Neurodevelopmental Biology of Neglected Children

描述（由候选人提供）：本申请的总体目的是为候选人准备以患者为导向的研究事业，探索与儿童忽视相关的神经生物学后遗症。候选人在儿童精神病学和儿科方面的培训，儿童虐待和儿童脑部疾病方面的专业知识为该提案提供了良好的基础。主要导师在探索下丘脑-垂体-肾上腺（HPA）轴，压力，物质使用和资助方面具有专业知识，并且是职业中期研究者奖获得者，致力于指导对患者导向研究感兴趣的个人。次要导师是在神经内分泌学、儿科内分泌学和儿童大脑发育与儿童虐待和儿童忽视相关风险因素方面经验丰富的临床研究人员。培训计划包括特定主题的指导，完成临床研究理学硕士学位，以及在普通临床研究中心（GCRC）的监督研究经验。该申请的最终目标是将候选人从受指导的研究员转变为独立的以患者为导向的研究人员，专注于儿童忽视和虐待的神经生物学。为了实现这一转变，在忽视、神经内分泌系统、幼儿评估、研究设计和招聘方面进行培训的保护时间是必不可少的。研究对象将包括最近因身体忽视被报告到查尔斯顿县（SC）社会服务部的3至6岁儿童。对照组将包括从学术初级保健诊所招募的年龄、性别、种族和社会经济匹配的儿童。测量其他类型虐待的慢性、严重程度和合并症。试点数据将探索一组被忽视的儿童（其中许多将经历共病虐待）的神经生物学标志物是否显示HPA失调和垂体功能减退的证据。该研究计划将提供招募和评估健康和被忽视儿童的经验，使用最先进的测量工具，在这一人群中产生关于神经内分泌和去甲肾上腺素能功能、一般健康、认知、语言和精神测量的试点数据。这项初步研究将用于确定这些标记是否有希望作为工具，增加我们对被忽视和虐待的儿童的医学和神经发育后遗症的理解。有必要更好地了解这一领域，以帮助理解儿童面对不利环境的复原力，并解决这些障碍的可逆性。希望获得的试点数据将支持纵向研究项目申请的发展，以进一步研究儿童忽视对发育中的大脑和神经生物系统的影响。

DESCRIPTION (provided by candidate): The overall aim of this application is to prepare the candidate for a patient oriented research career exploring neurobiologic sequelae associated with child neglect. The candidate's training in child psychiatry and pediatrics, expertise in child maltreatment, and childhood brain disorders provides an excellent foundation for this proposal. The primary mentor has expertise in the exploration of the hypothalamic-pituitary-adrenal (HPA) axis, stress, substance use and grantsmanship and is a Midcareer Investigator award recipient devoted to mentoring individuals with an interest in patient-oriented research. Secondary mentors are clinical researchers experienced in neuroendocrinology, pediatric endocrinology, and pediatric brain development associated with child maltreatment and risk factors associated with child neglect. The training plan includes topic-specific mentoring, completion of a Masters of Science in Clinical Research, and supervised research experience in the General Clinical Research Center (GCRC). The ultimate goal of this application is to transition the candidate from mentored researcher to independent patient-oriented researcher focused on the neurobiology of neglect and abuse in children. In order to effect this transition, protected time for training in neglect, neuroendocrine systems, young child assessment, research design, and recruitment is essential. Subjects will include children, ages 3 to 6 years old, that have been recently reported to the Charleston County (SC) Department of Social Service for physical neglect. The control group will include age, gender, race, and socio-economically matched children recruited from an academic primary care clinic. Measurement of chronicity, severity and comorbidity of other types of maltreatment will be obtained. Pilot data will explore whether neurobiologic markers in a group of children that have been neglected (many of which will have experienced co-morbid maltreatment) demonstrate evidence of HPA dysregulation and hypopituitarism. The research plan will provide experience in recruitment and assessment of healthy and neglected children, generate pilot data on neuroendocrine and noradrenergic function, general health, cognitive, language, and psychiatric measures in this population, using state of the art measurement tools. The pilot study will be used to determine if these markers show promise as tools to increase our understanding of medical, and neurodevelopmental sequelae in children that have been neglected and abused. A better understanding of this area is necessary to assist in understanding resilience in children facing adverse circumstances and in addressing the reversibility of these impairments. It is hoped that pilot data obtained will support development of an Research Project application for longitudinal studies to further study the effects of child neglect on the developing brain and neurobiologic systems.