title: Minor physical anomalies: modifiers of environmental risks for psychiatric impairment?
abstract: OBJECTIVE
  To test the hypothesis that minor physical anomalies (MPAs) modify an adolescent's vulnerability to environmental risk factors for psychopathology.
  
  
  METHODS
  One hundred eighteen unreferred male adolescents who had been evaluated as 7-year-olds received a comprehensive neuropsychiatric evaluation. The evaluation included standardized assessments of environmental risk factors for psychiatric impairment, neurological signs, IQ, MPAs, and psychiatric impairment. The relationship between psychiatric status and environmental risk was examined as a function of the MPA profile.
  
  
  RESULTS
  There was a significant interaction between MPAs and environmental risk in predicting psychiatric status. Environmental risk was more predictive of psychiatric impairment at age 17 in subjects with high scores on the MPA scale than in subjects with low scores on the scale. This relationship was particularly apparent in subjects with conduct disorder. MPAs also exhibited relationships with two childhood factors, neurological soft signs and Verbal IQ, that had been shown to predict adolescent psychopathology in prior reports on this cohort.
  
  
  CONCLUSIONS
  MPAs may contribute to psychiatric impairment by influencing an individual's vulnerability to environmental risk factors for psychopathology. These suggestive findings are consistent with an emerging body of literature examining the role of biopsychosocial interactions in psychiatric disorders.
authors.affiliation: Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute/Columbia University, New York 10032, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Pine
authors.forename: D
authors.initials: D
authors.lastname: Shaffer
authors.forename: I S
authors.initials: IS
authors.lastname: Schonfeld
authors.forename: M
authors.initials: M
authors.lastname: Davies
mesh_terms: D000293:Adolescent; D000013:Congenital Abnormalities; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D012307:Risk Factors