Neural Mechanisms for Early Development of Pervasive Anger and Irritability

描述（由申请人提供）：本研究的目的是利用功能磁共振成像（fMRI）研究6-9岁表现出早发性广泛性愤怒和易怒的幼儿的注意力控制障碍和情绪失调的神经基础。这些症状代表了一个重要的心理健康问题，一些人说，在DSM-V修订版中需要一个新的诊断类别，以确保这些儿童所需的研究和临床服务。这项被提议的研究将是第一个检查注意力控制障碍和情绪失调的大脑机制的研究，这表明了这些学龄儿童在首次临床表现时未接受药物治疗的关键行为缺陷。与年龄匹配的健康儿童相比，获得这些表现出普遍愤怒和易怒的幼儿的注意力控制和情绪调节神经系统功能异常的测量，将首先帮助我们确定哪些儿童在这些神经系统中表现出更大程度的功能障碍。这也是迈向长期目标的第一步，即检查这些神经系统异常在多大程度上可能代表有助于区分精神病理学相关发展轨迹的生物学标记，以便在症状学的早期阶段应用不同的治疗方法。将采用经过验证的实验范例，包括PI开发的一个范例和行为测量。初步分析将探讨与注意力控制障碍和情绪调节障碍相关的特定区域内的神经活动，以及它们之间的联系，以确定这种疾病的大脑缺陷。探索性分析将通过将这些神经系统的活动与父母报告的症状严重程度和临床医生的诊断报告相关联，来检查这些神经系统异常在多大程度上可以预测症状严重程度和临床诊断。最后，这项研究的长期计划包括未来完成纵向神经影像学研究的建议，在该研究中，表现出普遍愤怒和易怒的幼儿将每年进行扫描，以增加我们对这些症状的神经和临床轨迹的理解。私家侦探已经掌握了发展心理学的一般知识，特别强调情感发展，并在幼儿神经成像方面拥有丰富的经验，但缺乏成为儿童精神病学领域独立科学家所必需的临床技能。因此，拟议的培训计划旨在获得开展有关儿童精神病理早期风险的神经发育研究所需的相关临床技能。私家侦探将完成课程，与该领域的专家一起培训，并撰写经验和理论出版物，以发展对儿童临床问题的理解。因此，这个跨学科的研究和培训计划，允许一个循序渐进的方式进入儿童精神病理学的认知和情感神经科学的职业生涯。

DESCRIPTION (provided by applicant): The goal of this research is to use functional magnetic resonance imaging (fMRI) to study the neural basis of attentional dyscontrol and emotion dysregulation in a sample of young children (ages 6-9) who are displaying early onset pervasive anger and irritability. These symptoms represent a significant mental health concern that some say requires a new diagnostic category in the DSM-V revision in order to secure the research and clinical services that these children require. The proposed study will be the first to examine brain mechanisms for attentional dyscontrol and emotion dysregulation, which signify key behavioral deficits, in these young school-age, unmedicated children upon first clinic presentation. Obtaining these measures of functional abnormalities in attentional control and emotion regulatory neural systems in young children presenting with pervasive anger and irritability relative to age-matched healthy counterparts will first help us to identify which children show greater levels of dysfunction within these neural systems. It is also a first step toward the longer term goal of examining the extent to which these neural system abnormalities may represent biological markers that can help distinguish relevant developmental trajectories of psychopathology, so that different treatments can be applied at this early stage of symptomatology. Well-validated experimental paradigms, including one paradigm developed by the PI, and behavioral measures will be employed. Primary analyses will probe the neural activity within specific regions related to attentional dyscontrol and emotion dysregulation, and connectivity amongst them, in order to define brain deficits for this illness. Exploratory analyses will examine the extent to which these neural system abnormalities may predict symptom severity and clinical diagnosis by correlating activity in these neural systems with parent reported symptom severity and clinician diagnostic report. Finally, long term plans for this research include a future proposal to complete a longitudinal neuroimaging study in which young children presenting with pervasive anger and irritability will be scanned yearly to increase our understanding of the neural and clinical trajectories of these symptoms. The P.I. already possesses general knowledge of developmental psychology with specific emphasis on emotional development and has extensive experience in the neuroimaging of young children, but lacks the clinical skill set necessary to become an independent scientist in the field of child psychiatry. Therefore, the proposed training plan is aimed at acquiring the relevant clinical skill set necessary to conduct neurodevelopmental research regarding early risk for child psychopathology. The P.I. will complete coursework, train with experts in the field, and author empirical and theoretical publications in order to develop an understanding of child clinical issues. This cross-disciplinary research and training plan, therefore, allows for a stepwise approach to a career in the cognitive and affective neuroscience of child psychopathology.