Mapping Dimensional Aspects of Biobehavioral Threat Reactivity in Young, Violence-Exposed Children: Linkages to Fear and Distress

项目总结： 人际暴力(IV)每年影响美国五分之一以上的幼儿。对年轻人来说 儿童，IV型接触最常发生在家庭环境中，形式为伴侣暴力和 严厉的/虐待的育儿方式。接触静脉注射的儿童代表着一个不同的群体。一部分儿童 产生跨越多个诊断类别的心理问题，其特征是恐惧和 痛苦的症状。现有的模型广泛地将生物应激系统的紊乱与糖尿病的病因联系起来。 与暴力相关的症状，但缺乏解释不同症状表现的特异性 年幼的孩子。推动这门科学的发展需要新的实验室和分析方法来评估和 跨多个生物行为级别合成威胁反应性。受研究领域标准的启发 (RDoC)倡议，我们建议通过利用以人为中心的方法来识别独特的配置文件来实现这一目标 在多个生物行为功能水平上的威胁反应性以前从未在年轻人中一起研究过 儿童：观察到的行为，注意力偏向，自主神经反应，惊吓，事件相关脑电位。这个 拟议工作的基本科学前提是威胁的反应性是一个中心中介 早期IV的表型与幼儿的这种临床易损性有关。建议的样本将 包括360名4至6岁的儿童，有(n=240)和没有(n=120)静脉注射超过1年的儿童。 我们提出了三个目标。目标1是将生物行为威胁反应性特征映射到维度模式 暴露在静脉注射和未暴露的幼儿中的恐惧和痛苦。我们假设我们会发现 与非极端特征相比，高反应性和低反应性特征会导致更严重的症状，而且 高反应性与恐惧有关，而低反应性与基线及一年以上的痛苦有关。 目标2是测试威胁反应性特征是否可以作为解释 随着时间的推移，暴力暴露与症状之间的联系。我们假设孩子们接触到更多 严重IV更有可能被归类为高反应性或低反应性，且该配置文件类型将中介该链接 在基线和一年后静脉注射和症状之间。此外，鉴于儿童对儿童的高度依赖 在暴力环境中对照顾关系和监管能力的威胁进行自我监管，我们 假设母亲共同调节孩子负面情绪的能力将塑造这些风险途径。 因此，目标3是检验这一假设，即母亲对儿童负面情绪的反应将在 随着时间的推移，在塑造威胁反应途径方面发挥独特的作用。我们假设对情绪有反应 为人父母(使用多方法方案进行评估)将缓冲IV和威胁反应性之间的关联 以及一年以上暴露和症状轨迹之间的关系。这项研究将提供关键的见解 暴力相关精神病理学的病因学及其对开发新的治疗方法的关键意义 对这些高度脆弱的幼儿进行识别、预防和干预。

PROJECT SUMMARY: Interpersonal violence (IV) affects more than 1 in 5 young children in the United States annually. For young children, IV exposure most commonly occurs within the family context in the forms of partner violence and harsh/abusive parenting. Children exposed to IV represent a heterogeneous group. A portion of children develop psychological problems that cut across multiple diagnostic categories characterized by fear and distress symptoms. Existing models broadly implicate disruptions in biological stress systems in the etiology of violence-associated symptoms, but lack specificity for explaining heterogeneous symptom presentations in young children. Advancing this science requires novel laboratory and analytic methods for assessing and synthesizing threat reactivity across multiple biobehavioral levels. Inspired by the Research Domain Criteria (RDoC) initiative, we propose to achieve this by leveraging person-centered methods to identify unique profiles of threat reactivity across multiple levels of biobehavioral functioning never before studied together in young children: observed behavior, attention bias, autonomic reactivity, startle, event-related brain potentials. The fundamental scientific premise of the proposed work is that threat reactivity is a central intermediate phenotype linking early IV to this clinical vulnerability in young children. The proposed sample will include 360 children, ages 4 to 6 years, with (n = 240) and without (n = 120) IV exposure followed over 1 year. We advance three aims. Aim 1 is to map biobehavioral threat reactivity profiles to dimensional patterns of fear and distress in IV exposed and non-exposed young children. We hypothesize that we will identify hyper- and hypo-reactive profiles that link to greater symptoms relative to a non-extreme profile, and that hyper-reactivity will relate to fear, whereas hypo-reactivity will relate to distress at baseline and over 1 year. Aim 2 is to test whether threat reactivity profiles serve as intermediate phenotypes in explaining the link between violence exposure and symptoms over time. We hypothesize that children exposed to more severe IV will more likely be classified as hyper- or hypo-reactive and that profile type will mediate the link between IV and symptoms at baseline and 1 year later. Further, given high dependency of young children’s self-regulation on caregiving relationships and threats to regulatory capacity in violent environments, we hypothesize that mothers’ ability to co-regulate their children’s negative affect will shape these risk pathways. Thus, Aim 3 is to test the hypothesis that maternal responsiveness to child negative affect will play a unique role in shaping threat reactivity pathways over time. We hypothesize that emotionally-responsive parenting (assessed with a multi-method protocol) will buffer the associations between IV and threat reactivity profiles and between exposure and symptom trajectories over 1 year. This study will provide critical insight into the etiology of violence-related psychopathology with key implications for developing novel approaches for identification, prevention, and intervention for these highly vulnerable young children.