In this project, our group is examining biological aspects of risk for mood and anxiety disorders in children. Such work has major public impact. By identifying biological risks in children, information on novel treatments and preventative interventions will emerge. Given the understanding of most chronic mental illnesses as developmental disorders, such information holds the hope of dramatically influencing the mental well-being of many individuals. This project encompasses work that is being implemented in two protocols. In one protocol, we are examining the degree to which neurocognitive profiles vary among children and adolescents stratified with respect to personal and family history of mood and anxiety disorders. For these studies, personal history is defined based on early-childhood temperament. In a second protocol, we are acquiring fMRI data from a subset of these subjects. We also have expanded our efforts in these protocols to encompas studies in juveniles across the full span of childhood and adolescence. Thus, one set of studies is based among late adolescents who have been prospectively followed for nearly two decades. A second set of studies is based in school-aged children, who are being followed through their first decade of life. In both sets of studies, as well as the larger series of studies in this project, considerable progress continues to be made. Studies on temperamental risk continue to dominate activities in this set of projects during the past year, as they had in the few years immediately prior. Thus, in this past year, as in 2012, studies on temperament occupy approximately 75% of all resources in our research projects covered under the current project. Major questions remain on family-based associations, concerning the degree to which these associations reflect environmental, genetic, or interacting influences of genes and the environment. However, our focus on these issues this past year, as in the year immediately prior, continues to decrease, so that we can devote an increasingly large proportion of our resources to research on temperament. Moreover, as noted above, our work on temperament encompasses studies that are conducted in two cohorts, one of which is in early adulthood and a second of which is approaching adolescence. Finally, other questions relate to the identification of factors that differentiate among children who are at high risk yet remain resilient from those who are at risk but manifest problems. Work in this project over the next few years is designed to address these questions. Problems with anxiety tend to run in families. Thus, anxiety often occurs among children born to parents with anxiety disorders as well as in children born to parents with major depressive disorder (MDD). In adults, MDD involves dysfunction in prefrontal brain regions that regulate attention to emotional stimuli. These abnormalities: i) have been found primarily in adults with specific familial forms of MDD;ii) persist after recovery from MDD, and iii) relate to anxiety.In adults, some data suggest that anxiety disorders are also associated with prefrontal dysfunction. However, findings in anxiety appear most strongly related to attention, whereas findings in MDD appear most strongly related to memory. This has stimulated attempts to dissociate factors in children associated with risk for anxiety as oppsed to MDD. This protocol is attempting to dissociate these aspects of risk, through behavioral and fMRI studies of emotion regulation in high and low-risk adolescents. In general, research in this area continues to occupy a shrinking amount of resources in our group. Finally, as noted above, our most in-depth studies focus on temperament, particularly the temperament of "behavioral inhibition." This work is made possible through our strong collaborative relationship with Dr. Nathan Fox at the University of Maryland. More than the other areas of risk in the current set of studies, these studies with Dr. Fox have received very high priority. They continue to grow and expand this year, as they had done in the immediately prior years. Dr. Fox has followed cohorts of approximately 600 infants as they passed though childhood. As noted above, this includes two separate cohorts. These children have received repeated assessments of their temperament. Temperament classifications in the sample during infancy and early childhood have been shown to predict behavior later in life. We have also completed an ever-increasing series of investigations in this sample. Results from these studies support the conclusions generated in other research within our group. Namely, this work establishes the presence of strong, consistent associations between the presence of and risk factors for mental illness in children and the presence of perturbed brain function. In the past year, our group continues to have significant success in charting relationships between temperament and brain function. We continue to publish widely in this area, and we have acquired data from many subjects during the past 12 months. These efforts largely support three sets of activities. First, we continue to report results from completed research. This includes reports on subjects who are entering adulthood, examining the manner in which early temperament relates to later brain function and psychopathology. Second, we are completing imaging studies in relatively large samples. This includes studies both in late adolescents and in school-aged children. The hope would be to complete this second set of studies in the coming year, so that data might be analyzed. Finally, we have begun new projects that will extend over the subsequent years. These new projects primarily focus on implementing imaging studies in the cohort of school-aged children.

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Pine, Daniel S; Helfinstein, Sarah M; Bar-Haim, Yair et al. (2009) Challenges in developing novel treatments for childhood disorders: lessons from research on anxiety. Neuropsychopharmacology 34:213-28
Chronis-Tuscano, Andrea; Degnan, Kathryn Amey; Pine, Daniel S et al. (2009) Stable early maternal report of behavioral inhibition predicts lifetime social anxiety disorder in adolescence. J Am Acad Child Adolesc Psychiatry 48:928-35

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