Conduct Disorder and Depression in Childhood

描述(申请人提供)：品行障碍(CD)和抑郁症 儿童期和青春期高度并存的情况。这种共病是 与几种不良后果的风险增加有关，包括社会 排斥、药物使用、焦虑症和自杀。然而，因为太多 这一领域现有的研究大多是在症状层面上进行的， 人们对相关的作用机制知之甚少 关于观察到的合并症比率。此外，一些看似合理的 替代方案获得。确定这些机制中的哪一个在起作用是可能的 需要应用几种策略，这些策略通常 至今仍在共病文献中使用。这些措施包括(A) 区分儿童期和青春期CD，(B)扩大 共病研究的范围包括生物学和生理学 措施，(C)产生和测试共病的机制理论，以及 (D)研究共病的发展及其相关症状 纵向的。在拟议的研究中，这些问题中的每一个都将 在一项包括儿童期发作的行为--精神障碍，抑郁， 共病(品行障碍+抑郁)，并控制青春期前，年龄 8-12。在这个年龄段内进行的研究是至关重要的，因为它代表着 犯罪、抑郁和药物使用不断升级的时期，这通常 同时发生的。根据情绪调节理论(Porges，1995)和 动机(Gray，1982a，1982b，1987a，1987b)，模式 参与者的心理生理反应将在 奖励、惩罚和社会威胁的条件。此外，广泛的 与父母进行家族史访谈，并对儿童进行测量 青少年犯罪、抑郁症状和吸毒都会被记录在案 三个一年的间隔。利用这些数据，以下具体目标将 追求：(1)阐明自主神经系统活动的模式 并通过评估适当的心理生理标记物来跨组 行为抑制(惩罚期间的电刺激反应)， 行为激活(奖励期间的心脏射血前期)和情绪 管理(社会威胁期间的呼吸性窦性心律失常)；(2)评估 在障碍内部和跨障碍的自主反应的发展轨迹， 并将这些轨迹与父母的背景特征和 育儿实践；以及(3)评估儿童的发展轨迹 物质使用模式，并研究自主神经的潜在调节作用 对父母和儿童使用之间的关系作出回应。获得的调查结果 应该进一步加深我们对CD、抑郁症、 和他们的共病，并可能有区别治疗的影响 抑郁的先证者，他们有和没有出现共同的CD。

DESCRIPTION (provided by applicant): Conduct Disorder (CD) and depression are highly comorbid conditions in childhood and adolescence. This comorbidity is associated with increased risk for several adverse outcomes, including social rejection, substance use, anxiety disorders, and suicide. However, because much of the extant research in this area has been conducted at the symptom level, relatively little is known about the mechanisms of action that are responsible for the observed rates of comorbidity. Moreover, a number of plausible alternatives obtain. Identifying which of these mechanisms is at work is likely to require the application of several strategies that have generally not been employed in the comorbidity literature to date. These include (a) distinguishing between childhood-onset and adolescent-onset CD, (b) expanding the scope of comorbidity research to include biological and physiological measures, (c) generating and testing mechanistic theories of comorbidity, and (d) studying the development of comorbidity and its associated symptoms longitudinally. In the proposed research, each of these issues will be addressed in a study including childhood-onset conduct-disordered, depressed, comorbid (conduct-disordered + depressed), and control preadolescents, ages 8-12. Studies conducted within this age range are critical, as it represents a period of escalating delinquency, depression, and substance use, which often co-occur. Following from theories of emotion regulation (Porges, 1995) and motivation (Gray, 1 982a, 1 982b, 1 987a, 1 987b), patterns of psychophysiological responding will be assessed in participants during conditions of reward, punishment, and social threat. In addition, extensive family history interviews with be conducted with parents, and measures of child delinquency, symptoms of depression, and substance use will be obtained at each of three one-year intervals. Using these data, the following Specific Aims will be pursued: (1) elucidate patterns of autonomic nervous system activity within and across groups through assessment of appropriate psychophysiological markers of behavioral inhibition (electrodermal responding during punishment), behavioral activation (cardiac pre-ejection period during reward), and emotion regulation (respiratory sinus arrhythmia during social threat); (2) assess developmental trajectories in autonomic responding within and across disorders, and relate these trajectories to parental background characteristics and parenting practices; and (3) assess developmental trajectories in child substance use patterns, and examine the potential mediating roles of autonomic responding in relations between parental and child use. Findings obtained should further our understanding of the autonomic substrates of CD, depression, and their comorbidity, and may have differential treatment implications for depressed probands who do and do not present with comorbid CD.