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

项目摘要 在一个充满压力的家庭环境中长大-以冲突，不敏感的养育，混乱，功能障碍为标志 以及缺乏温暖-增加了一生中出现医疗问题的风险。最有力的证据表明， 这些风险是在心血管疾病（CVD）领域，尽管早期的家庭压力也会加剧 易患其他慢性疾病，包括糖尿病和癌症。总的来说，这些慢性疾病 影响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 对这些风险如何产生的机制理解有限，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 考虑到青少年时期的特点是心理社会和 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 出现。然而，关于青少年时期的家庭环境如何影响青少年的研究很少。 赋予早期疾病风险，特别是在前瞻性设计中。因此，我们对潜在的 机制等此外，这些过程是否在各族裔群体中同样发生也是未知的， 在健康风险、家庭价值观和心理社会过程方面存在重大文化差异的证据。 为了解决这些问题，本申请的拟议研究旨在：1）检查 青少年家庭经历与多层炎症表型和代谢的关系 在青春期和成年期的终点; 2）确定这些协会是否介导的穷人 社会关系，更高的威胁警惕性，不健康的饮食和身体不活动;和3）调查 种族在这些进程中的潜在调节作用。这些问题将通过两个 对青少年的纵向研究。这项研究计划将促进我们了解如何 青少年的家庭环境对各族裔群体的健康产生了机械性影响，这可以为青少年提供信息， 开展符合文化特点的预防和干预工作，以减少不良健康风险 结果。除了解决公共卫生问题外，执行拟议的研究将促进 申请人作为研究人员的发展，调查家庭和文化背景之间的相互作用 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，它将支持申请人的培训目标，加深她对如何尽早 压力通过免疫系统赋予长期健康不良的早期风险，获得实验室技能， 测量基本免疫过程，发展和应用纵向和路径的定量技能， 分析流行病学数据，并建立这些领域的出版记录。

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.