Early Childhood Parenting Predicts Late Childhood Brain Functional Connectivity During Emotion Perception and Reward Processing

Seventy-nine 3-year olds and their mothers participated in a laboratory-based task to assess maternal hostility. Mothers also reported their behavioral regulation of their child. Seven years later, functional magnetic resonance imaging data were acquired while viewing emotional faces and completing a reward processing task. Maternal hostility predicted more negative amygdala connectivity during exposure to sad relative to neutral faces with frontal and parietal regions as well as more negative left ventral striatal connectivity during monetary gain relative to loss feedback with the right posterior orbital frontal cortex and right inferior frontal gyrus. In contrast, maternal regulation predicted enhanced cingulo-frontal connectivity during monetary gain relative to loss feedback. Results suggest parenting is associated with alterations in emotion and reward processing circuitry 7-8 years later.

Best practices in research mentoring in clinical science

The growth of clinical science as a field depends on the work of engaged mentors nurturing future generations of scientists. Effective research mentoring has been shown to predict positive outcomes, including greater scholarly productivity, reduced attrition, and increased satisfaction with training and/or employment, which ultimately may enhance the quality of the clinical-science research enterprise. Barriers to effective research mentoring, however, pose significant challenges for both mentees and mentors, as well as for labs, training programs, and/or departments. We discuss some key issues as they apply to clinical-science mentoring and note how they are affected across different developmental levels (undergraduate, postbaccalaureate, doctoral, internship, postdoctoral associates, and early career faculty). Although we do not proclaim expertise on these issues-and have struggled with them in our own careers-we believe an open discussion around best mentoring practices will enhance our collective effectiveness and help mentees and our field to flourish. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Depression Severity Over 27 Months in Adolescent Girls Is Predicted by Stress-Linked Cortical Morphology

BACKGROUND

Evidence supports the notion that early-life stress and trauma impact cortical development and increase vulnerability to depression. However, it remains unclear whether common stressful life events in community-dwelling adolescents have similar consequences for cortical development.

METHODS

A total of 232 adolescent girls (mean age 15.29 ± 0.65 years) were assessed with the Stressful Life Events Schedule (a semistructured interview of stressors in the previous 9 months) and underwent a magnetic resonance imaging scan. FreeSurfer 5.3.0 was used to perform whole-brain surface-based morphometry. Dysphoria was assessed at the time of imaging and prospectively at three 9-month follow-up appointments using the Inventory of Depression and Anxiety Symptoms II.

RESULTS

At least one stressful life event was reported in 90% of the adolescent participants during the 9 months preceding imaging. Greater burden of recent life stress was associated with less left precuneus and left postcentral cortical thickness and smaller left superior frontal and right inferior parietal volume (all p < .05 after multiple comparisons correction). Left precuneus thickness in the stress-associated cluster significantly predicted dysphoria for 27 months after imaging controlling for prior dysphoria (β = -.11, p = .004). Left precuneus cortical thickness accounted for 17.0% of the association between stress and dysphoric mood for 27 months after imaging (β = .04, p = .05).

CONCLUSIONS

Consistent with evidence from imaging studies of trauma-exposed youths and preclinical stress models, a heavy burden of recent common life stress in community-dwelling adolescent girls was associated with altered frontal/parietal cortical morphology. Stress-linked precuneus cortical thickness represents a candidate prospective biomarker of adolescent depression.

Social-Experience and Temperamental Predictors of Rejection Sensitivity: A Prospective Study

Rejection sensitivity (RS) is the tendency for individuals to anxiously expect, readily perceive, and overreact to interpersonal rejection. Existing theory presumes that early experiences of rejection cause RS, although few studies have assessed this prospectively. Also relatively unstudied are individual differences in temperament that may contribute to RS. In a longitudinal study, we examined whether early social experiences and individual differences in temperament predict RS assessed subsequently. Results showed that positive early social experiences (ages 6 and 9 parents’ relationship quality and age 9 peer support) negatively predicted RS at age 12 and that negative affect (ages 6 and 9) positively predicted age-12 RS. These findings may have important implications for RS-reduction efforts and for understanding the many domain-specific manifestations of RS.

The short-term reliability and long-term stability of salivary immune markers

Salivary markers of immune function are increasingly commonly used in studies of human health. Yet, few studies have examined the short-term or long-term reliability or stability of these biomarkers, making their measurement properties unclear. We addressed this issue in the present study by collecting two saliva samples, two hours apart, from 426 adolescent girls during a baseline laboratory visit. Then, eighteen months later, we collected the same samples again from a subset of these participants (n = 113). The correlations between the two samples collected at each session were generally high (mean r = 0.67). In contrast, although single saliva samples were only weakly correlated across 18 month (mean rs = 0.18), averaging the two quantifications within a session considerably improved the reliability (mean r = 0.27). In short, salivary immune markers exhibited strong short-term test-retest correlations, and averaging across multiple assessments notably improved long-term test-retest correlations. Additional research is needed to establish the health relevance and mechanisms underlying these potentially useful, non-invasive biomarkers.

Developmental trajectory of the late positive potential: Using temporal-spatial PCA to characterize within-subject developmental changes in emotional processing

The late positive potential (LPP) is characterized by temporal and spatial changes across development-though existing work has primarily relied on visual or statistical comparisons of relatively few electrodes and averaged activity over time. The current study used an empirically based approach to characterize temporal and spatial changes in ERPs over time. Data were utilized from a large longitudinal study (N = 380) in which the LPP was recorded to pleasant, neutral, and unpleasant pictures around age 9 and again around age 12. Age 9 ERPs were subtracted from age 12 ERPs for all three image types; the resulting ERPs for each subject at each electrode site were then submitted to a temporospatial principal component analysis (PCA). A PCA factor was greater in amplitude for emotional pictures compared to neutral pictures between ages 9 and 12, evident as an occipital negativity and frontocentral positivity that peaked approximately 850 ms following picture presentation. Furthermore, the factor scores to emotional pictures for this component increased as a function of age 12 pubertal development, consistent with the notion that the LPP shifts from occipital to more frontocentral sites in relation to developmental changes from childhood to adolescence. A similar factor was observed when PCA was applied to all ERPs from both ages 9 and 12. Using temporospatial PCA on ERPs collected from the same subjects over time-especially within-subject subtraction-based ERPs-provides a concise way of characterizing and quantifying within-subject developmental changes in both the timing and scalp distribution of ERPs.

Self-criticism and dependency in female adolescents: Prediction of first onsets and disentangling the relationships between personality, stressful life events, and internalizing psychopathology

There is substantial evidence that personality traits, such as self-criticism and dependency, predict the development of depression and anxiety symptoms, as well as depressive episodes. However, it is unknown whether self-criticism and dependency predict the first onset of depressive and anxiety disorders, and unclear how to characterize dynamic mechanisms by which these traits, stressful life events, and psychopathology influence one another over time. In this study, 550 female adolescents were assessed at baseline, 528 and 513 of whom were assessed again at Waves 2 and 3, respectively, over the course of 18 months. Self-criticism and dependency were assessed with self-report inventories, depressive and anxiety disorders were assessed with diagnostic interviews, and stressful life events were assessed via semistructured interview. Logistic regression analyses showed that self-criticism and dependency significantly predicted the first onset of nearly all depressive and anxiety disorders (significant polychoric rs ranged from .15-.42). Subsequent path analyses focused on prediction of depression, and supported several conceptual models of personality-stress-psychopathology relationships. In particular, Personality × Stress interactions were evident for both dependency and self-criticism. These interactions took the form of dual vulnerability, such that stressful life events predicted an increased probability of a later depressive disorder only at low levels of each trait. Results suggest the traits of self-criticism and dependency are important to consider in understanding who is at risk for depressive and anxiety disorders. (PsycINFO Database Record

Observer-rated environmental sensitivity moderates children's response to parenting quality in early childhood

According to several developmental theories some children are more sensitive to the quality of their environment than others, but most supporting empirical evidence is based on relatively distal markers of hypothesized sensitivity. This study provides evidence for the validity of behaviorally observed Environmental Sensitivity as a moderator of parenting effects on children's early development in a sample of 292 children (Mage = 3.74; SD = 0.26) and their mothers. Sensitivity was coded using a newly developed observational measure for the specific and objective assessment of Environmental Sensitivity, the Highly Sensitive Child-Rating System (HSC-RS). HSC-RS factorial structure, associations with temperament traits, and interactions with parenting quality in the prediction of socioemotional child outcomes are reported. Findings supported a 1-factor solution. Observed sensitivity was relatively distinct from observed temperament and interacted with both low and high parenting quality in the development of behavior problems and social competence at ages 3 and 6. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Stability and change in emotional processing across development: A 6-year longitudinal investigation using event-related potentials

ERPs reveal the temporal dynamics of emotional processing and are easily assessed in children. Yet, little longitudinal research has examined ERPs sensitive to emotion across development. We aimed to systematically identify timing and spatial distributions of ERPs sensitive to emotion in a longitudinal sample of youth (N = 62) using principal component analysis (PCA) and evaluate stability and change in emotional responses across development. Participants completed an emotional interrupt paradigm in childhood (M_age  = 9.38, SD = 0.42), early adolescence (M_age  = 13.03, SD = 0.24), and midadolescence (M_age  = 15.16, SD = 0.17). ERPs were recorded to unpleasant, pleasant, and neutral images. Participants were instructed to respond to a target while viewing images. Two components sensitive to emotion emerged across development: P300/early late positive potential (LPP) and late LPP. The P300/early LPP component was characterized by an enhanced positivity for unpleasant compared to pleasant and neutral images. The late LPP was enhanced for both unpleasant and pleasant compared to neutral images, and more positive for unpleasant compared to pleasant images. The components showed moderate to strong stability. Overall LPP magnitude decreased from childhood into adolescence. There was a developmental shift in distributions from occipital sites in childhood to centroparietal sites in midadolescence. Results support use of PCA to inform scoring windows and electrode selection. The shift in distribution may reflect developmental focalization in underlying neural circuitry. Future work is needed using multimodal approaches to further understand the relationship between ERPs and changes in neural circuitry across development.

Neural Response to Rewards, Stress and Sleep Interact to Prospectively Predict Depressive Symptoms in Adolescent Girls

Blunted reward processing both characterizes major depressive disorder and predicts increases in depressive symptoms. However, little is known about the interaction between blunted reward processing and other risk factors in relation to increases in depressive symptoms. Stressful life events and sleep problems are prominent risk factors that contribute to the etiopathogenesis of depression and have been linked to reward dysfunction; these factors may interact with reward dysfunction to predict increased depressive symptoms. In a large sample of 8- to 14-year-old adolescent girls, the current study examined how blunted reward processing, stressful life events, and sleep problems at baseline interacted to predict increases in depressive symptoms 1 year later. Reward processing was indexed by the reward positivity (RewP), an event-related potential elicited during a simple monetary reward paradigm (i.e., Doors task). Two-way interactions confirmed that a blunted RewP predicted increased depressive symptoms at (a) high levels of stress but not average or low levels of stress, and (b) high and average levels of sleep problems but not low levels of sleep problems. Finally, a 3-way interaction confirmed that a blunted RewP predicted increased depressive symptoms at high levels of stress and sleep problems but not average or low levels of stress and sleep problems. Thus, adolescents characterized by low reward response (i.e., blunted RewP) were at an increased risk of developing depressive symptoms if they experienced increased stressful life events or sleep problems; moreover, risk was greatest among adolescents characterized by all 3.

Conducting Event-Related Potential (ERP) Research with Young Children: A Review of Components, Special Considerations and Recommendations for Research on Cognition and Emotion

There has been an unprecedented increase in the number of research studies employing event-related potential (ERP) techniques to examine dynamic and rapidly-occurring neural processes with children during the preschool and early childhood years. Despite this, there has been little discussion of the methodological and procedural differences that exist for studies of young children versus older children and adults. That is, reviewers, editors, and consumers of this work often expect developmental studies to simply apply adult techniques and procedures to younger samples. Procedurally, this creates unrealistic expectations for research paradigms, data collection, and data reduction and analyses. Scientifically, this leads to inappropriate measures and methods that hinder drawing conclusions and advancing theory. Based on ERP work with preschoolers and young children from 10 laboratories across North America, we present a summary of the most common ERP components under study in the area of emotion and cognition in young children along with 13 realistic expectations for data collection and loss, laboratory procedures and paradigms, data processing, ERP averaging, and typical challenges for conducting this type of work. This work is intended to supplement previous guidelines for work with adults and offer insights to aid researchers, reviewers, and editors in the design and evaluation of developmental research using ERPs. Here we make recommendations for researchers who plan to conduct or who are conducting ERP studies in children between ages 2 and 12, focusing on studies of toddlers and preschoolers. Recommendations are based on both data and our cumulative experience and include guidelines for laboratory setup, equipment and recording settings, task design, and data processing.

Family Aggregation of Substance Use Disorders: Substance Specific, Nonspecific, and Intrafamilial Sources of Risk

OBJECTIVE

The primary aim of this investigation was to evaluate substance-specific and nonspecific associations between parental and sibling histories of alcohol, cannabis, amphetamine, and hallucinogen use disorders with proband risk for these conditions. A second aim was to evaluate whether the specificity of substance use disorder (SUD) risk to probands varied by family member (i.e., father, mother, and any sibling).

METHOD

Lifetime SUD diagnostic data for this family-based investigation were derived from semistructured interviews of community residents. Participants were an age-based cohort (probands), selected at random during adolescence and followed longitudinally until age 30, and their first-degree family members (n = 803 probands and families).

RESULTS

Findings generally supported substance-specific and nonspecific forms of familial risk related to a particular type of SUD in probands. Family-based alcohol use disorder (AUD) demonstrated the greatest degree of risk specificity of any substance category, in that no other family SUD category predicted proband AUD. Family-based AUD, however, was also the most consistent nonspecific predictor of nonalcohol forms of SUD among probands. Among family members, the most consistent unique effects associated with a substance-specific risk to probands were observed for siblings.

CONCLUSIONS

Findings support both the generality and specificity of risk associated with the abuse of or dependence on specific substances within families and highlight the impact of siblings on SUD risk to other siblings. Study findings underscore the need for a better understanding of malleable family-based factors that promote and reduce SUD risk among members.

Family Aggregation of Substance Use Disorders: Substance Specific, Nonspecific, and Intrafamilial Sources of Risk

OBJECTIVE

The primary aim of this investigation was to evaluate substance-specific and nonspecific associations between parental and sibling histories of alcohol, cannabis, amphetamine, and hallucinogen use disorders with proband risk for these conditions. A second aim was to evaluate whether the specificity of substance use disorder (SUD) risk to probands varied by family member (i.e., father, mother, and any sibling).

METHOD

Lifetime SUD diagnostic data for this family-based investigation were derived from semistructured interviews of community residents. Participants were an age-based cohort (probands), selected at random during adolescence and followed longitudinally until age 30, and their first-degree family members (n = 803 probands and families).

RESULTS

Findings generally supported substance-specific and nonspecific forms of familial risk related to a particular type of SUD in probands. Family-based alcohol use disorder (AUD) demonstrated the greatest degree of risk specificity of any substance category, in that no other family SUD category predicted proband AUD. Family-based AUD, however, was also the most consistent nonspecific predictor of nonalcohol forms of SUD among probands. Among family members, the most consistent unique effects associated with a substance-specific risk to probands were observed for siblings.

CONCLUSIONS

Findings support both the generality and specificity of risk associated with the abuse of or dependence on specific substances within families and highlight the impact of siblings on SUD risk to other siblings. Study findings underscore the need for a better understanding of malleable family-based factors that promote and reduce SUD risk among members.

Parental depression moderates the relationships of cortisol and testosterone with children's symptoms

BACKGROUND

Previous research on the hormone-symptom relationship in children suggests that certain hormone patterns may be associated with symptoms, but only under certain circumstances. Having a parent with a history of depression may be one circumstance under which dysregulated hormone patterns are especially associated with emotional and behavioral symptoms in children. The current study sought to explore these relationships in a community sample of 389 9-year-old children.

METHODS

Children's salivary cortisol and testosterone levels were collected at home over three consecutive days; parental psychiatric histories were assessed using semi-structured diagnostic interviews; and children's internalizing and externalizing symptoms were rated by the child's mother.

RESULTS

Having two parents with a history of depression moderated the associations of reduced total daily cortisol output with higher externalizing scores, as well as the association of reduced testosterone with higher internalizing scores. A maternal history of depression, on the other hand, moderated the relationship between higher cortisol awakening response and higher internalizing scores. Furthermore, lower daily cortisol output was associated with higher internalizing scores among girls, but not boys, with two parents with a history depression.

LIMITATIONS

Limitations include the cross-sectional nature of the current analyses, as well as the limited racial, ethnic, and geographical diversity of the sample.

CONCLUSIONS

Taken together, the current results suggest that the relationship between hormones and internalizing and externalizing symptoms in children may vary as a function of parental depression and child sex, knowledge that may inform intervention efforts aimed at preventing psychopathology in children whose parents have a history of depression.

Reward processing and future life stress: Stress generation pathway to depression

Blunted reward sensitivity and life stress are each depressogenic. Additionally, individuals with clinical and psychosocial vulnerabilities are prone to experience or evoke dependent life stressors (e.g., interpersonal conflict) that, in turn, increase depression risk. However, no previous study has investigated the role of neural vulnerability factors in generating life stress. Therefore, the current study investigated whether a neural measure of reward sensitivity prospectively predicts the generation of life stress, which in turn mediates effects of these neural processes on subsequent depression. Participants were 467 never-depressed adolescent girls. Using event-related potentials, neural sensitivity to the difference between monetary reward and loss (the Reward Positivity [RewP]) was assessed at baseline. Negative life events were assessed twice via interview over the ensuing 18 months, yielding an index of total life stress over the follow-up period. A self-report dimensional measure of depression symptoms was administered at baseline and follow-up. After accounting for baseline age, depression, and race, a blunted RewP predicted greater dependent, but not independent, life stress over the follow-up. Mediation analyses revealed a significant indirect effect of the RewP on follow-up depression through dependent, but not independent, life stress. Our results suggest that neural processing reward and loss plays a crucial role in depressogenic stress generation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Structural correlates of the orbitofrontal cortex and amygdala and personality in female adolescents

The five-factor model consists of cognitive-affective-behavioral trait dimensions (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness) that are central to models of psychopathology. In adults, individual differences in three of the Big Five traits, neuroticism, extraversion, and conscientiousness, have been linked to structural morphology and connectivity of the orbitofrontal cortex (OFC) and the amygdala, two brain regions critically involved in affective and regulatory processing. It is unclear whether these associations manifest in adolescence, a critical neurodevelopmental period during which many forms of psychiatric illness emerge. A total of 223 adolescent girls (ages 14-16 years) completed a multimodal neuroimaging study that utilized T1-weighted structural MRI (e.g., cortical thickness and volume) and tractography-based diffusion tensor imaging (64-direction). Cortical thickness and volume were extracted from the medial orbitofrontal cortex (mOFC) and amygdala and tractography-based fractional anisotropy was computed in the uncinate fasciculus (UF; the white matter tract connecting the OFC to the temporal lobe). We found that high neuroticism was associated with less mOFC volume (bilateral), and low conscientiousness was associated with higher white matter integrity in the UF, more amygdala volume, and less mOFC thickness (right hemisphere). Extraversion was not observed to share associations with OFC markers. These OFC-amygdala structural correlations to personality do not match those reported in adult samples. Multimodal neuroimaging techniques can help to clarify the underpinnings of personality development between adolescence and adulthood.

Sensitivity to Peer Feedback in Young Adolescents with Symptoms of ADHD: Examination of Neurophysiological and Self-Report Measures

Many youth with ADHD experience peer difficulties, but the mechanisms underlying this dysfunction remain unknown. Very little work has examined neurophysiological measures of social feedback processing in relation to ADHD symptoms. The goal of this study was to examine associations of ADHD symptoms with indicators of sensitivity to social feedback in a laboratory task and self-report of rejection sensitivity. A large community sample of 10- to 15-year-old adolescents (N = 391; Mage = 12.64, 48.6% girls) participated in the study. Mothers rated youth ADHD symptoms. Youth completed the Island Getaway task, which elicits neurophysiological (i.e., event-related potentials [ERP]) measures of sensitivity to peer rejection and acceptance feedback, and also completed self-ratings of rejection sensitivity. Greater ADHD symptoms were associated with an enhanced N1 ERP component, which correlated with higher levels of self-reported rejection sensitivity. In addition, greater ADHD symptoms were associated with reduced reactivity to social acceptance, as measured by the later reward positivity ERP component. Youth with elevated ADHD symptoms exhibited enhanced sensitivity to peer rejection at the neurophysiological and self-report level, as well as reduced neurophysiological reactivity to peer acceptance. Future work including neural measures of social functioning may serve to elucidate mechanisms underlying the social dysfunction characteristic of ADHD.

Posterior parietal influences on visual network specialization during development: An fMRI study of functional connectivity in children ages 9 to 12

Visual processing in the primate brain is highly organized along the ventral visual pathway, although it is still unclear how categorical selectivity emerges in this system. While many theories have attempted to explain the pattern of visual specialization within the ventral occipital and temporal areas, the biased connectivity hypothesis provides a framework which postulates extrinsic connectivity as a potential mechanism in shaping the development of category selectivity. As the posterior parietal cortex plays a central role in visual attention, we examined whether the pattern of parietal connectivity with the face and scene processing regions is closely linked with the functional properties of these two visually selective networks in a cohort of 60 children ages 9 to 12. Functionally localized face and scene selective regions were used in deriving each visual network's resting-state functional connectivity. The children's face and scene processing networks appeared to show a weak network segregation during resting state, which was confirmed when compared to that of a group of gender and handedness matched adults. Parietal regions of these children showed differential connectivity with the face and scene networks, and the extent of this differential parietal-visual connectivity predicted individual differences in the degree of segregation between the two visual networks, which in turn predicted individual differences in visual perception performance. Finally, the pattern of parietal connectivity with the face processing network also predicted the foci of face-related activation in the right fusiform gyrus across children. These findings provide evidence that extrinsic connectivity with regions such as the posterior parietal cortex may have important implications in the development of specialized visual processing networks.

Reduced reward responsiveness moderates the effect of maternal depression on depressive symptoms in offspring: evidence across levels of analysis

BACKGROUND

Reduced reward responsiveness (RR) may contribute to depression vulnerability. At the neurophysiological level, RR is reliably and validly assessed using the reward positivity (RewP) event-related potential component. We previously identified a blunted RewP in 9-year-old children at high risk for depression due to maternal depression, but the role of RR in pathways from parental history to the development of depressive symptoms has not been examined.

METHODS

At age 9, never-depressed children (N = 369) completed a task in which RewP was measured in response to monetary reward and loss feedback. Parental history of depression was assessed using semistructured interviews, and children reported on their depressive symptoms. At age 12, youth depressive symptoms were reassessed, along with a self-report measure of RR. We tested RR as a moderator of the effects of parental depression on depressive symptoms at age 12, using both neurophysiological and self-report measures and controlling for age 9 symptoms.

RESULTS

Main effects of RR and interactions with maternal depression were significant. Maternal depression predicted greater depressive symptoms in youth with blunted and average RewP but was not a significant predictor in youth with an enhanced RewP. A similar pattern was observed for self-reported RR. The two measures of RR were not correlated with each other and accounted for unique variance in symptoms. Interactions between RR and paternal depression were not significant.

CONCLUSIONS

Reduced RR, as measured by neurophysiology and self-report, moderates the effects of maternal depression on depressive symptoms in offspring. Assessment of RR along with risk factors such as parental depression may aid in identifying children at greatest risk and enhancing RR could be a potential target for prevention. Results highlight the utility of multimethod approaches for advancing understanding of depression risk.

A neural biomarker, the error-related negativity, predicts the first onset of generalized anxiety disorder in a large sample of adolescent females

OBJECTIVE

An increased neural response to making mistakes has emerged as a potential biomarker of anxiety across development. The error-related negativity (ERN) is an event-related potential elicited when people make mistakes on simple laboratory-based reaction time tasks that has been associated with risk for anxiety. This study examined whether the ERN prospectively predicted the first onset of generalized anxiety disorder (GAD) over 1.5 years in adolescent girls.

METHODS

The sample included 457 girls between the ages of 13.5 and 15.5 years, with no history of GAD. At baseline, the ERN was measured using a flankers task. Psychiatric history of the adolescent and biological parent was assessed with diagnostic interviews, and the adolescent completed a self-report questionnaire regarding anxiety symptoms. Approximately 1.5 years later, adolescents completed the same interview.

RESULTS

An increased neural response to errors at baseline predicted first-onset GAD over 1.5 years. The ERN was a significant predictor independent of other prominent risk factors, including baseline anxiety and depression symptoms and parental lifetime psychiatric history. Jointly the ERN and social anxiety symptoms provided the greatest power for predicting first-onset GAD.

CONCLUSIONS

This study provides evidence for the utility of the ERN as a biomarker of risk for GAD during a key developmental period.

Cognitive-Behavioral Analysis System of Psychotherapy, Drug, or Their Combination for Persistent Depressive Disorder: Personalizing the Treatment Choice Using Individual Participant Data Network Metaregression

BACKGROUND

Persistent depressive disorder is prevalent, disabling, and often difficult to treat. The cognitive-behavioral analysis system of psychotherapy (CBASP) is the only psychotherapy specifically developed for its treatment. However, we do not know which of CBASP, antidepressant pharmacotherapy, or their combination is the most efficacious and for which types of patients. This study aims to present personalized prediction models to facilitate shared decision-making in treatment choices to match patients' characteristics and preferences based on individual participant data network metaregression.

METHODS

We conducted a comprehensive search for randomized controlled trials comparing any two of CBASP, pharmacotherapy, or their combination and sought individual participant data from identified trials. The primary outcomes were reduction in depressive symptom severity for efficacy and dropouts due to any reason for treatment acceptability.

RESULTS

All 3 identified studies (1,036 participants) were included in the present analyses. On average, the combination therapy showed significant superiority over both monotherapies in terms of efficacy and acceptability, while the latter 2 treatments showed essentially similar results. Baseline depression, anxiety, prior pharmacotherapy, age, and depression subtypes moderated their relative efficacy, which indicated that for certain subgroups of patients either drug therapy or CBASP alone was a recommendable treatment option that is less costly, may have fewer adverse effects and match an individual patient's preferences. An interactive web app (https://kokoro.med.kyoto-u.ac.jp/CBASP/prediction/) shows the predicted disease course for all possible combinations of patient characteristics.

CONCLUSIONS

Individual participant data network metaregression enables treatment recommendations based on individual patient characteristics.

Early Childhood Psychopathology Prospectively Predicts Social Functioning in Early Adolescence

Psychopathology in school-age children predicts impairment later in development. However, the long-term psychosocial consequences of early childhood psychopathology are less well known. The current study is the first to prospectively examine how a range of diagnoses and symptoms in early childhood predict psychosocial functioning across specific domains during early adolescence 6-9 years later. A community sample (N = 595; 44.9% female; 88.7% White, 12.6% Hispanic) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. Diagnoses and dimensional scores for depressive, anxiety, attention-deficit/hyperactivity (ADHD), and oppositional defiant disorders (ODD) were examined. When children were 12 years old, children and parents completed the UCLA Life Stress Interview for Children, a semistructured interview assessing functioning in multiple domains (academic, behavior, close friends, broader peers, maternal relationship, paternal relationship). Having a diagnosis in early childhood predicted greater impairment in all domains in early adolescence, except paternal relationship. Externalizing disorders predicted impairment in more domains than internalizing disorders. Most of the associations between early childhood psychopathology and poorer functioning in adolescence persisted after taking into account adolescent psychopathology. Moreover, the majority of bivariate associations with depressive, ODD, and ADHD symptoms, but not anxiety symptoms, persisted in a subsample of children who did not meet criteria for a diagnosis in early childhood. Early childhood psychopathology has long-lasting deleterious effects on several domains of psychosocial functioning, often beyond the effects of continuing or recurring adolescent psychopathology. Findings thereby highlight the validity and clinical significance of early psychopathology.

Preschool psychiatric disorders: homotypic and heterotypic continuity through middle childhood and early adolescence

BACKGROUND

Many preschool-age children meet criteria for psychiatric disorders, and rates approach those observed in later childhood and adolescence. However, there is a paucity of longitudinal research examining the outcomes of preschool diagnoses.

METHODS

Families with a 3-year-old child (N = 559) were recruited from the community. Primary caregivers were interviewed using the Preschool Age Psychiatric Assessment when children were 3 years old (n = 541), and, along with children, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version when children were 9 and 12 years old.

RESULTS

Rates of disruptive behavior disorders (DBD) decreased from preschool to middle childhood and early adolescence, whereas rates of attention-deficit/hyperactivity disorder (ADHD) increased. Rates of any psychiatric disorder and depression increased from preschool to early adolescence only. Preschoolers with a diagnosis were over twice as likely to have a diagnosis during later periods. Homotypic continuity was present for anxiety disorders from preschool to middle childhood, for ADHD from preschool to early adolescence, and for DBD through both later time points. There was heterotypic continuity between preschool anxiety and early adolescent depression, and between preschool ADHD and early adolescent DBD. Dimensional symptom scores showed homotypic continuity for all diagnostic categories and showed a number of heterotypic associations as well.

CONCLUSIONS

Results provide moderate support for the predictive validity of psychiatric disorders in preschoolers. Psychopathology in preschool is a significant risk factor for future psychiatric disorders during middle childhood and early adolescence.

The Development of Latent Dimensions of Psychopathology across Early Childhood: Stability of Dimensions and Moderators of Change

Recent research has described the structure of psychopathology as including one general and multiple specific factors, and this structure has been found in samples across development. However, little work has examined whether this structure is consistent across time, particularly in young children, within the same sample. Further, few studies have examined factors that influence the magnitude of the stability of latent dimensions of psychopathology. In the present study, we examine these issues in a community sample of 545 children assessed at ages 3 and 6. In addition, we explored child temperament, parental history of psychopathology, and parenting behaviors as potential moderators of the longitudinal stability of latent dimensions of psychopathology. We found that the same bifactor model structure identified at age 3 provided an adequate fit to the data at age 6. Further, our model revealed significant homotypic stability of the general, internalizing, and externalizing specific factors. We also found evidence of differentiation of psychopathology over time with the general factor at age 3 predicting the externalizing factor at age 6. However, we failed to identify moderators of the longitudinal associations between psychopathology latent factors. Overall, our results bolster support for the bifactor structure of psychopathology, particularly in early childhood.