Neurobiological Assessment

Neurobiological assessment techniques have great potential for psychiatric disorders and child mental health, holding promise for rapid and easy assessment of the central nervous system (CNS) so that we can accurately evaluate cognitive, emotional, and behavioral variation, and even measure the genetic variation of these domains to understand risk and vulnerability prior to their developmental manifestations. The discovery, testing, validation, and dissemination of technological procedures to fill gaps in our assessment protocols could reshape our practice of patient care, standards of treatment, the scope of our intervention goals, and the direction in which resources are expended on mental health care. This chapter describes the current and potential applications of several technologies, including pharmacogenomics, fluorescence in situ hybridization, the polymerase chain reaction, microarray analysis, single-photon emission computed tomography, positron emission tomography, magnetic resonance imaging, functional magnetic resonance imaging, and magnetic resonance spectroscopy. It also emphasizes the continuing role in diagnostics and research of electrophysiological phenomena, such as event-related potentials and electroencephalography, and also biochemical changes, particularly in the hypothalamic-pituitary-adrenal axis. Information generated by these laboratory procedures coupled with biological responses from the next generation of psychopharmacological agents may bring new insights into neurochemical brain-behavior relationships. These insights may provide the child and adolescent psychiatrist with powerful technologies to explore symptoms as well as comprehensive and integrative techniques that allow for predictive statements about disease progression and outcome.