Psychosocial Interventions for Genetically Influenced Problems in Childhood and Adolescence

Richard Rende, Ph.D., is a nationally and internationally recognized researcher who combines expertise at the intersection of developmental psychopathology and developmental behavioral genetics. As Associate Professor of Psychiatry and Human Behavior at Alpert Medical School of Brown University, he has been awarded multiple grants from 4 branches of the National Institutes of Health. He is the founder of Social Behavioral Research Applications (SBRA), a unique consultation service for industry, government, and academics. Rende developed the Red-Hot Parenting blog for Parents.com and a monthly column for the New Bedford Standard Times. His work has been featured on NPR, ABC News, The Huffington Post, Yahoo!, Time.com, CNN.com, and MSNBC.

Preface ix

Acknowledgments xiii

1 Prelude: Great Expectations 1

Aren’t Magic Bullets Possible? 10

So Aren’t Similar Successes Imminent? 11

What Will be the Yield of Genetic Research in Terms of Intervention? 14

Where Will All of This Lead? 17

2 Autism Spectrum Disorder: Can We Use Environmental Intervention to Reprogram Genetic Effects? 21

Genomic Approaches to ASD 24

Is There a New Fundamental Etiological Model of ASD? 27

Genomics, Complex Disorders, Hype, and Hope 30

Using the Environment to Reprogram the Effects of Genes 34

What’s Next? 41

References 44

3 Attention-Deficit/Hyperactivity Disorder and Reading Disorder: Illuminating How the Environment Shapes Highly Heritable Disorders 45

Genetic Models of ADHD and RD: Why Has Gene Discovery Been So Elusive? 47

Why Would the Environment be Important for Highly Heritable Disorders? 51

More Nuanced Models of Gene–Environment Interplay for ADHD and RD 54

The Promise of Psychosocial Interventions 59

Concluding Remarks 66

References 67

4 Conduct Problems and Substance Use: The Underappreciated Role of Shared Environmental Influences 69

Genetic Models of CP and SU 73

The Impact of Shared Environmental Influences 75

Getting Molecular About the Environment 81

A Developmental Gene–Environment Model 86

Family-Based Interventions and Genetic Epidemiology 90

Summary and Looking Ahead 95

References 96

5 Depression: The Importance of the Family as a Context for Gene Expression 99

High-Risk Studies of Offspring of Depressed Parents 101

Genetic Models of MDD 104

GxE Interaction and Depression 108

Depression in Adolescents and Children 112

Who Should be Treated in Families at Risk? 116

Implications of the Parental Treatment Studies 120

References 124

6 Pediatric Bipolar Disorder: Complex Phenotypes, Genotypes, and Environments 127

Current Thinking on the Genetics of BP 128

Is PBD an Early Manifestation of Genetic Risk to BP? 130

The Clinical Complexity of PBD 138

Emphasizing Psychosocial Interventions for PBD 143

Conclusions 148

References 150

7 Pediatric Anxiety Disorders: The Intersection of Genes and Environments 153

The Heterogeneity of Anxiety Disorders: Focusing on Anxiety-Related Behaviors in Childhood and Adolescence 154

Anxiety in the Family: The Intersection of Genes and Parenting 164

Genes, Environment, and Anxiety: Newer Methdologies 168

Concluding Remarks 174

References 177

8 The Future: Why Psychosocial Intervention Will Matter Even More 179

Future Genetic Research and the Conceptualization of Disorders 183

Genomics May Refine Diagnosis and Point to Tailored Interventions 188

Genomics Will Lead to Earlier Intervention 191

Genomics Will Accelerate the Development of Psychosocial Interventions 193

Will We Discover Magic Bullets? 194

Author Index 197

Subject Index 203

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