Physiology of Coping in Rural Low-income Preadolescents: An Experimental Approach

农村低收入青春期青少年的应对生理学：实验方法

• 批准号: 8770733
• 负责人: MARTHA E WADSWORTH
• 金额: $ 21.62万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8770733
• 关键词: Adolescent; Affect; Basic Science; Behavioral; Biological Process; Cessation of life; Characteristics; Child; Child Mental Health; Childhood; Chronic; Chronic stress; Code; Coping Skills; Cues; Data; Development; Disease; Distress; Down-Regulation; Economics; Emotional; Environment; Family; Family Characteristics; Future; Galvanic Skin Response; Health; Hydrocortisone; Individual; Individual Differences; Inequality; Informal Social Control; Instruction; Intervention; Knowledge; Lead; Learning; Life; Link; Low income; Measures; Mental Health; Modeling; Outcome; Participant; Pathway interactions; Pattern; Persons; Phase; Physiological; Physiology; Pilot Projects; Population Intervention; Populations at Risk; Poverty; Prevention; Preventive Intervention; Process; Questionnaires; Randomized; Regulation; Reliance; Research; Research Support; Risk; Route; Rural; Sampling; Shapes; Solutions; Staging; Stress; Subgroup; Symptoms; System; Time; Translating; Trier Social Stress Test; Wolves; alpha-amylase; base; biological adaptation to stress; combat; coping; cost effective; distraction; health disparity; hypothalamic-pituitary-adrenal axis; improved; in vivo; indexing; innovation; meetings; physical conditioning; preadolescence; premature; prevent; programs; prospective; public health relevance; response; skills; social stress; socioeconomics; stem

DESCRIPTION (provided by applicant): Physical and mental health disparities stemming from socioeconomic inequality and poverty are well documented (Evans, Wolf & Adler, 2012). There is clear evidence that (a) the groundwork for lifelong disease and premature death is laid during childhood (e.g., Chen & Miller, 2012), and (b) damage to and deregulation of the physiologic stress response is one of the most powerful mechanisms of the effects of poverty and economic inequality on illness and disease (e.g., Evans & Kim, 2012). To contribute solutions to health disparities, we need interventions that affect the physiologic systems that confer the risk. Since the stress response systems (hypothalamic-pituitary-adrenal axis/HPA and sympathetic-adrenomedullary/SAM) are a central mechanism for SES-based disparities, these are critical systems to target. Improving children's ability to cope with stress and regulate their reactivity has the potential to break the cycle of damage, but only if the coping strategies and regulatory processes that we target have effects at the physiologic level-we have preliminary findings suggesting that they do. The proposed project seeks to firmly establish this connection. Preadolescence is a crucial time during which children's ability to recognize stress and its causes matures, and repertoires for coping with stress grow in both size and complexity. Preadolescents are, therefore, at a ripe stage to both inform our basic science questions and benefit from future coping-based prevention. Our team has compiled a basic understanding of the efficacious and inefficacious forms of coping used by children and adolescents exposed to poverty-related stress (e.g., Santiago, Wadsworth et al., 2011; Wadsworth & Compas, 2002; Wadsworth & Santiago, 2008, 2009), and we have discovered that living with poverty-related stress constrains the development of and/or ability to utilize efficacious coping (Santiago, Etter et al., 2011; Wadsworth et al., 2011). We do not yet know whether coping that is efficacious at the behavioral level has concomitant effects on the underlying physiologic stress response systems in poor, rural preadolescents. The current project will use an experimental approach and data from multiple levels of analysis, including measures of both HPA and SAM activity, observational coding of in vivo coping, and experimental manipulation of coping to: (a) compare the physiologic downregulation of randomly assigned in vivo efficacious (secondary control) and ineffective (disengagement) coping in low-income preadolescents, (b) examine how preadolescents' typical strategies for coping moderate their ability to either make use of secondary control strategies or to regulate themselves despite being primed for avoidance, (c) identify subgroups of preadolescents with different reactivity and regulation profiles, and (d) examine the individual and family characteristics of the identified subgroups, including who is more and less successful in each condition-potentially identifying person-specific intervention targets. Discovery of ways to prevent and/or halt this progression of damage to a child's stress response system can offer new directions for combatting health disparities.

描述（由申请人提供）：由社会经济不平等和贫困引起的身心健康差异有据可查（Evans，Wolf & Adler，2012）。有明确的证据表明：（a）终身疾病和过早死亡的基础是在童年时期打下的（例如，Chen &米勒，2012），以及（B）生理应激反应的损害和失调是贫困和经济不平等对疾病和疾病的影响的最强大的机制之一（例如，Evans & Kim，2012）。为了解决健康差距问题，我们需要采取干预措施，影响产生风险的生理系统。由于应激反应系统（下丘脑-垂体-肾上腺轴/HPA和交感神经-肾上腺髓质/SAM）是基于SES的差异的中心机制，因此这些是要靶向的关键系统。提高孩子们科普压力和调节反应的能力有可能打破伤害的循环，但前提是我们针对的应对策略和调节过程在生理层面上产生影响我们有初步的发现表明它们确实如此。拟议的项目力求牢固地建立这种联系。 青春前期是一个关键时期，在此期间，儿童认识压力及其原因的能力成熟，应对压力的能力在规模和复杂性方面都有所增长。因此，青春前期是一个成熟的阶段，既可以为我们的基础科学问题提供信息，也可以从未来的应对预防中受益。我们的团队已经对暴露于贫困相关压力的儿童和青少年使用的有效和无效应对形式（例如，圣地亚哥、沃兹沃斯等人，二〇一一年;沃兹沃斯和Compas，2002年;沃兹沃斯和圣地亚哥，2008年，2009年），我们已经发现，生活在贫困相关的压力限制了发展和/或利用有效应对的能力（圣地亚哥，Etter等人，2011;沃兹沃斯等人，2011年）。我们还不知道在行为水平上有效的应对是否对贫困的农村前青少年的潜在生理应激反应系统产生伴随影响。目前的项目将使用一种实验方法和来自多层次分析的数据，包括HPA和SAM活性的测量，体内应对的观察编码，以及应对的实验操作：（a）比较随机分配的体内有效的生理下调，（二级控制）和无效（脱离接触）应对低收入的青春期前，（B）研究前青少年的典型应对策略如何调节他们利用二级控制策略或调节自己的能力，尽管他们已经准备好回避，（c）确定具有不同反应性和调节特征的青春期前亚组，（d）检查所确定的亚组的个人和家庭特征，包括在每种条件下谁更成功，谁更不成功-可能确定个人特定的干预目标。发现预防和/或阻止这种对儿童压力反应系统损害的进展的方法可以为消除健康差异提供新的方向。