Generating an Earlier Science of When to Worry: A Neurodevelopmental, Transactional Approach to Characterizing Irritability Patterns Beginning in Infancy

项目摘要：易怒在婴儿期出现，是精神病理学的基础。然而， 可靠地识别易激婴儿是临床进展的高危因素，这是具有挑战性的，因为 随着时间的推移，易怒婴儿适应或不适应结果的个体差异。什么时候该担心 (W2W)研究利用神经发育框架来生成经验性派生的参数 区分标记临床风险的易怒模式。此行政补充请求支持 完成36个月的临床终点和成像亚样本评估，因新冠肺炎而推迟 干扰。主要创新是：(1)从#年开始的发育非典型易怒模式的规范 婴儿期；(2)对易怒、执行功能和前额叶皮质区域的联合发展考虑； (3)交易焦点。我们首先对一个有代表性的12-36个月的样本进行横断面调查。 老年人(N=2,000)。然后，我们确定了一个独立的社区队列(N=356名过度抽样的婴儿 易怒)，并进行纵向随访(12-36)。易怒评估是：(A)双月家长报告和 通过Lena的实时易怒发声；以及(B)每年直接观察行政人员的易怒 功能任务(12-36个月)对行政职能的绩效评估每年进行一次。36个月。 时间点是关键的临床终点，当学龄前儿童精神病理学得到很好的验证时。事务性的 这一过程是通过亲子相互调节过程进行评估的。具体目标：IA。差异化 从婴儿期-学龄前期到以人群为基础的发育非典型易怒模式 横断面参数(IAI)和定量纵向参数(IAII)。IB。指定 易怒的纵向参数以优化临床进展的预测。IIa-B地图 对执行功能成熟和发育障碍的非典型易怒模式 前额叶皮质(PFC)区域，并检验他们的联合考虑将增强这一假设 预测性临床实用价值。前额叶皮质成熟将在12&12岁时从婴儿自然睡眠中进行评估-MRI 36个月(n=50~75)。我们测试非典型易怒模式是否预示执行功能减慢 发育和异常的PFC解剖。IIIA-B阐明交易流程如何塑造临床 预测、检验亲子相互调节过程调节临床的假说 进步。在交易环境中指定易怒表型是预防的关键。这个 补充是完成数据收集以满足W2W研究关键目标的关键。

PROJECT SUMMARY: Irritability emerges during infancy as a substrate of psychopathology. However, reliable identification of irritable infants at high risk for clinical progression is challenging, due to substantial individual differences in adaptive or maladaptive outcomes for irritable infants over time. The When to Worry (W2W) study utilizes a neurodevelopmental framework to generate empirically derived, parameters for differentiation of irritability patterns that mark clinical risk. This administrative supplement request supports completion of the 36 month clinical endpoint and imaging sub-sample assessments, delayed due to COVID-19 disruptions. Key innovations are: (1) specification of developmentally atypical patterns of irritability beginning in infancy; (2) joint developmental consideration of irritability, executive function, and prefrontal cortical regions; and (3) transactional focus. We first conduct a cross-sectional survey of a representative sample of 12-36 mos. olds (N=2,000). We then ascertain an independent community cohort (N=356 infants oversampled for irritability), with longitudinal follow-up (12-36). Irritability assessments are: (a) bimonthly parent reports and real-time irritable vocalizations via the LENA; and (b) annual direct observations of irritability with executive function tasks (12-36 mos.) Performance-based assessments of executive function occur annually. The 36 mo. timepoint is the key clinical endpoint, when preschool psychopathology is well validated. Transactional processes are assessed via parent-infant mutual regulation processes. SPECIFIC AIMS: IA. Differentiate developmentally atypical irritability patterns from infancy-early preschool age via population-based parameters cross-sectionally (IAi) and quantitative longitudinal parameters (IAii). IB. Specify longitudinal parameters of irritability to optimize prediction of clinical progression. IIA-B. Map developmentally atypical irritability patterns to disruptions in the maturation of executive function and prefrontal cortical (PFC) regions and test the hypothesis that their joint consideration will enhance predictive clinical utility. Prefrontal cortical maturation will be assessed from infant natural sleep-MRI at 12 & 36 months (n=50-75). We test whether atypical irritability patterns predict slowed executive function development and abnormal PFC anatomy. IIIA-B. Elucidate how transactional processes shape clinical prediction, testing the hypothesis that parent-infant mutual regulation processes modulate clinical progression. Specification of irritability phenotypes in transactional context is key for prevention. The supplement is key for completing data collection to meet critical objectives of the W2W study.