Conduct Disorder & Depression in Girls: Precursors, Development and Comorbidity

品行障碍

• 批准号: 8078320
• 负责人: ROLF LOEBER
• 金额: $ 27.9万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-30 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8078320
• 关键词: Address; Adolescence; Adolescent; African American; Age; Aggressive behavior; Alcohol or Other Drugs use; American; Anxiety; Area; Assertiveness; Attention deficit hyperactivity disorder; Basic Behavioral Science; Behavior; Behavioral Symptoms; Biological; Body Image; Borderline Personality Disorder; Childhood; Clinical Research; Cognition; Communities; Comorbidity; Conduct Disorder; DSM-IV; Data; Deltastab; Depressive disorder; Development; Devices; Disease; Dysthymic Disorder; Early identification; Emotional; Esthesia; European; Family; Fathers; Feeling suicidal; Female; Female Adolescents; Funding; Gender; Impairment; Income; Individual; Individual Differences; Intervention; Knowledge; Lead; Link; Longitudinal Studies; Major Depressive Disorder; Maps; Mediating; Mental Depression; Minor; Modeling; Mood Disorders; Morbidity - disease rate; Mothers; National Institute of Mental Health; Neighborhoods; Participant; Pathway interactions; Pattern; Phase; Phenotype; Post-Traumatic Stress Disorders; Prevention; Prevention program; Preventive; Preventive Intervention; Problem behavior; Prospective Studies; Psychopathology; Research; Risk; Sampling; Schools; Screening procedure; Self-control as a personality trait; Somatization Disorder; Strategic Planning; Subgroup; Symptoms; Syndrome; Testing; Violence; Woman; base; burden of illness; depressive symptoms; disorder risk; early childhood; early onset; girls; high risk; high risk sexual behavior; informant; minor depressive disorder; peer; public health relevance; satisfaction; social; social cognition; trait; young adult

DESCRIPTION (provided by applicant): Preventive interventions depend in large part on the availability of reliable and specific information about the development of psychopathology. Three of the priority areas for clinical research identified in the 2007/2008 NIMH Strategic Plan are the 1) prediction of individuals at risk for developing disease; 2) personalization of knowledge about individual biological, environmental and social factors to better personalize interventions; and 3) participation of the diversity of people and settings in clinical research The Pittsburgh Girls Study (PGS), a large-scale (n=2,451), longitudinal study of a representative, urban sample of African American and European American girls, is uniquely poised to illuminate each of these topic areas as they pertain to Conduct Disorder (CD) and Major Depressive Disorder (MDD): two disorders that generate the greatest amount of morbidity among adolescent females and contribute the largest portion to the global burden of disease among women (Murray & Lopez. 1997). In particular, the PGS aims to predict female CD and MDD by building developmental models of risk and protection from the early identification of individual vulnerabilities that serve as childhood precursors to disorders, and the contexts in which such vulnerabilities are more likely to lead to disorder, by operationalizing sub-syndromal phenotypes of disorders, and by examining developmental changes in the pattern of comorbid conditions. Prediction will be based on multiple annual assessments of this racially and economically diverse sample with high rates of participant retention (average of 94 percent over 7 waves). Thus far, we have generated data on the onset, stability and developmental course of DSM-IV symptoms for CD and MDD and a broad range of other disorders. We also have assessed potential moderating and mediating factors on the development of symptomatology in girls. We are seeking funds to continue this prospective study through adolescence with five annual assessments of the girls and their mothers and fathers. The girls will be aged 13-16 in wave 1, and aged 17-20 years in wave 5. The planned assessments, when linked to the developmental data already collected during childhood, will elucidate precursors to CD and MDD in adolescence, their sub-syndromal phenotypes, common patterns of comorbidity, and risk, promotive and protective factors associated with transitions from precursor, to sub-syndrome, to disorder, and to comorbid disorders. The study is relevant for understanding ethnic disparities in the manifestation of CD and MDD and can serve as a building block for personalized, preventive and remedial treatments to be developed for specific subgroups of girls at risk of CD, MDD, their co-occurrence, and comorbidity with other disorders. PUBLIC HEALTH RELEVANCE: The proposed study will provide information on specific emotional and behavioral problems assessed in young girls that are markers for later serious problems in adolescence and young adulthood. The study also examines family, peer, school, and neighborhood factors that increase or reduce these risks. The diversity of the participants in this community sample (e.g. equal numbers of African American and European American girls, broad range of income levels) will allow information to be gathered about early and ongoing risks and problems that are more important for different subgroups, which can serve as building blocks for screening devices and the prevention of adolescent emotional and behavioral problems.

描述（由申请人提供）：预防性干预在很大程度上取决于关于精神病理学发展的可靠和具体信息的可用性。在2007/2008年NIMH战略计划中确定的临床研究的三个优先领域是：1)预测有患病风险的个体；2)对个体生物、环境和社会因素的个性化知识，以更好地个性化干预；匹兹堡女孩研究（PGS）是一项大规模（n= 2451）的纵向研究，对非洲裔美国人和欧洲裔美国女孩的代表性城市样本进行了研究，它以独特的方式阐明了这些主题领域，因为它们与品行障碍（CD）和重度抑郁症（MDD）有关。这两种疾病在青春期女性中发病率最高，在全球妇女疾病负担中占最大比例（Murray & Lopez， 1997年）。特别是，PGS旨在通过建立风险和保护的发育模型来预测女性CD和MDD，从早期识别个体脆弱性作为疾病的前兆，以及这些脆弱性更有可能导致疾病的背景，通过操作疾病的亚综合征表型，并通过检查共病条件模式的发育变化。预测将基于对这些种族和经济多样化样本的多次年度评估，这些样本的参与者保留率很高（7波平均为94%）。到目前为止，我们已经获得了关于CD和MDD以及其他广泛疾病的DSM-IV症状的发病、稳定性和发展过程的数据。我们还评估了女孩症状发展的潜在调节和中介因素。我们正在寻求资金将这项前瞻性研究持续到青春期，每年对女孩及其父母进行五次评估。第一阶段的女孩年龄在13-16岁之间，第五阶段的女孩年龄在17-20岁之间。计划中的评估，当与儿童时期已经收集的发育数据相结合时，将阐明青春期CD和MDD的前兆，它们的亚综合征表型，共病的常见模式，以及从前兆、亚综合征、障碍和共病障碍转变的风险、促进和保护因素。该研究有助于理解乳糜泻和重度抑郁症表现的种族差异，并可为针对有乳糜泻、重度抑郁症、其共发及与其他疾病共发风险的特定亚组女孩开发个性化、预防和补救治疗提供基础。公共卫生相关性：拟议的研究将提供关于评估年轻女孩的特定情绪和行为问题的信息，这些问题是青春期和成年早期严重问题的标志。该研究还调查了家庭、同伴、学校和社区因素，这些因素会增加或减少这些风险。该社区样本参与者的多样性（例如，非洲裔美国人和欧洲裔美国女孩的数量相等，收入水平范围广泛）将允许收集有关早期和持续的风险和问题的信息，这些信息对不同的亚群体更重要，这些信息可以作为筛选设备和预防青少年情绪和行为问题的基础。