Developmental Trajectories of Attenuated Psychotic Symptoms: The Roles of Dispositional Emotion Regulation Strategy Use and Neural Connectivity in Pathways to Psychosis

Project Summary My career goal is to be an independent, productive clinical affective neuroscientist studying developmental mechanisms of psychosis-spectrum pathology. To achieve this goal, I have developed a training plan that is consistent with the mission of the NIH’s Ruth L. Kirschstein NRSA Individual Predoctoral Fellowship. My training plan has four specific goals. These training goals are to 1) learn how to preprocess and analyze functional magnetic resonance images (fMRI), 2) build an advanced repertoire of statistical knowledge and computing abilities, 3) master effective communication in scientific writing, and 4) develop professional relationships and network with cross-disciplinary researchers. Accomplishing these training goals will be important preparatory steps towards my attainment of a successful career in clinical research. To complement these training goals, I have crafted a research proposal focused on affective and clinical trajectories, and the influence of neural connectivity, in individuals at clinical high risk (CHR) for psychosis. The onset of psychosis is a complex developmental process. Despite interdisciplinary attention, the developmental trajectories of positive symptoms (i.e., delusions and hallucinations) and attenuated psychotic symptoms (APS), or less severe or distressing forms of delusions and hallucinations, are not fully understood. One reason for limitations in our scientific knowledge could be heterogeneity across developmental trajectories and timelines in individuals at-risk for psychosis. Thus, studying changes in APS severity across time in subclinical samples, such as individuals at CHR for psychosis, could help us to understand heterogeneity in clinical outcomes. Heterogeneity in clinical outcomes in individuals at CHR may be explained in-part by risk and resilience factors, such as predispositions to use certain emotion regulation (ER) strategies and related neural connectivity patterns. Defining the roles of dispositional ER and neural connectivity in changes in APS severity can elucidate how these factors may contribute to the progression of APS. Hence, the proposed multi- method, longitudinal study will clarify how the use of select ER strategies (rumination, expressive suppression, cognitive reappraisal) and connectivity in regions of interest contribute to heterogeneity in APS severity through two specific aims. Aim 1 will investigate the relations between dispositional ER strategy use and APS severity across time. Aim 2 will investigate the influence of baseline neural connectivity in regions of interest on between-persons differences in trajectories of dispositional ER strategy use and APS severity across time. The study will leverage five self-report assessments across two years and resting-state fMRI at baseline to address these aims. Overall, the proposed study will advance knowledge on mechanisms of psychotic symptom development in CHR, thereby facilitating the identification of behavioral and biological points of intervention and improving the specificity of early intervention in CHR.