The role of familial/parental factors in modulating youths? reactions to terrorism is supported by the scientific literature, including the Child Psychiatric Epidemiology Group?s (CPEG) findings from youth assessed six months after 9/11 (N=8,236; see Significance). Those findings led to a NICHD-funded grant (Wave 1-2 WTC Family Study) to understand the impact, over time, of parental direct WTC-exposure on their children?s psychopathology. For that study, N=855 families (parents + one child) of WTC First Responders, WTC Evacuees and local Residents were recruited from the World Trade Center Health Registry (WTCHR), as well as 9/11 unexposed Control families. The Wave 1-2 WTC Family Study was innovative and unique in that it: (a) examined the effects of direct exposure of parents to the consequential effect of indirect (?take home?) exposure on their children, (b) it followed families over time, and (c) assessed a broad array of psychiatric disorders in parents and children with DSM diagnostic instruments. Since initiation of the WTCHR and the Wave 1-2 WTC Family Study, NIMH developed the Research Domain Criteria (RDoC) project, a new way to classify mental disorders based on validated behavioral functions, supported by neural circuits. RDoC domains have quickly illuminated the conceptualization of psychopathology by providing a more comprehensive framework of functions/deficits across a spectrum of disorders and the health-illness dimension. This conceptualization is critical to understanding the long-term consequences to individuals and families with 9/11 exposure. Additionally, the explosion of high-throughput technologies has led to a more comprehensive view of the genetic architecture of observable behaviors and of gene-environment interactions (GE), which may be critical in the development of individualized treatment plans for 9/11 exposed individuals. To date, there has been no other 9/11 investigation that encompasses families, even of First Responder, WTC and Residential Evacuee families, the most adversely impacted WTC population. Based on findings from the Wave 1-2 WTC Family Study on the effects of parental WTC-exposure/psychiatric disorders on their child?s? psychopathology, as well as other epidemiological, behavioral and genetic findings by CPEG regarding these individuals (see Approach-C.4), we propose to follow-up the same families for a 3rd wave, to examine how four key RDoC domains of functioning (negative valence; positive valence; cognitive systems; social cognition) are associated upward with (i) long-term psychiatric outcomes (DSM disorders), (ii) emotional health (psychological resilience), and (iii) trajectories of psychopathology, and downward, with interactions between genetic variation and direct/indirect WTC exposures.
While psychiatric disorders (DSM) are known to be linked to traumatic exposure/s, families play a key role in modulating youth?s reaction to terrorism and who may experience greater emotional impact from having a family member exposed than from being directly exposed themselves. Because DSM disorders do not map well onto emerging findings from genetics, systems neuroscience and behavioral science the NIMH initiated the Research Domain Criteria-(RDoC) project, as a new classification system, with gene x environment (GE) interactions having a major role in understanding etiological processes. The RDoC factors have never been simultaneously taken into account with 9/11-related populations, which has the potential to move forward the field of translational research in WTC-exposed populations, especially within families as proposed here, so that individualized treatments directed at etiologic mechanisms might soon be available to 9/11 and other trauma-exposed individuals.
