Generating an Earlier Science of When to Worry: A Neurodevelopmental, Transactional Approach to Characterizing Irritability Patterns Beginning in Infancy

 描述(由申请人提供)：易怒出现在婴儿期，是许多常见形式的发展精神病理学的基础。然而，可靠地识别临床进展的高危易激婴儿是具有挑战性的，因为随着时间的推移，易怒婴儿的正常变异水平很高，并且在适应或不适应结果方面存在显著的个体差异。在我们先前学龄前工作的基础上，这项拟议的研究利用神经发育框架来产生经验性派生的参数，用于区分标记临床进展风险的易怒模式。主要创新点是：(1)从婴儿期开始规范发育非典型应激性模式的新方法；(2)对应激性、执行功能和前额叶皮质区域的联合发展考虑；(3)在亲子相互(Dys)调节的背景下，研究早期应激性的临床意义的交易焦点。为了得出基于人口的参数，我们首先对具有代表性的12-36个月的样本进行了横断面调查。老年人(N=2,000)。然后，我们确定了一个独立的社区队列(N=350名因易怒而过度抽样的婴儿)，并进行了12-36个月的密集纵向随访。重点刺激性评估是：(A)通过语言环境分析(Lena)Pro设备对刺激性发声的双月父母报告和实时监测；以及(B)对易怒的气质和行为的年度直接观察(12、24和36个月)。对行政职能的绩效评估每年进行一次。通过父母对Lena Pro上婴儿易怒发声的或有反应来评估交易过程(双月)和事件编码的亲婴相互调节过程(每年)。临床进展是通过随时间推移的潜在维度临床风险来捕捉的。具体目标：IA。通过基于人群的横断面参数(IAI)和定量纵向参数(IAII)区分发育非典型易怒模式与婴幼儿早期学龄前年龄。IB。指定易怒的纵向参数，以优化临床进展的预测。IIa-B将发育的非典型应激模式映射到执行功能和前额叶皮质(PFC)区域的成熟中断，并检验它们联合考虑将增强预测性临床实用的假设。前额叶皮质成熟度将从婴儿自然睡眠中进行评估--在一个极端组子样本(n=100)中，MRI对12&36个月时的解剖学特性进行了评估。我们测试了这样的假设，即非典型的易怒模式将预测执行功能发展缓慢和PFC解剖异常。IIIA-B阐明交易过程如何塑造临床预测，检验父母-婴儿相互调节过程调节临床进展的假设。神经发育易激表型在交易性背景下的规范为在精神障碍的最早前驱期有针对性地预防提供了关键的经验基础。

 DESCRIPTION (provided by applicant): Irritability emerges during infancy and is a substrate of many common forms of developmental psychopathology. However, reliable identification of irritable infants at high risk for clinical progression is challenging due to high levels of normatve variation combined with substantial individual differences in adaptive or maladaptive outcomes for irritable infants over time. Building on our prior work at preschool age, the proposed study utilizes a neurodevelopmental framework to generate empirically derived, parameters for differentiation of irritability patterns that mark risk for clinical progression. Key innovations ae: (1) novel approach to specification of developmentally atypical patterns of irritability beginning n infancy; (2) joint developmental consideration of irritability, executive function, and prefrontal cortical regions; and (3) transactional focus examining the clinical import of early irritability wthin the context of parent-infant mutual (dys)regulation. To derive population-based parameters, we first conduct a cross-sectional survey of a representative sample of 12-36 mos. olds (N=2,000). We then ascertain an independent community cohort (N=350 infants oversampled for irritability), with intensive longitudinal follow-up from 12-36 months. Focal irritability assessments are: (a) bimonthly parent reports and real-time monitoring of irritable vocalizations via the Language Environment Analysis (LENA) Pro device; and (b) annual direct observations of irritable temperament and behavior (12, 24 & 36 mos.). Performance-based assessments of executive function occur annually. Transactional processes are assessed via parental contingent responses to infant irritable vocalizations on the LENA Pro (bimonthly) and event-coded parent-infant mutual regulation processes (annually). Clinical progression is captured via latent dimensional clinical risk over time. SPECIFIC AIMS: IA. Differentiate developmentally atypical irritability patterns from infancy-early preschool age via population-based parameters cross-sectionally (IAi) and quantitative longitudinal parameters (IAii). IB. Specify longitudinal parameters of irritability to optimize prediction of clinical progression. IIA-B. Map developmentally atypical irritability patterns to disruptions in the maturation of executive functin and prefrontal cortical (PFC) regions and test the hypothesis that their joint consideration will enhance predictive clinical utility. Prefrontal cortical maturation will be assessed from infant natural sleep-MRI derived estimates of anatomical properties at 12 & 36 months in an extreme group sub-sample (n=100). We test the hypothesis that atypical irritability patterns will predict slowed executive function development and abnormal PFC anatomy. IIIA-B. Elucidate how transactional processes shape clinical prediction, testing the hypothesis that parent-infant mutual regulation processes modulate clinical progression. Specification of neurodevelopmental irritability phenotypes within transactional context provides a critical empirical base for targete prevention of mental disorder in its earliest prodromal phases.