Irritability emerges during infancy, and is a substrate of many common forms of developmental psychopathology. However, reliable identification of irritable infants at high risk for clinical progression is challenging due to high levels of normative variation combined with substantial individual differences in adaptive or maladaptive outcomes for irritable infants over time. Building on our prior work at preschool age, the proposed study utilizes a neurodevelopmental framework to generate empirically-derived, parameters for differentiation of irritability patterns that mark risk for clinical progression. Key innovations are: (1) novel approach to specification of developmentally atypical patterns of irritability beginning in infancy; (2) joint developmental consideration of irritability, executive function and prefrontal cortical regions; and (3) transactional focus examining the clinical import of early irritability within the context of parent-infant mutual (dys)regulation. To derive population-based parameters, we first conduct a cross-sectional survey of a representative sample of 12-36 mos. olds (N=2,000). We then ascertain an independent community cohort (N=350 infants oversampled for irritability), with intensive longitudinal follow-up from 12-36 months. Focal irritability assessments are: (a) bi-monthly parent reports and real-time monitoring of irritable vocalizations via the Language Environment Analysis (LENA) Pro device; and (b) annual direct observations of irritable temperament and behavior (12, 24 & 36 mos). Performance-based assessments of executive function occur annually. Mutual regulation is assessed bi-monthly via LENA data on sequences of infant irritable vocalizations and parental responses and annually via event-coded parent-infant observed mutual regulation. Clinical progression is captured via latent dimensional clinical risk over time. SPECIFIC AIMS: IA. Differentiate developmentally atypical irritability patterns from infancy-early preschool age via population-based parameters cross-sectionally (IAi), and quantitative longitudinal parameters (IAii). IB: Specify longitudinal parameters of irritability optimize prediction of clinical progression. IIA-B. Map developmentally-atypical irritability patterns to disruptions in the maturation of executive function and the prefrontal cortical regions, and test the hypothesis that their joint consideration will enhance predictive clinical utility. Prefrontal cortical maturation will be assessed from infant natural sleep MRI-derived estimates of anatomical properties at 12 & 36 months in an extreme group sub-sample (n=100). We test the hypothesis that atypical irritability patterns will predict slowed executive function development and abnormal PFC anatomy. IIIA-B. Elucidate how transactional processes shape clinical prediction, testing the hypothesis that parent-infant mutual (dys)regulation processes respectively amplify or buffer clinical risk. Specification of neurodevelopmental irritability phenotypes within transactional context provides a critical empirical base for targeted prevention of mental disorder in its earliest prodromal phases.
|Effective start/end date||3/2/16 → 2/28/22|
- National Institute of Mental Health (5R01MH107652-03)