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

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 “有许多生物系统可以调节人类对压力的反应，包括产生皮质醇和儿茶酚胺等激素的下丘脑-垂体-肾上腺(HPA)轴。”这些系统的失调有时被称为“平衡负荷”或AL。研究表明，慢性创伤后应激障碍(PTSD)和严重抑郁障碍(MDD)患者的AL失调和较小的海马体(一种大脑结构)。然而，在经历过急性和慢性应激的个体中，我们不知道AL系统失调与海马体大小的确切关系。此外，我们不知道这种关系是否取决于当前创伤后应激障碍或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应激个体中看到。 本项目研究应激影响生物系统(AL)的生物标志物与海马体大小之间的关系。研究参与者将由被诊断患有癌症、癫痫、哮喘、糖尿病或自闭症等严重疾病的儿童的女性初级照料者(例如母亲)组成。先前的研究表明，一些母亲会出现创伤后应激障碍或MDD的症状，有些不会，但所有母亲在应对孩子的疾病和治疗时都会承受长期的压力。因此，有可能研究应激系统失调和海马体大小与创伤后应激障碍或MDD的关系。 患有严重疾病的儿童的母亲将接受以下方面的评估：a)创伤后应激障碍、多动症和其他相关的情绪障碍症状；b)受压力影响的生物系统(AL：尿皮质醇、多巴胺、去甲肾上腺素和肾上腺素；收缩和舒张压；以及腰臀比)的调节失调；c)海马区体积缩小(通过磁共振成像)。这项研究将提供急慢性应激对生物系统和大脑结构影响的急需数据，并可能有助于未来预防和治疗工作的发展。

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.