Neurobehavioral assessments of RDoC domains to detect preschool mood disorders

描述(由申请人提供)：儿童情绪障碍是一个重大的公共卫生问题，6%至11%的人口患有症状。在受影响的人中，70%的人会在童年和/或青春期复发，50%的人会在成年后继续出现症状。这些慢性化的模式表明，在生命后期观察到的心理健康问题通常在童年早期具有可识别的标记。因此，及早识别和干预至关重要。美国国立卫生研究院提出了研究领域标准(RDoC)，通过建议对几个基于行为和生物学的过程进行调查，作为检验精神疾病机制的启发式方法。尽管RDoC提供了一个有价值的理论框架，但RDoC在发展精神病理学研究中的适用性一直是有限的，这主要是因为缺乏有效的、可行的、标准化的评估工具来检查幼儿的RDoC领域。我们的目标是创建和验证幼儿的行为和神经生物学评估，以检查RDoC领域(积极和消极的价值)与儿童抑郁和焦虑的相关性，这些儿童抑郁和焦虑经常发生在儿童抑郁和焦虑之前或与之混合。具体地说，我们将使用这些结构的行为和神经生理学相关性来研究奖励评估(正价值)和急性威胁(负价值)的结构，并测试这些结构与临床评估的4-6岁儿童抑郁和焦虑的相关性。通过密歇根大学精神病学系的婴儿和儿童早期诊所以及我们医疗系统中的普通儿科诊所进行招募，将确保我们研究中的儿童出现广泛的焦虑和抑郁症状，从临床到非临床范围。我们寻求NIH试点资金，以调查行为和神经生理学任务的可行性，这些任务将长期用于1)通知评估程序，将基础科学进步与患者及其家人的可及性相结合；2)改进我们对儿童焦虑和抑郁的潜在机制的表征；以及3)为后续干预提供信息，以解决个性化的儿童水平缺陷。由于NIMH认为RDoC标准的研究和未来的应用是高度优先的，因此研究结果将被证明具有很大的影响，然而，在幼儿中探索这种应用的经验数据很少。这项建议回应了对验证的、可行的和标准化的评估电池的迫切需求，以检查幼儿的RDoC领域，并代表了为患有抑郁和焦虑的学龄前儿童实现有效和基于机制的识别和治疗策略的长期计划的关键一步。

DESCRIPTION (provided by applicant): Childhood mood disorders represent a significant public health concern, with 6 to 11% of the population suffering from symptomology. Among those affected, 70% will have a recurrence during childhood and/or adolescence, and 50% will continue to experience symptoms in adulthood. These patterns of chronicity suggest that mental health problems observed later in life often have identifiable markers during early childhood. Therefore, early identification and intervention is critical. The NIH has put forth the Research Domain Criteria (RDoC), which acts as a heuristic to examine mechanisms of mental illness by suggesting the investigation of several behaviorally and biologically based processes. Although RDoC provides a valuable theoretical framework, the applicability of RDoC for developmental psychopathology research has been limited, primarily due to a lack of validated, feasible, standardized assessment batteries to examine RDoC domains in young children. Our aim is to create and validate behavioral and neurobiological assessments for young children in order to examine the relevance of RDoC domains, Positive and Negative Valence, for childhood depression and anxiety that often precedes or commingles with it. Specifically, we will study the constructs of reward valuation (Positive Valence) and acute threat (Negative Valence) using behavioral and neurophysiologic correlates of these constructs and test for associations with clinically assessed depression and anxiety in 4-6 year old children. Recruitment through the Infant and Early Childhood Clinic at the University of Michigan's Department of Psychiatry, as well as general pediatrics clinics in our health system, will ensure that a broad spectrum of anxiety and depressive symptoms, across the clinical to non-clinical range are represented in the children in our study. We seek NIH pilot funding to investigate the feasibility of behavioral and neurophysiology tasks that will long-term 1) inform assessment procedures, blending basic science advances with accessibility for patients and their families; 2) improve our characterization of underlying mechanisms of child anxiety and depression; and 3) inform subsequent interventions to address personalized child-level deficits. Findings will prove high impact as the NIMH considers the study and future application of RDoC criteria a high priority, and, yet, there are few empirical data exploring such application among young children. This proposal is responsive to the urgent need for validated, feasible, and standardized assessment batteries to examine RDoC domains in young children, and represents a critical step in a long-term plan to achieve effective and mechanism-based identification and treatment strategies for preschool-age children with depression and anxiety.