Intervening Early with Neglected Children: Key Behavioral and Neurobiological Outcomes in Adolescence

项目总结/摘要 父母是幼儿的共同调节者，帮助他们调节行为、情绪和行为。 生理学和支持健康的大脑回路的发展。忽视的父母往往不能作为 共同调节者，这对幼儿的自我调节能力和大脑发育有影响。 随着孩子年龄的增长，这些自我调节的困难可能会变得更加明显。青春期 这是一个特别容易出现心理健康问题的时期， 对情绪和行为调节的需求不断增加，加上神经系统的持续发展， 支持情绪和行为调节的回路。在这一竞争性更新中，我们建议遵循 进入青春期的儿童最初参加了一项依恋和依恋的随机临床试验设计， 生物行为追赶（ABC）作为婴儿，使我们能够实验评估可塑性和修改的 大脑回路和自我调节作为早期干预的结果。ABC干预旨在 帮助父母学会以敏感和敏感的方式互动，并期望孩子能表现出 增强调节行为、情绪和生理的能力。我们评估了ABC的疗效 参与儿童保护服务（CPS）的父母之间的干预。父母被随机分配到ABC或 进行控制干预在T1（1-4岁）和T2（8-10岁）对儿童进行随访。在T1， ABC组的儿童比DEF组的儿童发展了安全和有组织的依恋， ABC组的儿童表现出更多的皮质醇正常产生，较少的负面情绪表达， 在DEF中，ABC父母比儿童更敏感，表现出更优的抑制控制能力 神经活动比DEF父母。在T2，ABC儿童表现出更大的前额叶皮层激活， 与DEF儿童相比，他们对恐惧面孔的照片的反应更好，这表明在大脑水平上对威胁有更好的调节 activation.同样在T2，ABC组的孩子报告说与父母的关系更安全， 更规范的皮质醇生产和更优化的自主神经系统功能比DEF 孩子在青春期，ABC干预预计将导致增强大脑回路和更多 相对于控制干预的最佳功能。在拟议的研究中，我们将评估行为和 13岁、14岁和15岁青少年的神经生物学发育， CPS在婴儿期（n=120）和低风险青少年中进行随机临床试验， 儿童（n=80）。在每次年度评估中，主要的结构，抑制控制，情绪调节， 生理调节和依恋/联系，将在大脑激活和电路水平上进行评估， 以及行为层面的影响。

PROJECT SUMMARY/ ABSTRACT Parents serve as co-regulators for their young children, helping them regulate behaviors, emotions, and physiology and supporting the development of healthy brain circuitry. Neglecting parents often fail to serve as co-regulators, which has implications for young children’s self-regulatory capabilities and brain development. As children become older, these difficulties with self-regulation may become more pronounced. Adolescence represents a period of particular vulnerability for the emergence of mental health problems because of increasing demands for regulation of emotions and behaviors, coupled with on-going development of neural circuits that support emotional and behavioral regulation. In this competing renewal, we propose to follow children into adolescence who initially participated in a randomized clinical trial design of Attachment and Biobehavioral Catch-up (ABC) as infants, allowing us to experimentally assess plasticity and modification of brain circuits and self-regulation as the result of an early intervention. The ABC intervention was designed to help parents learn to interact in responsive and sensitive ways, with the expectation that children would show enhanced ability to regulate behavior, emotions, and physiology. We assessed the efficacy of the ABC intervention among parents involved with Child Protective Services (CPS). Parents were randomized to ABC or to a control intervention. Children were followed at T1 (ages 1-4) and T2 (ages 8-10). At T1, more of the children in the ABC group developed secure and organized attachments than children in the DEF group, and children in ABC showed more normative production of cortisol, less expression of negative emotions, and stronger inhibitory control than children in DEF. ABC parents were more sensitive and showed more optimal neural activity than DEF parents. At T2, ABC children showed greater prefrontal cortex activation in response to photographs of fearful faces than DEF children, suggesting better regulation to threat at the level of brain activation. Also at T2, children in the ABC group reported more secure relationships with parents, and showed more normative cortisol production and more optimal autonomic nervous system functioning than DEF children. In adolescence, the ABC intervention is expected to result in enhanced brain circuitry and more optimal functioning relative to the control intervention. In the proposed study, we will assess behavioral and neurobiological development among 13-, 14- and 15-year-old adolescents whose parents were referred by CPS to a randomized clinical trial in infancy (n=120), and among low-risk adolescents followed since middle childhood (n=80). At each annual assessment, the primary constructs, inhibitory control, emotion regulation, physiological regulation, and attachment/affiliation, will be assessed at the level of brain activation and circuitry, and at the behavioral level.