Preventive interventions depend in large part on the availability of reliable and specific information about the development of psychopathology. Three of the priority areas for clinical research identified in the 2007/2008 NIMH Strategic Plan are the 1) prediction of individuals at risk for developing disease;2) personalization of knowledge about individual biological, environmental and social factors to better personalize interventions;and 3) participation of the diversity of people and settings in clinical research The Pittsburgh Girls Study (PGS), a large-scale (n=2,451), longitudinal study of a representative, urban sample of African American and European American girls, is uniquely poised to illuminate each of these topic areas as they pertain to Conduct Disorder (CD) and Major Depressive Disorder (MDD): two disorders that generate the greatest amount of morbidity among adolescent females and contribute the largest portion to the global burden of disease among women (Murray &Lopez. 1997). In particular, the PGS aims to predict female CD and MDD by building developmental models of risk and protection from the early identification of individual vulnerabilities that serve as childhood precursors to disorders, and the contexts in which such vulnerabilities are more likely to lead to disorder, by operationalizing sub-syndromal phenotypes of disorders, and by examining developmental changes in the pattern of comorbid conditions. Prediction will be based on multiple annual assessments of this racially and economically diverse sample with high rates of participant retention (average of 94 percent over 7 waves). Thus far, we have generated data on the onset, stability and developmental course of DSM-IV symptoms for CD and MDD and a broad range of other disorders. We also have assessed potential moderating and mediating factors on the development of symptomatology in girls. We are seeking funds to continue this prospective study through adolescence with five annual assessments of the girls and their mothers and fathers. The girls will be aged 13-16 in wave 1, and aged 17-20 years in wave 5. The planned assessments, when linked to the developmental data already collected during childhood, will elucidate precursors to CD and MDD in adolescence, their sub-syndromal phenotypes, common patterns of comorbidity, and risk, promotive and protective factors associated with transitions from precursor, to sub-syndrome, to disorder, and to comorbid disorders. The study is relevant for understanding ethnic disparities in the manifestation of CD and MDD and can serve as a building block for personalized, preventive and remedial treatments to be developed for specific subgroups of girls at risk of CD, MDD, their co-occurrence, and comorbidity with other disorders.
The proposed study will provide information on specific emotional and behavioral problems assessed in young girls that are markers for later serious problems in adolescence and young adulthood. The study also examines family, peer, school, and neighborhood factors that increase or reduce these risks. The diversity of the participants in this community sample (e.g. equal numbers of African American and European American girls, broad range of income levels) will allow information to be gathered about early and ongoing risks and problems that are more important for different subgroups, which can serve as building blocks for screening devices and the prevention of adolescent emotional and behavioral problems.
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