Improving Brain-Behavior Markers of Preschool Executive Function through aGroup-Based Parenting Intervention for Low-Income Families

项目摘要 执行功能障碍(EF)，即支持自我调节的认知过程，不成比例 影响生活贫困的儿童，增加儿童破坏性行为障碍(DBDS； 对立违抗障碍、品行障碍)，引发一连串的心理健康问题和 一生中都会遇到心理社会问题。与贫困相关的压力和不适应的育儿方式 与儿童神经和行为EF标志物的改变有关；尽管如此，还没有研究 如果育儿预防计划可以直接针对儿童的EF，并通过提高EF来减少破坏性 高危儿童的行为。本次K23导师以患者为导向的研究事业发展奖 应用程序寻求进行机械性随机临床试验，以确定神经行为 儿童EF指数是一个实验性的治疗目标，可以通过照顾者参与 芝加哥家长计划(CPP；AIM 1)。与NIMH研究领域标准框架一致， 儿童EF将通过多个层次的分析(脑电[EEG]、行为、 调查)。该项目还试图评估儿童神经行为EF的增加是否在 CPP在短期随访中减少破坏性行为问题的效果(目标2)。该项目将 还可以探索具体的育儿做法(管教、脚手架)的增加是否与以前的 EF的个体差异在CPP预测儿童神经行为EF变化中的作用 (目标3)。该样本将包括90名符合医疗补助条件的父母-子女(4-5岁)；并将雇用一名 新的招募方法，目标儿童在基线时会有中度到严重的EF延迟，但 不符合DBD的诊断标准。与候选人的翻译临床科学家职业生涯一致 目标，候选人寻求关键的培训：以社区为基础的研究和传播以及 实施科学、先进的脑电方法评价预防性神经行为EF指标 干预，以及设计和评估临床试验的统计技能。培训将在一个杰出的 伊利诺伊大学芝加哥分校精神病学系的跨学科环境 利用该部门在社区精神健康服务研究、传播方面的既定优势 和实施科学，以及情感神经科学。导师阿特金斯、菲茨杰拉德和鲍米克博士以及 顾问克伦普博士、瓦克施拉格博士、格罗斯博士和汉德利博士在培训领域拥有专业知识，并拥有广泛的 早期职业指导的历史，并将共同努力确保候选人成功过渡到 研究独立性。研究结果将支持R01应用程序在更大范围内验证结果 并启动候选人的学术生涯，成为一名预防干预科学家。研究结果具有重要的意义 有可能确定CPP，一种成本效益高的育儿干预措施，是否会修改神经行为EF指数 在城市贫困儿童中，对DBDS的病因风险机制进行理论分析，从而预防DBDS。

PROJECT ABSTRACT Impairments in executive functioning (EF), cognitive processes that support self-regulation, disproportionately impact children living in poverty and increase vulnerability for childhood disruptive behavior disorders (DBDs; oppositional defiant disorder, conduct disorder), which trigger a cascade of mental health problems and psychosocial difficulties across the lifespan. Poverty-related stress and maladaptive parenting styles have been linked to alterations of neural and behavioral EF markers in children; despite this, no studies have studied if parenting prevention programs can directly target childhood EF, and through improving EF, reduce disruptive behaviors in at-risk children. This K23 Mentored Patient-Oriented Research Career Development Award application seeks to conduct a mechanistic randomized clinical trial to determine whether neural-behavioral indices of childhood EF is an experimental therapeutic target that can be modified via caregiver participation in the Chicago Parent Program (CPP; Aim 1). Consistent with the NIMH Research Domain Criteria framework, childhood EF will be assessed across multiple levels of analysis (electroencephalogram [EEG], behavior, survey). The project also seeks to evaluate whether increases in childhood neural-behavioral EF mediate the effects of CPP in reducing disruptive behavior problems over a short-term follow-up (Aim 2). The project will also explore whether increases in specific parenting practices (discipline, scaffolding), previously linked to individual differences in EF, mediate the effects of CPP in predicting change in childhood neural-behavioral EF (Aim 3). The sample will include 90 Medicaid eligible parent-child (ages 4-5 years old) dyads; and will employ a novel recruitment approach where the target child will have moderate-to-severe EF delays at baseline but does not meet diagnostic criteria for a DBD. Consistent with the candidate's translational clinical scientist career goals, the candidate seeks crucial training in: community-based research and dissemination and implementation science, advanced EEG methods to evaluate neural-behavioral EF targets of preventive interventions, and statistical skills to design and evaluate clinical trials. Training will occur in an outstanding interdisciplinary environment at the University of Illinois at Chicago, in the Department of Psychiatry and leverage the department's established strengths in community mental health services research, dissemination and implementation science, and affective neuroscience. Mentors Drs. Atkins, Fitzgerald and Bhaumik and consultants Drs. Klumpp, Wakschlag, Gross, and Handley have expertise in the training areas and extensive histories of early career mentorship, and will work together to ensure the candidate's successful transition to research independence. Study findings will support an R01 application to validate the results on a larger scale and launch the candidate's academic career as a preventive intervention scientist. Findings have significant potential to identify whether CPP, a cost-efficient parenting intervention, modifies neural-behavioral EF indices in urban poor children, a theorized etiological risk mechanism of DBDs, and therefore prevent DBDs.