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Kretzer S, Lawrence AJ, Pollard R, Ma X, Chen PJ, Amasi-Hartoonian N, Pariante C, Vallée C, Meaney M, Dazzan P. The Dynamic Interplay Between Puberty and Structural Brain Development as a Predictor of Mental Health Difficulties in Adolescence: A Systematic Review. Biol Psychiatry 2024; 96:585-603. [PMID: 38925264 DOI: 10.1016/j.biopsych.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 06/16/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024]
Abstract
Puberty is a time of intense reorganization of brain structure and a high-risk period for the onset of mental health problems, with variations in pubertal timing and tempo intensifying this risk. We conducted 2 systematic reviews of articles published up to February 1, 2024, focusing on 1) the role of brain structure in the relationship between puberty and mental health, and 2) precision psychiatry research evaluating the utility of puberty in making individualized predictions of mental health outcomes in young people. The first review provides inconsistent evidence about whether and how pubertal and psychopathological processes may interact in relation to brain development. While most studies found an association between early puberty and mental health difficulties in adolescents, evidence on whether brain structure mediates this relationship is mixed. The pituitary gland was found to be associated with mental health status during this time, possibly through its central role in regulating puberty and its function in the hypothalamic-pituitary-gonadal and hypothalamic-pituitary-adrenal axes. In the second review, the design of studies that have explored puberty in predictive models did not allow for a quantification of its predictive power. However, when puberty was evaluated through physically observable characteristics rather than hormonal measures, it was more commonly identified as a predictor of depression, anxiety, and suicidality in adolescence. Social processes may be more relevant than biological ones to the link between puberty and mental health problems and represent an important target for educational strategies.
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Affiliation(s)
- Svenja Kretzer
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Singapore Institute for Clinical Sciences, Agency for Science, Technology & Research (A∗STAR) Singapore, Republic of Singapore.
| | - Andrew J Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Rebecca Pollard
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Xuemei Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Pei Jung Chen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Nare Amasi-Hartoonian
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
| | - Carmine Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Corentin Vallée
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Michael Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology & Research (A∗STAR) Singapore, Republic of Singapore; Douglas Hospital Research Centre, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom.
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Michelini G, Carlisi CO, Eaton NR, Elison JT, Haltigan JD, Kotov R, Krueger RF, Latzman RD, Li JJ, Levin-Aspenson HF, Salum GA, South SC, Stanton K, Waldman ID, Wilson S. Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? Incorporating a new neurodevelopmental spectrum. World Psychiatry 2024; 23:333-357. [PMID: 39279404 PMCID: PMC11403200 DOI: 10.1002/wps.21225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2024] Open
Abstract
Features of autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disorders, intellectual disabilities, and communication and motor disorders usually emerge early in life and are associated with atypical neurodevelopment. These "neurodevelopmental conditions" are grouped together in the DSM-5 and ICD-11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges in both research and clinical settings (e.g., high co-occurrence, arbitrary diagnostic boundaries, high within-disorder heterogeneity). Taking a transdiagnostic dimensional approach provides a useful alternative for addressing these limitations, accounting for shared underpinnings across neurodevelopmental conditions, and characterizing their common co-occurrence and developmental continuity with other psychiatric conditions. Neurodevelopmental features have not been adequately considered in transdiagnostic psychiatric frameworks, although this would have fundamental implications for research and clinical practices. Growing evidence from studies on the structure of neurodevelopmental and other psychiatric conditions indicates that features of neurodevelopmental conditions cluster together, delineating a "neurodevelopmental spectrum" ranging from normative to impairing profiles. Studies on shared genetic underpinnings, overlapping cognitive and neural profiles, and similar developmental course and efficacy of support/treatment strategies indicate the validity of this neurodevelopmental spectrum. Further, characterizing this spectrum alongside other psychiatric dimensions has clinical utility, as it provides a fuller view of an individual's needs and strengths, and greater prognostic utility than diagnostic categories. Based on this compelling body of evidence, we argue that incorporating a new neurodevelopmental spectrum into transdiagnostic frameworks has considerable potential for transforming our understanding, classification, assessment, and clinical practices around neurodevelopmental and other psychiatric conditions.
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Affiliation(s)
- Giorgia Michelini
- Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Christina O Carlisi
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - John D Haltigan
- Department of Psychiatry, Division of Child and Youth Mental Health, University of Toronto, Toronto, ON, Canada
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | | | - James J Li
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Giovanni A Salum
- Child Mind Institute, New York, NY, USA
- Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para a Infância e Adolescência, São Paulo, Brazil
| | - Susan C South
- Department of Psychological Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Kasey Stanton
- Department of Psychology, University of Wyoming, Laramie, WY, USA
| | - Irwin D Waldman
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Van den Bergh BRH, Antonelli MC, Stein DJ. Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation. Curr Opin Psychiatry 2024; 37:237-250. [PMID: 38415742 DOI: 10.1097/yco.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW Perinatal mental health research provides an important perspective on neurobehavioral development. Here, we aim to review the association of maternal perinatal health with offspring neurodevelopment, providing an update on (self-)regulation problems, hypothesized mechanistic pathways, progress and challenges, and implications for mental health. RECENT FINDINGS (1) Meta-analyses confirm that maternal perinatal mental distress is associated with (self-)regulation problems which constitute cognitive, behavioral, and affective social-emotional problems, while exposure to positive parental mental health has a positive impact. However, effect sizes are small. (2) Hypothesized mechanistic pathways underlying this association are complex. Interactive and compensatory mechanisms across developmental time are neglected topics. (3) Progress has been made in multiexposure studies. However, challenges remain and these are shared by clinical, translational and public health sciences. (4) From a mental healthcare perspective, a multidisciplinary and system level approach employing developmentally-sensitive measures and timely treatment of (self-)regulation and coregulation problems in a dyadic caregiver-child and family level approach seems needed. The existing evidence-base is sparse. SUMMARY During the perinatal period, addressing vulnerable contexts and building resilient systems may promote neurobehavioral development. A pluralistic approach to research, taking a multidisciplinary approach to theoretical models and empirical investigation needs to be fostered.
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Affiliation(s)
| | - Marta C Antonelli
- Laboratorio de Programación Perinatal del Neurodesarrollo, Instituto de Biología Celular y Neurociencias "Prof.E. De Robertis", Facultad de Medicina. Universidad de Buenos Aires, Buenos Aires, Argentina
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Munich, Germany
| | - Dan J Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
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Wakschlag LS, MacNeill LA, Pool LR, Smith JD, Adam H, Barch DM, Norton ES, Rogers CE, Ahuvia I, Smyser CD, Luby JL, Allen NB. Predictive Utility of Irritability "In Context": Proof-of-Principle for an Early Childhood Mental Health Risk Calculator. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:231-245. [PMID: 36975800 PMCID: PMC10533737 DOI: 10.1080/15374416.2023.2188553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVE We provide proof-of-principle for a mental health risk calculator advancing clinical utility of the irritability construct for identification of young children at high risk for common, early onsetting syndromes. METHOD Data were harmonized from two longitudinal early childhood subsamples (total N = 403; 50.1% Male; 66.7% Nonwhite; Mage = 4.3 years). The independent subsamples were clinically enriched via disruptive behavior and violence (Subsample 1) and depression (Subsample 2). In longitudinal models, epidemiologic risk prediction methods for risk calculators were applied to test the utility of the transdiagnostic indicator, early childhood irritability, in the context of other developmental and social-ecological indicators to predict risk of internalizing/externalizing disorders at preadolescence (Mage = 9.9 years). Predictors were retained when they improved model discrimination (area under the receiver operating characteristic curve [AUC] and integrated discrimination index [IDI]) beyond the base demographic model. RESULTS Compared to the base model, the addition of early childhood irritability and adverse childhood experiences significantly improved the AUC (0.765) and IDI slope (0.192). Overall, 23% of preschoolers went on to develop a preadolescent internalizing/externalizing disorder. For preschoolers with both elevated irritability and adverse childhood experiences, the likelihood of an internalizing/externalizing disorder was 39-66%. CONCLUSIONS Predictive analytic tools enable personalized prediction of psychopathological risk for irritable young children, holding transformative potential for clinical translation.
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Affiliation(s)
- Lauren S. Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
| | - Leigha A. MacNeill
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
| | - Lindsay R. Pool
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Justin D. Smith
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at University of Utah, Salt Lake City, UT
| | - Hubert Adam
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Deanna M. Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, MO
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Elizabeth S. Norton
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Cynthia E. Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Isaac Ahuvia
- Department of Clinical Psychology, Stony Brook University, Stony Brook, NY
| | - Christopher D. Smyser
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Joan L. Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Norrina B. Allen
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
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5
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Tone EB, Henrich CC. Principles, policies, and practices: Thoughts on their integration over the rise of the developmental psychopathology perspective and into the future. Dev Psychopathol 2024:1-9. [PMID: 38415398 DOI: 10.1017/s0954579424000257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Developmental psychopathology has, since the late 20th century, offered an influential integrative framework for conceptualizing psychological health, distress, and dysfunction across the lifespan. Leaders in the field have periodically generated predictions about its future and have proposed ways to increase the macroparadigm's impact. In this paper, we examine, using articles sampled from each decade of the journal Development and Psychopathology's existence as a rough guide, the degree to which the themes that earlier predictions have emphasized have come to fruition and the ways in which the field might further capitalize on the strengths of this approach to advance knowledge and practice in psychology. We focus in particular on two key themes first, we explore the degree to which researchers have capitalized on the framework's capacity for principled flexibility to generate novel work that integrates neurobiological and/or social-contextual factors measured at multiple levels and offer ideas for moving this kind of work forward. Second, we discuss how extensively articles have emphasized implications for intervention or prevention and how the field might amplify the voice of developmental psychopathology in applied settings.
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Affiliation(s)
- Erin B Tone
- Department of Psychology, Georgia State University, Atlanta, GA, USA
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Williams LM, Carpenter WT, Carretta C, Papanastasiou E, Vaidyanathan U. Precision psychiatry and Research Domain Criteria: Implications for clinical trials and future practice. CNS Spectr 2024; 29:26-39. [PMID: 37675453 DOI: 10.1017/s1092852923002420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Psychiatric disorders are associated with significant social and economic burdens, many of which are related to issues with current diagnosis and treatments. The coronavirus (COVID-19) pandemic is estimated to have increased the prevalence and burden of major depressive and anxiety disorders, indicating an urgent need to strengthen mental health systems globally. To date, current approaches adopted in drug discovery and development for psychiatric disorders have been relatively unsuccessful. Precision psychiatry aims to tailor healthcare more closely to the needs of individual patients and, when informed by neuroscience, can offer the opportunity to improve the accuracy of disease classification, treatment decisions, and prevention efforts. In this review, we highlight the growing global interest in precision psychiatry and the potential for the National Institute of Health-devised Research Domain Criteria (RDoC) to facilitate the implementation of transdiagnostic and improved treatment approaches. The need for current psychiatric nosology to evolve with recent scientific advancements and increase awareness in emerging investigators/clinicians of the value of this approach is essential. Finally, we examine current challenges and future opportunities of adopting the RDoC-associated translational and transdiagnostic approaches in clinical studies, acknowledging that the strength of RDoC is that they form a dynamic framework of guiding principles that is intended to evolve continuously with scientific developments into the future. A collaborative approach that recruits expertise from multiple disciplines, while also considering the patient perspective, is needed to pave the way for precision psychiatry that can improve the prognosis and quality of life of psychiatric patients.
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Affiliation(s)
- Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - William T Carpenter
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Evangelos Papanastasiou
- Boehringer Ingelheim Pharma GmbH & Co, Ingelheim am Rhein, Rhineland-Palatinate, Germany
- HMNC Holding GmbH, Wilhelm-Wagenfeld-Strasse 20, 80807Munich, Bavaria, Germany
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7
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Zhang Y, MacNeill LA, Edwards RC, Burns JL, Zola AR, Poleon RB, Nili AN, Giase GM, Ahrenholtz RM, Wiggins JL, Norton ES, Wakschlag LS. Developmental Trajectories of Irritability across the Transition to Toddlerhood: Associations with Effortful Control and Psychopathology. Res Child Adolesc Psychopathol 2024; 52:125-139. [PMID: 37410219 DOI: 10.1007/s10802-023-01098-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 07/07/2023]
Abstract
Preschool-age irritability is a transdiagnostic marker of internalizing and externalizing problems. However, researchers have generally been reluctant to examine irritability within a clinically salient framework at younger ages due to some instability during the "terrible twos" period. Developmentally sensitive and dense measurements to capture intra- and inter-individual variability, as well as exploration of developmental processes that predict change, are needed. This study aimed to examine (1) the trajectories of irritability at the transition to toddlerhood (12-24 months of age) using repeated measures, (2) whether effortful control was associated with individual differences in level and growth rate of irritability, and (3) whether individual differences in the irritability trajectories were associated with later psychopathology. Families were recruited when the child was 12-18 months old (N = 333, 45.65% female). Mothers reported on their toddler's irritability at baseline and every two months until a follow-up laboratory assessment approximately one year later. Effortful control was measured at baseline. Clinical internalizing/externalizing symptoms were measured at the follow-up assessment. Hierarchical linear models revealed an increase in irritability over time, yet there was relatively little within-person variability. Effortful control was only associated with the level of irritability and not growth rate. Level of irritability was associated with internalizing, externalizing, and combined symptoms, but growth rate was not. Findings suggest intraindividual stability in irritability at the transition to toddlerhood and the possibility that screening for elevated irritability at toddler age is meaningful.
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Affiliation(s)
- Yudong Zhang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA.
| | - Leigha A MacNeill
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Renee C Edwards
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - James L Burns
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anne R Zola
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Roshaye B Poleon
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Amanda N Nili
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Gina M Giase
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Rachel M Ahrenholtz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jillian Lee Wiggins
- Department of Psychology, San Diego State University, San Diego, USA
- San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, USA
| | - Elizabeth S Norton
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
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Yu Q, Hernandez B, Swineford C, Walker N, MacNeill L, Zhang Y, Wakschlag LS, Wiggins JL. Toward an optimized assessment of adolescent psychopathology risk: Multilevel environmental profiles and child irritability as predictors. JCPP ADVANCES 2023; 3:e12180. [PMID: 38054055 PMCID: PMC10694535 DOI: 10.1002/jcv2.12180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/05/2023] [Indexed: 12/07/2023] Open
Abstract
Background Adolescence is a developmental period during which youth experience vulnerability to psychopathology. To build the foundation for a parsimonious psychopathology risk calculator while capturing the complexity and dynamic nature of the environment, the current study aimed to identify distinct risk and resilience profiles with a wide range of environmental factors guided by Bronfenbrenner's biopsychosocial ecological system theory. The association between the early-mid childhood risk profiles and psychopathology in adolescence were examined. Moreover, the predictive utility of early childhood irritability was evaluated in addition to the risk profiles. Methods The data from Future of Families and Child Wellbeing Study a nation-wide longitudinal study, were used in the latent profile analyses to identify the risk profiles with family, school, and neighborhood characteristics from 3 to 9 years old. To capture the socio-environmental and cultural nuances, we extracted three subsamples, including Black/African American (n = 2587), Hispanic/Latinx (n = 1577), and White (n = 776) for separate analyses. Risk profile memberships were used to predict adolescence psychopathology, including depression, anxiety, attention deficits, oppositional defiant disorder, and conduct disorder symptoms. The predictive utility of early childhood irritability above and beyond environmental risk profiles was evaluated using stepwise regression. Results Three risk profiles were identified in the Hispanic/Latinx and Black/African American subsamples, while four profiles were identified in White subsample. Almost all risk profile membership predicted both internalizing and externalizing psychopathology, while some profiles are predictive of externalizing symptoms only. Higher level of irritability predicted higher symptomatology in all five mental health outcomes above and beyond the environmental profiles. Conclusions Distinct risk and resilience profiles primarily driven by parent and family characteristics were identified for all three major race/ethnicity groups. Our findings lay the foundation for a more efficient multi-tiered information gathering process in mental health clinical settings to aid the decision making for intervention and prevention.
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Affiliation(s)
- Qiongru Yu
- San Diego State University/University of CaliforniaSan Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
| | - Brianna Hernandez
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Conner Swineford
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Nia Walker
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Leigha MacNeill
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Yudong Zhang
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Lauren S. Wakschlag
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Institute for Innovations in Developmental SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Jillian L. Wiggins
- San Diego State University/University of CaliforniaSan Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
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9
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Zarubin VC, Damme KSF, Vargas T, Osborne KJ, Norton ES, Briggs-Gowan M, Allen NB, Wakschlag L, Mittal VA. Neurodevelopmental vulnerability to psychosis: developmentally-based methods enable detection of early life inhibitory control deficits that predict psychotic-like experiences at the transition to adolescence. Psychol Med 2023; 53:7746-7755. [PMID: 37395596 PMCID: PMC10761594 DOI: 10.1017/s003329172300171x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
BACKGROUND Inhibitory control develops in early childhood, and atypical development may be a measurable marker of risk for the later development of psychosis. Additionally, inhibitory control may be a target for intervention. METHODS Behavioral performance on a developmentally appropriate Go/No-Go task including a frustration manipulation completed by children ages 3-5 years (early childhood; n = 107) was examined in relation to psychotic-like experiences (PLEs; 'tween'; ages 9-12), internalizing symptoms, and externalizing symptoms self-reported at long-term follow-up (pre-adolescence; ages 8-11). ERP N200 amplitude for a subset of these children (n = 34) with electrophysiological data during the task was examined as an index of inhibitory control. RESULTS Children with lower accuracy on No-Go trials compared to Go trials in early childhood (F(1,101) = 3.976, p = 0.049), evidenced higher PLEs at the transition to adolescence 4-9 years later, reflecting a specific deficit in inhibitory control. No association was observed with internalizing or externalizing symptoms. Decreased accuracy during the frustration manipulation predicted higher internalizing, F(2,202) = 5.618, p = 0.004, and externalizing symptoms, F(2,202) = 4.663, p = 0.010. Smaller N200 amplitudes were observed on No-Go trials for those with higher PLEs, F(1,101) = 6.075, p = 0.020; no relationship was observed for internalizing or externalizing symptoms. CONCLUSIONS Long-term follow-up demonstrates for the first time a specific deficit in inhibitory control behaviorally and electrophysiology, for individuals who later report more PLEs. Decreases in task performance under frustration induction indicated risk for internalizing and externalizing symptoms. These findings suggest that pathophysiological mechanisms for psychosis are relevant and discriminable in early childhood, and further, suggest an identifiable and potentially modifiable target for early intervention.
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Affiliation(s)
- Vanessa C Zarubin
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Katherine S F Damme
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA
| | - Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - K Juston Osborne
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Elizabeth S Norton
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Department of Communication Sciences & Disorders, School of Communication, Northwestern University, Evanston, IL, USA
| | - Margaret Briggs-Gowan
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Norrina B Allen
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA
- Department of Preventative Medicine, Northwestern University, Chicago, IL, USA
| | - Laurie Wakschlag
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
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Wiggins JL, Ureña Rosario A, MacNeill LA, Krogh‐Jespersen S, Briggs‐Gowan M, Smith JD, Wakschlag LS. Prevalence, stability, and predictive utility of the Multidimensional Assessment of Preschoolers Scales clinically optimized irritability score: Pragmatic early assessment of mental disorder risk. Int J Methods Psychiatr Res 2023; 32:e1991. [PMID: 37728118 PMCID: PMC10654826 DOI: 10.1002/mpr.1991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVES Characterizing the scope and import of early childhood irritability is essential for real-world actualization of this reliable indicator of transdiagnostic mental health risk. Thus, we utilize pragmatic assessment to establish prevalence, stability, and predictive utility of clinically significant early childhood irritability. METHODS Data included two independent, diverse community samples of preschool age children (N = 1857; N = 1490), with a subset enriched for risk (N = 425) assessed longitudinally from early childhood through preadolescence (∼4-9 years old). A validated, brief (2-item) scale pragmatically assessed clinically significant irritability. In the longitudinal subsample, clinical interviews assessed internalizing/externalizing disorders. RESULTS One in five preschool-age children had clinically significant irritability, which was independently replicated. Irritability was highly stable through preadolescence. Children with versus without clinically significant early childhood irritability had greater odds of early onset, persistent internalizing/externalizing disorders. The pragmatic assessment effectively screened out low-risk children and identified 2/3 of children with early-onset, persistent psychopathology. CONCLUSIONS Clinically significant early childhood irritability prevalence is akin to the pediatric obesity epidemic and may warrant similar universal screening/intervention. Also, irritability's stability demonstrates the common guidance "they'll grow out of it" to be false. Finally, pragmatic irritability assessment has transdiagnostic predictive power and addresses a need for feasible measures to flag risk.
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Affiliation(s)
- Jillian Lee Wiggins
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
| | - Ana Ureña Rosario
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Leigha A. MacNeill
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Institute for Innovations in Developmental SciencesNorthwestern UniversityEvanstonIllinoisUSA
| | - Sheila Krogh‐Jespersen
- Institute for Innovations in Developmental SciencesNorthwestern UniversityEvanstonIllinoisUSA
| | | | - Justin D. Smith
- Department of Population Health SciencesUniversity of UtahSalt Lake CityUtahUSA
| | - Lauren S. Wakschlag
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Institute for Innovations in Developmental SciencesNorthwestern UniversityEvanstonIllinoisUSA
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Michelini G, Gair K, Tian Y, Miao J, Dougherty LR, Goldstein BL, MacNeill LA, Barch DM, Luby JL, Wakschlag LS, Klein DN, Kotov R. Do general and specific factors of preschool psychopathology predict preadolescent outcomes? A transdiagnostic hierarchical approach. Psychol Med 2023; 53:5405-5414. [PMID: 37795688 PMCID: PMC10482704 DOI: 10.1017/s003329172200246x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 06/16/2022] [Accepted: 07/18/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Preschool psychiatric symptoms significantly increase the risk for long-term negative outcomes. Transdiagnostic hierarchical approaches that capture general ('p') and specific psychopathology dimensions are promising for understanding risk and predicting outcomes, but their predictive utility in young children is not well established. We delineated a hierarchical structure of preschool psychopathology dimensions and tested their ability to predict psychiatric disorders and functional impairment in preadolescence. METHODS Data for 1253 preschool children (mean age = 4.17, s.d. = 0.81) were drawn from three longitudinal studies using a similar methodology (one community sample, two psychopathology-enriched samples) and followed up into preadolescence, yielding a large and diverse sample. Exploratory factor models derived a hierarchical structure of general and specific factors using symptoms from the Preschool Age Psychiatric Assessment interview. Longitudinal analyses examined the prospective associations of preschool p and specific factors with preadolescent psychiatric disorders and functional impairment. RESULTS A hierarchical dimensional structure with a p factor at the top and up to six specific factors (distress, fear, separation anxiety, social anxiety, inattention-hyperactivity, oppositionality) emerged at preschool age. The p factor predicted all preadolescent disorders (ΔR2 = 0.04-0.15) and functional impairment (ΔR2 = 0.01-0.07) to a significantly greater extent than preschool psychiatric diagnoses and functioning. Specific dimensions provided additional predictive power for the majority of preadolescent outcomes (disorders: ΔR2 = 0.06-0.15; functional impairment: ΔR2 = 0.05-0.12). CONCLUSIONS Both general and specific dimensions of preschool psychopathology are useful for predicting clinical and functional outcomes almost a decade later. These findings highlight the value of transdiagnostic dimensions for predicting prognosis and as potential targets for early intervention and prevention.
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Affiliation(s)
- Giorgia Michelini
- Department of Biological & Experimental Psychology, School of Biological & Behavioural Sciences, Queen Mary University of London, London, UK
- Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Kelly Gair
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Yuan Tian
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Jiaju Miao
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Lea R. Dougherty
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Brandon L. Goldstein
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Leigha A. MacNeill
- Department of Medical Social Sciences, Feinberg School of Medicine, and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Deanna M. Barch
- Departments of Psychological & Brain Sciences, Washington University, St. Louis, MO, USA
- Departments of Psychiatry, Washington University, St. Louis, MO, USA
- Departments of Radiology, Washington University, St. Louis, MO, USA
| | - Joan L. Luby
- Departments of Psychiatry, Washington University, St. Louis, MO, USA
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
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12
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Qiu A, Liu C. Pathways link environmental and genetic factors with structural brain networks and psychopathology in youth. Neuropsychopharmacology 2023; 48:1042-1051. [PMID: 36928354 PMCID: PMC10209108 DOI: 10.1038/s41386-023-01559-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/18/2023]
Abstract
Adolescence is a period of significant brain development and maturation, and it is a time when many mental health problems first emerge. This study aimed to explore a comprehensive map that describes possible pathways from genetic and environmental risks to structural brain organization and psychopathology in adolescents. We included 32 environmental items on developmental adversity, maternal substance use, parental psychopathology, socioeconomic status (SES), school and family environment; 10 child psychopathological scales; polygenic risk scores (PRS) for 10 psychiatric disorders, total problems, and cognitive ability; and structural brain networks in the Adolescent Brain Cognitive Development study (ABCD, n = 9168). Structural equation modeling found two pathways linking SES, brain, and psychopathology. Lower SES was found to be associated with lower structural connectivity in the posterior default mode network and greater salience structural connectivity, and with more severe psychosis and internalizing in youth (p < 0.001). Prematurity and birth weight were associated with early-developed sensorimotor and subcortical networks (p < 0.001). Increased parental psychopathology, decreased SES and school engagement was related to elevated family conflict, psychosis, and externalizing behaviors in youth (p < 0.001). Increased maternal substance use predicted increased developmental adversity, internalizing, and psychosis (p < 0.001). But, polygenic risks for psychiatric disorders had moderate effects on brain structural connectivity and psychopathology in youth. These findings suggest that a range of genetic and environmental factors can influence brain structural organization and psychopathology during adolescence, and that addressing these risk factors may be important for promoting positive mental health outcomes in young people.
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Affiliation(s)
- Anqi Qiu
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore.
- The N.1 Institute for Health, National University of Singapore, Singapore, Singapore.
- NUS (Suzhou) Research Institute, National University of Singapore, Suzhou, China.
- Institute of Data Science, National University of Singapore, Singapore, Singapore.
- Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD, USA.
| | - Chaoqiang Liu
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
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13
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Spann MN, Rogers C. The Infant Brain: A Critical Antecedent of Psychiatric Risk. Biol Psychiatry 2023; 93:854-857. [PMID: 37121613 DOI: 10.1016/j.biopsych.2023.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Marisa N Spann
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; New York State Psychiatric Institute, New York, New York.
| | - Cynthia Rogers
- Departments of Psychiatry and Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
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14
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Wakschlag LS, Finlay-Jones AL, MacNeill LA, Kaat AJ, Brown CH, Davis MM, Franklin P, Berkel C, Krogh-Jespersen S, Smith JD. Don't Get Lost in Translation: Integrating Developmental and Implementation Sciences to Accelerate Real-World Impact on Children's Development, Health, and Wellbeing. Front Public Health 2022; 10:827412. [PMID: 35493380 PMCID: PMC9046665 DOI: 10.3389/fpubh.2022.827412] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/24/2022] [Indexed: 01/14/2023] Open
Abstract
Translation of developmental science discoveries is impeded by numerous barriers at different stages of the research-to-practice pipeline. Actualization of the vast potential of the developmental sciences to improve children's health and development in the real world is imperative but has not yet been fully realized. In this commentary, we argue that an integrated developmental-implementation sciences framework will result in a translational mindset essential for accelerating real world impact. We delineate key principles and methods of implementation science of salience to the developmental science audience, lay out a potential synthesis between implementation and developmental sciences, provide an illustration of the Mental Health, Earlier Partnership (MHE-P), and set actionable steps for realization. Blending these approaches along with wide-spread adoption of the translational mindset has transformative potential for population-level impact of developmental science discovery.
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Affiliation(s)
- Lauren S. Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Amy L. Finlay-Jones
- Early Neurodevelopment and Mental Health Team, Telethon Kids Institute, Nedlands, WA, Australia
- School of Population Health, Curtin University, Bentley, WA, Australia
| | - Leigha A. MacNeill
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Aaron J. Kaat
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - C. Hendricks Brown
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Matthew M. Davis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Patricia Franklin
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Cady Berkel
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
| | - Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Justin D. Smith
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, United States
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