Assessment of suicide risk in adolescents and young adults with ASDs 

Our goal is to further understand how suicidal thoughts and behaviors may be perceived and understood differently by adolescents and young adults with ASDs who are receiving psychiatric care.  Focus is on how providers may need to modify traditional assessments of suicidality to relate to the unique social and communication needs to those with ASDs. Primary Investigators: Todd Levine MD, Anthony Spirito, PhD.

Fetal and Infant Response to SRI Treatment

Approximately 600,000 infants born each year are exposed to maternal depression. At least 30% of those infants will also be exposed to psychotropic medication. Fetal exposure during pregnancy to maternal depression and the medications to treat the disorder have been associated with neurobehavioral differences in infants. It has been suggested that these differences are transient and it is not known if they are related to the mother's depression or the medication used to treat the depression. The F.I.R.S.T. is studying the clinical course of newborns' symptoms directly after birth and for the infants' first 30 days after birth. Fetal neurobehavior measures are obtained by ultrasound and fetal heart rate evaluation at 28-30 and 32-34 weeks gestational age. After delivery, we observe the infants motor patterns, reflexes, behavior, sleep, and attention. Primary Investigator: Amy Salisbury PhD.

Fetal and Neonatal Neurobehavior and Prenatal Antidepressant Exposure: The Child

The goal of this project is to examine the effects of prenatal antidepressant exposure and untreated maternal depression on sleep, neurobiological rhythms, and socio-emotional development in children through age 5 with the goals of identifying guidelines for the treatment of depression during pregnancy and biomarkers for developmental psychopathology. Primary Investigators: Todd Levine MD, Amy Salisbury PhD.

Maternal Lifestyle Study

The Maternal Lifestyle Study (MLS) is the largest of the NIH longitudinal studies of children with prenatal cocaine exposure.  MLS is a multi-site observational study of the long term effects of in-utero exposure to cocaine on child development.  The study included 25 data collection visits (birth to age 16 years) in the birth hospital, study clinic, home, and school. Neurobehavior evaluation (NNNS) and acoustic cry analysis were conducted at the 1-month visit.  Quality of attachment was conducted at 18 and 36 months. Heart rate recording occurred during child activity in the study clinic.  Cortisol reactivity during the stressful Trier Task and diurnal cortisol pattern both showed a blunted response in cocaine exposed children, suggesting chronic stress in these children’s lives.  Cocaine exposed children are likely to live in adverse circumstances that may increase the likelihood of behavior problems leading to poor executive function and school achievement, psychopathology, delinquency, early sex and drug use.  MLS has published over 75 publications. Primary Investigators: Barry Lester PhD, Linda LaGasse PhD.

The MLS data set has been submitted for public access to the National Addiction and HIV Data Archive Program, Inter-University Consortium for Political and Social Research (University of Michigan). The URL is http://dx.doi.org/10.3886/ICPSR34312.v1

Preschool Neurobehavior and Prenatal Antidepressant Exposure

Over 400,000 pregnant women and their fetuses experience Major Depressive Disorder (MDD) every year in the United States.   Serotonin/Norepinephrine Reuptake Inhibitors (SRIs) are the most commonly chosen antidepressant medications for MDD during pregnancy.  The original prenatal project focused on prenatal and postnatal development of infants whose mothers had MDD during pregnancy, with and without SRI treatment, compared to non-depressed mothers.  Our early findings suggest that prenatal MDD and SRI exposure are both associated with alterations in sensory-motor development in the fetal period and early infancy. We are now following these children and their families through the preschool years. We hypothesize that the early motor effects of prenatal SRI exposure are related to alterations in fetal serotonin development and that these effects will diminish in exposed children by preschool age.  By comparison, effects attributed to maternal MDD will be longer-lasting.  We are currently examining the role of maternal MDD and prenatal SRI exposure on child sensory-motor integration, gross and fine motor control (kinematics), temperament, behavioral and emotional development, and sleep state with circadian biomarkers (urinary melatonin sulfate levels) related to psychiatric symptoms.  We are also identifying potential epigenetic markers associated with these effects.  The rationale for the proposed research is that once we know how early SRI exposure affects these key areas related to serotonin function, we will be able to identify specific mechanistic pathways, including epigenetic targets and biomarkers, for psychopathology.  The expected outcomes will have a positive impact because they will lead to informed risk-benefit decision-making for pregnant women with MDD and provide new preventive and therapeutic targets for psychopathology in children.  This will further translate into enormous reductions in overall costs due to the social and functional disability that may result from such conditions. Primary Investigators:  Amy Salisbury PhD.

The Impact of Prenatal Methamphetamine Exposure on Children in New Zealand (NZ)

Does the impact of prenatal exposure to methamphetamine on children differ with cultural and resource differences?  The IDEAL (Infant Development Environment and Lifestyle) study in the US was replicated in NZ to compare whether differences between the societies may influence outcome in children with prenatal METH exposure.  Unlike the US, NZ has a harm reduction approach toward drug use, no mandatory reporting statutes for prenatal illicit drug use hence rare child removal, free universal health care and generous financial resources. Drug-using NZ mothers are far more likely to have prenatal care than US mothers and their infants were born  heavier and longer than US infants.  However, exposed infants in both US and NZ had a similar neurobehavioral pattern (NNNS) including under arousal, poorer quality of movement and increased stress and similar mild motor deficits from 1 to 3 years of age.  On the other hand, NZ mothers were 5 times more likely to have comorbidity between psychopathology and substance use disorder than US mothers. Ongoing analyses of academic achievement, social-emotional development and behavioral problems from 5 -7 years may be more sensitive to culture and resources as well as early adversity.  Primary Investigators: Linda LaGasse PhD, Barry Lester PhD.