Biobehavioral Trajectories of Social Anxiety from Early to Middle Adolescence

青春期早期到中期社交焦虑的生物行为轨迹

• 批准号: 10019719
• 负责人: Kristin A Buss
• 金额: $ 8.15万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-17 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10019719
• 关键词: Address; Adolescence; Adolescent; Adult; Age; Anxiety; Attention; Behavior; Behavioral; Behavioral inhibition; Benign; Biological; Biological Markers; Biology; Child; Child Rearing; Childhood; Classification; Clinical; Development; Developmental Course; Developmental Process; Diagnosis; Diagnostic; Dimensions; Electroencephalography; Endocrine; Etiology; Evoked Potentials; Foundations; Fright; Functional disorder; Growth; Heterogeneity; Hydrocortisone; Impairment; Individual; Individual Differences; Link; Literature; Longitudinal Studies; Measures; Mental Depression; Methods; Modeling; National Institute of Mental Health; Negative Valence; Neurobiology; Neurosecretory Systems; Outcome; Pathway interactions; Pattern; Physiological; Predisposition; Prevalence; Process; Psychopathology; Psychophysiology; Puberty; Reporting; Research Domain Criteria; Risk; Risk Factors; Sampling; School-Age Population; Sex Differences; Sexual Maturation; Shapes; Social Anxiety Disorder; Social Development; Social Functioning; Symptoms; System; Temperament; Testing; Toddler; Translating; Treatment Effectiveness; Variant; Work; Youth; anxiety symptoms; anxious; anxious behavior; associated symptom; attentional bias; base; biobehavior; boys; clinical anxiety; cognitive system; comorbidity; contextual factors; disorder risk; early adolescence; girls; high risk; high school; junior high school; longitudinal design; neural circuit; peer; prospective; recruit; relating to nervous system; social; social anxiety; social situation; stem; symptomatology

Social Anxiety Disorder (SAD) is among the most common forms of pediatric psychopathology. These symptoms are associated with significant impairment encompassing familial, social and academic domains, and they are often comorbid with other internalizing symptoms (e.g., depression) especially in adolescence and into adulthood. Efforts to address the burden of SAD suffer from the limited understanding of its underlying pathophysiology. SAD symptoms peak in adolescence making this developmental transition an important period to study. However, considerable heterogeneity in symptomatology, risk factors, and underlying biology exists across anxious adolescents, which has implications for (1) understanding the developmental etiology of who is at highest risk, (2) identifying individual profiles of symptom course, (3) matching treatments to symptom patterns and (4) determining for whom these treatments are most effective. A substantial clinical literature exists focused on anxiety problems in children and adolescents examining clinical features with little focus on developmental processes and biological mechanisms. In contrast, the developmental literature is dominated by a temperament approach whereby extreme fearful temperament is our strongest individual differences predictor of anxiety. Exclusive focus on either model creates a barrier to progress in the field. Specifically, (1) identification of anxiety problems is typically diagnostic, with classification based solely on reported anxious behavior (rather than convergent information from different types of measures to predict a dimensional outcome); (2) we have a limited understanding of the underlying processes linking fearful temperament and anxiety across development; (3) most anxiety in children is benign, yet we lack methods to separate the true cases from false positives; and (4) although early temperament variation is ideal for identifying risk and potential mechanisms, we know little about how variation in temperament influences symptom course and effectiveness of treatments. The current study will employ a longitudinal design including continuation of a sub- sample followed since 24-months and characterized for fearful temperament. We add to this addition youth recruited for a range of SAD symptoms. Together this sampling will capture a wide range of anxiety symptom presentation (i.e., low risk, temperamental risk, and clinical anxiety). We will follow adolescents (N = 240) annually across the transitions to middle- and high-school – ages 13, 14, 15, & 16 years. We will implement a rich assessment of anxiety symptoms, temperament, attention bias, endocrine (cortisol), physiological (RSA) and neurobiological (N1, P2, N2 evoked potentials of attention) processes. This multi-method approach aligns with the NIMH objective 2.2 to identify biomarkers and behavioral indicators of illness trajectories and explicitly tests components of the Research Domain Criteria (RDoC). Specifically, we will examine the development of the Negative Valence System of Potential Threat (“anxiety”), and the Cognitive System of Attention across multiple units of analysis including behavioral, physiological, and neural circuits.

社交焦虑障碍(SAD)是儿科精神病理学最常见的形式之一。这些 症状与家庭、社会和学术领域的重大损害有关， 它们通常与其他内在性症状(如抑郁症)共存，尤其是在青春期 并进入成年期。解决SAD负担的努力由于对其根本原因的了解有限而受到影响 病理生理学。悲伤症状在青春期达到顶峰，这使得这种发育转变成为一个重要的 学习的时间段。然而，在症状、危险因素和潜在生物学方面存在相当大的异质性 在焦虑的青少年中存在，这对于(1)理解焦虑的发展病因学具有重要意义 谁是风险最高的人，(2)确定症状过程的个人概况，(3)将治疗与症状相匹配 模式和(4)确定这些治疗对谁最有效。一部丰富的临床文献 专注于儿童和青少年的焦虑问题，检查临床特征，而很少关注 发育过程和生物学机制。相比之下，发展性文学则由 一种气质方法，即极端可怕的气质是我们最大的个体差异 焦虑的预报者。只专注于这两种模式中的任何一种，都会给该领域的进步制造障碍。具体来说，(1) 焦虑问题的识别通常是诊断性的，分类仅基于报告的焦虑 行为(而不是来自不同类型的度量的收敛信息来预测维度 结果)；(2)我们对恐惧气质和恐惧的潜在过程的理解有限 (3)儿童的焦虑大多是良性的，但我们缺乏区分真实焦虑的方法 假阳性的病例；以及(4)尽管早期的气质变化是识别风险和 潜在的机制，我们对气质的变化如何影响症状进程和 治疗的有效性。目前的研究将采用纵向设计，包括分部的延续 样本跟踪了24个月，以可怕的气质为特征。我们为这件事增添了青春 因一系列忧郁症症状而被招募。这一抽样将捕捉到广泛的焦虑症状 表现(即低风险、易怒风险和临床焦虑)。我们将跟踪调查青少年(N=240)。 每年过渡到初中和高中--13岁、14岁、15岁和16岁。我们将实施一个 丰富的焦虑症状、气质、注意力偏向、内分泌(皮质醇)、生理(RSA)评估 以及神经生物学(N1、P2、N2注意诱发电位)过程。这种多方法的方法符合 NIMH目标2.2确定疾病轨迹的生物标记物和行为指标，并明确 测试研究领域标准(RDoC)的组成部分。具体地说，我们将研究 潜在威胁的负值系统(“焦虑”)和注意的认知系统 多个分析单元，包括行为、生理和神经回路。