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

描述（由申请人提供）：精神障碍起源于神经发育，通常出现在生命早期。然而，缺乏方法来区分临床脆弱的幼儿谁是在一个慢性临床途径的开始从那些问题是暂时的。设计用于连接脑功能测量的发育敏感尺寸测量的出现为提高预防目标的准确性提供了强有力的机会。将这些维度与基于发育的神经科学方法相结合，产生了一种新颖的、真正的“神经发育”视角，以推进NIMH战略计划目标1.4，“为研究目的，开发基于可观察行为维度和神经生物学测量的精神障碍分类的新方法”。“破坏性行为是应用这种方法的理想场所，因为它出现得很早，是高达60%的成人精神障碍的前兆。此外，破坏性行为的特定组成维度，即易怒和冷酷/无情的特征，可以预测老年临床样本中不同的临床过程和神经破坏模式。我们的MAPS研究的最新发现为学龄前儿童的这些模式提供了支持。这项竞争性更新的总体目标是在病理生理通路的早期阶段确定非典型易怒和冷酷特征的发育敏感标记，并证明这些标记区分慢性精神障碍高风险幼儿的能力。我们建议对MAPS研究（1R01MH082830）进行纵向随访，该研究包括400名学龄前儿童（3-5岁）。我们利用MAPS对易怒（“脾气失控”）、冷酷特质（“对他人不关心”）和相关神经认知标记的发育敏感维度评估。拟议的研究将这些儿童早期数据与早期学龄（6-8岁）和青春期前（9-10岁）的结果联系起来。具体目的：(1)明确预测慢性临床模式的早期儿童脾气损失和低关注的维度属性；（II）明确儿童早期脾气丧失和低关注的维度属性，预测青春期前的神经认知中断，包括神经成像亚样本中基于任务的fMRI脑活动（n=120）；（三）检验联合考虑幼儿脾气损失和低关注维度属性和神经认知标记对增强连续性和非连续性预测的增量效用。利用早期大脑非典型性信息：行为关系预测心理发展进程

DESCRIPTION (provided by applicant): 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 t 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.