Advancing earlier transdiagnostic identification of mental health risk: A pragmatic approach at the transition to toddlerhood

IF 2.4 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research Pub Date : 2023-09-18 DOI:10.1002/mpr.1989

Jillian Lee Wiggins, Ana Ureña Rosario, Yudong Zhang, Leigha MacNeill, Qiongru Yu, Elizabeth Norton, Justin D. Smith, Lauren S. Wakschlag

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引用次数: 7

Abstract

Objectives

In light of the youth mental health crisis, as 1 in 5 children have a mental disorder diagnosis by age 3, identification of transdiagnostic behavioral vulnerability prior to impairing psychopathology must occur at an earlier phase of the clinical sequence. Here, we lay the groundwork for a pragmatic irritability measure to identify at-risk infant-toddlers.

Methods

Data comprised N = 350 diverse infant-toddlers and their mothers assessed at ∼14 months old for irritability (Multidimensional Assessment Profiles- Temper Loss-Infant/Toddler (MAPS-TL-IT) and impairment (Early Childhood Irritability-Related Impairment Interview, E-CRI; and Family Life Impairment Scale (FLIS). Bimonthly follow-up surveys assessed impairment (FLIS) over the following year.

Results

Stepwise logistic regression indicated that 5 MAPS-TL-IT items were most informative for differentiating concurrent impairment on the FLIS: “frustrated about small things”; “hit, bite, or kick during tantrums”; “trouble cheering up when grumpy”; “grumpy during fun activities” and “tantrums in public”. With this summed score, Receiver Operating Characteristics analysis differentiating concurrent impairment on the E-CRI indicated good classification accuracy for (Area under the curve = 0.755, p < 0.05), with a cutoff of 5 maximizing sensitivity (71.4%) and specificity (70.6%). Elevated irritability on this MAPS-TL-IT clinically optimized screener increased likelihood of persistently elevated FLIS impairment trajectories over the following year more than fourfold (OR = 4.37; Confidence intervals = 2.40–7.97, p < 0.001).

Conclusions

Our findings represent the first step toward a pragmatic tool for screening for transdiagnostic mental health risk in toddlers, optimized for feasibility in clinical care. This has potential to strengthen resilience pathways via earlier identification of mental health risk and corollary prevention in toddlers.

Abstract Image

查看原文本刊更多论文

推进早期心理健康风险的跨诊断识别:在过渡到幼儿期的实用方法。

鉴于青少年心理健康危机，由于每5个儿童中就有1个在3岁时被诊断为精神障碍，因此必须在临床序列的早期阶段识别出在精神病理受损之前的跨诊断行为脆弱性。在这里，我们为一个实用的易怒措施奠定了基础，以确定在危险的婴幼儿。方法:数据包括N = 350个不同的婴幼儿及其母亲，在14个月大时进行易怒评估(多维评估档案-脾气丧失-婴幼儿(MAPS-TL-IT))和损害评估(早期儿童易怒相关损害访谈，E-CRI;家庭生活障碍量表(FLIS)。在接下来的一年里，每两个月的随访调查评估了损伤(FLIS)。结果:逐步logistic回归结果显示，5个map - tl - it项目对FLIS并发性损伤的鉴别信息量最大:“对小事感到沮丧”;“发脾气时打、咬或踢”;“烦恼时要高兴起来”;“在有趣的活动中脾气暴躁”和“在公共场合发脾气”。根据这一综合评分，接受者工作特征分析表明，区分E-CRI并发损伤的分类准确率很高(曲线下面积= 0.755,p)。结论:我们的研究结果代表了一种实用的工具，用于筛查幼儿的跨诊断精神健康风险，并优化了临床护理的可行性。这有可能通过早期识别幼儿的心理健康风险和相应的预防来加强恢复能力途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Methods in Psychiatric Research 医学-精神病学

CiteScore

5.20

自引率

6.50%

发文量

审稿时长

>12 weeks

期刊介绍： The International Journal of Methods in Psychiatric Research (MPR) publishes high-standard original research of a technical, methodological, experimental and clinical nature, contributing to the theory, methodology, practice and evaluation of mental and behavioural disorders. The journal targets in particular detailed methodological and design papers from major national and international multicentre studies. There is a close working relationship with the US National Institute of Mental Health, the World Health Organisation (WHO) Diagnostic Instruments Committees, as well as several other European and international organisations. MPR aims to publish rapidly articles of highest methodological quality in such areas as epidemiology, biostatistics, generics, psychopharmacology, psychology and the neurosciences. Articles informing about innovative and critical methodological, statistical and clinical issues, including nosology, can be submitted as regular papers and brief reports. Reviews are only occasionally accepted. MPR seeks to monitor, discuss, influence and improve the standards of mental health and behavioral neuroscience research by providing a platform for rapid publication of outstanding contributions. As a quarterly journal MPR is a major source of information and ideas and is an important medium for students, clinicians and researchers in psychiatry, clinical psychology, epidemiology and the allied disciplines in the mental health field.