Developmental psychopathology: A paradigm shift or just a relabeling?

Do traumatic events and substance use co-occur during adolescence? Testing three causal etiologic hypotheses

BACKGROUND

Why do potentially traumatic events (PTEs) and substance use (SU) so commonly co-occur during adolescence? Causal hypotheses developed from the study of posttraumatic stress disorder (PTSD) and substance use disorder (SUD) among adults have not yet been subject to rigorous theoretical analysis or empirical tests among adolescents with the precursors to these disorders: PTEs and SU. Establishing causality demands accounting for various factors (e.g. genetics, parent education, race/ethnicity) that distinguish youth endorsing PTEs and SU from those who do not, a step often overlooked in previous research.

METHODS

We leveraged nationwide data from a sociodemographically diverse sample of youth (N = 11,468) in the Adolescent Brain and Cognitive Development Study. PTEs and substance use prevalence were assessed annually. To account for the many pre-existing differences between youth with and without PTE/SU (i.e. confounding bias) and provide rigorous tests of causal hypotheses, we linked within-person changes in PTEs and SU (alcohol, cannabis, nicotine) across repeated measurements and adjusted for time-varying factors (e.g. age, internalizing symptoms, externalizing symptoms, and friends' use of substances).

RESULTS

Before adjusting for confounding using within-person modeling, PTEs and SU exhibited significant concurrent associations (βs = .46-1.26, ps < .05) and PTEs prospectively predicted greater SU (βs = .55-1.43, ps < .05) but not vice versa. After adjustment for confounding, the PTEs exhibited significant concurrent associations for alcohol (βs = .14-.23, ps < .05) and nicotine (βs = .16, ps < .05) but not cannabis (βs = -.01, ps > .05) and PTEs prospectively predicted greater SU (βs = .28-.55, ps > .05) but not vice versa.

CONCLUSIONS

When tested rigorously in a nationwide sample of adolescents, we find support for a model in which PTEs are followed by SU but not for a model in which SU is followed by PTEs. Explanations for why PTSD and SUD co-occur in adults may need further theoretical analysis and adaptation before extension to adolescents.

Hot and cool executive function in the development of behavioral problems in grade school

Despite the well-established link between children's executive function and behavioral adjustment, it remains unclear whether the hot and cool aspects of executive function are uniquely associated with children's behavioral problems. Using longitudinal data spanning in the grade school (N = 1,140), this study aimed to examine whether hot and cool executive function skills may be uniquely related to the development of behavioral problems. Hot and cool executive function skills were measured with tasks, standardized tests, and questionnaires at 54 months and in the first grade, respectively. Internalizing and externalizing problems were evaluated by teachers using questionnaires throughout the grade school. The results indicated that, independent of each other, hot and cool executive function skills were uniquely and negatively related to the development of internalizing and externalizing problems over time at the between-individual level, adjusting for within-individual fluctuations. Moreover, internalizing and externalizing problems were positively related at the between-individual level across the grade school. Findings provide needed evidence to clarify the relations between hot and cool executive function and children's behavioral problems, emphasizing the importance of both aspects of executive function in understanding the development of behavioral problems in school-age children.

Developmental psychopathology as a meta-paradigm: From zero-sum science to epistemological pluralism in theory and research

In a thoughtful commentary in this journal a decade ago, Michael Rutter reviewed 25 years of progress in the field before concluding that developmental psychopathology (DP) initiated a paradigm shift in clinical science. This deduction requires that DP itself be a paradigm. According to Thomas Kuhn, canonical paradigms in the physical sciences serve unifying functions by consolidating scientists' thinking and scholarship around single, closed sets of discipline-defining epistemological assumptions and methods. Paradigm shifts replace these assumptions and methods with a new field-defining framework. In contrast, the social sciences are multiparadigmatic, with thinking and scholarship unified locally around open sets of epistemological assumptions and methods with varying degrees of inter-, intra-, and subdisciplinary reach. DP challenges few if any of these local paradigms. Instead, DP serves an essential pluralizing function, and is therefore better construed as a metaparadigm. Seen in this way, DP holds tremendous untapped potential to move the field from zero-sum thinking and scholarship to positive-sum science and epistemological pluralism. This integrative vision, which furthers Dante Cicchetti's legacy of interdisciplinarity, requires broad commitment among scientists to reject zero-sum scholarship in which portending theories, useful principles, and effective interventions are jettisoned based on confirmation bias, errors in logic, and ideology.

Fostering resilience and well-being in emerging adults with adverse childhood experiences: study protocol for a randomized controlled trial to evaluate the FACE self-help app

BACKGROUND

Adverse childhood experiences (ACE) are linked to an increased risk of psychological disorders and lower psychosocial functioning throughout life. This study aims to evaluate the FACE self-help app, designed to promote resilience and well-being in emerging adults with a history of ACE. The app is based on cognitive-behavioural principles and consists of two thematic components: (1) self- and emotion regulation (SER) and (2) social skills and biases in social information processing (SSIP).

METHODS

The efficacy of the app will be tested through a single-centre, two-arm randomized controlled trial, comparing an active intervention group against a waiting list control group. The active group is divided into two subgroups, in which the two components are delivered in a different order to investigate differential effects in a crossover design. Up to 250 emerging adults aged 18 to 25 years with a history of ACE from a general population cohort study will be recruited. The primary objective is to test the efficacy of the app in improving resilience (primary outcome) and well-being (co-primary outcome) compared to a waiting list control group and to examine the stability of these effects. The secondary objectives include testing the efficacy of the app in improving the secondary outcomes, i.e., self-efficacy in managing emotions, problem solving, fear of evaluation, social avoidance, and self-esteem; examining the differential effects of the two components; and assessing the effect of the app on real-life data on resilience, affective states, distress in social interactions and coping strategies. Furthermore, the study will investigate potential moderators (e.g. ACE severity) and mediators of intervention outcomes (e.g. self-efficacy in managing emotions).

DISCUSSION

The results will provide insights into the efficacy of the self-help intervention as well as mediators and moderators of outcomes. Furthermore, results will extend the existing knowledge by testing the differential effects of the SER and SSIP component on the outcomes. Findings can inform improvements to the FACE app and the development of other interventions for this target group and assess its potential as a scalable, low-threshold intervention to support emerging adults with a history of ACE in their transition to adulthood.

TRIAL REGISTRATION NUMBER

NCT05824182.

The Role of Maternal Personality Organization and of the p Factor in Predicting Parental Distress, the Quality of Parental Care, and Offspring's Dysregulation Symptoms

Background

It has been posited that parental distress, the quality of maternal care and offspring's dysregulation can be predicted by maternal maladaptive characteristics. However, only a few studies have considered mothers' personality organizations and features of the p factor in mothers as possible predictors of symptoms in their children.

Methods

In a sample of N=524 subjects, this study evaluated the effect of mothers' personality organization and of the p factor on parental distress, parental care and offspring's dysregulation symptoms. Mothers filled out the IPO, the ASR, and the PSI-SF; children's teachers filled out the TRF; children were administered the PBI.

Results

We found that different mother groups (neurotic, borderline, psychotic organization) have distinct impact on parental distress, quality of care, and children's dysregulation, mediated by the p factor.

Conclusion

This study can contribute to the understanding of the key factors underpinning mothers and children's psychopathology.

The role of psychosocial adversity in the aetiology and course of attention deficit hyperactivity disorder

INTRODUCTION

Attention deficit/hyperactivity disorder (ADHD) has genetic and environmental aetiological factors. There are few publications on the environmental factors. The objective of this review is to present the role of psychosocial adversity in the aetiology and course of ADHD.

METHODS

A search was carried out in the following databases: PubMed, ScienceDirect, SciELO, ClinicalKey, EMBASE, Lilacs, OVID, APA and PsycNET. English and Spanish were selected without being limited by type of study or year of publication. Finally, a qualitative synthesis was conducted.

RESULTS

ADHD development could be related to exposure to adverse factors in the family, school or social environment. It has been proposed as an explanatory mechanism that adversity interacts with genetic variants and leads to neurobiological changes. There may also be a gene-environment correlation whereby individual hereditary characteristics increase the risk of exposure to adversity, and indirectly increase the probability of developing ADHD. Research on psychosocial adversity represents a big challenge, not only due to the complexity of its construct, but also to the effect of subjective perception of a given event.

CONCLUSIONS

ADHD aetiology is complex and involves the interaction of both genetic and environmental factors, in which these factors correlate and cause the disorder. The study of the role of psychosocial adversity in ADHD is fundamental, but it remains a task that entails great difficulties.

Development and validation of a self-report measure of epistemic trust

Epistemic trust (ET) refers to trust in communicated knowledge. This paper describes the development and validation of a new self-report questionnaire, the Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ). We report on two studies (Study 1, n = 500; Study 2, n = 705) examining the psychometric properties of the ETMCQ and the relationship between EMTCQ scores (i.e., an individual’s epistemic stance) and exposure to adverse childhood experiences, mental health symptoms, attachment, mentalizing and general self-efficacy. The factor structure of the ETMCQ was examined using Exploratory and Confirmatory Factor Analyses, and its reliability and test-retest reliability were tested. Both studies yielded three correlated yet distinct factors–Trust, Mistrust and Credulity–and confirmed the reliability and validity of the ETMCQ. Preregistered hypotheses were confirmed and replicated across both studies. Main findings suggest intriguing links between the ETMCQ and developmental psychopathology constructs and are consistent with thinking on the role of epistemic stance in undermining adaptation and increasing the developmental risk of mental health problems. Mistrust and Credulity scores were associated with childhood adversity and higher scores on the global psychopathology severity index and both factors partially mediated the link between early adversity and mental health symptoms. Mistrust and Credulity were positively associated with difficulties in understanding mental states and insecure attachment styles. Post-hoc analysis identified that different attachment styles were associated with differences in epistemic stance. In addition, Trust was not associated with reduced levels of mental health symptoms and did not moderate the impact of childhood adversity–findings are congruent with the suggestion that the reduction of mistrust and credulity may be crucial common factors in promoting resilience and the effectiveness of psychotherapeutic interventions. This investigation and the ETMCQ provide an empirical measure of what until now has been largely a theoretical concept and open new avenues for future research.

The role of psychosocial adversity in the aetiology and course of attention deficit hyperactivity disorder

INTRODUCTION

Attention deficit/hyperactivity disorder (ADHD) has genetic and environmental aetiological factors. There are few publications on the environmental factors. The objective of this review is to present the role of psychosocial adversity in the aetiology and course of ADHD.

METHODS

A search was carried out in the following databases: PubMed, ScienceDirect, SciELO, ClinicalKey, EMBASE, Lilacs, OVID, APA and PsycNET. English and Spanish were selected without being limited by type of study or year of publication. Finally, a qualitative synthesis was conducted.

RESULTS

ADHD development could be related to exposure to adverse factors in the family, school or social environment. It has been proposed as an explanatory mechanism that adversity interacts with genetic variants and leads to neurobiological changes. There may also be a gene-environment correlation whereby individual hereditary characteristics increase the risk of exposure to adversity, and indirectly increase the probability of developing ADHD. Research on psychosocial adversity represents a big challenge, not only due to the complexity of its construct, but also to the effect of subjective perception of a given event.

CONCLUSIONS

ADHD aetiology is complex and involves the interaction of both genetic and environmental factors, in which these factors correlate and cause the disorder. The study of the role of psychosocial adversity in ADHD is fundamental, but it remains a task that entails great difficulties.

Just a phase? Mapping the transition of behavioural problems from childhood to adolescence

PURPOSE

Young people change substantially between childhood and adolescence. Yet, the current description of behavioural problems does not incorporate any reference to the developmental context. In the current analysis, we aimed to identify common transitions of behavioural problems between childhood and adolescence.

METHOD

We followed 6744 individuals over 6 years as they transitioned from childhood (age 10) into adolescence (age 16). At each stage, we used a data-driven hierarchical clustering method to identify common profiles of behavioural problems, map transitions between profiles and identify factors that predict specific transitions.

RESULTS

Common profiles of behavioural problems matched known comorbidity patterns but crucially showed that the presentation of behavioural problems changes markedly between childhood and adolescence. While problems with hyperactivity/impulsivity, motor control and conduct were prominent in childhood, adolescents showed profiles of problems related to emotional control, anxiety and inattention. Transitions were associated with socio-economic status and cognitive performance in childhood CONCLUSION: We show that understanding behavioural difficulties and mental ill-health must take into account the developmental context in which the problems occur, and we establish key risk factors for specific negative transitions as children become adolescents.

Relations of Stress and Drinking Motives to Young Adult Alcohol Misuse: Variations by Gender

Theory and empirical findings have linked stress exposure to young adult alcohol misuse, but the processes underlying this association have not been fully investigated. This study examined gender differences in the indirect pathways linking stress in developmentally relevant domains to alcohol misuse in young adults, focusing on drinking motives as a possible mediator of the association. The longitudinal associations between adolescent heavy drinking and young adult stress were also explored. Participants were rural young adults who had been surveyed previously in adolescence (N = 442; 55.7% female; 96% White; Mage = 23.29, SD = 1.07). Chronic stress and drinking motives were concurrently associated with young adult alcohol misuse. For men, occupational stress was indirectly related to alcohol misuse through both social and coping motives for drinking, whereas for women relationship stress was indirectly related to alcohol misuse through social motives only. When investigating the longitudinal effects of adolescent drunkenness, more frequent drunkenness in adolescence was related to more adult occupational stress for men but to neither kind of stress for women. These findings indicate that stress in specific life domains is related to young adult alcohol misuse through drinking motives, that the link between stress and alcohol misuse may be bidirectional for men, and that different stressors and drinking motives are salient for young adult men and women.

Stability and Change in Patterns of Adolescent Antisocial Behavior

Research examining relations between various types of antisocial behavior (ASB) have generally been based on cross-sectional data. Although there is a strong correlation between types of ASB, it has been less common to examine how patterns of adolescents’ problems vary over time. This study used a person-oriented approach to examine patterns of ASB in adolescents longitudinally and also investigated how these patterns were associated with three outcomes. The sample consisted of 778 Swedish adolescents in grade 7 (13 years old) followed over time to grade 9. Patterns of ASB were identified based on adolescent-reported tobacco and alcohol use, truancy, bullying in school, and delinquency. The outcomes were drug use, depressive symptoms, and missing grades in grade 9. Results revealed an escalation in the frequency and seriousness of ASB over time, although the largest single cluster over time evidenced no ASB. One cluster in particular increased the risk of drug use, depression, and missing grades at grade 9. Results are discussed in relation to school-based prevention efforts.

Developmental pathways towards mood disorders in adult life: Is there a role for sleep disturbances?

INTRODUCTION

Mood disorders are among the most prevalent and serious mental disorders and rank high among to the leading global burdens of disease. The developmental psychopathology framework can offer a life course perspective on them thus providing a basis for early prevention and intervention. Sleep disturbances, are considered risk factors for mood disorders across childhood, adolescence and adulthood. Assuming that sleep disturbances may play a pivotal role in the pathogenesis of mood disorders from a life course point of view, we reviewed the data on developmental pathways towards mood disorders in adult life in relation to sleep disturbances.

METHOD

From February 2017, a systematic search was conducted in PubMed, PsycINFO and Embase electronic databases for literature on developmental pathways to mood disorders in adult life in relation to sleep disturbances and to 1) pre-natal stress, 2) early brain developmental processes, and 3) temperaments, character and attachment style.

RESULTS

Eleven, 54 and 15 articles were respectively selected.

CONCLUSIONS

Experimental and clinical studies revealed that exposure to prenatal/early life stress results in sleep disturbances such as poor sleep and altered circadian regulation phases and may predict or even precipitate mood disorders in adulthood. Chronic sleep disruption may interfere with neuronal plasticity, connectivity and the developing brain thus contributing to the development of mood disorders. In addition sleep and circadian dysregulations have been shown to be related to those temperaments, character and attachment styles which are considered precursors of mood disorders. Sleep and circadian behaviours may serve as early targets regarding mood disorders.

Age-Related Changes in Distractibility: Developmental Trajectory of Sustained Attention in ADHD

OBJECTIVE

This study investigated age-related changes in sustained attention in children with ADHD and in their typically developed peers.

METHOD

The study used a Continuous Performance Test (CPT) that includes visual and auditory stimuli serving as distractors. The rate of omission errors was used as a measurement of difficulty in sustained attention. Participants were children and adolescents aged 7 to 18 years (478 with ADHD and 361 without ADHD).

RESULTS

Both groups of adolescents (with and without ADHD) showed reduced distractibility than younger children from the same group. However, distractibility tended to diminish in non-ADHD adolescents, but not in adolescents with ADHD.

CONCLUSION

Although part of the difficulties in ADHD could be explained by developmental delay that improves with time, other deficits, such as increased distractibility causing more omission errors, do not show a clear developmental trajectory. The results suggest that deficits in inhibitory control might be the core of ADHD.

A Social Ecological Modeled Explanation of the Resilience Processes of a Sample of Black Sesotho-Speaking Adolescents

The primary aim of the study that this article reports was to model and test a social ecological explanation of resilience as explained by Ungar. Its secondary aim was to investigate resilience-promoting supports in school-going Black South African adolescents. School attendance was specified as a culturally appropriate, functional outcome of resilience. The Pathways to Resilience Research Project gathered data through the Pathways to Resilience Youth Measure. Seven hundred and thirty school-going adolescents (age 12-19 years, 388 female, 341 male, one unspecified) from Thabo Mofutsanyana District, in South Africa's Free State province, participated in this cross-sectional study. Latent variable modeling was used to test measurement models of adolescents' self-reported perceptions of social ecological contributions (resources and risks) to their resilience. A complex model based on a social ecological explanation of resilience fitted the data best. The structural model showed that the resilience process predicted 32% of the variance in school attendance. Social skills, cultural, and spiritual resources were most supportive of adolescents' resilience. The results confirmed that the complex model explained resilience in Black South African adolescents as a person-context relational process and prompt principals, parents, teachers, and governmental departments to encourage school attendance.

Understanding comorbidity among internalizing problems: Integrating latent structural models of psychopathology and risk mechanisms

It is well known that comorbidity is the rule, not the exception, for categorically defined psychiatric disorders, and this is also the case for internalizing disorders of depression and anxiety. This theoretical review paper addresses the ubiquity of comorbidity among internalizing disorders. Our central thesis is that progress in understanding this co-occurrence can be made by employing latent dimensional structural models that organize psychopathology as well as vulnerabilities and risk mechanisms and by connecting the multiple levels of risk and psychopathology outcomes together. Different vulnerabilities and risk mechanisms are hypothesized to predict different levels of the structural model of psychopathology. We review the present state of knowledge based on concurrent and developmental sequential comorbidity patterns among common discrete psychiatric disorders in youth, and then we advocate for the use of more recent bifactor dimensional models of psychopathology (e.g., p factor; Caspi et al., 2014) that can help to explain the co-occurrence among internalizing symptoms. In support of this relatively novel conceptual perspective, we review six exemplar vulnerabilities and risk mechanisms, including executive function, information processing biases, cognitive vulnerabilities, positive and negative affectivity aspects of temperament, and autonomic dysregulation, along with the developmental occurrence of stressors in different domains, to show how these vulnerabilities can predict the general latent psychopathology factor, a unique latent internalizing dimension, as well as specific symptom syndrome manifestations.

Antecedents of transition patterns of depressive symptom trajectories from adolescence to young adulthood

This study examined (a) transition patterns from adolescent-specific depressive symptom trajectory classes to young adult-specific trajectory classes (N = 537; 15-26 years) and (b) identified risk factors associated with these transition patterns. The latent classes and transition analyses identified three transitional patterns of depressive symptom trajectories, including a deteriorating pattern (8.2%), a recovering pattern (22.5%), and a consistently low pattern (69.3%). Additionally, the results showed that contextual risk factors (i.e., negative economic events, negative romantic relationships, and low college enrolment rates) in the transition period to young adulthood were more positively associated with deteriorated or recovered transition patterns of depressive symptom trajectories than with the consistently low transition patterns even after taking into account the effects of adolescent risk factors. The identification of dynamic transition patterns in depressive symptom trajectories from adolescence to young adulthood and risk factors provide useful tools for preventive and intervention efforts. Statement of contribution What is already known on this subject? Heterogeneous trajectories of depressive symptoms across adolescence and young adulthood have been reported. Psychosocial characteristics differentiate trajectories of depressive symptoms from adolescence to young adulthood. What does this study add? Dynamic transition patterns of depressive symptom trajectories are found between adolescence and young adulthood. Life experiences in the transition period are uniquely associated with the transition patterns of depressive symptom trajectories even after adjusting the effects of adolescent characteristics.

Re-interpreting: Narratives of childhood language brokering over time

This article probes how childhood experiences are actively taken into adult lives and thus challenges the unwitting and unintentional reproduction of an adult-child binary in childhood studies. We do this by analyzing interviews with one adult daughter of immigrants from Mexico to the United States at four points in time (ages 19, 26, 27, and 33). Using narrative analysis to examine the mutability of memory, we consider how Eva oriented herself to her childhood story, what was salient and invisible in each recount, the values she associated with the practice, and the meanings she took from her experiences. We show how Eva re-interpreted her experiences as an immigrant child language broker in relation to unfolding life events, showing her childhood to be very much alive in her adult life. Language brokering serves as one way in which to examine the interpenetration of childhood into adulthood, rather than being the focus per se.

Biological embedding: evaluation and analysis of an emerging concept for nursing scholarship

AIM

The purpose of this paper was to report the analysis of the concept of biological embedding.

BACKGROUND

Research that incorporates a life course perspective is becoming increasingly prominent in the health sciences. Biological embedding is a central concept in life course theory and may be important for nursing theories to enhance our understanding of health states in individuals and populations. Before the concept of biological embedding can be used in nursing theory and research, an analysis of the concept is required to advance it towards full maturity.

DESIGN

Concept analysis.

DATA SOURCES

PubMed, CINAHL and PsycINFO were searched for publications using the term 'biological embedding' or 'biological programming' and published through 2015.

METHODS

An evaluation of the concept was first conducted to determine the concept's level of maturity and was followed by a concept comparison, using the methods for concept evaluation and comparison described by Morse.

RESULTS

A consistent definition of biological embedding - the process by which early life experience alters biological processes to affect adult health outcomes - was found throughout the literature. The concept has been used in several theories that describe the mechanisms through which biological embedding might occur and highlight its role in the development of health trajectories. Biological embedding is a partially mature concept, requiring concept comparison with an overlapping concept - biological programming - to more clearly establish the boundaries of biological embedding.

CONCLUSIONS

Biological embedding has significant potential for theory development and application in multiple academic disciplines, including nursing.

Integrating care for neurodevelopmental disorders by unpacking control: A grounded theory study

BACKGROUND

To establish integrated healthcare pathways for patients with neurodevelopmental disorders (ND) such as autism spectrum disorder and attention-deficit hyperactivity disorder is challenging. This study sets out to investigate the main concerns for healthcare professionals when integrating ND care pathways and how they resolve these concerns.

METHODS

Using classic grounded theory (Glaser), we analysed efforts to improve and integrate an ND care pathway for children and youth in a Swedish region over a period of 6 years. Data from 42 individual interviews with a range of ND professionals, nine group interviews with healthcare teams, participant observation, a 2-day dialogue conference, focus group meetings, regional media coverage, and reports from other Swedish regional ND projects were analysed.

RESULTS

The main concern for participants was to deal with overwhelming ND complexity by unpacking control, which is control over strategies to define patients' status and needs. Unpacking control is key to the professionals' strivings to expand constructive life space for patients, to squeeze health care to reach available care goals, to promote professional ideologies, and to uphold workplace integrity. Control-seeking behaviour in relation to ND unpacking is ubiquitous and complicates integration of ND care pathways.

CONCLUSIONS

The Unpacking control theory expands central aspects of professions theory and may help to improve ND care development.

The Great Smoky Mountains Study: developmental epidemiology in the southeastern United States

AIMS

To describe the Great Smoky Mountains Study (GSMS).

METHODS

GSMS is a longitudinal study of child psychiatric disorders that began in 1992 to look at need for mental health services in a rural area of the USA. Over 20 years it has expanded its range to include developmental epidemiology more generally, not only the development of psychiatric and substance abuse problems but also their correlates and predictors: family and environmental risk, physical development including puberty, stress and stress-related hormones, trauma, the impact of poverty, genetic markers, and epigenetics. Now that participants are in their 30s the focus has shifted to adult outcomes of childhood psychopathology and risk, and early physical, cognitive, and psychological markers of aging.

RESULTS

This paper describes the results from over 11,000 interviews, examples of the study's contributions to science and policy, and plans for the future.

CONCLUSIONS

Longitudinal studies can provide insights that aid in policy planning.

Developmental psychopathology in an era of molecular genetics and neuroimaging: A developmental neurogenetics approach

The emerging field of neurogenetics seeks to model the complex pathways from gene to brain to behavior. This field has focused on imaging genetics techniques that examine how variability in common genetic polymorphisms predict differences in brain structure and function. These studies are informed by other complimentary techniques (e.g., animal models and multimodal imaging) and have recently begun to incorporate the environment through examination of Imaging Gene × Environment interactions. Though neurogenetics has the potential to inform our understanding of the development of psychopathology, there has been little integration between principles of neurogenetics and developmental psychopathology. The paper describes a neurogenetics and Imaging Gene × Environment approach and how these approaches have been usefully applied to the study of psychopathology. Six tenets of developmental psychopathology (the structure of phenotypes, the importance of exploring mechanisms, the conditional nature of risk, the complexity of multilevel pathways, the role of development, and the importance of who is studied) are identified, and how these principles can further neurogenetics applications to understanding the development of psychopathology is discussed. A major issue of this piece is how neurogenetics and current imaging and molecular genetics approaches can be incorporated into developmental psychopathology perspectives with a goal of providing models for better understanding pathways from among genes, environments, the brain, and behavior.

The National Institute of Mental Health Research Domain Criteria and Clinical Research in Child and Adolescent Psychiatry

OBJECTIVE

This review discusses the relevance of the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) to clinical research in child and adolescent psychiatry.

METHOD

We summarize the characteristics of the NIMH RDoC project and then provide examples of RDoC designs that are of relevance to clinical investigators in child and adolescent psychiatry. The final section addresses questions regarding the impact of RDoC on clinical care.

RESULTS

RDoC encourages investigators to investigate psychopathology dimensionally: greater or lesser degrees of healthy/adapted functioning of neurobiological, cognitive, and behavioral processes (constructs) that cut across current diagnostic categories. Elucidation of the developmental components of RDoC constructs is needed to ensure they are fully validated. Integrating RDoC approaches into clinical research of child and adolescent psychopathology is contributing to our understanding of development as an aspect of the heterogeneity within DSM disorders and commonalities across seemingly disparate disorders. Continued efforts promise to also explain the processes that lead to mental illness in at-risk populations.

CONCLUSION

Incorporating an RDoC approach in clinical research in child and adolescent psychiatry promises to be a fruitful avenue of research into the root causes and manifestations of mental illness, which will eventually lead to more precise treatments. Although the long-term aspiration of RDoC is to help reduce the burden of suffering for those with mental illnesses, it is not intended to be used for practical clinical purposes at this early stage.

Effect of the Nature of Subsequent Environment on Oxytocin and Cortisol Secretion in Maltreated Children

Childhood maltreatment (CM), including abuse and neglect, is a crucial factor that distorts child development. CM is associated with alterations in numerous brain regions, and may be associated with hormonal dysregulation. This study aimed to investigate differences in secretion patterns of cortisol (CT) and oxytocin (OT) among children who experienced CM, children living in residential care facilities and in unstable environments. Among 38 maltreated children, 23 (mean age = 12.2 years, SD = 3.0) were categorized as "Settled" and 15 (mean age = 13.1 years, SD = 2.2) as "Unsettled." Twenty-six age- and gender-matched (mean age = 12.6 years, SD = 2.1), typically developing (TD) children were also included. Clinical and psychological assessments, including IQ and trauma evaluations, were conducted for all participants. Age, gender, and full-scale IQ were used as covariates in hormone analysis. Two saliva samples were collected, one on awakening and the other at bedtime. There were significant differences in the awakening CT levels of the "Unsettled" group, and in bedtime OT levels in the "Settled" group as compared with TD children, and between CM groups. Furthermore, there was a significant difference in trauma-symptomatic depression scores between the "Settled" and "Unsettled" CM group. These results suggest that CT diurnal secretions tend to be reactive to current stress rather than previous experience. OT diurnal secretions are presumably hyper-regulated for coping with the environment to survive and thrive. By measuring salivary CT/OT diurnal patterns, hormonal dysregulation of CM children living in "Settled" environments and "Unsettled" environments was indicated.

Psychiatric comorbidity in childhood and adolescence headache

Primary headaches among children and adolescents have a substantial impact on quality of life, daily activities, social interaction, and school performance in combination with psychopathological symptoms. The main purpose of the present paper is to summarize clinical and epidemiological evidence for psychiatric comorbidity among children and adolescents with headaches, to describe how evidence in headache research suggest different pathways involved in the development and maintenance of these comorbid conditions, and finally suggest some elements professionals may find helpful to assess the scope of complaints, related functional impairment, and potential precipitating factors in planning of more targeted treatments.

Dopamine ups and downs in vulnerability to addictions: a neurodevelopmental model

Addictions are commonly presaged by problems in childhood and adolescence. For many individuals this starts with the early expression of impulsive risk-taking, social gregariousness, and oppositional behaviors. Here we propose that these early diverse manifestations reflect a heightened ability of emotionally salient stimuli to activate dopamine pathways that foster behavioral approach. If substance use is initiated, these at-risk youth can also develop heightened responses to drug-paired cues. Through conditioning and drug-induced sensitization, these effects strengthen and accumulate, leading to responses that exceed those elicited by other rewards. At the same time, cues not paired with drug become associated with comparatively lower dopamine release, accentuating further the difference between drug and non-drug rewards. Together, these enhancing and inhibiting processes steer a pre-existing vulnerability toward a disproportionate concern for drugs and drug-related stimuli. Implications for prevention and treatment are discussed.

The promise of developmental psychopathology: Past and present

Progress in the field of developmental psychopathology is appraised in general and with regard to the particular lens of our understanding of the development of disorder. In general, the outpouring of research on various features of disorder and underlying processes could not have even been imagined 25 years ago. The progress is dazzling. At the same time, work on the development of disorders, beginning with antecedent patterns of adaptation, pales in comparison with work on the correlates of disorder. However, progress has been made. It is well established that the brain develops in the context of experience and that organism and environment continually interact over time. Something is now known about pathways leading to certain disorders and what initiates and impels individuals along them. If developmental psychopathology is to completely fulfill its promise of offering new ways of conceptualizing disorder and new guidance for prevention and intervention, much more work on developmental processes and a new way of exploring the development of disorder will be needed. Such a path is suggested.