Developmental origins and early detection of ADHD and dysregulatory psychopathology

ADHD 和失调性精神病理学的发育起源和早期发现

• 批准号: 10320345
• 负责人: JOEL T NIGG
• 金额: $ 72.2万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2025-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10320345
• 关键词: 3 year old; 3-Dimensional; 5 year old; Affect; Affective; Age; Age-Months; Aggressive behavior; Algorithms; Anger; Area; Attention deficit hyperactivity disorder; Behavioral; Biological; Biological Markers; Birth; Blood Circulation; Brain; Breast Feeding; Child; Child Health; Clinical; Clinical Trials; Cognition; Data; Depressed mood; Development; Developmental Process; Diagnostic; Early Diagnosis; Early Intervention; Early identification; Electroencephalography; Emotional; Environmental Risk Factor; Fetal Development; Formulation; Fright; Frustration; Functional disorder; Future; Genetic; Goals; Hand; Healthcare; Impairment; Impulsivity; Individual; Infant; Inflammation; Inflammatory; Intercept; Intervention; Intervention Trial; Justice; Kynurenine; Learning; Life; Literature; Magnetic Resonance Imaging; Measurable; Measures; Mediating; Mental Health; Modeling; Nursery Schools; Outcome; Parents; Pathway interactions; Phenotype; Physiological; Pregnancy; Pregnancy Trimesters; Preschool Child; Program Development; Psychopathology; Regulation; Risk; Risk Factors; Risk Marker; Role; School-Age Population; Schools; Second Pregnancy Trimester; Serotonin; Shapes; Signal Transduction; Socialization; Symptoms; System; Testing; Third Pregnancy Trimester; Time; Toddler; Tryptophan; Up-Regulation; Weather; Woman; Work; base; behavioral outcome; caregiving; clinical application; clinical candidate; clinical risk; cohort; cost; early childhood; emotion dysregulation; emotion regulation; executive function; experimental study; family burden; fetal; follow-up; inattention; indexing; interest; negative affect; offspring; prenatal; prevent; prospective; relating to nervous system; sound; systemic inflammatory response; teacher

PROJECT SUMMARY: The goal of this proposal is to identify early life predictors of symptoms of ADHD and associated behavioral and emotional problems. To do so children are followed from before birth to 4.5 years of age—on the cusp of school entry and well into the preschool period. ADHD and related problems with behavioral and emotional dysregulation are often not clinically identified until school age. By that point they are difficult to reverse. This proposal answers calls in the literature for earlier identification of risk and for discovery of early life mechanisms that can be targets for low-risk yet effective early life intervention to prevent the full onset of these problems. To do so we expand the study of an existing maternal- infant cohort by adding measures, time points, and an older outcome. We extend the cohort from the toddler years into the preschool period when psychopathology has begun to take shape and be able to be relatively reliably characterized. Key mechanisms to be examined are (a) biological signals in early life, focused on maternal inflammation and serotonergic metabolites during pregnancy and the trajectory of change in those signals in the first three years of life; (b) brain development as indexed by EEG measures from birth to age 3 years (lower cost and more readily clinically applicable than MRI at this stage); and (c) behavioral dynamics in early caregiving, about which little is known regarding ADHD risk in the first 24 months of life. The inflammation hypothesis builds on striking preliminary data uncovered by the PI's in their prior work. The EEG metrics likewise are supported by preliminary evidence. The behavioral data also have strong preliminary data and build on multiple theorists' proposals about the role of early emotional regulation in subsequent risk for dysregulatory psychopathology and ADHD. Both baseline (intercept) and change (trajectory) measures will be examined to help evaluate when in development a particular domain or level of analysis is most informative to subsequent outcome. Each of these hypotheses is examined in stand-alone fashion, and then with those findings in hand, an integrative developmental model will be tested. If successful the study will open new directions for low-risk yet potentially effective early intervention by identifying specific, measurable, and reversible risk factors or mechanisms as candidates for clinical trial follow up.

项目摘要： 该提议的目的是确定ADHD症状和相关行为的早期生活预测指标 情绪问题。为此，儿童从出生前到4.5岁，在学校入学和 进入学龄前时期。行为和情感失调的ADHD和相关问题通常不是 临床确定直到学龄。到那时，它们很难逆转。该建议在文献中接听电话 为了早期确定风险和发现早期生活机制，这些机制可能是低风险却有效的目标 早期生活干预以防止这些问题的全部发作。为此，我们扩大了现有母校的研究 - 婴儿队列通过添加措施，时间点和较旧的结果。我们将队列从蹒跚学步的岁月扩展到 学龄前时期，心理病理学开始成形并能够相对可靠地表征。钥匙 要检查的机制是（a）早期生命的生物信号，侧重于母体炎症和血清素能 怀孕期间的代谢产物和生命头三年这些信号的变化轨迹； （b）大脑 从出生到3岁的脑电图测量结果所索引（成本较低，更容易临床适用 比此阶段的MRI）； （c）早期护理中的行为动态，关于多动症知之甚少 在生命的头24个月中的风险。炎症假设建立在罢工的初步数据基于PI的初步数据的基础上 在他们的先前工作中。脑电图指标同样得到了初步证据的支持。行为数据也有 强有力的初步数据并基于多个理论家关于早期情绪调节在 随后发生失调心理病理学和多动症的风险。基线（截距）和变化（轨迹） 将检查措施，以帮助评估开发何时特定领域或分析水平是最多的 随后的结果提供了信息。这些假设中的每一个都以独立的方式进行了研究，然后与这些假设一起检查 在手中的发现，将测试一个集成的发展模型。如果成功的话，研究将为 通过识别特定，可衡量和可逆风险因素或 机制作为临床试验的候选者随访。