Adolescent Family Stress and Early Cardiovascular Risk: Psychosocial and Behavioral Pathways

项目摘要 在充满压力的家庭环境中长大--以冲突、麻木不仁的父母教育、混乱和功能障碍为标志 缺乏体温--增加了一生中出现医疗问题的风险。最有力的证据证明 这些风险属于心血管疾病(CVD)，尽管早期的家庭压力也会增加 易患其他慢性病，包括糖尿病和癌症。总而言之，这些慢性疾病 影响到美国一半的成年人口，因此构成了主要的公共卫生负担。目前 对于这些风险是如何产生的，人们的机械理解是有限的，但对潜在途径的见解 可以促进风险分层和预防工作。在这方面，青春期是一个特别重要的 需要考虑的时期，因为青春期的特点是心理和社会方面的重大变化 对健康很重要的生物行为过程。青春期也是慢性疾病的临床前症状 浮出水面。然而，很少有研究关注青春期的家庭环境 增加早期疾病风险，特别是在前瞻性设计中。因此，我们对潜在的知识知之甚少 机械装置。此外，这些过程是否在各种族群体中类似地发生尚不清楚，尽管 在健康风险、家庭价值观和心理社会过程方面存在显著文化差异的证据。 针对这些问题，本文提出的应用研究的目的是：1)考察其应用前景 青少年家庭经历与多层炎症表型和代谢的关系 青春期和成年期的终点；2)决定这些联系是否由贫穷所调节 社会关系、更高的威胁警觉性、不健康的饮食和缺乏身体活动；以及3)调查 种族在这些进程中的潜在调节作用。这些问题将通过以下两个方面来解决 对青春期的单独纵向研究。这项研究计划将增进我们对 青少年家庭环境机械地影响各种族群体的健康，这可以告知 制定有文化针对性的预防和干预努力，旨在降低不良健康风险 结果。除了解决公共卫生问题外，执行拟议的研究还将促进 申请人作为研究家庭和文化背景之间相互作用的研究人员的发展 以及青春期的心理社会和行为过程及其对早期疾病风险的贡献。 更具体地说，它将支持申请者的培训目标，即加深她对 压力通过免疫系统增加长期健康不良的早期风险，获得实验室技能以应对 测量基本的免疫过程，发展和应用纵向和路径的定量技能 分析流行病学数据，并在这些领域建立出版记录。

Project Summary Growing up in a stressful family environment - marked by conflict, insensitive parenting, chaos, dysfunction and a lack of warmth - increases risk for medical problems across the lifespan. The strongest evidence for these risks is in the realm of cardiovascular disease (CVD), although early-life family stress also heightens vulnerability to other chronic illnesses, including diabetes and cancer. Collectively, these chronic conditions affect half of the adult population in the US, and as such constitute a major public health burden. Presently there is limited mechanistic understanding of how these risks arise, but insights about underlying pathways could facilitate risk stratification and preventive efforts. In that regard, adolescence is a particularly important period to consider, given that the adolescent years are marked by significant changes in psychosocial and biobehavioral processes important to health. Adolescence is also when preclinical signs of chronic diseases emerge. However, there is a paucity of research focusing on how the family context during adolescence confers early disease risk, especially within prospective designs. As such, we know little about underlying mechanisms. Furthermore, whether these processes occur similarly across ethnic groups is unknown, despite evidence of significant cultural differences in health risks, family values, and psychosocial processes. To address these issues, the proposed research of this application aims to: 1) examine the prospective relations between adolescent family experiences and a multi-layer inflammatory phenotype and metabolic endpoints during adolescence and adulthood; 2) determine whether these associations are mediated by poor social relationships, greater threat vigilance, unhealthy eating, and physical inactivity; and 3) investigate the potential moderating role of ethnicity in these processes. These questions will be addressed using two separate longitudinal studies of adolescence. This program of research will advance our understanding of how the adolescent family context mechanistically impacts health across ethnic groups, which can inform the development of culturally tailored prevention and intervention efforts aimed at reducing risk for adverse health outcomes. In addition to addressing a public health concern, execution of the proposed studies will foster the applicant's development as a researcher investigating the interplay between the family and cultural contexts and psychosocial and behavioral processes during adolescence and their contributions to early disease risk. More specifically, it will support the applicant's training goals of deepening her understanding of how early stress confers early risk for poor long-term health via the immune system, acquiring laboratory skills for measuring basic immunologic processes, developing and applying quantitative skills in longitudinal and path analysis of epidemiological data, and establishing a publication record in these areas.