CARING FOR A CHILD WITH SERIOUS ILLNESS PROJECT (CCI PROJECT)

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 有许多生物系统调节人类对压力的反应，包括下丘脑-垂体-肾上腺（HPA）轴，它产生皮质醇和儿茶酚胺等激素。 这些系统中的失调有时被称为“非稳态负荷”或AL。研究表明，慢性创伤后应激障碍（PTSD）和重度抑郁症（MDD）患者的AL失调和海马体（一种大脑结构）较小。然而，我们不知道AL系统失调和海马大小之间的确切关系的个人经历了急性和慢性压力。 此外，我们不知道这种关系是否取决于当前PTSD或MDD症状的存在。 也许AL和大脑结构的变化也可以在没有症状的压力个体中看到。 本研究旨在探讨应激影响的生物系统（AL）的生物标志物与海马大小之间的关系。 研究参与者将包括女性初级保健提供者（例如，这些儿童被诊断患有癌症、癫痫、哮喘、糖尿病或自闭症等严重疾病。 先前的研究表明，一些母亲会出现PTSD或MDD的症状，有些不会，但所有人都会在科普孩子的疾病和治疗时承受慢性压力。 因此，将有可能研究应激系统失调和海马大小与PTSD或MDD的关系。 将评估患有严重疾病的儿童的母亲的a）PTSD、MDD和其他相关的情绪障碍症状; B）应激影响的生物系统失调（AL：尿皮质醇、多巴胺、去甲肾上腺素和肾上腺素;收缩压和舒张压;腰臀比）和c）海马大小减小（通过磁共振成像（MRI）。 这项研究将提供急需的数据，说明急性和慢性压力对生物系统和大脑结构的影响，并可能有助于今后开展预防和治疗工作。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. 'There are a number of biological systems that regulate the human response to stress, including the hypothalamic-pituitary-adrenal (HPA) axis which produces hormones like cortisol and catecholamines. Dysregulation in these systems is sometimes called "allostatic load" or AL. Studies have shown AL dysregulation and a smaller hippocampus (a brain structure) among individuals with chronic posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). However, we do not know the exact relationship between AL system dysregulation and hippocampal size among individuals who have experienced acute and chronic stress. Also, we do not know if the relationship depends on the presence of current PTSD or MDD symptoms. Perhaps AL and structural brain changes can also be seen in stressed individuals without symptoms. This project investigates the relationship between biomarkers of stress-influenced biological systems (AL) and hippocampal size. Research participants will consist of female primary careproviders (e.g., mothers) of children who have been diagnosed with a serious illness such as cancer, epilepsy, asthma, diabetes or autism. Previous research has shown that some mothers will develop symptoms of PTSD or MDD and some will not, but all will undergo chronic stress as they cope with their child's illness and its treatment. Thus, it will be possible to study stress-system dysregulation and hippocampal size in relation to PTSD or MDD. Mothers of children with a serious illness will be assessed for a) PTSD, MDD and other related symptoms of mood disturbance; b) dysregulation in stress-influenced biological systems (AL: urinary cortisol, dopamine, norepinephrine and epinephrine; systolic and diastolic blood pressure; and waist-to-hip ratio) and c) reduced hippocampal size (via Magnetic Resonance Imaging (MRI). The study will provide much-needed data on the impact of acute and chronic stress on biological systems and brain structure and may help in the development of prevention and treatment efforts in the future.