COBRE for Stress, Trauma and Resilience (STAR)

项目总结/摘要 越来越多的证据表明，童年压力和创伤对一生中的心理和身体健康结果产生深刻而持久的影响。这些协会的力量和一致性 导致了一个模式的转变，在处理成人疾病，其中解决儿童早期的健康起源， 疾病被认为与成人的干预措施同等重要，如果不是更重要的话。然而，尽管与不良童年经历相关的风险很大，但对儿童健康的了解有限。 早期逆境影响健康的确切机制。我们建议建立一期中心 生物医学研究卓越（COBRE）的压力，创伤和恢复力（星星）在米里亚姆 医院要解决这一关键问题。星星COBRE由一个概念框架统一起来，重点是： 隔离/解开特定的应激暴露和创伤，以及（B）识别 通过体内生态取样，提高风险和复原力，这将迅速导致新的和可操作的干预目标，以改善健康。COBRE采用了生命周期方法，重点是 发育的敏感期--怀孕期、儿童期和青年期。三个有前途的，早期职业生涯的项目负责人，一个初级教师招聘专业知识的星星从一个代表性不足的少数群体， 和由Miriam医院资助的以多样性为重点的试点项目计划形成了星星合作的纽带， BRE。由两个领先的NIH资助的科学家与互补的专业知识的共同指导将促进项目领导人的过渡到独立的资金。Bublitz博士将利用尖端的生态学方法， 了解母亲儿童期性虐待史与妊娠期高血压疾病之间的联系。埃文斯博士将在儿童中进行一项自然主义实验，以阐明其他与贫困有关的压力源对饮食，炎症和代谢生物标志物以及夏季食物不安全的具体影响。 体重增加; Vergara-Lopez博士将利用一种新颖的维度方法来研究儿童虐待， 剥夺（忽视）与威胁（虐待）对青少年情绪调节策略和心理的影响 健康症状。为了支持项目领导和星星COBRE，我们将建立一个管理核心， 包括社区咨询委员会和最先进的指导和教育计划，以及两个 研究核心：技术、评估、数据和分析（TADA）核心将支持利用尖端技术、数据管理和统计的方法;人类受试者和弱势群体（VP）核心将支持招募/保留弱势和多样化的人群和社区 伙伴关系。星星COBRE将作为罗得岛唯一的研究中心， 压力创伤和恢复力我们的长期目标是培养和维持一批关键的调查人员， 建立米里亚姆医院作为一个充满活力的区域和国家中心，对儿童暴露于压力，创伤和逆境后的风险和复原力机制进行变革性研究。

PROJECT SUMMARY / ABSTRACT There is increasing evidence for a profound and persistent impact of childhood stress and trauma on psychological and physical health outcomes over the lifespan. The strength and consistency of these associations has led to a paradigm shift in approaching adult disease in which addressing the early childhood origins of health and disease is considered to be equal to if not more critical than intervention efforts with adults. However, despite the magnitude of risk associated with adverse childhood experiences, there is limited understanding of the precise mechanisms by which early adversity impacts health. We propose to establish a Phase I Center of Biomedical Research Excellence (COBRE) for Stress, Trauma, and Resilience (STAR) at The Miriam Hospital to address this critical gap. The STAR COBRE is unified by a conceptual framework focused on (a) isolating/disentangling specific stress exposures and traumas, and (b) identifying proximal mechanisms of risk and resilience with in-vivo ecological sampling that will lead rapidly to novel and actionable intervention targets to improve health. The COBRE incorporates a life course approach, with an emphasis on sensitive periods of development—pregnancy, childhood, and young adulthood. Three promising, early career Project Leaders, a junior faculty recruit with expertise in STAR from an under-represented minority group, and a diversity-focused pilot project program funded by The Miriam Hospital form the nexus of the STAR CO- BRE. Co-mentorship by two leading NIH-funded scientists with complementary expertise will catalyze the transition of the Project Leaders to independent funding. Dr. Bublitz will utilize cutting-edge ecological methods to understand links between maternal history of childhood sexual abuse and hypertensive disorders of pregnancy. Dr. Evans will conduct a naturalistic experiment in children to elucidate the specific impact of food insecurity from other poverty-related stressors on diet, inflammatory and metabolic biomarkers and summer weight gain; Dr. Vergara-Lopez will utilize a novel dimensional approach to childhood maltreatment to contrast the impact of deprivation (neglect) vs. threat (abuse) on young adult emotion regulation strategies and mental health symptoms. To support Project Leaders and the STAR COBRE, we will establish an Administrative Core, including a community advisory board and a state-of-the art Mentoring and Education program, and two research cores: the Technology, Assessment, Data, and Analysis (TADA) Core will support methods harnessing cutting-edge technology, data management and statistics; the Human Subjects and Vulnerable Populations (VP) Core will support recruitment/retention of vulnerable and diverse populations and community partnerships. The STAR COBRE will serve as the only research center in Rhode Island focused on stress, trauma, and resilience. Our long-term goal is to develop and sustain a critical mass of investigators to establish The Miriam Hospital as a vibrant regional and national hub for transformative research into mechanisms of risk and resilience following childhood exposure to stress, trauma, and adversity.