Transdiagnostic Mechanisms of Youth Externalizing Psychopathology from Childhood to Adolescence: A Longitudinal Person-Centered Approach

青少年从童年到青春期外化精神病理学的跨诊断机制：以人为中心的纵向方法

• 批准号: 10589022
• 负责人: Jessica Nicole Smith
• 金额: $ 3.85万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-30 至 2024-04-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10589022
• 关键词: 14 year old; Address; Adolescence; Adolescent; Aggressive behavior; Analysis of Variance; Anger; Attention deficit hyperactivity disorder; Basic Science; Behavior; Child; Childhood; Clinical Sciences; Cognition; Cognitive; Conduct Disorder; Cross-Sectional Studies; Data; Data Set; Development; Diagnosis; Diagnostic; Diagnostic and Statistical Manual of Mental Disorders; Disease; Emotional; Emotions; Ethics; Etiology; Family; Fellowship; Florida; Goals; Heterogeneity; Hyperactivity; Impairment; Impulsivity; Individual; International; Intervention; Interview; Investigation; Knowledge; Literature; Longitudinal Studies; Methodology; Modeling; Motivation; Nature; Oppositional Defiant Disorder; Outcome; Pathway interactions; Population; Prevention; Probability; Process; Psychology; Psychopathology; Research; Research Domain Criteria; Risk; Risk Factors; Role; Sampling; Subgroup; Sum; Symptoms; Time; Training; Translations; Universities; Work; Youth; career; comorbidity; conduct problem; design; diagnostic criteria; disease classification; doctoral student; effective intervention; externalizing behavior; functional disability; improved; inattention; interest; member; motivational processes; novel strategies; peer; person centered; recruit; social; substance use; symptomatology

PROJECT SUMMARY/ABSTRACT Youth externalizing psychopathology, such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD), are highly comorbid with one another and are associated with many negative outcomes. Greater knowledge of etiology (e.g., cognitive, emotional, or motivational mechanisms) may improve interventions or facilitate prevention. However, the high rate of comorbidity and the popularity of investigating individual disorders has obscured relationships between symptoms and potential etiologies. While recognition of this problem has inspired more research on mechanisms of comorbidity, the extant literature suffers from two critical limitations. One, many studies implicitly treat diagnostic entities as distinct and independent by comparing disorders in group-based analyses or by utilizing separate factors for each disorder. These approaches often remove meaningful shared variance, and by treating diagnoses as unitary, do not account for the role of heterogeneity in comorbidity (i.e., heterogeneity within disorders may lead to higher comorbidity across disorders). Two, cross-sectional studies undermine our understanding of whether the externalizing pathway from childhood to adolescence represents the development of unique disorders or whether it represents different presentations of the same disease entity. Person-centered longitudinal approaches, such as Latent Transition Analysis, overcome both of these limitations. Aim 1 will establish the latent classes of externalizing symptoms present at three time points and the transitions between classes across time points. Aim 2 will examine cognitive, emotional, and motivational predictors of latent class status at each time point as well as the probability of transitioning between latent classes across time points. Exploratory aim 3 will evaluate the extent to which latent classes are correlated with functional impairments in order to examine if certain mechanisms are useful in predicting membership in, or transitions to, more impaired classes. Impact statement: This work will illustrate how key mechanisms are related to externalizing symptomatology over time, irrespective of DSM diagnosis. This will pave the way for greater etiological understanding, inform how knowledge of etiology can be utilized to refine our nosology, and improve risk identification. The proposed fellowship allows the applicant to build upon her foundational expertise in cognition to investigate other processes, such as emotion and motivation (training goal 1); advance her understanding of the theoretical and methodological approaches to examining comorbidity (training goal 2); and expand her statistical repertoire to include latent and longitudinal approaches (training goal 3). Lastly, the fellowship will provide opportunities for professional development and ethical training (training goal 4). PI Smith is a doctoral student in Clinical Science in Child and Adolescent Psychology at Florida International University. The fellowship is designed to prepare the applicant for an independent research career.

项目概要/摘要 青少年外化精神病理学，例如注意力缺陷/多动障碍（ADHD）、对立 违抗性障碍 (ODD) 和品行障碍 (CD) 彼此高度共存且相关 并带来许多负面结果。更多的病因学知识（例如认知、情感或动机） 机制）可以改善干预措施或促进预防。然而，高并发症发生率和 研究个体疾病的流行掩盖了症状和潜在疾病之间的关系 病因学。虽然对这个问题的认识激发了对共病机制的更多研究， 现有文献存在两个严重的局限性。一，许多研究隐含地将诊断实体视为 通过在基于群体的分析中比较疾病或利用单独的因素来区分和独立 各有障碍。这些方法通常消除有意义的共享方差，并将诊断视为 单一的，不考虑异质性在共病中的作用（即，疾病内的异质性可能 导致跨疾病更高的合并症）。第二，横断面研究破坏了我们对 从童年到青春期的外化途径是否代表了独特的发展 疾病或它是否代表同一疾病实体的不同表现。以人为本 纵向方法，例如潜在转移分析，克服了这两个限制。目标1将 建立三个时间点存在的潜在外化症状类别以及之间的转换 跨时间点的课程。目标 2 将检查潜在类别的认知、情感和动机预测因素 每个时间点的状态以及跨时间点的潜在类别之间转换的概率。 探索性目标 3 将评估潜在类别与功能障碍的相关程度 为了检查某些机制是否有助于预测受损程度较高的成员身份或过渡情况 类。影响陈述：这项工作将说明关键机制如何与外部化相关 随着时间的推移，无论 DSM 诊断如何，都会出现症状。这将为更深入的病因学研究铺平道路 理解，告知如何利用病因学知识来完善我们的疾病分类学并降低风险 鉴别。拟议的奖学金允许申请人利用她在认知方面的基础专业知识 调查其他过程，例如情绪和动机（培训目标 1）；增进她的理解 检查合并症的理论和方法方法（培训目标 2）；并扩展她 统计方法包括潜在方法和纵向方法（培训目标 3）。最后，联谊会 提供专业发展和道德培训的机会（培训目标 4）。 PI史密斯是一名博士 佛罗里达国际大学儿童和青少年心理学临床科学专业的学生。这 奖学金旨在帮助申请人为独立研究生涯做好准备。