Developmental comorbidity of pain and depression in preadolescent girls

青春期前女孩疼痛和抑郁的发育合并症

• 批准号: 7658508
• 负责人: Kathryn Elizabeth Keenan
• 金额: $ 7.49万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7658508
• 关键词: 9 year old; Address; Adolescence; Adolescent; Adrenal Glands; Adult; Age; Area; Behavioral; Biological; Biological Assay; Characteristics; Childhood; Comorbidity; Data; Depressed mood; Depressive disorder; Development; Disease; Dissociation; Distress; Emotional; Etiology; Female; Functional disorder; Funding; Goals; Hydrocortisone; Hypothalamic structure; Impairment; Individual; Individual Differences; Laboratories; Link; Longitudinal Studies; Measurement; Measures; Medical; Modeling; Mothers; NIH Program Announcements; National Institute of Mental Health; Pain; Pain Disorder; Pain Research; Pain Threshold; Pain management; Parents; Pathway interactions; Pattern; Perception; Pituitary Gland; Play; Population; Productivity; Puberty; Public Health; Publishing; Request for Applications; Research; Resources; Risk; Role; Saliva; Sampling; Secure; Services; Stimulus; System; Testing; Variant; biobehavior; biological adaptation to stress; boys; chronic pain; clinically significant; cost; depressed; depression; depressive symptoms; experience; functional disability; girls; high risk; hypothalamic-pituitary-adrenal axis; indexing; innovation; neural circuit; noradrenergic; preadolescence; programs; prospective; public health relevance; response; sex; stressor

DESCRIPTION (provided by applicant): The revised application is in response to PA-06-543, "Mechanisms, Models, Measurement, & Management in Pain Research (R03)." Consistent with this program announcement, we aim to test hypotheses about the developmental pathways to comorbid pain and depressive disorders in females. Clinically significant pain disorders are markedly more common in individuals with depression, particularly in females who are more likely to experience both pain and depression from adolescence on. This is an issue of considerable public health significance, as depressed individuals who experience high levels of pain experience marked distress and functional impairment and are frequent consumers of medical services. Aims: The specific aims for this application are to address the following questions: 1) Are individual differences in behavioral and biological response to a pain stressor concurrently associated with depression and impairment at ages 10 and 12 and does this association grow stronger as puberty progresses; 2) Do specific patterns of behavioral and biological response to a pain stressor explain variance in depression and functional impairment at ages 10 and 12; and 3) Are individual differences in response to a pain stressor at ages 10 and 12 prospectively associated with individual differences in depression and impairment at ages 11 and 13, after controlling for depression and impairment at ages 10 and 12? Approach: In the context of a longitudinal study currently funded by NIMH, Preadolescence precursors to depression in girls (R01 MH66167), 232 nine-year old girls are being assessed annually for a period of 5 years. Data are collected from both the girls and their mothers. We have embedded a pain stimulus into the longitudinal study, the cold pressor task (CPT), which was administered at age 10 and is planned for administration at age 12. We have collected saliva in response to the CPT age 10 and plan to collect samples again at age 12. There are no funds for assaying cortisol from the saliva or for conducting analyses on pain response in the parent R01. The purpose of this application for an R03 is to secure funding for testing hypotheses about the developmental phenomenology of comorbid pain and depression in females, an aim that was not included in the parent R01 study. Innovation: This will be the first study to explore the developmental interface between pain and depression using behavioral and biological responses to a controlled pain stimulus and clinically meaningful measures of depressive symptoms beginning in childhood. PUBLIC HEALTH RELEVANCE: Clinically significant pain disorders are much more common in individuals with depression, particularly in females who are more likely to experience both pain and depression from adolescence on. Given the impact of co-occurring pain and depression on public health for females especially, probing the developmental unfolding of the relations between depression and pain in girls is an important area of research. This will be the first study to explore the developmental interface between pain and depression using behavioral and biological responses to a controlled pain stimulus and clinically meaningful measures of depressive symptoms beginning in childhood.

描述（由申请人提供）：修订后的申请是对PA-06-543“疼痛研究中的机制、模型、测量和管理（R03）”的回应。与本项目公告一致，我们的目的是测试关于女性共病疼痛和抑郁障碍的发育途径的假设。临床上明显的疼痛障碍在抑郁症患者中更为常见，尤其是在女性中，她们从青春期开始就更有可能经历疼痛和抑郁。这是一个具有重大公共卫生意义的问题，因为经历高度疼痛的抑郁症患者会经历明显的痛苦和功能损害，并且经常需要医疗服务。目的：本应用程序的具体目的是解决以下问题：1)在10岁和12岁时，对疼痛压力源的行为和生物反应的个体差异是否与抑郁和损伤同时相关，并且这种关联是否随着青春期的进展而增强；2)对疼痛应激源的特定行为和生物反应模式能否解释10岁和12岁儿童抑郁和功能障碍的差异？3)在控制了10岁和12岁的抑郁和损伤后，10岁和12岁时对疼痛应激源的反应的个体差异是否与11岁和13岁时抑郁和损伤的个体差异有前瞻性关联？方法：在NIMH资助的一项纵向研究的背景下，女孩青春期前抑郁前兆（R01 MH66167），每年对232名9岁女孩进行为期5年的评估。从女孩和她们的母亲那里收集数据。我们在纵向研究中嵌入了一种疼痛刺激，即冷压任务（CPT），该任务在10岁时进行，计划在12岁时进行。我们已经收集了10岁时的唾液样本，并计划在12岁时再次收集样本。没有资金用于分析唾液中的皮质醇，也没有资金用于分析亲本R01的疼痛反应。本R03申请的目的是为验证女性共病疼痛和抑郁的发育现象学假设提供资金，这一目的未包括在母体R01研究中。创新：这将是第一个探索疼痛和抑郁之间的发展界面的研究，利用对受控疼痛刺激的行为和生物学反应以及从童年开始的抑郁症状的临床有意义的测量。公共卫生相关性：临床显著的疼痛障碍在抑郁症患者中更为常见，特别是在女性中，她们更有可能从青春期开始经历疼痛和抑郁。鉴于共同发生的疼痛和抑郁对女性公共健康的影响，探索女孩抑郁和疼痛之间关系的发展展开是一个重要的研究领域。这将是第一个探索疼痛和抑郁之间的发育界面的研究，使用对受控疼痛刺激的行为和生物学反应以及从童年开始的抑郁症状的临床有意义的测量。