A LONGITUDINAL FOLLOW UP OF CHILDREN AT RISK FOR ANXIETY

对有焦虑风险的儿童进行纵向追踪

• 批准号: 6351684
• 负责人: JERROLD F ROSENBAUM
• 金额: $ 61.12万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-05-01 至 2004-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6351684
• 关键词: DNA; agoraphobia; anxiety disorders; behavior prediction; behavioral /social science research tag; biomarker; child (0-11); child psychology; clinical research; disease /disorder proneness /risk; family genetics; human genetic material tag; human subject; interview; longitudinal human study; molecular genetics; outcomes research; panic disorder; phobias; psychophysiology; social psychology; socioeconomics

In the proposed study, we seek to address a basic scientific question: Is it possible to predict the development of anxiety disorders among young children whose parents have panic disorder (PD)? This question is straightforward, yet the answer has broad implications. Although it is well established that children of parents with PD are at high risk for anxiety disorders, only some of these children will develop psychopathology. The identification of a predictor would facilitate primary prevention by delineating a group of young children at very high risk for anxiety disorders among those already at risk by having a PD parent. During the prior funding period we have completed a cross-sectional study of over 200 children at risk for PD and comparison offspring of normal control parents. Our sample is unique in that the children have been identified and characterized extensively before they entered the age of risk for childhood anxiety disorders. These youngsters have already been assessed for behavioral inhibition, psychophysiological markers, and early signs of anxiety as well as for markers of psychosocial adversity. A subsample who have grown old enough to be reliably assessed for DSM-IV diagnoses, have already been assessed for psychopathology using structured clinical interviews. Therefore this valuable sample affords us the unique opportunity to track the development of dysfunction and psychopathology in prospectively followed children at risk for psychopathology. To our knowledge, this would represent the largest such sample followed longitudinally. As we describe in the Progress Report, our work suggests that multiple domains of measurement will be useful predictors of psychopathology in high risk children. These domains are: parental disorders, child temperament (as indexed by "behavioral inhibition to the unfamiliar" [BI]), psychophysiologic abnormalities, and psychosocial adversity. The proposed work seeks to validate these measures as predictors of subsequent psychopathology and dysfunction by following up the sample five years after their baseline evaluation. The main aims of this project were determined by our past 12 years of work studying BI and anxiety disorders among young children. Our three main aims are: l) to characterize the psychopathologic and functional outcomes of children at risk for panic disorder; 2) to determine predictors of adverse outcomes among children at risk for anxiety disorders; and 3) to characterize the developmental sequence of anxiety disorders in these children. Moreover, under separate funding, we are collecting DNA samples from this cohort of families. Thus, by assuring that DNA samples will be available in the future, we leave open the possibility that our sample will be useful for prospectively predicting psychiatric disorders and disability from putative anxiety genes. Given that we are also assessing adverse features of the environment, we will also be able to determine if gene-environment interactions play a role in the genesis of anxiety disorders.

在拟议的研究中，我们试图解决一个基本的科学问题：是否有可能预测父母患有恐慌症（PD）的幼儿焦虑症的发展？ 这个问题很简单，但答案具有广泛的影响。尽管有很好的确定是PD父母的孩子处于焦虑症的高风险，但其中一些孩子只会发展精神病理学。通过描述一群幼儿患有PD父母，预测因子的识别将促进初级预防。在以前的资助期间，我们已经完成了200多名有PD风险的儿童以及正常对照父母的比较后代的横断面研究。我们的样本是独一无二的，因为在儿童进入儿童焦虑症的风险时代之前，已经对孩子进行了广泛的识别和特征。这些年轻人已经接受了行为抑制，心理生理标志物以及焦虑症的早期迹象以及心理社会逆境标志的评估。已经长大的子样本可以可靠地评估DSM-IV诊断，已经通过结构化的临床访谈评估了心理病理学。因此，这个有价值的样本为我们提供了一个独特的机会，可以追踪前瞻性的儿童患有精神病理学风险的孩子的功能障碍和心理病理学的发展。据我们所知，这将代表纵向遵循的最大样本。正如我们在进度报告中所描述的那样，我们的工作表明，测量的多个领域将是高风险儿童心理病理学的有用预测指标。这些领域是：父母疾病，儿童气质（如“对陌生的行为抑制” [BI]），心理生理异常和心理社会逆境所索引。拟议的工作旨在通过在基线评估后五年跟踪样本来验证这些措施作为随后的心理病理学和功能障碍的预测指标。该项目的主要目的是由我们过去12年的工作研究BI和幼儿焦虑症决定的。我们的三个主要目的是：l）表征有恐慌症风险的儿童的心理病理学和功能结果； 2）确定有焦虑症风险的儿童不良后果的预测因素； 3）表征这些儿童焦虑症的发育顺序。此外，在单独的资金下，我们正在从这个家庭中收集DNA样本。因此，通过确保将来可以使用DNA样本，我们就可以打开可能的可能性，即我们的样本将有助于预测假定焦虑基因的精神疾病和残疾。鉴于我们还在评估环境的不利特征，我们还将能够确定基因环境相互作用是否在焦虑症的起源中起作用。