Psychological Distress, Socioeconomic Position and Inflammatory Biomarkers Across the Life Course:Elucidating the Interplay Using Causal Inference...

整个生命过程中的心理困扰、社会经济地位和炎症生物标志物：利用因果推理阐明相互作用......

• 批准号: 2725193
• 金额: --
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2725193
• 关键词: Psychological; Distress; Socioeconomic; Position; Inflammatory

Mental health issues belong among the primary contributors to the disease burden. Depression and anxiety are linked to deteriorating physical health, which amplifies their impact on individuals and the health economy. Due to high population levels of psychological distress, research has focused on identifying biological pathways that underpin its negative effects on health. Chronic systemic inflammation is a major suspected mechanism, as pro-inflammatory biomarkers can increase both directly through stress system activation and indirectly through unhealthy behaviours.Psychological distress often reflects underlying adverse socioeconomic conditions. Consequently, although psychological interventions can mitigate some of the impacts of psychological distress, they alone might not be sufficient in addressing the broader mental health crisis. Inflammatory biomarkers also show a social gradient, with studies finding higher inflammation levels in those with a lower socioeconomic position. Although psychological distress might partly explain this association, other mechanisms are plausible, including limited access to resources and different social environments. Additionally, increased access to resources might also enable individuals to cope better with mental health issues, suggesting possible interactive effects between socioeconomic indicators and psychological distress on health outcomes. The relationships between socioeconomic indicators, psychological distress, and inflammation likely evolve throughout an individual's life. Plasma inflammatory biomarker levels increase with age, and socioeconomic disparities in their concentration also change over time. Despite advancements in life course modelling, traditional analytical methods are not fully equipped to elucidate these relationships, as they cannot handle time-varying confounding or integrate mediation with interaction. Addressing these limitations necessitates the use of causal inference approachesThis project aims to apply causal inference approaches to:1. Assess the time-varying impacts of psychological distress on biomarkers of systemic inflammation.2. Estimate the causal interactive effect of socioeconomic indicators (education, income/wealth) and psychological distress on biomarkers of systemic inflammation.3. Decompose the average causal effect of socioeconomic indicators on biomarkers of inflammation into the effect mediated by psychological distress, the effect due to exposure-mediator interactions, and the effect operating through other pathways. To meet these aims, the project will use three comprehensive cohort datasets spanning various life stages: The Avon Longitudinal Study of Parents and Children, the National Child Development Study, and the English Longitudinal Study of Ageing. To achieve greater comparability of findings across cohorts, measures of psychological distress will be calibrated using item-response theory-based linking. Socioeconomic indicators will comprise financial and educational metrics that best reflect one's access to resources at different life stages. These will encompass parental or household income, accumulated wealth, and either parental or personal educational qualifications. The main biomarker of interest will be the plasma concentration of C-reactive protein. Analyses will be conducted separately on each dataset, resulting in a qualitative synthesis of findings.The findings will advance the understanding of the mechanisms connecting social conditions, mental health challenges, and physical health. As many interventions target either psychological issues or social adversity separately, combined approaches may be essential to change the health trajectories of socially disadvantaged individuals. Moreover, integrating a life course perspective within a causal inference framework may highlight specific periods in the mental health-inflammation relationship, offering insights into the timing for effective interventions

心理健康问题属于造成疾病负担的主要因素之一。抑郁和焦虑与身体健康恶化有关，这放大了它们对个人和卫生经济的影响。由于心理困扰的人群水平很高，研究的重点是确定其对健康产生负面影响的生物学途径。慢性全身性炎症是主要的怀疑机制，因为促炎生物标志物可以通过应激系统激活直接增加，也可以通过不健康行为间接增加。心理困扰往往反映了潜在的不利社会经济条件。因此，虽然心理干预可以减轻心理困扰的一些影响，但仅靠心理干预可能不足以解决更广泛的心理健康危机。炎症生物标志物也显示出社会梯度，研究发现社会经济地位较低的人炎症水平较高。虽然心理困扰可能部分解释了这种联系，但其他机制也似乎是合理的，包括有限的资源获取和不同的社会环境。此外，增加获得资源的机会也可能使个人能够更好地应对心理健康问题，这表明社会经济指标和心理困扰对健康结果可能产生互动影响。社会经济指标、心理困扰和炎症之间的关系可能在个体的一生中不断发展。血浆炎症生物标志物水平随着年龄的增长而增加，其浓度的社会经济差异也随着时间的推移而改变。尽管在生命过程建模方面取得了进步，但传统的分析方法并不能完全阐明这些关系，因为它们不能处理时变的混淆或将中介与交互结合起来。解决这些限制需要使用因果推理方法。本项目旨在将因果推理方法应用于：1。评估心理困扰对全身性炎症生物标志物的时变影响。评估社会经济指标（教育、收入/财富）和心理困扰对全身性炎症生物标志物的因果互动效应。将社会经济指标对炎症生物标志物的平均因果效应分解为心理困扰介导的效应、暴露-中介相互作用的效应以及通过其他途径运作的效应。为了实现这些目标，该项目将使用三个跨越不同生命阶段的综合队列数据集：雅芳父母和儿童纵向研究、国家儿童发展研究和英国老龄化纵向研究。为了实现跨群体研究结果的更大可比性，将使用基于项目反应理论的联系来校准心理困扰的测量。社会经济指标将包括最能反映一个人在不同人生阶段获得资源的财务和教育指标。这些因素包括父母或家庭收入、积累的财富以及父母或个人的教育程度。感兴趣的主要生物标志物将是c反应蛋白的血浆浓度。将对每个数据集分别进行分析，从而对研究结果进行定性综合。这些发现将促进对社会条件、心理健康挑战和身体健康之间联系机制的理解。由于许多干预措施要么单独针对心理问题，要么针对社会逆境，因此综合方法对于改变社会弱势个人的健康轨迹可能至关重要。此外，在因果推理框架内整合生命历程视角可以突出心理健康-炎症关系中的特定时期，为有效干预的时机提供见解