Neurodevelopmental Biology of Neglected Children

描述(由候选人提供)：此应用程序的总体目标是为以患者为导向的研究生涯做准备，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，在虐待儿童和儿童大脑障碍方面的专业知识，为这一提议提供了良好的基础。这位主要导师在探索下丘脑-垂体-肾上腺(HPA)轴、压力、物质使用和勇气方面拥有专业知识，是职业生涯中期调查人员奖获得者，致力于指导对以患者为导向的研究感兴趣的个人。二级导师是在神经内分泌学、儿童内分泌学和儿童大脑发育与儿童虐待和与儿童忽视相关的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，完成临床研究的理学硕士学位，以及在综合临床研究中心(GCRC)的监督研究经验。该应用程序的最终目标是将候选人从有指导的研究人员转变为独立的、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、研究设计和招募方面的培训时间是至关重要的。受试者将包括最近向查尔斯顿县社会服务部报告的3至6岁的儿童，他们因身体疏忽而被报告。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。将获得其他类型虐待的慢性化、严重性和共病的测量。试点数据将探索一组被忽视的儿童(其中许多人将经历共病虐待)的神经生物标记物是否表明HPA调节失调和垂体功能低下的证据。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功能、一般健康、认知、语言和精神测量的试点数据。这项试点研究将被用来确定这些标记物是否有希望成为提高我们对被忽视和虐待儿童的医学和神经发育后遗症的了解的工具。有必要更好地了解这一领域，以帮助了解面临不利环境的儿童的复原力，并解决这些损害的可逆性。希望获得的先导数据将支持开发一个研究项目应用于纵向研究，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.