The overarching goal of this proposal is to map neurodevelopmental trajectories of emotion regulation in healthy adolescents and adolescents with affective disorders. The ability to regulate emotion is a critical developmental task and predicts numerous social and emotional outcomes into adulthood. Conversely, emotion regulation development is compromised in affective disorders, particularly in youth with a history of maltreatment. Crucially, maltreatment not only increases risk for affective disorders, but is also associated with greater illness severity, suicide attempts, and treatment resistance in both youth and adults. However, no studies have comprehensively and longitudinally examined neurodevelopmental trajectories of cognitive- emotional control in typical development, nor how these trajectories are disrupted in affective disordered youth with and without maltreatment. Notably, preliminary data suggest that maltreatment may represent a unique subtype of affective disorders, characterized by declining emotion regulation capacity over adolescence. This innovative research program will 1) map trajectories of cognitive-emotional neurodevelopment in typically developing (TD) adolescents, 2) characterize divergence in these trajectories in non-maltreated and maltreated adolescents with affective disorders (AD, AD+M, respectively), and 3) determine to what extent neurodevelopmental trajectories of emotion regulation contribute to recovery vs. illness persistence over time. This interdisciplinary research team will recruit 210 youth (70/group TD, AD, AD+M), ages 10-16, to be followed over 3 annual assessments. At each assessment, behavioral and neural indices of cognitive- emotional control will be captured during fMRI. Here, youth will complete a comprehensive battery of validated tasks probing multiple levels of cognitive-emotional function including emotional reactivity, implicit (automatic) emotion regulation, explicit (voluntary) emotion regulation, and general executive function. Simultaneous with fMRI, physiological markers of emotional arousal will be measured including skin conductance, corrugator EMG, and pupillary response. Primary analyses will 1) examine neurobehavioral trajectories of emotion regulation in TD youth, 2) elucidate divergence in neurobehavioral trajectories of emotion regulation in AD and AD+M youth, and 3) map neurodevelopmental trajectories of illness recovery vs. persistence in affective disordered youth. This ambitious program of neurodevelopmental research promises to yield the first longitudinal and comprehensive set of behavioral and neural markers of cognitive-emotional control in pediatric affective disorders. Furthermore, it will explore the potential for maltreatment to represent a deleterious subtype of affective disorders. In total, this research addresses key areas of the NIMH Strategic Plan including (1) characterizing neurodevelopmental trajectories and biomarkers of illness trajectories, and (2) identifying biomarkers which may be utilized for tailoring treatments and developing novel interventions.
The project seeks to establish the first comprehensive and longitudinal set of biomarkers in non-maltreated and maltreated youth with affective disorders. These measures would represent a significant advance beyond the subjective assessments currently used in clinical settings, paving the way towards brain- and behavior-based treatment of youth to hasten and sustain recovery from illness in adolescence and beyond.
