Distinguishing which young children with clinical problems are likely to experience chronic mental health issues over time is the focus of a new multimillion dollar grant awarded to Lauren Wakschlag, PhD, vice chair for Scientific and Faculty Development and professor in Medical Social Sciences (MSS).
The newly funded project, supported by the National Institute of Mental Health (NIMH), will build upon earlier findings from the MAPS Preschool Study conducted in the MSS Developmental Mechanisms Program, directed by Wakschlag.
The grant is a five year renewal of a recently completed NIMH project that assessed more than 3,000 ethnically and socioeconomically diverse Chicago-area preschoolers. Wakschlag and colleagues validated a first-of-its-kind tool – the Multidimensional Assessment of Preschool Disruptive Behavior (MAP-DB) questionnaire – designed to more sharply differentiate emerging clinical problems from the normal misbehavior of early childhood.
Wakschlag was first author of a recently published paper in the Journal of the American Academy of Child and Adolescent Psychiatry regarding the research. She is now collaborating with MSS measurement scientists to develop ways to integrate the tool into pediatric waiting rooms to provide pediatricians with real-time information about young children’s behavioral risk.
“One of our key hypotheses for the new study is that preschool children who have a double hit –evidence of both behavioral abnormality and disruptions in early brain processes – will be most likely to show chronic mental problems from early childhood through adolescence,” said Wakschlag, who is also a fellow of the Institute for Policy Research and member of the Institute for Public Health and Medicine.
The next phase of the project will look at children from the previous study as they near age 10, linking data from their preschool days to behavioral patterns as they near adolescence in an attempt to distinguish serious, ongoing clinical problems.
“All of this work has strong neuroscientific underpinnings,” said collaborator Joel Voss, PhD, assistant professor of MSS. “In this new project, we hope to identify early-life brain abnormalities that underlie emergent psychopathology, specifically in relation to irritability and the inability to control or regulate actions.”
Common mental disorders often begin early in life, but many clinically vulnerable young children do not develop mental disorders. By using information about early-life abnormalities in the brain-behavior relationship to predict the onset and course of a mental disorder, the study looks to advance a developmentally-based, neurodevelopmental approach to psychiatric classification.
“The advent of a tool that can help differentiate clinically significant patterns from the normal behavioral upheaval of early childhood in conjunction with biomarkers provides an unparalleled opportunity to enhance the accuracy of identifying children at highest risk for mental disorder. This in turn would enable targeting of healthcare resources to this vulnerable group before mental health problems become entrenched and treatment-resistant,” Wakschlag said. “If this new project is successful, it will get us closer to being able to provide a very targeted and cost-effective way to intervene in early life prior to the onset of full-blown disease.”
The new study is a collaboration with Voss and scientists at the University of Connecticut and University of Illinois at Chicago.
