E. Sonuga-Barke
Feb 1, 2010
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0
Influential Citations
33
Citations
Journal
Journal of child psychology and psychiatry, and allied disciplines
Abstract
JCPP provides a scholarly interface between the basic science of developmental psychopathology and clinical practice in child and adolescent psychiatry and psychology. Here scientists can set out their data and ideas for both fellow researchers keen to build on, and also for interested clinicians keen to keep abreast of, the latest scientific developments. Aware of the need to speak to this broad constituency, we select manuscripts for publication only if they combine scientific value and clinical relevance. This means that questions typically travel in pairs: the science question comes first, its clinical corollary follows soon after. The scientist asks: What processes drive the development of mental disorder in childhood and adolescence? The clinician naturally follows up with: How can I exploit science to produce more effective ways of working with patients? In JCPP big science themes sit alongside workaday goals to create the translational imperative that is at the heart of our mission. That said, clearly many studies we publish, especially those focusing on causal processes, are not always directly or immediately applicable in practice (although papers reporting high quality trials and practitioner reviews form an important and popular focus of our output). However, when taking the longer and broader view, such studies are of great clinical significance in as much as they address core issues about the nature of disorder. Take, for instance, the debate over the relative importance of genetic vs. environmental influences on the development of common childhood disorders: a subject of broad but obvious clinical relevance because it has implications about how tractable conditions are to environmental therapies. Unfortunately, this debate has often in the past got bogged down in ideology and politics. Battle lines have been drawn and redrawn and scientist-protagonists have taken extreme positions often well beyond the available data. Thankfully, because of new genetic technologies of immense quantitative power developed over the past 10 to 15 years, and the recent development of sophisticated methods for testing environmental influence on biological processes, we can at last bypass this stale stand-off over nature vs. nurture ‘dogma’. Rather than having to infer genetic and environmental effects on the basis of indirect tests, we can study the role of genes and environments (and the effect they have on each other) directly. Against the initial expectations of many, approaches employing technologies such as wholegenome association studies have tended not to demonstrate the power of genes alone to determine disorder, but rather have highlighted the complexity and heterogeneity of the causal architecture of common mental disorders and the way that genes and environments work together to shape development. Serious science is now more than ever focused on the power of the environment to shape neurodevelopmental processes and pathways. In a way, the more we have found out about the genetics of common childhood disorders, the more we confirm the importance of environmental factors in the aetiological mix. Now, all but the most dogged of genetic determinists have revised their view of the primacy of genetic factors so as to encompass a central role for the environment in the development of mental disorder. This is the case even for the most heritable conditions. For instance, in my field, attention-deficit hyperactivity disorder (ADHD), despite the remarkable early advances using candidate gene approaches (Turic, Swanson, & Sonuga-Barke, in press), subsequent progress has been slow: we are now using larger and larger samples of patients to demonstrate smaller and smaller molecular genetic main effects. Even the most comprehensive genomewide scans available, with thousands of patients using hundreds of thousands of genetic markers, such effects appear to account for a relatively small proportion of disorder expression (Neale et al., 2008). At the same time we are seeing fascinating examples of the power of the environment to shape disorder expression and the neurobiological processes presumed to underpin it. Powerful new concepts are being applied to help explain the ways that environments influence gene expression (Mill & Petronis, 2008), program biological systems (Swanson & Wadhwa, 2008) and promote both functional and Thankfully, because of new genetic technologies of immense quantitative power developed over the past 10 to 15 years, and the recent development of sophisticated methods for testing environmental influence on biological processes, we can at last bypass this stale stand-off over nature vs. nurture ‘dogma’ Journal of Child Psychology and Psychiatry 51:2 (2010), pp 113–115 doi:10.1111/j.1469-7610.2009.02213.x