的认知脆弱性抑郁症的起源，告知规范的青少年大脑和认知发展的知识，将进行检查。通过隔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预防抑郁症产生重大影响，特别是在最佳时机和目标领域（即，高认知和/或遗传风险）的干预措施，可以适当调整，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.