Understanding Mental Health in Neurodevelopmental Conditions: A Hidden Talents Approach

神经发育疾病（ndc），如自闭症、多动症和发育协调障碍是影响约10%人口的终身疾病（Emerging Minds， 2021年）。它们与各种心理健康困难的发生率很高（Emerging Minds 2021）。自闭症本身比癌症、中风和心脏病加起来还要昂贵（Buescher et al.， JAMA），然而相对于其他疾病，在国家自主贡献上的研究支出很少（例如，每个自闭症成年人6.60英镑，而每个癌症患者295英镑（自闭症，2014））。包括博士培训在内的资金不足，在理解国家自主贡献方面留下了两个特别的空白，这将在本项目中解决。首先，尽管神经发育特征在人群中重叠且持续分布，但对ndc的研究过于关注单一条件（Thapar et al., Lancet Psychiatry）。研究表明，患有ndc的个体更常见的情况是患有一种以上的疾病，而不是“纯粹的”疾病（Rutter, 2008）。因此，人们呼吁研究人员在研究ndc时开发跨诊断方法，而不是专注于离散的类别（Astle等人，2021;Emerging Minds, 2021）。其次，假设NDC相关症状和逆境（如欺凌）可预测认知和心理健康状况不佳。然而，之前的研究忽略了适应性发展过程有时如何增强认知，从而减少精神疾病。这最近被正式定义为“隐藏人才”方法（Frankenhuis et al., 2020, TiCS）。利用以人口为基础的数据和以认知为基础的隐性人才方法，这一跨学科项目将确定国家自主贡献中的隐性人才，从而为了解和干预改善国家自主贡献中的心理健康提供信息。研究1：一项在线定性调查研究，探讨青少年和成人ndc的生活经验，重点关注他们的才能和应对。研究2-4的主题和发现将为变量选择和建模提供信息。研究2-4-3项在青少年大脑认知发展队列中利用遗传、神经影像学和认知数据的研究；abcdstudy.org。这是美国最大的以人群为基础的神经认知和健康研究（N~12K），采用了几种重叠ndc和心理健康的测量方法。分析将侧重于发现隐藏的才能，即与ndc和相关逆境呈正相关的神经和认知标记。然后，我们将使用遗传敏感的纵向分析来测试这些隐藏的才能是否调节了ndc、相关逆境和后来的心理健康结果之间的关联。在确定国家自主贡献中隐藏的才能时，研究结果将能够为理解和干预改善神经发育条件下的心理健康提供信息。大多数关于国家自主贡献的研究都集中在单一条件上，因此该项目将提供对条件之间重叠的见解。研究结果将提交给临床医生和慈善合作伙伴，从而增加研究结果为临床实践和国家政策提供信息的可能性。本研究与GW4 BioMed MRC战略研究主题“人口健康”相关。

Neurodevelopmental conditions (NDCs) such as Autism, ADHD and Developmental Coordination Disorder are lifelong conditions which affect around 10% of the population (Emerging Minds, 2021). They have high co-occurrence with various mental health difficulties (Emerging Minds 2021).Autism alone is more costly than cancer, stroke, and heart disease, combined (Buescher et al., JAMA), yet there is little research spending on NDCs relative to other conditions (for example £6.60 per autistic adult vs £295 per cancer patient (Autistica, 2014)). Such underfunding, including PhD training, has left two particular gaps in understanding NDCs, which will be addressed in this project.First, research on NDCs is overly focussed on single conditions even though neurodevelopmental traits are overlapping and continuously distributed in the population (Thapar et al., Lancet Psychiatry). Research suggests that it is more common for individuals with NDCs to have more than one condition rather than a 'pure' disorder (Rutter, 2008). Consequently there are calls for researchers to develop transdiagnostic approaches when researching NDCs rather than focusing on discrete categories (Astle et al., 2021; Emerging Minds, 2021).Second, it is assumed that NDC related symptoms and adversities (e.g., bullying) are predictive of poor cognition and mental health. However, previous research has neglected to consider how adaptive developmental processes sometimes enhance cognition and thereby could reduce mental illness. This has recently been formalised as the 'hidden talents' approach (Frankenhuis et al., 2020, TiCS). Drawing on population-based data and the cognitively grounded hidden talents approach, this cross-disciplinary project will identify hidden talents in NDCs and thereby inform understanding of and interventions for improving mental health in NDCs.Study 1-An online qualitative survey study to investigate the lived experience of adolescents and adults with NDCs focusing on their talents and coping. Themes and findings will inform variable selection and modelling in Studies 2-4. Studies 2-4-Three studies drawing on genetic, neuroimaging, and cognitive data in the Adolescent Brain Cognitive Development cohort; abcdstudy.org. This is the largest population-based study of neurocognition and health in the US (N~12K), with several measures of overlapping NDCs and mental health. Analyses will focus on uncovering hidden talents, i.e., neural and cognitive markers positively associated with NDCs and related adversities. We will then test if these hidden talents moderate the association between NDCs, related adversities, and later mental health outcomes, using genetically sensitive longitudinal analyses. In identifying hidden talents in NDCs, the findings will be able to inform understanding of and interventions for improving mental health in neurodevelopmental conditions. Most research on NDCs focuses on single conditions, and so this project will provide insight into overlaps between conditions. The results will be presented to clinicians and charity partners, thereby increasing the potential for the findings to inform clinical practice and national policy. This research is relevant to the GW4 BioMed MRC strategic research theme of 'population health'.