A Relationship Process Model of Individual Psychopathology

描述（由申请人提供）：在给定的一年中，大约四分之一的成年人患有某种形式的精神疾病，每年花费近1500亿美元用于治疗精神障碍;然而，只有一半的寻求精神病理学治疗的人实际上经历了临床显着的改善。拟议的研究的总体目标是开发和测试一个综合的理论模型，解释关键的风险因素如何相互作用，以促进发展过程中的内化（抑郁和焦虑）和外化（酒精使用）障碍，通过整合的关键组成部分的素质压力，内化，外化模型的精神病理学和一个可持续性压力适应模型的关系功能障碍。我的中心假设是，精神疾病的遗传脆弱性导致更大的环境压力和更差的关系功能，这反过来又有助于精神病理学的过程。拟议研究有5个具体目标，将在2项独立研究中进行测试。研究#1：目标1 - 2将在7年内对275对社区夫妇进行6次评估的样本中进行检查。第一个目的是解释全球关系不和谐和精神病理学症状之间的纵向关联，在前7年的婚姻，以确定在何种程度上亲密关系有助于精神病理学的发展过程。第二个目标是开发一个综合的概念框架，使用Kraemer等人。的标准来解释关系功能如何与遗传脆弱性和环境压力相互作用，以促进精神病理学症状的发展。第三个目标是确定特定的关系过程（例如，支持，冲突）有助于在目标2中开发的框架内发展内化和外化症状。研究#2：将在评估一次的临床样本（100例门诊患者）中检查目的4和5。第四个目标是使用Kraemer等人开发一个框架。的标准解释了全球关系功能如何与基因和压力相互作用，以有助于当前的精神病理学诊断。第五个目标是确定与寻求治疗的个体的并发内化和外化障碍相关的特定关系过程。将采用自我报告问卷和客观的半结构化访谈。这项拟议的研究是朝着我的长期目标迈出的第一步，即制定/加强针对抑郁症，焦虑症和酒精使用障碍的预防和治疗计划，并与公共卫生特别相关，因为它有可能减轻我们社会中精神疾病的负担。

DESCRIPTION (provided by applicant): Approximately 1 in 4 adults suffers from some form of mental illness in a given year, and almost $150 billion is spent annually on the treatment of mental disorders; however, only half of individuals seeking treatment for psychopathology actually experience clinically significant improvement. The overall objective of the proposed research is to develop and test an integrated theoretical model explaining how key risk factors interact to contribute to the developmental courses of internalizing (depression and anxiety) and externalizing (alcohol use) disorders, by integrating key components of diathesis-stress, internalizing, and externalizing models of psychopathology and a vulnerability-stress-adaptation model of relationship dysfunction. My central hypothesis is that genetic vulnerabilities for mental illness contribute to greater environmental stress and poorer relationship functioning, which in turn contribute to the course of psychopathology. There are 5 specific aims to the proposed research to be tested across 2 independent studies. Study #1: Aims 1 -2 will be examined in a sample of 275 community couples assessed 6 times over 7 years. The 1st aim is to explain the longitudinal associations between global relationship discord and psychopathology symptoms over the first 7 years of marriage, to determine the extent to which intimate relationships contribute to the developmental course of psychopathology. The 2nd aim is to develop an integrated conceptual framework using Kraemer et al.'s criteria to explain how relationship functioning interacts with genetic vulnerabilities and environmental stress to contribute to the development of psychopathology symptoms. The 3rd aim is to identify the specific relationship processes (e.g., support, conflict) contributing to the development of internalizing and externalizing symptoms within the framework developed in Aim 2. Study #2: Aims 4 and 5 will be examined in a clinical sample (100 outpatients) assessed once. The 4th aim is to develop a framework using Kraemer et al.'s criteria that explains how global relationship functioning interacts with genes and stress to contribute to current diagnoses of psychopathology. The 5th aim is to identify the specific relational processes associated with concurrent internalizing and externalizing disorders for treatment-seeking individuals. Self-report questionnaires and objective semi-structured interviews will be implemented. The proposed research is the first step toward my long-term goal to develop/enhance prevention and treatment programs targeting depression, anxiety, and alcohol use disorders and has particular relevance to public health given its potential to reduce the burden of mental illness in our society.