Study of Adolescent Neural Development (SAND): 5R01MH103761-04
Children who grow up in poverty are at greater risk for developing disorders, such as anxiety and depression. Despite this clear association, little is known about how poverty impacts underlying biological mechanisms and gives rise to anxiety and depression. This lack of knowledge hinders efforts to develop interventions targeting mechanisms linking poverty and psychopathology. Our objective is to better understand how poverty affects biology during development and leads to psychopathology. To this end, we recently completed data collection of 237 families from Detroit, Toledo and Chicago who had participated in the Fragile Families and Child Wellbeing Study (FFCWS). These children have been followed since birth and they visited the University of Michigan at age 15. Teens participated in an MRI session, psychiatric interviews, and family interaction tasks. We also obtained measures of the home and neighborhood as well as genetic, epigenetic and stress hormone material. We are currently following up with the families as the teens turn 17. This study is funded by the National Institute of Mental Health (R01 MH10376; PIs: Christopher Monk) and is a collaboration with Luke Hyde, Colter Mitchell, and Nestor Lopez-Duran, at Michigan, as well as the FFCWS investigators.
Dimensional Brain Behavior Predictors of CBT Outcomes in Pediatric Anxiety: 5R01MH107419-02
Anxiety disorders affects 33% of the population by adolescence and can become chronic, leading to depression, substance abuse, school-drop out and even suicide. To reduce anxiety and prevent its sequelae, patients must be effectively treated early; yet, the first line intervention, cognitive behavioral therapy (CBT), has a heterogeneous response with 40-60% of treated patients continuing to experience impairment from residual symptoms. The reasons for variability in CBT outcomes remain poorly understood, but individual (including developmental) differences in brain-behavioral targets of CBT may contribute. This project addresses two fundamental questions: 1) Do individual differences in CBT-relevant brain-behavioral functions lead to variation in CBT outcomes? and 2) Does development contribute to this variation? To address these questions, we are acquiring data at multiple levels: brain function-structure (fMRI, DTI) and behavioral performance to index threat response and cognitive control, and clinical measures of anxiety in 280 youths. Of these, 210 youths with impairing anxiety will be randomized to receive CBT or a relaxation control therapy and multilevel data will be collected again after treatment. The project will connect developmental neuroscience and clinical trial research to enable a mechanistic understanding of how different patients at different ages benefit from CBT. This study is funded by the National Institute of Mental Health (5R01MH107419-02; PIs: Christopher Monk, Kate Fitzgerald and K. Luan Phan).