Integrating Neuroscience, Developmental Psychopathology, and Preventive Interventions: Critical Questions for the Next Generation of Transformative Research
June 01, 2010
National Institute of Mental Health (NIMH)
In conjunction with the 18th annual conference of the Society for Prevention Research, NIMH held a one-day, pre-conference workshop. The goal of the meeting was to identify strategies to advance prevention science research for mental disorders through the integration of basic science, neurodevelopment research, and intervention expertise. This goal was guided, in part, by recommendations from the 2009 Institute of Medicine report, “Preventing Mental, Emotional, and Behavioral Disorders Among Young People”. Invitees included basic neuroscientists, experts in developmental psychopathology, and psychosocial interventionists. Primary discussion included how each person’s work could inform the others’ expertise, opportunities to develop collaborations, and ideas for how NIMH could optimize progress in these interrelated domains.
The workshop was organized into three sessions. Each session began with presentations in key areas, followed by group discussion, which were informed by questions that had been sent in advance of the meeting.
Topic 1: Biological Targets in Prevention Trials: What are Appropriate Targets and How Should They be Assessed?
The first session focused on the collection of biological markers (biomarkers) in intervention trials, with a specific focus on those biomarkers that could be most readily collected. The session began with three state-of-the-science presentations: (i) thorough integration of genetic material collection and utility for prevention research; (ii) blood, sweat, and hair as possible sources of biomarkers to be employed in intervention studies; and (iii) the use of functional MRI to study typical and atypical brain development and connectivity.
Several themes emerged from discussions. First, participants agreed on the critical importance of theory to guide decision-making about what biological data to collect and how it should be analyzed. Second, participants agreed that biomarkers may help to identify novel areas of investigation for singular disorders that are increasingly viewed as heterogeneous. Finally, participants recognized that there are increasing opportunities to understand the association between biomarkers and mental disorders better, and that interdisciplinary collaborations can help streamline research processes and improve data collection.
It is also noteworthy that discussants emphasized the need for ethical and conscientious collection of biological data, acknowledging the public’s inherent and historic wariness towards medical research. Moving forward, close collaboration with stakeholders and communities was viewed as important to build trust in support of long-term efforts.
Topic 2: Designing Prevention Trials with a Neurodevelopmental Perspective
The second session emphasized the importance of the neurodevelopmental perspective for understanding the prevention of mental disorders. For this session, the presentations focused on (i) sensitive and silent periods for symptomatology and their role in emerging mental illnesses; (ii) progress in the early identification and prevention of schizophrenia; and (iii) the potential utility of integrating biomarkers into prevention trials (e.g., oxytocin, cortisol).
Discussants asserted that there is a need to understand healthy development better in order to identify leverage points for prevention interventions, and thereby to preempt mental disorders. In addition, “diagnostic neighborhoods” were raised as a useful conceptual model, to include endophenotypes of behavior that may also indicate risk for disorders. Finally, discussion turned to questions related to the influence of environment and social context, and the need to understand and incorporate context into an assessment and understanding of dysregulated biological systems.
Topic 3: Implications of the Next Generation of Prevention Research for Communities at Risk
The final presentations addressed the role of preclinical neuroscience research for prevention, with a specific emphasis on whether current understanding of risk and protective factors for bipolar disorder can be used to reduce morbidity and promote resilience.
Discussion addressed the importance of conducting research in real-world settings such as public schools and primary care practices. Workshop participants emphasized the importance of interdisciplinary collaborations within research teams to the success of such integrated research. Suggestions for how to encourage interdisciplinary collaboration included meeting grants (e.g., R13 awards) to bring together researchers from the relevant fields; and, configuring review panels such that they comprise membership that reflects the range of expertise needed for the evaluation of innovative, interdisciplinary prevention science grant applications.
The meeting organizers will prepare a full report on the workshop for dissemination.
For more information, please contact Christopher Gordon, Ph.D., firstname.lastname@example.org.