Emotion Regulation in Children of Parents with Bipolar Disorder

NIMH指导以患者为导向的研究职业发展(K-23)奖的目的 应用程序是为了支持我长期的职业目标，即整合创新的神经成像技术 以及情绪调节机制，以了解双相情感障碍(BD)的神经发育。我的 之前的培训是现象学和磁共振成像(MRI)形态计量分析 有患BD的家庭风险的儿童。先前双相神经影像研究的一个局限性 子代是对潜在的潜在情绪调节机制的不充分评估 易受伤害的人群，独立于与疾病发病相关的混淆，如共生精神疾病 条件、药物暴露和物质使用。因此，为了实现我的职业目标最大化 活体神经成像技术在高危临床人群中的应用，我建议获得专业知识 整合情绪调节和调节障碍的儿科研究，功能性(FMRI)，磁学 共振光谱学(MRS)、统计分析和参与研究的伦理行为 课程作业、教学读物、指导和体验式学习活动，以补充建议的 研究活动。BD是一种流行的终身进行性疾病，通常始于青春期或 成人期早。BD的一个主要症状是情绪失调。大脑和小脑区域，包括 前额叶皮质、腹侧纹状体、杏仁核、海马体和小脑蠕虫已被显示为 调节患有BD的儿童和青少年的情绪过程，并面临BD的家庭风险。我的短期 目标是应用功能磁共振成像和磁共振波谱，结合在 情感神经科学，阐明情绪调节的功能和神经化学基础 青春期前儿童有患BD的家庭风险。在这个项目中获得的数据将为未来 进行纵向研究，以促进我们对以下风险和保护因素的了解 参与了这种疾病的发展。拟议的综合研究和培训方案， 再加上斯坦福大学强大的研究环境，将把我培养成一名 BD神经发育领域的独立研究员。 相关性(请参阅说明)： 尽管在儿童双相情感障碍(BD)的识别方面有了重大改进，但关键指标 在过去十年中，治疗反应和结果保持不变或恶化。vt.给出 青年BD的临床诊断率不断提高，显然需要新的概念方法 在这些人群中取得有利的长期结果。拟议的研究将有助于 确定可改变的BD风险因素，以预防儿童及其家庭的不良后果。

The purpose of this NIMH Mentored Patient-Oriented Research Career Development (K-23) Award application is to support my long-term career objective of integrating innovative neuroimaging techniques and mechanisms of emotion regulation to understand the neurodevelopment of Bipolar Disorder (BD). My previous training is in the phenomenology and Magnetic Resonance Imaging (MRI) morphometric analyses of children at familial risk for developing BD. One limitation of previous neuroimaging studies in bipolar offspring is the inadequate assessment of the potential underlying mechanisms of emotion regulation in this vulnerable cohort, independent of confounds associated with illness onset, such as co-occurring psychiatric conditions, medication exposure, and substance use. Therefore, to achieve my career goal of maximizing the application of in vivo neuroimaging techniques to at-risk clinical populations, I propose to gain expertise integrating pediatric investigations of emotion regulation and dysregulation, functional (fMRI), magnetic resonance spectroscopy (MRS), statistical analyses, and the ethical conduct of research by participating in course work, didactic readings, mentoring, and experiential learning activities that complement the proposed research activities. BD is a prevalent, life-long, progressive disease that typically begins in adolescence or early adulthood. A cardinal symptom of BD is emotion dysregulation. Brain and cerebellar regions, including the prefrontal cortex, ventral striatum, amygdala, hippocampus, and cerebellar vermis have been shown to modulate emotional processes in children and adolescents with, and at familial risk for, BD. My short-term goal is to apply fMRI and MRS, in conjunction with reward and information-processing paradigms used in affective neuroscience, to elucidate the functional and neurochemical bases for emotion regulation in preadolescent children at familial risk for developing BD. Data obtained in this project will inform future longitudinal studies to facilitate the advancement of our understanding of risk and protective factors that are involved in the development of this illness. The proposed integrated research and training programs, together with the strong research environment of Stanford University, will foster my development into an independent investigator in the field of the neurodevelopment of BD. RELEVANCE (See instructions): Despite major improvements in the identification of pediatric bipolar disorder (BD), key indicators of treatment response and outcome have remained unchanged or worsened over the past decade. Given increasing rates of clinical diagnosis of BD in youth, it is clear that new conceptual approaches are required to achieve gains in favorable long-term outcomes in these populations. The proposed research will help to identify modifiable risk factors for BD that could prevent adverse outcomes for children and their families.