Social anxiety disorder, obsessive-compulsive disorder (OCD), anorexia nervosa, and chronic depression are all debilitating, chronic, and often treatment-resistant mental disorders that are characterized by high rates of comorbidity. These disorders also share an underlying transdiagnostic cognitive and emotional processing style, namely, heightened performance monitoring and overcontrol (Research Domain Criteria (RDoC) Cognitive Systems: Cognitive Control: Performance Monitoring). Little is known of how this underlying characteristic of heightened performance monitoring and overcontrol (HPM/OC) develops in early childhood prior to disorder onset. Moreover, it is largely unknown how this transdiagnostic construct contributes to increasing symptoms of psychopathology and social impairment in young children. This knowledge may provide meaningful targets for preventive intervention of multiple disorders. Consistent with the NIMH Strategic plan, particularly Strategy Objective 2, to ?chart mental illness trajectories to determine when, where, and how to intervene,? this K23 application aims to identify neural markers and caregiving processes associated with developmental risk trajectories of HPM/OC in young children. Under the mentorship of a diverse team of experts in neurophysiological methods, developmental and caregiving processes in early childhood, longitudinal and statistical methodology, and treatment of overcontrol, this proposal will examine the developmental psychopathology of this NIMH RDoC construct in children age 5-6 during the transition to school. Specifically, this proposal will use event-related potentials (ERPs) to identify neural markers of HPM/OC and parent-child observational interactions to assess caregiving styles and dyadic features. Children will be assessed two years later to investigate how neural markers and caregiving styles predict symptoms of social anxiety, OCD and social impairment. Findings will inform the developmental course of this RDoC construct in relation to trajectories of mental illness. The long-term goal is to understand the biological and behavioral development of HPM/OC from early ages through adolescence so as to inform interventions directly targeting HPM/OC prior to disorder onset. Mentored training will allow the applicant to gain expertise in ERP methods and analysis, developmental psychopathology and caregiving processes in young children, longitudinal design and analysis, and training in clinical translation to begin mechanistically identifying and targeting youth with HPM/OC for early intervention.

Public Health Relevance

Self-control is adaptive, yet too much control, in the form of heightened performance monitoring and `overcontrol,' underlies multiple mental disorders and significant social impairment. This project will investigate the developmental trajectories of heightened performance monitoring and overcontrol in young children, examining neural markers and caregiving styles at school entry that predict increasing symptoms of psychopathology and social impairment two years later. Elucidating the early development of heightened performance monitoring and overcontrol will have implications for transdiagnostic models of psychiatric illness and will inform targeted preventive intervention development.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Mentored Patient-Oriented Research Career Development Award (K23)
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Child Psychopathology and Developmental Disabilities Study Section (CPDD)
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Bechtholt, Anita J
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Washington University
Schools of Medicine
Saint Louis
United States
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