fMRI Studies of Risk for Mood and Anxiety Disorders in Children

National Institute Of Mental Health

Investigators

Linked publications, trials & patents

Abstract

This work is conducted under protocol 03-M-0186, NCT00060775. In this project, our group is examining biological aspects of risk for mood and anxiety disorders in children. Such work has major public impact. By identifying biological risks in children, information on novel treatments and preventative interventions will emerge. Given the understanding of most chronic mental illnesses as developmental disorders, such information holds the hope of dramatically influencing the mental well-being of many individuals. This project encompasses work examining the degree to which neurocognitive profiles vary among children and adolescents stratified with respect to risk factors for mood and anxiety disorders. For these studies, risk is defined based on personal histories of early-childhood temperament, and we are acquiring fMRI data from a subset of these individuals. Our work in these protocols encompasses studies in juveniles across the full span of infancy, childhood, and adolescence. Thus, one set of studies is based among young adults who have been prospectively followed for more than three decades. A second set of studies is based in adolescents now approaching adulthood. In both sets of studies, as well as the larger series of studies in this project, considerable progress continues to be made. A third set of studies examines infants. This set of studies has grown particularly rapidly in the past four years. Data collection activities during infancy is highly active. Across the two sets of cohorts, this project seeks to achieve a developmental perspective throughout the entire period of maturation. Studies on temperamental risk are the focus in the protocol. During the past five years, we spent approximately half of our efforts on collecting data in a childhood cohort, where the participants are now approximately 30 years old. The other major component of our effort examined individuals who are in their early 20s. For the last three years, our work in these cohorts consistently replicates findings across cohorts. We demonstrate the persistent influence of temperament on risk into for psychopathology. In this past year, we have identified important neurocognitive factors that isolate subsets of children with particular temperaments who face the greatest risk for psychopathology. This has generated a steady stream of brain-imaging papers. A particularly important paper utilized longitudinal data to document changes in brain function occurring in tandem with changes in symptoms of anxiety and depression. This paper, appearing in a high-impact journal, spanned more than 20 years of research. Another particularly important paper shows that the response to errors predicts high risk for anxiety and depression. These findings are similar to results in patients seen in other work. As a result, these findings could impact thoughts about prevention. In comparing risk factors for behavioral and emotional problems, other questions relate to the identification of factors that differentiate among children who are at high risk yet remain resilient from those who are at risk but manifest problems. Still other questions focus on different psychiatric outcomes from particular temperaments. Work has been particularly active in infants, where we are working with our collaborators at the University of Maryland. To date data has been collected in nearly 200 infants and we have collaborated on two extramural grants. Our most in-depth studies focus on the temperament of "behavioral inhibition." This work is made possible through our strong collaborative relationship with Dr. Nathan Fox at the University of Maryland. Our studies in this area continued to grow and expand this year, as they had done in the immediately prior years. Dr. Fox has followed cohorts of approximately 600 infants as they passed though childhood. These children have received repeated assessments of their temperament. Temperament classifications in the sample during infancy and early childhood have been shown to predict behavior later in life. We have also completed a series of investigations in this sample. Results from these studies support the conclusions generated by other research within our group. Namely, this work establishes the presence of strong, consistent associations between the presence of and risk factors for mental illness in children and the presence of perturbed brain function. In the past year, our group has begun to transition the focus of our work in this protocol. We will be bringing to a close our studies focused on late adolescence and adulthood so that we can devote an increasingly large number of resources to new studies targeting infants and young children. This work has grown particularly swiftly in the past year, through collaborations on two extramurally funded projects. Overall, the results from these studies show that the seeds of temperament continue to be expressed throughout development. Behaviorally, these seeds are expressed in measures of task performance and signs of psychopathology. From a brain-function perspective, these seeds are expressed in measures of electrophysiology and fMRI. Moreover, these measures of brain function mediate and moderate the relationships between temperament and psychopathology. As such, the studies provide important information on understanding risk for psychopathology.