Predictors of Social Dysfunction in Adolescents at Risk for Schizophrenia

描述(申请人提供)：本研究的目的是研究青少年(14-17岁)精神分裂症患者的一级亲属(HR-SZ)的面部情绪识别缺陷和社会威胁敏感性的作用，以更好地了解社会功能障碍和亚阈值精神病症状。40%-75%的HR-SZ青少年有资格获得重大精神健康诊断，4%-22%的青少年最终将发展为精神障碍。社会功能障碍是预测哪些HR-SZ人群会患上精神分裂症的关键标志；然而，人们对青春期后期功能障碍的具体途径知之甚少。面部情感识别缺陷，即难以破译他人面部情感的缺陷 在HR-SZ人群中存在，并预测精神病和社交功能障碍。对社会威胁的敏感性也可能是精神病风险的重要标志和社会功能障碍的预测指标，因为初步证据表明，HR-SZ青少年报告在日常生活中对威胁更敏感，并具有心脏自主神经反应的“高敏感”模式，其特征是在暴露于威胁后较慢地恢复到基线心率变异性模式。这项拟议的研究将考察在三个时间点：基线、6个月后和1年后，对社会威胁的过度敏感(通过心脏心理生理学评估)和面部情感识别缺陷是否会使HR-SZ青少年比对照组更容易出现症状增加和社交功能障碍的模式。对社会威胁的敏感性和面部情感识别缺陷是精神分裂症患者及其亲属的特征，但不是他们所特有的；这些领域已被确定为NIMH研究领域标准(RDocs)，因此拟议的研究应该与跨越诊断边界的精神病理学的研究相关。这项拟议的研究还将首次使用生态瞬时评估(EMA)来检查HR-SZ青少年日常生活中的社交功能障碍和亚阈值精神病症状。从拟议资助期的第二年开始，EMA方法将与动态心率变异性相结合，以检查自主功能的日常生活测量与实验室评估的基线对社会威胁和行为EMA反应的敏感度之间的关系。为了恰当地评估她的研究问题，候选人将接受典型和前驱青少年发育的社会和神经生物学方面的培训，纵向研究设计和数据分析，以及通过实验室和动态心血管反应评估威胁的心理生理反应。她的指导团队在发展精神病理学(Silk博士)、导致精神分裂症风险的发育过程(Haas和Walker博士)、高级纵向数据分析(Molenaar博士)和心率变异性评估(Jennings博士)方面拥有丰富的经验。通过调查HR-SZ青少年社交功能障碍和症状的认知和情感基础，拟议的奖项应该为寻求改善早期识别和干预以预防精神障碍和其他精神病理学的未来研究提供有用的目标。

DESCRIPTION (provided by applicant): The goal of this research is to study the role of facial affect recognition deficits and social threat sensitivity in a sample of adolescent (ages 14-17) first-degree relatives of people with schizophrenia (HR-SZ) in order to better understand social dysfunction and sub-threshold symptoms of psychosis. 40-75% of HR-SZ adolescents qualify for a major mental health diagnosis and 4-22% will eventually develop a psychotic disorder. Social dysfunction is a key marker for predicting which HR-SZ people will develop schizophrenia; however, little is known about specific pathways to dysfunction during late adolescence. Facial affect recognition deficits, difficulty decoding facial emotions in others, are present in HR-SZ people and predict psychosis and social dysfunction. Sensitivity to social threat may also be an important marker of psychosis risk and predictor of social dysfunction, as preliminary evidence suggests that HR-SZ adolescents report greater sensitivity to threat in daily life and have a "hypersensitive" pattern of cardiac autonomic responding characterized by slower return to baseline heart rate variability pattern after exposure to threats. The proposed study will examine whether excessive sensitivity to social threat (assessed through cardiac psychophysiology) and facial affect recognition deficits predispose HR-SZ adolescents to a pattern of increasing symptoms and social dysfunction compared to controls over three time points: baseline, 6 months later, and 1 year later. Sensitivity to social threat and facial affect recognition deficits are characteristic of those with schizophrenia and their relatives but not specific to them; these domains have been identified as NIMH Research Domain Criteria (RDocs), and thus the proposed research should have relevance to the study of psychopathology across diagnostic boundaries. The proposed study would also provide the first-known use of ecological momentary assessment (EMA) to examine social dysfunction and sub-threshold symptoms of psychosis in daily life for HR-SZ adolescents. Starting the second year of the proposed funding period, EMA methods will be combined with ambulatory heart rate variability to examine how daily life measures of autonomic functioning relate to baseline laboratory-assessed sensitivity to social threat and behavioral EMA responses. To appropriately evaluate her research questions, the candidate will receive training in social and neurobiological aspects of typical and prodromal adolescent development, longitudinal study design and data analysis, and assessing psychophysiological response to threat with laboratory and ambulatory cardiovascular responding. Her mentorship team has extensive experience in developmental psychopathology (Dr. Silk), developmental processes contributing to risk for schizophrenia (Drs. Haas and Walker), advanced longitudinal data analysis (Dr. Molenaar), and heart rate variability assessment (Dr. Jennings). By investigating cognitive and affective underpinnings of social dysfunction and symptoms in HR-SZ adolescents, the proposed award should provide useful targets for future research seeking to improve early identification and interventions to prevent psychotic disorders and other psychopathology.