Digital Phenotyping To Screen For Early Childhood Internalizing Disorders

摘要 儿童期的焦虑和抑郁是常见的，有害的，并有可能破坏发展良好 长大成人儿科医生需要心理健康筛查工具，以满足这些内化的流行 儿童早期的疾病我们已经开发出一种很有前途的数字健康方法来检测运动 和语言表型的内化障碍的幼儿。我的长期目标是创作一部小说 大规模筛查幼儿内化障碍的技术。我的短期目标是 利用我最初的方法和我提出的培训课程，创建一个原型移动的健康 （mHealth）应用，其提供复合数字表型以检测儿童内化障碍。 我的具体目标是（1）评估一个新的mHealth系统测量的数字表型的有效性， 识别幼儿的内化障碍，以及（2）发展复合数字表型， 儿童期内化障碍涉及研究领域标准（RDoC）的多个结构， 识别调节RDoC结构变量。如果成功，这些mHealth启用数字表型可能是 用于促进NIMH健康计划，以便更好地跟踪内化心理健康的变化 儿童期的地位，并支持与儿科建立新的和创新的研究实践伙伴关系， 改善循证精神健康筛查的传播。同样，这种方法满足了一种需求， 美国儿科学会确定的新工具，筛选行为和情绪 问题70名4至8岁的儿童，因内化障碍而被过度采样， 这项研究从一所大学的儿科和儿童心理健康服务中心招募了100名儿童， 为佛蒙特州和纽约北部提供服务的医疗中心。他们将被管理情绪 归纳任务设计为按下RDoC负价和正价结构，同时使用 一款带着腰带的智能手机，支持原型mHealth应用程序。复合数字表型将是 基于使用数据机器学习训练的统计分类模型， 在执行任务的过程中。为了作为独立调查员开展这项工作，我建议进行一次强化培训， 课程，以获得数字表型的基础技能。培训内容包括：（1）发展 流行病学，通过公共卫生透镜更好地研究早期儿童精神病理学，以及（2a）移动的 应用程序开发，以便与应用程序开发人员进行有效沟通（2b）分析复杂系统，包括 机器学习方法，（2c）有关数字精神病学的伦理和社会问题。完成这些 培训和研究目标将为我提供技能和证据，以开发一个易于管理的数字 健康技术，用于在短期内识别患有内化障碍的幼儿，并在长期内，成功地为数字健康的新兴领域做出贡献的能力，以改善 儿童心理健康。

ABSTRACT Childhood anxiety and depression are common, impairing, and have the potential to disrupt development well into adulthood. Pediatricians need mental health screening tools to meet the prevalence of these internalizing disorders early in childhood. We have developed a promising digital health approach for detecting movement and speech phenotypes of internalizing disorders in young children. My long-term goal is to create a novel technology for screening young children for internalizing disorders at scale. My short term objective is to leverage my original approach and my proposed training curriculum to create a prototype mobile health (mHealth) application that provides a composite digital phenotype to detect childhood internalizing disorders. My specific aims are to (1) evaluate the validity of digital phenotypes measured by a novel mHealth system for identifying internalizing disorders in young children and (2) develop a composite digital phenotype for childhood internalizing disorders involving multiple constructs from the Research Domain Criteria (RDoC) and identify moderating RDoC construct variables. If successful, these mHealth enabled digital phenotypes may be used to further NIMH health initiatives of enabling better tracking of changes in internalizing mental health status across childhood and supporting new and innovative research-practice partnerships with pediatrics to improve dissemination of evidence-based mental health screening. Similarly, this approach answers a need identified by the American Academic of Pediatrics for new tools that screen for behavioral and emotional problems. Seventy children between the ages of 4 and 8 years, oversampled for internalizing disorders, will be recruited for this study from pediatric and childhood mental health services at a university-based regional medical center that services the state of Vermont and upstate New York. They will be administered mood induction tasks design to press for RDoC Negative and Positive Valence constructs, while instrumented with a belt-worn smartphone enabled with the prototype mHealth application. A composite digital phenotype will be developed across constructs based on statistical classification models trained using machine learning on data captured during the tasks. To carry out this work as an independent investigator, I propose an intensive training curriculum to gain foundational skills in digital phenotyping. It includes training in (1) developmental epidemiology to better research early childhood psychopathology through a public health lens, and (2a) mobile app development to communicate effectively with app developers (2b) analysis of complex systems including machine learning approaches, (2c) ethical and societal issues regarding digital psychiatry. Completion of these training and research aims will provide me the skills and evidence to develop an easily administered digital health technology for identifying young children with internalizing disorders in the short-term, and in the long term, the ability to successfully contribute to the emerging field of digital health for the purpose of improving childhood mental health.