Biomarkers of Risk and Resilience to Trauma in Syrian Refugee Youth

项目总结/摘要 对创伤后应激障碍（PTSD）的研究，更具体地说，在受创伤的难民中， 主要针对成年人。我的共同赞助人（Javanbakht博士）进行了第一次阿拉伯人的心理健康研究。 在美国重新定居的难民（成人和儿童），评估患病率，遗传，表观遗传， 创伤相关心理后果的环境相关性。我的赞助商（约万诺维奇博士）开创了 采用皮肤电传导反应（SCR）和恐惧增强惊吓对青年创伤的纵向研究 (FPS)来理解精神病理学的生理关联该应用程序的目标是扩展 我的赞助商的工作，以量化神经生理生物标志物的创伤后应激障碍的青年难民。 暴露于压力和创伤激活了一个关键的适应途径-交感肾上腺髓质 系统（SAM）。增加的交感神经反应性可通过非侵入性方法测量。皮肤电导 当叙述创伤时，反应（SCR）上升，可以预测暴露后6个月的PTSD。FPS 量化了安全学习的障碍以及恐惧的过度概括。高水平的亲- 炎症成分与更严重的PTSD和焦虑症病理学有关。拟议 该项目将测量PTSD与其症状群、SCR、FPS和炎症之间的关系 在遭受过平民战争创伤的叙利亚难民青年中，并已被评估为可能的 焦虑症这将为学员提供一个机会，i）提高与多元文化接触的技能 临床研究中的人群，ii）学习FPS范式以及如何分析肌电图 记录（EMG;测量惊吓反应的工具）和SCR，以及iii）提高收集，存储， 和促炎蛋白的分析，同时扩大了对神经生理学基础的理解， 创伤后应激障碍在年轻人中的发病率，这一点一直没有得到充分的研究。科学前提：生物标志物，如SCR，FPS， 和炎症（即急性时相蛋白C反应蛋白（CRP））将是PTSD的可量化相关因素 叙利亚难民青年。这些生物标志物将在那些筛查阳性的人中显著升高， 焦虑症的症状。意义：我们的方法将有助于调查 与青年PTSD的心理生理病理学相关的合理神经生物学机制，提供数据 来自一个在心理健康研究中代表性不足的群体--中东难民。 潜在的未来研究将：A）调查体积和功能神经影像学相关的 与儿童和青少年创伤相关的行为、炎症和电生理变化; B）利用该信息来建立预测模型，该预测模型结合炎症状态的基线测量， 自主觉醒，大脑结构和心理症状，以确定预后， 在青年的进步;和C）扩大这些方法的机械调查用于评估身体为重点 治疗方式和结果，特别是运动和基于正念的干预措施。

Project Summary/Abstract Research in posttraumatic stress disorder (PTSD), more specifically in traumatized refugees, has primarily focused on adults. My Co-Sponsor (Dr. Javanbakht) has conducted the first mental health study of Arab refugees (adults and children) resettling in the United States that evaluates prevalence, genetic, epigenetic, and environmental correlates of trauma-related psychological outcomes. My Sponsor (Dr. Jovanovic) has pioneered longitudinal studies of trauma in youth, employing skin conductance response (SCR) and fear-potentiated startle (FPS) to understand physiological correlates of psychopathology. The goal of this application is to expand my Sponsors’ work to quantify neurophysiological biomarkers of PTSD in youth refugees. Exposure to stress and trauma activates a key adaptive pathway—the sympathetic adrenomedullary system (SAM). Increased sympathetic reactivity is measurable through non-invasive methods. Skin conductance response (SCR) rises when recounting trauma and can predict PTSD 6 months following exposure. FPS quantifies impairments in safety learning as well as overgeneralization of fear. Elevated levels of pro- inflammatory components have been linked to more severe pathology of PTSD and anxiety. The proposed project will measure the relationship between PTSD and its symptom clusters, and SCR, FPS, and inflammation in Syrian refugee youth who have been exposed to civilian war trauma and have been assessed for possible anxiety disorder. This will provide the trainee with an opportunity to i) enhance skills engaging with multicultural populations in clinical research, ii) learn the FPS paradigm as well as how to analyze electromyography recordings (EMG; tool to measure startle response) and SCR, and iii) to enhance skills in collection, storage, and analysis of pro-inflammatory proteins, all while expanding the understanding of the neurophysiological basis of PTSD in youth, which has been grossly underexplored. Scientific premise: Biomarkers such as SCR, FPS, and inflammation (namely acute phase protein C-reactive protein (CRP)) will be quantifiable correlates of PTSD in Syrian refugee youth. Such biomarkers will be significantly elevated in those who have screened positive for an anxiety disorder compared to those who have not. Significance: Our approach will facilitate investigation of plausible neurobiological mechanisms associated with psychophysiopathology of PTSD in youth, providing data from a largely underrepresented group in mental health research—Middle Eastern refugees. Potential future research would: A) investigate volumetric and functional neuroimaging correlates of the behavioral, inflammatory, and electrophysiological changes associated with trauma in children and adolescents; B) leverage this information to build a predictive model combining baseline measures of inflammatory state, autonomic arousal, brain structure, and psychological symptoms in order to determine prognosis and progression in youth; and C) expand these methods of mechanistic inquiry for use in assessing body-focused treatment modalities and outcomes, particularly exercise and mindfulness-based interventions.