Longitudinal Research at the Interface of Affective Neuroscience, Developmental Psychopathology, Health and Behavioral Genetics: Findings from the Wisconsin Twin Project

The Wisconsin Twin Project comprises multiple longitudinal studies that span infancy to early adulthood. We summarize recent papers that show how twin designs with deep phenotyping, including biological measures, can inform questions about phenotypic structure, etiology, comorbidity, heterogeneity, and gene-environment interplay of temperamental constructs and mental and physical health conditions of children and adolescents. The general framework for investigations begins with rich characterization of early temperament and follows with study of experiences and exposures across childhood and adolescence. Many studies incorporate neuroimaging and hormone assays.

Psychiatry and developmental psychopathology: Unifying themes and future directions

In the past 35 years, developmental psychopathology has grown into a flourishing discipline that shares a scientific agenda with contemporary psychiatry. In this editorial, which introduces the special issue, we describe the history of developmental psychopathology, including core principles that bridge allied disciplines. These include (1) emphasis on interdisciplinary research, (2) elucidation of multicausal pathways to seemingly single disorders (phenocopies), (3) description of divergent multifinal outcomes from common etiological start points (pathoplasticity), and (4) research conducted across multiple levels of analysis spanning genes to environments. Next, we discuss neurodevelopmental models of psychopathology, and provide selected examples. We emphasize differential neuromaturation of subcortical and cortical neural networks and connectivity, and how both acute and protracted environmental insults can compromise neural structure and function. To date, developmental psychopathology has placed greater emphasis than psychiatry on neuromaturational models of mental illness. However, this gap is closing rapidly as advances in technology render etiopathophysiologies of psychopathology more interrogable. We end with suggestions for future interdisciplinary research, including the need to evaluate measurement invariance across development, and to construct more valid assessment methods where indicated.

I. INTRODUCTION: UNDERSTANDING THE TRANSITION TO SIBLINGHOOD FROM A DEVELOPMENTAL PSYCHOPATHOLOGY AND ECOLOGICAL SYSTEMS PERSPECTIVE

The birth of an infant sibling is a common occurrence in the lives of many toddler and preschool children. Early childhood is also a time for the emergence of disruptive behavior problems that may set the stage for later problem behaviors. The current study examined individual differences in young children’s behavioral and emotional adjustment after the birth of a sibling in an effort to uncover developmental trajectories reflecting sudden and persistent change (maladaptation), adjustment and adaptation (resilience), gradual linear increases, and no change (stability and continuity). Growth mixture modeling (GMM) was conducted with a sample of 241 families expecting their second child using a longitudinal research design across the first year after the sibling’s birth (prenatal, 1, 4 8 and 12 months) on seven syndrome scales of the Child Behavior Checklist (CBCL 1.5–5:(Achenbach & Rescorla, 2000 ): aggression, attention problems, anxiety/depression, emotional reactivity, withdrawal, somatic complaints, and sleep problems. For all scales, multiple classes describing different trajectory patterns emerged that reflected predominantly intercept differences; children high on problem behavior after the birth were those high before the birth. There was no evidence of a sudden, persistent maladaptive response indicating children underwent a developmental crisis for any of the problem behaviors examined. Most children were low on all problem behaviors examined and showed little change or actually declined in problem behaviors over time, although some children did experience more pronounced changes in the borderline clinical or clinical range. Only in the case of aggressive behavior was there evidence of an Adjustment and Adaptation Response showing a sudden change (prenatal to 1 month) that subsided by 4 months, suggesting that some young children react to stressful life events but adapt quickly to these changing circumstances. Further, children’s withdrawal revealed a curvilinear, quadratic path, suggesting children both increased and decreased in their withdrawal over time. Guided by a developmental ecological systems framework, we employed data mining procedures to uncover the child, parent, and family variables that best discriminated the different trajectory classes and found that children’s temperament, coparenting, parental self-efficacy, and parent-child attachment relationships were prominent in predicting children’s adjustment after the birth of an infant sibling. Finally, when trajectory classes were used to predict sibling relationship quality at 12 months, children high on aggression, attention problems, and emotional reactivity in the year after the birth engaged in more conflict and less positive involvement with the infant sibling at the end of the first year.

[Is delusion a reasonable scientific term? Reflections on psychopathology in the psychiatry of the twenty-first century]

Delusion is a central but difficult and controversial term in psychiatry. Similar to the term schizophrenia at the nosological level, the basic questions in the specialty are linked in the debate on delusion at the clinical psychopathological level, beginning with epistemological and methodological aspects up to concrete embodiment of the physician-patient relationship. The text of this article reflects this development from the nineteenth century up to the present day and makes reference to the lively discussion on the future directions of psychiatric research triggered by the research domain criteria (RDoC). Under certain prerequisites, including in particular an extensive understanding of psychopathology, delusion is considered to be a reasonable scientific term, also in the future.

Fibroblast growth factors in neurodevelopment and psychopathology

In psychiatric disorders, the effect of genetic and environmental factors may converge on molecular pathways and brain circuits related to growth factor functioning. In this review, we describe how disturbances in fibroblast growth factors (FGFs) and their receptors influence behavior by affecting brain development. Recently, several studies reported associations of members of the FGF family with psychiatric disorders. FGFs are key candidates to modulate the impact of environmental factors, such as stress. Mutant mice for FGF receptor 1 show schizophrenia-like behaviors that are related to general loss of neurons and postnatal glia dysfunction. Mice lacking FGF2, a FGFR1 ligand, show similar reductions in brain volume and hyperactivity, as well as increased anxiety behaviors. FGFR2 and FGF17 are involved in the development of frontal brain regions and impairments in cognitive and social behaviors, respectively. Moreover, treatment with FGF2 was beneficial for depressive and cognitive measures in several animal studies and one human study. These findings indicate the importance of the FGF system with respect to developing novel etiology-directed treatments for psychopathology.

Trends in psychopathology across the adolescent years: what changes when children become adolescents, and when adolescents become adults?

BACKGROUND

Little is known about changes in the prevalence of psychiatric disorders between childhood and adolescence, and adolescence and adulthood.

METHODS

We reviewed papers reporting prevalence rates of psychiatric disorders separately for childhood, adolescence, and early adulthood. Both longitudinal and cross-sectional papers published in the past 15 years were included.

RESULTS

About one adolescent in five has a psychiatric disorder. From childhood to adolescence there is an increase in rates of depression, panic disorder, agoraphobia, and substance use disorders (SUD), and a decrease in separation anxiety disorder (SAD) and attention-deficit hyperactivity disorder (ADHD). From adolescence to early adulthood there is a further increase in panic disorder, agoraphobia, and SUD, and a further decrease in SAD and ADHD. Other phobias and disruptive behavior disorders also fall.

CONCLUSIONS

Further study of changes in rates of disorder across developmental stages could inform etiological research and guide interventions.

Can we define mental disorder by using the criterion of mental dysfunction?

The concept of mental disorder is often defined by reference to the notion of mental dysfunction, which is in line with how the concept of disease in somatic medicine is often defined. However, the notions of mental function and dysfunction seem to suffer from some problems that do not affect models of physiological function. Functions in general have a teleological structure; they are effects of traits that are supposed to have a particular purpose, such that, for example, the heart serves the goal of pumping blood. But can we single out mental functions in the same way? Can we identify mental functions scientifically, for instance, by applying evolutionary theory? Or are models of mental functions necessarily value-laden? I want to identify several philosophical problems regarding the notion of mental function and dysfunction and point out some possible solutions. As long as these questions remain unanswered, definitions of mental disorder that rest upon the concept of mental dysfunction will lack a secure foundation.

Cultural neuroscience and psychopathology: prospects for cultural psychiatry

There is a long tradition that seeks to understand the impact of culture on the causes, form, treatment, and outcome of psychiatric disorders. An early, colonialist literature attributed cultural characteristics and variations in psychopathology and behavior to deficiencies in the brains of colonized peoples. Contemporary research in social and cultural neuroscience holds the promise of moving beyond these invidious comparisons to a more sophisticated understanding of cultural variations in brain function relevant to psychiatry. To achieve this, however, we need better models of the nature of psychopathology and of culture itself. Culture is not simply a set of traits or characteristics shared by people with a common geographic, historical, or ethnic background. Current anthropology understands culture as fluid, flexible systems of discourse, institutions, and practices, which individuals actively use for self-fashioning and social positioning. Globalization introduces new cultural dynamics and demands that we rethink culture in relation to a wider domain of evolving identities, knowledge, and practice. Psychopathology is not reducible to brain dysfunction in either its causes, mechanisms, or expression. In addition to neuropsychiatric disorders, the problems that people bring to psychiatrists may result from disorders in cognition, the personal and social meanings of experience, and the dynamics of interpersonal interactions or social systems and institutions. The shifting meanings of culture and psychopathology have implications for efforts to apply cultural neuroscience to psychiatry. We consider how cultural neuroscience can refine use of culture and its role in psychopathology using the example of adolescent aggression as a symptom of conduct disorder.

Psychopathology in neuropsychiatry: DSM and beyond

The case reports described in this article indicate that current neuropsychiatric practice is strongly limited by reliance on the Diagnostic and Statistical Manual of Mental Disorders (DSM). Knowledge of new psychopathology that will enable the neuropsychiatrists and neuroscientists identify specific areas of brain dysfunction is essential to modern practice of neuropsychiatry. Today, less than 20% of neuropsychiatry and neuroscience programs teach such psychopathology.The development of brain imaging and metabolic measurement technologies; the continuous and rapid introduction of many new pharmaceutical agents into clinical care; and the various, detailed editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have all shaped modern psychiatric training and thus future psychiatric practice. This "shaping" is observed most often in the teaching of psychopathology and of mental status examinations, both currently focusing on how to recognize and elicit the clinical features needed to apply the criteria set by the DSM. Once DSM criteria are met, a best-choice treatment plan based on DSM diagnosis is selected from an array of pharmacotherapy algorithms. It is assumed that the known reliability of the DSM system maximizes the likelihood that these diagnostic decisions are valid and treatment choices are therefore appropriate. Descriptive psychopathology that goes beyond the DSM is primarily relegated to historical consideration and rarely pertains to issues regarding patient care.

[A crucial moment of psychopathology: Heidegger's review of Jaspers' Psychology of the conceptions of the world]

From the current status of psychopathology abolition, in behalf of a reductionist and non-satisfactory empiricism that has overwhelmed psychiatry in a sterile paralysis, we question its origin, discovering in Jaspers the methodological problems that made him unable to assume obstacles and led us to the present situation. Matching Heidegger's review on Psychology of the conceptions of the world, we are tracing the criticism to that methodology, in an attempt to approach the model of a new empiricism for psychopathology that solves the current situation. We use this occasion to pursue the tracks followed by one of the confronted attitudes or another that we consider a psychopathology crossroad. We are investigating the consequences and alternatives derived for that new task in present time, once these methodological positions have been assumed.

[Psychopathology of development and structural dynamics]

The mental structure provides every human with a potential repertoire of behavior. In every interaction a reactivation of past actualization- and representation processes concerning the particular prevailing context takes place. A child's mental structure should not be devaluated in comparison to a structure of an adult person. Levels of functioning depend on the developmental age. Structural dispositions consist of represented experiences of interaction. The so-called affect attenuement plays an important part in individual affect regulation. If the structural representation follows mechanisms of memory, procedural structural dispositions may be postulated, which affect the behavior besides iconic and symbolic representations. Within the structure affect dispositions are integrated. They are able to give value to certain contents of experience and reexperience. Disorders in the development of empathy are connected with impairments of the structural development. By inherent faintness of the regulation of affects or by sensitization and traumatization processes, which involve dissociative phenomena, the affective load of representations can be changed. This may result in structural deficits.

Psychopathology in the postgenomic era

We are rapidly approaching the postgenomic era in which we will know all of the 3 billion DNA bases in the human genome sequence and all of the variations in the genome sequence that are ultimately responsible for genetic influence on behavior. These ongoing advances and new techniques will make it easier to identify genes associated with psychopathology. Progress in identifying such genes has been slower than some experts expected, probably because many genes are involved for each phenotype, which means the effect of any one gene is small. Nonetheless, replicated linkages and associations are being found, for example, for dementia, reading disability, and hyperactivity. The future of genetic research lies in finding out how genes work (functional genomics). It is important for the future of psychology that pathways between genes and behavior be examined at the top-down psychological level of analysis (behavioral genomics), as well as at the bottom-up molecular biological level of cells or the neuroscience level of the brain. DNA will revolutionize psychological research and treatment during the coming decades.

Die gegenw�rtige Situation der japanischen Psychopathologie

The last World Congress of Psychiatry took place in Yokohama, Japan. It gave the opportunity for presenting specifically Japanese approaches to psychopathology to the international psychiatric community. This paper reports on prominent trends in Japanese psychopathological research, which has close ties to German psychopathology

Benefits and pitfalls in the merging of disciplines: the example of developmental psychopathology and the study of persons with autism

Recent advances in the discipline of developmental psychopathology highlight the contributions of developmental thought to the study of persons with autism. This article briefly outlines primary developmental innovations in theory, methodology, and the interpretation of findings. Specifically. we discuss two sets of issues that arise from the general notion of developmental level. One set is relevant to the choice of persons that comprise the comparison group and the other to the various implications of the subjects' levels of functioning. In sum, we contend that researchers need to frame their empirical work within the context of developmental theory and methodology and interpret their findings accordingly. This will lead to scientifically compelling work and an increasingly heuristic approach to the study of persons with autism.

Annotation: attachment disorganisation and psychopathology: new findings in attachment research and their potential implications for developmental psychopathology in childhood

BACKGROUND

The past 10 years have seen a fruitful line of enquiry building on identification of previously unclassifiable patterns of infant-mother interaction. A critical review of these new findings in attachment theory, highlighting their potential relevance to child psychopathology, is presented.

METHOD

Selective literature review relating to disorganised attachment in childhood.

RESULTS

Disorganised patterns of attachment have only relatively recently been described. They show characteristic patterns of evolution in development. There is evidence that disorganised attachments are associated with specific forms of distorted parenting, which are distinct from general parental insensitivity and are associated with unresolved loss or trauma in the caregiver. There are also links with aspects of neurodevelopment vulnerability in the child. Attachment disorganisation is a powerful predictor of a range of later social and cognitive difficulties and psychopathology.

CONCLUSIONS

The identification of disorganised attachment has greatly increased the potential relevance of attachment theory to general clinical work. However, the concept raises many methodological and theoretical issues. Among issues needing further exploration is the way in which attachment disorganisation relates to children's general mental states and may be affected by cognitive functioning and developmental impairment.

[Psychopathology - an exhausted mine?]

Proceeding from the considerations of European psychiatrists that trends in the contemporary psychiatry seem to underestimate or even neglect the psychopathological approach, resulting in a threatening loss of clinical-psychiatric competence, this critical review deals with the reasons and arguments, why our discipline does still need the phenomenological PP for diagnostics and therapy, practice and research. Only the PP under discussion is able to meet the demand of clinical psychiatry to provide a reasonably reliable description of symptoms and syndromes, upon which rational diagnosis and adequate prevention and treatment can be based. The overly objectifying psychiatry of Kraepelin has been overcome by the descriptive-analytic and understanding PP in the direction of Jaspers and Schneider, aiming more at the elucidation of the patients' own inner experiences than at the observation of behaviour and expression. It is shown that important concepts, findings and results of the classical and recent psychiatry could be obtained by means of the PP, developed by representatives of the German speaking clinical psychiatry and psychology. PP has to take the lead previous to all other basic sciences, relevant for our discipline, also because it is not a self-contained theory, but an open approach, based on methodological reflection, showing ways for research. If the maxime "phenomenology is prior to genesis and interpretation" is ignored, or, if this PP is confused with and mistaken for philosophical phenomenology, the results of such a procedure must be doubtful. An intense training and thorough adoption of PP, the "phenomenological attitude" of the physician is urgently demanded as well by German speaking as recently also by anglophone psychiatrists. The substantial influence of the "phenomenological attitude" on psychology and sociology of clinical practice, on the atmosphere of a psychiatric hospital and the style and kind of psychiatric research, due to the fact that the psychopathologist can do practical and scientific work only with the patient and in very close relation with the patient, is also meaningful in order to avoid faulty developments. In this connection the dependence of psychiatry of political and sociological conditions and its susceptibility for ideologies is discussed and illustrated by some pertinent examples of the last decades.

[Clinical dimensions of contemporary cultural psychiatry]

In spite of the difficulties to define the term "culture" there is agreement with regards to its profound influence in the contemporary social environment of which medicine and psychiatry are important components. Cultural psychiatry studies psychopathology inasmuch as it reflects and it is subjected to the influence of cultural factors within the biopsychosocial context. Its contemporary clinical dimensions cover five fundamental areas: culture as an interpretive/explanatory instrument of human behavior; as a pathogenic/pathoplastic agent; as a diagnostic/nosological factor; as a therapeutic/protective element, and as a tool for management and service delivery. This paper examines the conceptual nature of each of these roles and presents pertinent examples from the clinical literature, away from theoretical lucubrations. The cultural legacy of each and every patient seen by the psychiatrist or any other mental health professional demands serious studies and effective actions at all levels.

Chronic psychoses and rehabilitation: an ecological perspective

Traditional explanatory models, based on core psychological deficits, vulnerability-stress models or distinctions between negative and positive symptoms, may not be sufficient to understand the phenomenon of chronicity. This linear thinking, looking for monocausal explanations, should be replaced by exploring multicausal and circular processes over time, including the individual ecological context of a given patient. Thus, chronicity appears to result much more from endless loops and irreversible bifurcations in its dynamics over time than to be a stable state. Furthermore, the current views on psychopathology and prognosis need to be fundamentally reexamined in the light of this new way of thinking. For understanding and treatment of chronic psychoses, this ecological perspective implies programs which do not focus only on the patient, but look for 'ecological niches' and interventions favoring synergetics and self-organization within the social networks and at the worksite of a given patient. A recently implemented five-step program for vocational rehabilitation and the corresponding research plan will be presented and discussed.

[Unexplored themes in the psychopathology of Karl Jaspers]

This study discusses: (1) the impact of the methodological approach to psychopathology of K. Jaspers and its potential for further development; (2) the possibility of developing phenomenological sight to participating insight (into the inner experiences of patients) as a preliminary form of therapy; (3) Jaspers' discrimination between the "understandable" and the "non-understandable" as a problem of communication (strictly differentiating between common sense communication and psychotherapeutic understanding and communicating); (4) the considerable relationship between existential communication ("Existenzerhellung") or maieutic procedure and psychotherapy. The bibliography contains 151 references.

[Prospects for general psychopathology in modern psychiatry]

The Author describes the interest and the meaning of General Psychopathology in today's Psychiatry. The Author defines the methodological aspects necessary in psychopathology as well as their gnoseological and formative value. The "-structural constants" defined in psychopathology appear irreplaceable in the basic aspects of psychotic mind models, and other dimensions of contemporary psychiatry cannot disregard them. The Author emphasise the risk of an inaccurate and irresponsibly exhaustive use of psychopathological categories in psychiatric practice. However it seems that a conscious exercise of psychopathological methods can avoid confusion about investigatory psychiatric research, and may help recognizing basic structures of psychotic experience. These structures are not only necessary in a diagnostic field, but also for a correct pharmacotherapeutical epproach.