Self-regulation as a Health-Protective Factor in Adverse Socioeconomic Conditions

描述(由申请人提供)：社会经济劣势是许多终生健康问题的重要风险因素，包括呼吸系统和心血管疾病、精神疾病、糖尿病和癌症。尽管降低这些疾病的患病率对公共卫生具有重要意义，但在有关可能抵消低社会经济地位(SES)带来的风险的因素方面，文献中存在着一个重大缺口。目前的项目考察了自我调节技能(有意控制一个人的思想、情绪和行为的能力)与低SES在统计上相互作用的程度，以预测(研究1)或与预测未来健康结果的生物标记物(研究2)相关联。这一可能性得到了儿童发展研究的支持，这些研究表明，高自我调节能力对生活在贫困中的儿童的社会功能具有保护作用，并报告了自我控制措施与成人健康结果之间的相关性。这些问题将使用两个已完成项目(PI：Miller)的数据进行审查。研究1前瞻性跟踪147名青春期女孩(年龄15-19岁)2.5年，评估基线时的自尊和自我调节能力，以及每6个月随访一次的免疫和代谢危险因素。研究2对420名成年人(15-55岁)的样本进行了横断面评估，评估了当前的社会经济状况、儿童父母的职业、自我调节、免疫和代谢生物标志物。两项研究都通过对多个水平的炎症(包括RNA表达、体外细胞因子对细菌刺激的反应，以及循环C反应蛋白和白介素6水平等全身炎症标志物)和代谢风险指数(葡萄糖、胰岛素、甘油三酯、胆固醇组分和糖化血红蛋白水平)的综合评估来衡量健康风险。目的1是测试青春期自我调节技能是否在基线后6-30个月的低SES和随后的免疫和代谢生物标记物轨迹之间起调节作用(研究1)。目的2在研究2中检验低SES、自我调节及其与炎症和代谢功能障碍的统计交互作用的线性关系。第三个目的在研究2中检验自我调节与健康实践(例如，酒精和烟草的使用、药物、运动、睡眠卫生)之间的相关性，并探索在控制健康实践后目标2的结果是否成立。这些目标与赞助机构的使命直接相关，因为它们提供了关于潜在的健康保护因素的知识，可以帮助减少人口的发病率和过早死亡的负担。重要的是，这一保护因素已被证明在儿童干预中是可塑性的。该项目是培训计划的一部分，该计划将在西北大学格雷戈里·E·米勒博士的指导下，为申请者提供心理免疫学方面的示范研究、教学和动手实验室培训。这项培训将使申请者能够实现她的长期研究目标，即调查早期生活压力与一生中健康之间的联系。

DESCRIPTION (provided by applicant): Socioeconomic disadvantage is a significant risk factor for numerous lifespan health problems, including respiratory and cardiovascular disease, psychiatric illness, diabetes, and cancer. Despite the public health significance of reducing the prevalence of these conditions, there is a major gap in the literature regarding factors that may offset the risks posed by low socioeconomic status (SES). The present projects examine the extent to which self-regulation skills (the ability to intentionally control one's thoughts, emotios, and behavior) statistically interact with low SES to predict (Study 1) or associate with (Study 2) biological markers predictive of later health outcomes. This possibility is supported by child development studies showing protective effects of high self-regulatory abilities for the social functioning of children living in poverty, and reported correlations between measures of self-control and adult health outcomes. These issues will be examined using data from two completed projects (PI: Miller). Study 1 prospectively followed 147 adolescent girls (ages 15-19) for 2.5 years, assessing SES and self-regulation skills at baseline, as well as immune and metabolic risk factors every 6 months for the follow-up duration. Study 2 cross-sectionally assessed current SES, childhood parental occupation, self-regulation, immune and metabolic biomarkers in a sample of 420 adults (ages 15-55). Health risk was measured by both studies through comprehensive assessments of inflammation at multiple levels (including RNA expression, ex vivo cytokine responses to bacterial stimuli, and markers of systemic inflammation such as circulating levels of C-reactive protein and Interleukin-6) and indices of metabolic risk (levels of glucose, insulin, triglycerides, cholesterol fractions, and glycosylated hemoglobin). Aim 1 is to test if adolescent self-regulation skills moderate associations between low SES and subsequent immune and metabolic biomarker trajectories from 6-30 months post-baseline (Study 1). Aim 2 examines linear associations of low SES, self-regulation, and their statistical interaction with inflammation and metabolic dysfunction in Study 2. The third aim examines correlations between self-regulation and health practices in Study 2 (e.g., alcohol and tobacco use, medications, exercise, sleep hygiene) and explores whether results in Aim 2 hold true after controlling for health practices. These aims are directly relevant for the mission of th sponsoring agency, as they provide knowledge about a potentially health-protective factor that could help reduce the burden of morbidity and premature mortality on the population. Importantly, this protective factor has been shown to be malleable in childhood interventions. This project is part of a training plan that will provide the applicant with exemplary research, didactic, and hands-on laboratory training in psychoimmunology under the mentorship of Dr. Gregory E. Miller at Northwestern University. This training will allow the applicant to pursue her long-term research goals of investigating the links between early life stress and health across the lifespan.