A new study on psychiatric disorders suggests that by focusing on temperament, childhood adversity, and dopamine, the onset of some of these disorders can be predicted with 90% accuracy. A wide range of conditions like depression, anxiety, addiction, ADHD, bulimia, and dyslexia may result from a combination of those three factors.
The Research
A new study from McGill University followed 52 participants from birth, collecting information on temperament and early life history, as well as brain imaging scans. This allowed researchers to focus on a combination of three key biological, psychological and social factors at once. Those factors included early life adversity, such as physical or emotional abuse or neglect, sexual abuse or other forms of trauma during childhood; the brain’s dopamine autoreceptors, or variability in responses to rewards and punishments; and adolescent externalizing traits, which include impulsivity, altered responses to rewards and punishments and difficulty regulating strong emotions. “These features represented some of the best-supported risk factors thought to influence multiple mental health problems,” says the study’s senior author Marco Leyton, PhD. “Our study is unique because we had the unprecedented opportunity to study all three factors together.” The findings, published in Neuropsychopharmacology, revealed that these three factors predicted with over 90% accuracy a wide range of psychiatric disorders experienced in participants’ past or during the study’s three-year follow-up period. Leyton points out that for decades, the dominant model has operated as if there are many discrete illnesses with their own unique causes. “Despite this, it has become clear that many disorders commonly occur together,” Leyton says. “If you meet criteria for one mental health problem, both you and your family members can be at risk for multiple disorders.” This observation reveals the potential for many diseases to have shared causes.
Prevention and Intervention
Dr. Gail Saltz, MD, clinical associate professor of psychiatry at the New York Presbyterian Hospital Weill-Cornell School of Medicine and host of podcast “How Can I Help?", doesn’t see the study as presenting new or surprising information, but rather confirms known factors for predicting psychiatric disorders. Early life trauma is a risk factor for various psychiatric disorders, Saltz says, and aggressive behavior is often a symptom of psychiatric illness, while dopamine is the neurotransmitter involved in numerous disorders. It makes sense that a combination of these risk factors can raise an individual’s risk. But predicting this earlier in that person’s life could be incredibly beneficial. Previous research on developing predictive methods for mental health conditions has sparked ethical conversations, as well. Do people really want to know their level of risk? And what are the potential negative effects of data sharing, early diagnosis, and treatment? Regardless, early research has shown that there are individuals who feel predictive research is valuable and would partake in studies. The benefits might outweigh the potential negatives. Most importantly, this kind of predictive ability would enable preventive care and early intervention. “Both of these are known to decrease the impact of the illness on the person’s functionality in their lives as well as shorten the course of or even prevent numbers of relapses,” Saltz says. It could also make a difference for practitioners in their decisions for providing care. “Mental health professionals can recommend that those with early life trauma and externalizing behaviors get early evaluation and be taught coping skills,” Saltz says. “It is possible to have earlier treatment interventions which can definitely change the course of illness.” While the results of this particular study must be replicated in a larger and more ethnically diverse sample, they could introduce new areas of focus when it comes to understanding the causes of psychiatric disorders.
