Predictors of Social Dysfunction in Adolescents at Risk for Schizophrenia

有精神分裂症风险的青少年社会功能障碍的预测因素

• 批准号: 8957022
• 负责人: LESLIE E HORTON
• 金额: $ 15.7万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-12-01 至 2017-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8957022
• 关键词: Adolescence; Adolescent; Adolescent Development; Affect; Affective; Age; Autonomic Dysfunction; Award; Behavioral; Benign; Cardiac; Cardiovascular system; Characteristics; Cognitive; Conflict (Psychology); Data; Data Analyses; Development; Developmental Process; Diagnosis; Diagnostic; Dimensions; Disease; Early Intervention; Early identification; Ecological momentary assessment; Emotional; Emotions; Exposure to; Face; First Degree Relative; Functional disorder; Funding; Future; Goals; Health; Heart Rate; Individual; Intervention; Label; Laboratories; Lead; Life; Link; Longitudinal Studies; Measurement; Measures; Mental Health; Mentorship; Methods; Modeling; Monitor; National Institute of Mental Health; Neurobiology; Outcome; Pathway interactions; Patient Self-Report; Pattern; Perception; Population Intervention; Process; Psychopathology; Psychophysiology; Psychotic Disorders; Qualifying; Questionnaires; Recovery; Reporting; Research; Research Design; Research Domain Criteria; Rest; Risk; Risk Marker; Role; Sampling; Schizophrenia; Silk; Social Functioning; Symptoms; Testing; Time; Training; Trier Social Stress Test; Walkers; Work; acute stress; base; behavior measurement; behavioral outcome; biological adaptation to stress; contextual factors; design; expectation; experience; functional disability; heart rate variability; high risk; improved; indexing; negative affect; neural circuit; prevent; response; social; social cognition; trait

DESCRIPTION (provided by applicant): The goal of this research is to study the role of facial affect recognition deficits and social threat sensitivity in a sample of adolescent (ages 14-17) first-degree relatives of people with schizophrenia (HR-SZ) in order to better understand social dysfunction and sub-threshold symptoms of psychosis. 40-75% of HR-SZ adolescents qualify for a major mental health diagnosis and 4-22% will eventually develop a psychotic disorder. Social dysfunction is a key marker for predicting which HR-SZ people will develop schizophrenia; however, little is known about specific pathways to dysfunction during late adolescence. Facial affect recognition deficits, difficulty decoding facial emotions in others, are present in HR-SZ people and predict psychosis and social dysfunction. Sensitivity to social threat may also be an important marker of psychosis risk and predictor of social dysfunction, as preliminary evidence suggests that HR-SZ adolescents report greater sensitivity to threat in daily life and have a "hypersensitive" pattern of cardiac autonomic responding characterized by slower return to baseline heart rate variability pattern after exposure to threats. The proposed study will examine whether excessive sensitivity to social threat (assessed through cardiac psychophysiology) and facial affect recognition deficits predispose HR-SZ adolescents to a pattern of increasing symptoms and social dysfunction compared to controls over three time points: baseline, 6 months later, and 1 year later. Sensitivity to social threat and facial affect recognition deficits are characteristic of those with schizophrenia and their relatives but not specific to them; these domains have been identified as NIMH Research Domain Criteria (RDocs), and thus the proposed research should have relevance to the study of psychopathology across diagnostic boundaries. The proposed study would also provide the first-known use of ecological momentary assessment (EMA) to examine social dysfunction and sub-threshold symptoms of psychosis in daily life for HR-SZ adolescents. Starting the second year of the proposed funding period, EMA methods will be combined with ambulatory heart rate variability to examine how daily life measures of autonomic functioning relate to baseline laboratory-assessed sensitivity to social threat and behavioral EMA responses. To appropriately evaluate her research questions, the candidate will receive training in social and neurobiological aspects of typical and prodromal adolescent development, longitudinal study design and data analysis, and assessing psychophysiological response to threat with laboratory and ambulatory cardiovascular responding. Her mentorship team has extensive experience in developmental psychopathology (Dr. Silk), developmental processes contributing to risk for schizophrenia (Drs. Haas and Walker), advanced longitudinal data analysis (Dr. Molenaar), and heart rate variability assessment (Dr. Jennings). By investigating cognitive and affective underpinnings of social dysfunction and symptoms in HR-SZ adolescents, the proposed award should provide useful targets for future research seeking to improve early identification and interventions to prevent psychotic disorders and other psychopathology.

描述（由申请人提供）：这项研究的目的是研究面部情感识别缺陷和社会威胁敏感性在青少年样本（14-17岁）的一级亲戚（HR-SZ）的一级亲戚中，以便更好地了解社会功能障碍和精神病症状。 HR-SZ青少年中有40-75％有资格进行重大的心理健康诊断，而4-22％的青少年最终将发展为精神病。社会功能障碍是预测哪些HR-SZ人会发展精神分裂症的关键标志。然而，关于青春期晚期功能障碍的特定途径知之甚少。面部情感识别缺陷，难以解码他人的面部情绪，是 出现在HR-SZ人中，并预测精神病和社会功能障碍。对社会威胁的敏感性也可能是精神病风险的重要标志和社会功能障碍的预测指标，因为初步证据表明，HR-SZ青少年报告对日常生活中威胁的敏感性更高，并且具有“心脏自主性的“超敏感”模式，其表征的表现为较慢的基础心脏速度变化模式，在暴露于威胁之后的基本心脏率变化模式。拟议的研究将检查对社会威胁（通过心理生理学评估）和面部影响识别缺陷是否过度敏感性是否使HR-SZ青少年倾向于与三个时间点：基线，6个月后和1年后的对照相比，HR-SZ青少年对增加症状和社会功能障碍的模式。对社会威胁和面部影响识别缺陷的敏感性是精神分裂症及其亲戚的人的特征，但对他们而不是特定。这些领域已被确定为NIMH研究领域标准（RDOC），因此拟议的研究应与跨诊断边界的心理病理学研究相关。拟议的研究还将提供对HR-SZ青少年日常生活中精神病的社会功能障碍和阈值症状的首次使用生态瞬时评估（EMA）。从拟议的融资期开始的第二年，EMA方法将与卧床心率变异性相结合，以研究自主功能的日常生活度量与基线实验室对社会威胁和行为EMA反应的敏感性有关。为了适当评估她的研究问题，候选人将接受典型和前驱青少年发展的社会和神经生物学方面的培训，纵向研究设计和数据分析，并评估对威胁的心理生理反应，并通过实验室和卧床性心血管响应。她的指导团队在发育心理病理学（Silk博士），发展过程中有助于精神分裂症的风险（Haas和Walker博士），高级纵向数据分析（Molenaar博士）和心率可变性评估（Jennings博士）。通过调查HR-SZ青少年的社会功能障碍和症状的认知和情感基础，拟议的奖项应为未来的研究提供有用的目标，以寻求改善早期识别和干预措施，以防止精神病和其他精神病理学。