Unit on Neuroscience and Novel Therapeutics

National Institute Of Mental Health

Investigators

Linked publications, trials & patents

Abstract

We had five main accomplishments this past year. First, we published a conceptual review examining issues of measurement and specificity of the construct of inhibitory control, with a focus on potential treatment implications. We dissected the role of inhibitory control in psychosocial treatment and proposed a research agenda to further test inhibitory control as a candidate behavioral treatment target for youth with irritability. Second, we published a novel mobile application to assess inhibitory control in vivo in 200 youth. We provided evidence that our novel inhibitory control mobile application was accessible, feasible, and engaging. We found performance was reliable over time and associated with established measures of inhibitory control. We linked impaired performance to increased levels of co-occurring anxiety, irritability, and attention deficit hyperactivity disorder (ADHD) symptoms. Third, we published a paper examining associations between pre-pandemic brain activation patterns during cognitive control processing and anxiety trajectories during the pandemic in N = 291 youth; N = 47 who completed a cognitive control fMRI task. Neural response during conflict and error processing related to anxiety in distinct cortical and subcortical regions. Level of anterior cingulate cortex engagement during cognitive control related to anxiety. However, during error processing, level of engagement in the dorsolateral prefrontal, rather than anterior cingulate cortex, related to anxiety. Fourth, following the publication of our novel treatment, we published a series of studies exploring the aspects of the intervention that may have led to the efficacy. Examining in-session therapist behaviors, we found that adherence to parent treatment-specific components, particularly dealing with outbursts and active ignore, were associated with decreased irritability. In another published study, using ecological momentary assessment (EMA), we examined the psychometric properties of our irritability items and demonstrated acceptable variability, consistency, reliability and convergent validity. Critically, we found associations between changes in parental behaviors and youth symptoms. Finally, we provide the rationale for a study testing the performance of a classifier trained to predict temper outbursts in a group of clinically-referred youth presenting with symptoms of irritability and temper outbursts. Our preliminary data included digital based event sampling from an existing EMA dataset consisting of n = 54 participants with a total of 932 time points. Our initial evaluation provided encouraging evidence for the possibility of predicting the presence of a temper outburst based on individual’s momentary clinical responses (e.g., whether the participant is feeling grouchy, hungry, happy, sad, anxious, tired, etc.) prior to the outburst event, as well as external features (e.g., time of day, day of week). This work will potentially provide the foundation for the identification of features predictive of risk and future development of novel mobile-device-based interventions in youth affected with severe and impairing psychopathology.