Dimensions of Early Temper Loss and Low Concern: Clinical Utility and Mechanisms

精神障碍起源于神经发育，通常出现在生命的早期。然而，目前还缺乏方法。 用于区分处于慢性临床路径开始阶段的临床脆弱幼儿和 他们的问题是暂时的。对发展敏感的维度测量的出现旨在将 脑功能的测量为提高预防目标的准确性提供了一个强有力的机会。集成 这些维度与基于发育的神经科学方法产生了一种新颖的、真正的 推进NIMH战略计划目标1.4的“神经发育”视角，“发展，研究” 目的，根据可观察的行为和行为的维度对精神障碍进行分类的新方法 破坏行为是应用这种方法的理想场所，因为它出现得很早， 并且是高达60%的成人精神障碍的先兆。此外，颠覆性的特定组件维度 行为，即易怒和麻木不仁/冷酷无情的特征，预示着不同的临床过程和神经模式 较老的临床样本中的干扰。我们地图研究的最新发现支持这些模式 学龄前儿童。这次竞争性更新的首要目标是确定对发育敏感的标记 在病理生理途径的早期阶段，非典型的应激性和老茧特征，并证明 这些标记物区分患有慢性精神障碍风险最高的幼儿的能力。我们提出了一个 MAP研究的纵向随访(1R01MH082830)，400名学龄前儿童(3-5岁)的不同队列。我们 利用地图对易怒(“脾气失控”)的发展敏感维度评估，冷酷无情 特征(“不关心他人”)和相关的神经认知标记物。拟议的研究将这些早期联系在一起 从儿童到学龄儿童(6-8岁)的数据和青春期前(9-10岁)结果。具体目标：(I) 指定儿童早期脾气失控和低关注度的维度属性，以预测慢性临床 模式；(Ii)具体说明儿童早期脾气失控和低关注度的维度属性，这些维度属性可以预测儿童早期情绪失控 青春期神经认知障碍，包括神经成像亚样本中基于任务的fMRI脑活动 (n=120)；(Iii)检验联合考虑幼儿情绪失控和低关注度的增量效用 维度属性和神经认知标记，以增强连续性和间断性的预测。 利用大脑中早期生命异常的信息：行为关系预测精神障碍的进程 将推进预测心理健康结果的目标。研究结果将为有针对性的 旨在改变精神障碍早期寿命轨迹的预防措施。

Mental disorders are neurodevelopmental in origin and often emerge in early life. However, methods are lacking for distinguishing clinically vulnerable young children who are at the start of a chronic clinical pathway from those whose problems are transient. The advent of developmentally-sensitive dimensional measures designed to link to measures of brain function provides a potent opportunity to enhance accuracy of prevention targets. Integration of these dimensions with developmentally-based neuroscientific methods generates a novel, truly "neurodevelopmental"perspective with which to advance NIMH Strategic Plan Goal 1.4, "to develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures."Disruptive behavior is an ideal venue for applying this approach as it emerges early, and is antecedent to up to 60% of adult mental disorders. Further, specific component dimensions of disruptive behavior, i.e., irritability and callous/unemotional traits, predict differential clinical courses and patterns of neural disruption in older clinical samples. Recent findings from our MAPS Study provide support for these patterns in preschoolers. The overarching goal of this competitive renewal is to identify developmentally-sensitive markers of atypical irritability and callous traits at an early phase of the pathophysiological pathway, and to demonstrate the ability of these markers to distinguish young children at highest risk for chronic mental disorder. We propose a longitudinal follow-up of the MAPS Study (1R01MH082830), a diverse cohort of 400 preschoolers (3-5 yrs.). We capitalize on MAPS' developmentally-sensitive dimensional assessment of irritability ("Temper Loss"), callous traits ("Low Concern for Others"), and associated neurocognitive markers. The proposed study links these early childhood data to early school age (6-8 yrs.) and pre-adolescent (9-10 yrs.) outcomes. SPECIFIC AIMS: (I) Specify dimensional attributes of early childhood Temper Loss and Low Concern that predict chronic clinical patterns; (II) Specify dimensional attributes of early childhood Temper Loss and Low Concern that predict pre- adolescent neurocognitive disruptions, including task-based fMRI brain activity in a neuroimaging subsample (n=120); (III) Test the incremental utility of jointly considering early childhood Temper Loss and Low Concern dimensional attributes and neurocognitive markers to enhance prediction of continuities and discontinuities. Utilizing information about early life atypicalities in brain:behavior relations to predict course of mental disorder will advance the goal of predicting mental health outcomes. Study findings will lay the groundwork for targeted prevention designed to alter lifespan trajectories of mental disorder at early stages.