The long-term objectives of this Mentored Patient-Oriented Research Career Development Award are to provide the applicant with the conceptual background and research skills necessary to develop into an independent investigator in the field of translational interventions research with child neuropsychiatric disorders. The applicant's primary goal is to gain proficiency in the research of pediatric Tourette Syndrome (TS), specifically in the integration of neurocognitive paradigms with empirically validated behavior treatments to elucidate the cognitive mechanisms underlying treatment response. To accomplish this goal, the candidate will be mentored by experts in the fields of child TS assessment and treatment, neuropsychology of psychiatric populations, cognitive and developmental neuroscience, research design, and biostatisics. She will participate in didactic training including formal coursework and other educational activities in these relevant training areas. The award's research project investigates neurocognitive functioning in child TS before and after behavior intervention for tics, with the overarching goal of exploring the hypothesis that cognitive tasks sensitive to frontal-striatal dysfunction are implicated in the etiology and presentation of pediatric TS. As an adjunct to UCLA's NIMH-funded Center for Intervention Development and Applied Research, the proposed study will examine response inhibition, affect regulation, and risky decision-making performance before and after an eight-session trial of an empirically validated behavioral treatment (Habit Reversal Training) in 20 children with TS compared to 20 TS waitlist control subjects. We hypothesize that at baseline, TS children will have greater impairments in neurocognitive functioning than a sample of age-matched healthy controls. Furthermore, neurocognitive indices will be used to predict and probe clinical treatment effects reflected by tic severity variables. The association between neurocognitive indices and psychosocial function will also be explored. To date, there have been few studies of child TS neurocognition from both response inhibition and affective/motivational perspectives in conjunction with a focus on treatment development. The understanding and modeling of mechanisms underlying cognitive deficits in disorders such as TS may lead to the development of targeted and more efficacious treatments to enhance cognition in children who share a similar profile of impairment.
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