Psychiatric outcome studies

精神病学结果研究

• 批准号: 6581877
• 负责人: DAVID B. GOLDSTON
• 金额: $ 24.14万
• 依托单位: WAKE FOREST UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-12-01 至 2002-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6581877
• 关键词: adolescence (12-20); aggression; attention deficit disorder; behavior disorders; behavioral /social science research tag; clinical depression; clinical research; comorbidity; disease /disorder classification; dyslexia; human subject; juvenile delinquency; mental health epidemiology; quality of life; reading disorder; student dropouts; young adult human (21-34)

Description: This study involves a prospective, naturalistic study of the psychiatric outcomes of adolescent and young adults with reading disabilities. The investigators note that previous cross-sectional studies support the notion that reading and reading-related disabilities are associated with increased psychiatric morbidity during childhood. There are three specific aims, each tied to a series of thoughtful hypotheses, which guide this study: Specific Aim 1: Estimate the degree to which adolescents and young adults with reading disabilities are at higher risk (compared to individuals without reading disabilities) for (A) psychiatric disorder; (B) greater severity of psychiatric symptomatology; (C)significant life outcomes; and (D) poor quality of life and greater functional impairment. Related to this specific aim are four hypotheses: Hypothesis 1A: Adolescents with reading disabilities will evidence higher rates of both externalizing and internalizing disorders than adolescents without reading disabilities; Hypothesis 1B: Adolescents with reading disabilities will evidence more aggressive and delinquent behaviors, more severe depressive symptoms, and more trait anxiety over time than adolescents without reading disabilities; Hypothesis 1C: Adolescents with reading disabilities will evidence a greater likelihood over time of incarceration and school dropout and will report a greater number of undesirable objective life events than adolescents without reading disabilities; Hypothesis 1D: Adolescents with reading disabilities will report a poorer quality of life and more functional impairment over time than adolescents without reading disabilities. Specific Aim 2: Examine the degree to which the relationships between reading disabilities and various outcomes of interest (psychiatric disorders, severity of symptomatology, significant life outcome, and quality of life) are mediated by co-occurring attention deficit hyperactivity disorder. The investigators predict that the poor outcomes will not be solely mediated by the presence of attention deficit disorder. The following specific hypotheses will be tested: Hypothesis 2A: Adolescents with reading disabilities will evidence higher rates of both externalizing and internalizing disorders than adolescents without reading disabilities, after accounting for the effects of attention deficit hyperactivity disorder; Hypothesis 2B: Adolescents with reading disabilities will evidence more aggressive and delinquent behaviors, more severe depressive symptoms, and more trait anxiety over time than adolescents without reading disabilities, after accounting for the effects of attention deficit hyperactivity disorder; Hypothesis 2C: Adolescents with reading disabilities will evidence a greater likelihood over time of incarceration and school dropout, and will report a greater number of undesirable objective life events than adolescents without reading disabilities, after accounting for the effects of attention deficit hyperactivity disorder; Hypothesis 2D: Adolescents with reading disabilities will report a poorer quality of life and more functional impairment over time than adolescents without reading disabilities, after accounting for the effects of attention deficit hyperactivity disorder. Specific Aim 3: Test hypotheses regarding the associated of three reading-related phenotypes with differing behavioral manifestations. The investigators point to their previous research that suggests that one phenotype of reading disability is marked by difficulties with phonemic awareness and is involved with linkage to chromosome 6. A second reading-related phenotype is defined by phonological decoding difficulties and appears to be associated with chromosome 1. A third reading-related phenotype is marked by difficulties with single word identification and is associated with chromosome 15. The preliminary data indicate that these three reading-related phenotypes are also associated with specific genetic linkages and brain morphology, and may be associated with specific psychiatric and behavioral manifestations. There are three related hypotheses: Hypothesis 3A: Adolescents with the phonemic awareness phenotype will evidence higher rates of attention deficit hyperactivity disorder, inattentive type, than all other adolescents except those with the single word reading phenotype; Hypothesis 3B: Adolescents with phonological decoding deficits will show higher levels of social withdrawal than adolescents without this phenotype; Hypothesis 3C: Adolescents with difficulties with single word reading will evidence more severe aggressive and delinquent behaviors, a higher rate of conduct and oppositional disorder, and a higher rate of substance-use disorders than all other adolescents. Adolescents with single word reading deficits will also exhibit a higher rate of attention deficit hyperactivity disorder, inattentive type, than all other youths, except those with the phonemic awareness phenotype. Thus, the two groups that are related to attention deficit hyperactivity disorder are the phonemic awareness phenotype (chromosome 6) and the single word reading phenotype (chromosome 15).

描述：本研究涉及一项前瞻性、自然主义研究 有阅读障碍的青少年和年轻人的精神结局。 研究人员指出，之前的横断面研究支持 认为阅读和与阅读相关的障碍与 儿童时期精神疾病发病率增加。具体有以下三点 目标，每个目标都与一系列深思熟虑的假设相关，这些假设指导本研究： 具体目标 1：估计青少年和年轻人的程度 有阅读障碍的人面临更高的风险（与没有阅读障碍的人相比） 阅读障碍）针对 (A) 精神障碍； (B) 更严重的 精神症状学； (C) 重大的生活成果； (D) 质量差 生命和更大的功能障碍。 与这一具体目标相关的是四个假设： 假设 1A：有阅读障碍的青少年的阅读能力会更高 外化和内化障碍的发生率均高于青少年 没有阅读障碍； 假设 1B：有阅读障碍的青少年会证明更多 攻击性和犯罪行为、更严重的抑郁症状等等 随着时间的推移，与没有阅读障碍的青少年相比，特质焦虑会增加； 假设 1C：有阅读障碍的青少年会表现出更大的阅读障碍。 随着时间的推移被监禁和辍学的可能性，并将报告 与没有经历过的青少年相比，经历过更多不良客观生活事件的青少年 阅读障碍； 假设 1D：有阅读障碍的青少年的阅读能力较差 随着时间的推移，与青少年相比，生活质量和功能损伤更多 没有阅读障碍。 具体目标 2：检查阅读之间的关系程度 残疾和各种感兴趣的结果（精神疾病、严重程度 症状学、重要的生活结果和生活质量）是介导的 由同时发生的注意力缺陷多动障碍引起。调查人员 预测不良结果不会仅仅由存在的因素引起 注意力缺陷障碍。将测试以下具体假设： 假设 2A：有阅读障碍的青少年的阅读能力会更高 外化和内化障碍的发生率均高于青少年 在考虑注意力的影响后，没有阅读障碍 缺陷多动障碍; 假设 2B：有阅读障碍的青少年会证明更多 攻击性和犯罪行为、更严重的抑郁症状等等 随着时间的推移，与没有阅读障碍的青少年相比，特质焦虑 考虑注意力缺陷多动障碍的影响； 假设 2C：有阅读障碍的青少年会表现出更大的阅读障碍。 随着时间的推移被监禁和辍学的可能性，并将报告 与没有经历过的青少年相比，经历过更多不良客观生活事件的青少年 考虑到注意力缺陷的影响后，阅读障碍 多动症; 假设 2D：有阅读障碍的青少年的阅读能力较差 随着时间的推移，与青少年相比，生活质量和功能损伤更多 在考虑注意力的影响后，没有阅读障碍 缺乏性多动症。 具体目标 3：测试关于三个阅读相关的假设 具有不同行为表现的表型。调查人员 指出他们之前的研究表明，阅读的一种表型 残疾的特点是音位意识困难，并涉及 与 6 号染色体连锁。第二种与阅读相关的表型定义为 语音解码困难，似乎与 染色体1。第三个与阅读相关的表型的特点是难以阅读 单个单词识别并与 15 号染色体相关。 初步数据表明，这三种与阅读相关的表型也 与特定的遗传联系和大脑形态有关，并且可能是 与特定的精神和行为表现有关。有 三个相关假设： 假设 3A：具有音素意识表型的青少年会 证据表明，注意力缺陷多动障碍、注意力不集中的发病率较高 类型，比所有其他青少年（除了那些只能阅读单个单词的青少年） 表型； 假设 3B：具有语音解码缺陷的青少年会表现出 与没有这种表型的青少年相比，社交退缩程度更高； 假设 3C：有单字阅读困难的青少年会 证据表明，攻击性和犯罪行为更严重，发生率更高 行为和对立障碍，以及更高的物质使用率 疾病比所有其他青少年都要严重。青少年单字阅读 缺陷也会表现出更高的注意力缺陷多动发生率 精神错乱、注意力不集中的类型，比所有其他年轻人都严重，除了那些患有 音素意识表型。因此，这两个相关组 注意力缺陷多动障碍是音素意识表型 （6 号染色体）和单字阅读表型（15 号染色体）。