Longitudinal Development of Attention-Related Brain Networks from Birth to School-Age and Risk for Anxiety Disorders

Washington University, Saint Louis MO

Investigators

Linked publications & trials

Abstract

Anxiety disorders are the most common pediatric psychiatric illness, affecting up to 30% and severely impairing up to 20% of all youth prior to age 18. Unfortunately, up to 50% of children remain symptomatic even with the best available treatment, making anxiety disorders a major public health problem. Clarifying how the brain develops differently in children who end up developing an anxiety disorder could help us devise new, more effective treatments based on correcting or preventing these underlying brain differences. Prior studies had indicated that anxiety disorders are associated with changes in a part of the brain that directs attention to new, unexpected stimuli (the “ventral attention network”, VAN) and in a part of the brain that is involved in staying focused on current goals and not being distracted (the “fronto-parietal network”, FPN). Problems in the VAN and FPN may decrease the ability of individuals with anxiety disorders to maintain attention on current goals and cause them to instead be distracted by new stimuli that are interpreted as threatening. Work from the original grant (which this current renewal proposes to extend) indicated for the first time these VAN and FPN changes are present in neonates (age < 6 weeks) at high risk for developing an anxiety disorder based on family history or observed infant behaviors at age 1 year. Thus, the altered brain development associated with developing an anxiety disorder may start already by the time of birth. The goal of this proposed renewal is to continue to track the infants from the original study at two more visits: at preschool (3-5 years) and at school- age (6-8 years), thus being able to track how the brain continues to develop up until the time when many of these children are expected to have developed anxiety disorders. At each visit, we will use brain scans to measure VAN and FPN function, perform psychiatric interviews to determine whether an anxiety disorder is present, and observe how parents and children interact together in challenging situations (like doing a hard puzzle together). The goals of the study are to learn (1) how the VAN and FPN develop from birth to age 8 years, (2) how the VAN and FPN develop differently in children who end up having an anxiety disorder, and (3) to learn if there are specific types of interactions between children and their parents that are associated with changes in the VAN and FPN and in the child developing anxiety. Past work has shown that when parent-child interactions include a lot of “parental overcontrol” in which parents are highly controlling, the children are more likely to develop problems with anxiety. Overall, this study represents a time-limited opportunity to follow a group of children from birth up until the age by which many of them are likely to develop an anxiety disorder. Using the results of this study, we hope in future work to design new strategies that might prevent changes in the VAN and FPN and thus reduce risk for children to develop anxiety disorders. These strategies could include teaching parents and children how to interact in challenging situations to minimize parental overcontrol or training children to stay focused and avoid distractions by new, unexpected stimuli.