PTSD and Depression in Parents of Children with Cancer

描述(由申请者提供)：本修订后的指导职业发展 申请书概述了职业发展和研究计划，以学习 下丘脑-垂体-肾上腺(HPA)轴活动与 海马区在急性和慢性应激中的状态。研究课题将包括 最近被诊断出癌症的孩子的父母。这个人口是 独一无二的是因为有些人会患上创伤后应激障碍(PTSD)，有些人 不会，但所有人都会在这一年里承受长期的压力 随着他们的孩子接受积极的癌症治疗，它将是 大鼠下丘脑HPA轴活动及海马体大小和形态的研究 随着时间的推移与创伤后应激障碍状态和慢性压力的关系。我已经有一个 学习、行为和焦虑方面的理论和应用背景。这个 职业发展和研究计划旨在使我能够 熟练掌握和掌握使用、分析和应用 神经内分泌学测量人类应激反应和神经成像 解决这些反应的机制。我将开发和测试一个理论 研究早期结构和神经内分泌相互作用的模型 纵向设计中的异常和随后的创伤经历。 导师包括一位神经学教授和一位神经成像主任 中心；2)有专门知识的心理神经内分泌学家 压力心理生物学和3)精通医疗创伤的精神病学家 与焦虑相关的课程作业和实验室轮换 神经科学博士项目将完成，导师将在体内指导 训练。关于人类HPA轴失调的时间进程，我们知之甚少 与暴露在极端压力下有关。尽管之前的研究已经 表现为皮质醇和海马体体积减少的患者 慢性创伤后应激障碍，没有人同时评估HPA状态和脑形态。 此外，研究还受到经常进行的单一评估的限制 在这起突如其来的创伤性事件发生多年后。这项建议旨在 研究HPA轴的即刻和长期活动及其与 新发创伤的海马体大小和形态。巨蟹座父母(双方) 患有和不患有创伤后应激障碍的患者将在癌症后1个月内接受评估 诊断，然后在诊断后12个月诊断为a)创伤后应激障碍、抑郁和其他 (B)神经内分泌活动异常(24小时尿皮质醇)和 C)异常的海马体大小和形态(通过磁共振成像)。 这项研究将提供急需的关于HPA轴线和 急、慢性应激时的海马区异常。

DESCRIPTION (provided by applicant): This revised Mentored Career Development application outlines a program of career development and research to study the relationship between hypothalamic-pituitary-adrenal (HPA) axis activity and hippocampal status in acute and chronic stress. Research subjects will consist of parents of children recently diagnosed with cancer. This population is unique because some will develop posttraumatic stress disorder (PTSD) and some will not, but all will undergo chronic stress during the year that they are followed as their child undergoes active cancer treatment Thus, it will be possible to study HPA-axis activity and hippocampal size and morphology in relation to PTSD status and chronic stress over time. I already have a theoretical and applied background in learning, behavior and anxiety. The career development and research plans are designed to enable me to develop proficiency and expertise in the use, analysis and application of neuroendocrinology to measure human stress responses and neuroimaging to address mechanisms of these responses. I will develop and test a theoretical model that examines the interaction between early structural and neuroendocrme abnormalities and subsequent traumatic experiences in a longitudinal design. Mentors include 1) a professor of neurology and director of a neuroimaging center; 2) a psychoneuroendocrinologist with special expertise in the psychobiology of stress and 3) a psychiatrist who is expert in medical trauma anxiety Relevant coursework and laboratory rotations from the curriculum of the Neuroscience Ph.D. program will be completed and mentors will direct in vivo training. Little is known about the time course of human HPA-axis dysregulation associated with exposure to extreme stress. Although previous studies have shown lower cortisol and hippocampal volume reductions in individuals with chronic PTSD, none have assessed HPA status and brain morphology concurrently. In addition, studies have been limited by single assessments often conducted years after the precipitating traumatic event. This proposal aims to investigate immediate and long-term HPA-axis activity and its relation to hippocampal size and morphology in recent-onset trauma. Cancer parents (both genders) with and without PTSD will be assessed within 1 month of the cancer diagnosis, then 12 months post-diagnosis for a) PTSD, depression, and other disorders); b) abnormal neuroendocrine activity (24-hour urinary cortisol) and c) abnormal hippocampal size and morphology (via Magnetic Resonance Imaging). The study will provide much-needed longitudinal data on HPA-axis and hippocampal abnormalities in acute and chronic stress.