AMMERMAN SPINA BIFIDA STUDY

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。青少年脊柱裂表现出各种神经认知缺陷，被认为会影响心理社会适应。据信，高达40%和50%的人患有指示非语言学习障碍（NLD）的神经心理障碍，这反过来又与不良的社会适应和内化行为问题（例如，抑郁症）。一般来说，脊柱裂青少年在行为、社会和人格适应方面存在问题，尽管这一人群存在相当大的差异。这项研究（题为“学习和发展项目”）正在审查神经心理障碍的类型和严重程度，特别是NLD特征，与脊柱裂青少年的心理社会功能之间的关系。具体而言，招募了160名年龄在10-17岁之间的脊柱裂青少年及其家人。根据具体标准，他们被平均分为有民盟和无民盟的两类。青少年按性别平均分为四个年龄组（10-12岁、12-14岁、14-16岁、16-17岁）。在基线时，青少年完成一个全面的神经心理电池，将用于创建两个组，并更充分地阐明NLD的概况。在这个时候，父母和青少年也完成了儿童的心理社会功能和家庭适应的几项措施。18个月后，他们接受了一项跟踪评估，测量行为、社会和人格功能。在这两个评估点，青少年的老师完成了几项心理社会功能的措施。第三组75名患有NLD但没有脊柱裂或脑积水的青少年也被招募并在每个时间点给予相同的方案。最后，招募第四组75名无NLD或脊柱裂或脑积水的青少年作为对照组。本研究的主要目的是（1）对比四组，以确定青少年发展不同阶段的心理社会失调的差异模式，（2）确定NLD概况对随后的心理社会功能的预测效用，并确定NLD患者的心理社会问题是否随年龄增长而增加，（3）检验家庭功能是否调节神经心理损伤与心理社会适应之间的关系。本研究的结果将阐明脊柱裂青少年神经心理障碍和社会心理功能之间的因果关系，描述有助于早期识别和设计更有效干预措施的风险因素，并揭示青少年各年龄段的社会心理功能模式。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Adolescents with spina bifida exhibit a variety of neurocognitive deficits that are thought to impact psychosocial adjustment. It is believed that up to 40% and 50% have neuropsychological impairments indicative of nonverbal learning disability (NLD), which in turn is strongly associated with poor social adjustment and internalizing behavior problems (e.g., depression). In general, adolescents with spina bifida display problems in behavioral, social, and personality adjustment, although there is considerable variability in this population. This study (entitled the Learning and Development Project) is examining the relationship between type and severity of neuropsychological impairment, in particular the NLD profile, and psychosocial functioning in adolescents with spina bifida. Specifically, 160 adolescents with spina bifida between the ages of 10-17 years and their families are being recruited. They are divided equally between those with and without NLD using specific criteria. Adolescents are divided equally between four age groups (10-12, 12-14, 14-16, 16-17 years) and by gender. At baseline, adolescents complete a comprehensive neuropsychological battery, which will be used to create the two groups and more fully elucidate the NLD profile. At this time, parents and adolescents also complete several measures of the child's psychosocial functioning and family adjustment. Eighteen months later, they receive a follow-up assessment measuring behavioral, social, and personality functioning. At both assessment points, the adolescent's teacher completes several measures of psychosocial functioning. A third group of 75 adolescents with NLD, but without spina bifida or hydrocephalus, is also being recruited and administered the same protocol at each time point. Finally, a fourth group of 75 adolescents without NLD or spina bifida or hydrocephalus, is being recruited to serve as controls. Primary goals of the study are to (1) contrast the four groups to identify differential patterns of psychosocial maladjustment at different points in adolescent development, (2) determine the predictive utility of the NLD profile to subsequent psychosocial functioning, and to determine if psychosocial problems increase with age in those with NLD, and (3) test whether family functioning moderates the association between neuropsychological impairment and psychosocial adjustment. Results from this study will elucidate causal relationships between neuropsychological impairment and psychosocial functioning in adolescents with spina bifida, delineate risk factors that will contribute to early identification and the design of more effective interventions, and reveal patterns of psychosocial functioning across age in adolescence.