Risk for Child Psychopathology: A Twin-Study Perspective

描述(由申请人提供)：利用流行病学定义的纵向双胞胎研究的资源，我们检查了儿童精神病理学的发育过程和生物心理社会风险。在2岁和7岁现有筛查的基础上，我们在2岁、7岁和12岁时表征了与内在化(焦虑和抑郁)、外在化(对立和品行障碍)和ADHD发展相关的风险因素。我们的大多数高危病例都有资格被诊断为DSM-IV，但我们包括有亚临界值症状的个人和一大批对照组。具体目标包括确定风险因素的特征，分析遗传和环境影响，以及改进对儿童障碍的衡量和分类。“以儿童为基础”的风险因素包括早期症状、气质和应激反应、基础皮质醇和反应性皮质醇、睾酮和脱氢表雄酮、认知能力和归因方式，以及认知-情感处理技能。家庭和其他心理社会风险因素包括父母诊断和家庭精神病病史、双胞胎和双胞胎父母的社交方式、家庭压力的多个方面以及消极的育儿方式。我们采用的研究方法包括对照顾者和儿童的结构化诊断性访谈、医疗记录、观察者评分、儿童自我报告和父母报告问卷、录像的家庭行为电池和基于计算机的测试(主要是反应时间任务)。这项研究的意义在于了解已知的风险因素如何在遗传信息丰富的纵向设计中相互作用和/或中介对方对儿童精神病理学的影响。TWINE方法允许我们将指标之间的表型方差和协方差解析为遗传和环境成分，并对这些成分进行发展性研究。研究结果还应该加强我们对共病、障碍内的异质性以及障碍与特征之间的联系的理解。该项目的公共卫生意义在于它确定了常见儿童障碍的风险因素，并调查了这些因素如何在遗传和环境因素的背景下相互作用。所获得的知识应该有助于早期发现、改进干预措施和更好地对儿童障碍进行分类。

DESCRIPTION (provided by applicant): Using the resources of an epidemiologically defined, longitudinal twin study, we examine developmental course and biopsychosocial risks for childhood psychopathology. Building on existing screening at ages 2 and 7 years, we characterize risk factors at ages 2, 7, and 12 relevant to the development of internalizing (anxiety and depression), externalizing (oppositional and conduct disorder), and ADHD. Most of our at-risk cases qualify for a DSM-IV diagnosis, yet we include individuals with sub-threshold symptoms and a large control group. Specific aims include characterization of risk factors, analysis of genetic and environmental effects, and improved measurement and classification of childhood disorders. "Child-based" risk factors include earlier symptoms, temperament and stress reactivity, basal and reactive cortisol, testosterone and DHEA, cognitive abilities and attributional styles, and cognitive-affective processing skills. Family and other psychosocial risk factors include parental diagnosis and family history of psychopathology, twin-twin and twin-parent social interaction styles, multiple facets of family stress, and negative parenting. The research methods that we employ include structured diagnostic interviews with caregivers and children, medical records, observer ratings, child self-report and parent-report questionnaires, videotaped home-based behavioral batteries, and computer-based testing (mostly reaction time tasks). The study's significance lies in understanding how known risk factors interact and/or mediate each other's effects on child psychopathology in a genetically informative, longitudinal design. Twin methodology allows us to parse phenotypic variance and covariance among measures into genetic and environmental components, and the components are studied developmentally. The results should also enhance our understanding of comorbidity, heterogeneity within disorders, and the association of disorders with traits. The project's public health relevance lies in its identification of risk factors for common childhood disorders and its investigation of how they interact in the context of genetic and environmental factors. The knowledge gained should inform efforts toward early detection, improved interventions, and better classification of childhood disorders.