Neurobiological pathways from trauma exposure to child mental health outcomes in a high adversity South African Birth Cohort

南非出生队列的高逆境中从创伤暴露到儿童心理健康结果的神经生物学途径

• 批准号: MR/T002816/1
• 负责人: Sarah Halligan
• 金额: $ 129.55万
• 依托单位: University of Bath
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FT002816%2F1
• 关键词: Neurobiological; pathways; trauma; exposure; child

Children growing up in many low and middle income country (LMIC) contexts are at high risk of exposure to trauma, such as domestic or community violence, child abuse, or severe injury. Exposure to such adversity has been identified as a major contributor to psychological disorders in children. The negative impacts of childhood trauma exposure have been found to persist into adulthood, with wide ranging individual and societal consequences. Indeed, individuals exposed to childhood trauma are disproportionately represented among the most vulnerable groups in societies worldwide (e.g., the homeless). Despite this robust evidence of the detrimental effects of trauma exposure, there are key limitations to our understanding of this problem. First, the majority of relevant evidence derives from high income countries, rather than from LMICs, where exposure to childhood trauma is substantially more common and many children experience multiple adversities. Consequently, we have limited knowledge of the impact of childhood trauma as experienced in the types of contexts in which the majority of the world's children live. This, in turn, undermines capacity for targeted prevention or intervention in such settings. Second, there is extremely limited understanding of the underlying mechanisms that link early trauma with negative mental health outcomes, particularly considering biological processes. Our understanding of how trauma becomes embedded in the brain and body in children, and how that, in turn, confers risk of multiple psychological disorders, is particularly limited. We plan to address limitations in our understanding of the mental health consequences of trauma in children through capitalizing on and extending a key South African birth cohort, the Drakenstein Child Health Study (DCHS). Childhood trauma is a major mental health related concern in South Africa, particularly due to high levels of interpersonal violence (including high rates of community violence, intimate partner violence and child maltreatment). We propose to conduct an in depth study of the mental health impacts of childhood trauma in this cohort, which will address limitations in our understanding and achieve a major change in knowledge in an area of key importance for LMIC contexts. The DCHS is exceptional in having repeatedly measured child trauma exposure during the first years of life, and having simultaneously completed biological assessments and measures of child mental health at multiple times points. High rates of trauma exposure among children in the DCHS mean that it provides an opportunity to study the impact of childhood trauma which is not afforded by birth cohorts based in high income country contexts, in which very few children are exposed to severe or recurrent trauma. We plan to follow-up children in the DCHS cohort at age 8-9 years, when many common psychological disorders manifest for the first time in children. Because we have measures of both exposure to trauma and biological processes which are repeated over time, we will be able to understand how trauma influences stress-related biological systems, and how those effects, in turn, may lead to psychological disorder in children. We will be able to study key biological systems involved in the body's response to stress, the immune system (which is increasingly being understood to be closely related to stress), and brain development. Through identifying pathways from trauma to psychological disorders in children, this work may change the way we provide interventions in the future.

在许多中低收入国家(LMIC)长大的儿童面临家庭或社区暴力、虐待儿童或严重伤害等创伤的高风险。暴露在这样的逆境中被认为是导致儿童心理障碍的主要因素。童年创伤暴露的负面影响已被发现持续到成年，产生广泛的个人和社会后果。事实上，受童年创伤影响的个人在世界各地社会中最脆弱的群体(如无家可归者)中的比例不成比例。尽管有这些强有力的证据表明创伤暴露的有害影响，但我们对这个问题的理解存在关键限制。首先，大多数相关证据来自高收入国家，而不是低收入国家，在这些国家，儿童遭受创伤的情况要普遍得多，许多儿童经历了多种逆境。因此，我们对在世界上大多数儿童生活的环境中所经历的童年创伤的影响的了解有限。这反过来又削弱了在这种情况下进行有针对性的预防或干预的能力。其次，对于将早期创伤与消极心理健康结果联系起来的潜在机制，特别是考虑到生物过程，人们的理解极其有限。我们对创伤如何嵌入儿童的大脑和身体，以及如何反过来增加患多种心理障碍的风险的理解，尤其有限。我们计划通过利用和扩大一个关键的南非出生队列--Drakenstein儿童健康研究(DCHS)，来解决我们对创伤对儿童心理健康影响的理解方面的局限性。在南非，儿童创伤是一个与精神健康有关的主要问题，特别是由于人际暴力的高水平(包括社区暴力、亲密伴侣暴力和虐待儿童的高比率)。我们建议在这一群体中深入研究儿童创伤对精神健康的影响，这将解决我们在理解方面的局限性，并在一个对LMIC背景至关重要的领域实现知识的重大变化。DCHS的特殊之处在于，它在生命的第一年反复测量儿童创伤暴露，并同时完成了多个时间点的儿童心理健康生物学评估和测量。托儿所儿童的高创伤暴露比率意味着，它为研究儿童创伤的影响提供了一个机会，而在高收入国家的出生队列中，很少有儿童受到严重或反复的创伤。我们计划在8-9岁对DCHS队列中的儿童进行跟踪调查，届时许多常见的心理障碍首次在儿童中表现出来。因为我们有创伤暴露和随着时间重复的生物过程的测量，我们将能够理解创伤如何影响与压力相关的生物系统，以及这些影响如何反过来可能导致儿童的心理障碍。我们将能够研究与身体对压力的反应有关的关键生物系统、免疫系统(越来越多地被理解为与压力密切相关)和大脑发育。通过确定从儿童创伤到心理障碍的途径，这项工作可能会改变我们未来提供干预的方式。

项目成果

Sex differences in post-traumatic stress disorder in a high adversity cohort of South African adolescents: an examination of depressive symptoms, age, and trauma type as explanatory factors.

• DOI: 10.1080/20008198.2021.1978669
• 发表时间: 2021
• 期刊: European journal of psychotraumatology
• 影响因子: 5
• 作者: Hiscox LV;Hiller R;Fraser A;Rabie S;Stewart J;Seedat S;Tomlinson M;Halligan SL
• 通讯作者: Halligan SL

Managing depression and anxiety in people with epilepsy: A survey of epilepsy health professionals by the ILAE Psychology Task Force.

• DOI: 10.1002/epi4.12455
• 发表时间: 2021-03
• 期刊: Epilepsia open
• 影响因子: 3
• 作者: Gandy M;Modi AC;Wagner JL;LaFrance WC Jr;Reuber M;Tang V;Valente KD;Goldstein LH;Donald KA;Rayner G;Michaelis R
• 通讯作者: Michaelis R

Comparison of the stability of Glycoprotein Acetyls and high sensitivity C-reactive protein as markers of chronic inflammation

糖蛋白乙酰基和高敏 C 反应蛋白作为慢性炎症标志物的稳定性比较

• DOI: 10.1101/2023.03.02.23286349
• 发表时间: 2023
• 作者: Crick D

Change in prevalence of post-traumatic stress disorder in the two years following trauma: a meta-analytic study.

• DOI: 10.1080/20008198.2022.2066456
• 发表时间: 2022
• 期刊: EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY
• 影响因子: 5
• 作者: Diamond, P. R.;Airdrie, J. N.;Hiller, R.;Fraser, A.;Hiscox, L., V;Hamilton-Giachritsis, C.;Halligan, S. L.
• 通讯作者: Halligan, S. L.

Antenatal maternal intimate partner violence exposure is associated with sex-specific alterations in brain structure among young infants: Evidence from a South African birth cohort.

• DOI: 10.1016/j.dcn.2023.101210
• 发表时间: 2023-04
• 期刊: DEVELOPMENTAL COGNITIVE NEUROSCIENCE
• 影响因子: 4.7
• 作者: Hiscox, Lucy, V;Fairchild, Graeme;Donald, Kirsten A.;Groenewold, Nynke A.;Koen, Nastassja;Roos, Annerine;Narr, Katherine L.;Lawrence, Marina;Hoffman, Nadia;Wedderburn, Catherine J.;Barnett, Whitney;Zar, Heather J.;Stein, Dan J.;Halligan, Sarah L.
• 通讯作者: Halligan, Sarah L.