Undiagnosed and subclinical health problems in vulnerable adults exposed to stress and adversity

面临压力和逆境的弱势成年人的未诊断和亚临床健康问题

• 批准号: 9891077
• 负责人: TODD I HERRENKOHL
• 金额: $ 12.75万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-11 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9891077
• 关键词: 6 year old; Acute; Address; Adolescence; Adult; Age; Algorithms; Antibodies; Bedside Testings; Behavior; Biological; Biological Assay; Biological Markers; Blood Pressure; Blood capillaries; Body fat; Buffers; C-reactive protein; Cause of Death; Cells; Child; Child Abuse and Neglect; Childhood; Cholesterol; Chronic; Chronic Disease; Chronic stress; Collection; Colon Carcinoma; Data; Data Collection; Data Reporting; Data Sources; Deterioration; Development; Diabetes Mellitus; Diagnosis; Diet; Diet Habits; Disease; Exposure to; Family history of; Foundations; Future; Gender; Glycosylated Hemoglobin; Health; Health Policy; Heart Diseases; Height; High Density Lipoproteins; Human Herpesvirus 4; Hypertension; Immune response; Immune system; Immunologic Markers; Individual; Inflammation; Injury; Knowledge; Laboratories; Life Style; Literature; Longitudinal Studies; Measurement; Measures; Mediating; Outcome; PF4 Gene; Pain; Pathway interactions; Patient Self-Report; Physical activity; Physiological; Plant Roots; Prevention program; Preventive Intervention; Process; Public Health; Publications; Pulse Rates; Research; Retrospective Studies; Risk; Risk Factors; SF-36; Sampling; Serum; Services; Sexual abuse; Shapes; Site; Skin; Sleep; Stress; Stress and Coping; Surveys; Symptoms; System; Time; United States; Weight; Work; abuse neglect; acute stress; allostatic load; arm; base; breast cancer diagnosis; cardiovascular disorder risk; childhood adversity; coping; early childhood; elementary school; emotional abuse; functional disability; gender difference; health practice; help-seeking behavior; immune function; improved; intervention program; longitudinal dataset; maltreatment; middle age; multimodal data; nutrition; physical abuse; physical conditioning; prospective; protective effect; resilience; response; social determinants; stress resilience; theories

ABSTRACT The long-term physical health effects of child maltreatment are well documented in self-report, mostly retrospective, studies. However, there have been very few objective, longitudinal, multimethod and gender- balanced studies on physiological responses to stress and the onset of symptoms related to chronic disease, thereby slowing the advancement of prevention and intervention programs. Building on four earlier waves of data, the proposed study will address critical gaps in the research literature on social determinants and the biological embedding of stress by adding biomarker data to an expansive longitudinal dataset that contains comprehensive, prospective measures of child maltreatment subtypes, stress, coping, and resilience, as well as self-reports of health. Biomarkers include on-site measurements of blood pressure and pulse rate; height and weight for computing BMI and body fat percentage; and capillary serum collection and point-of-care testing to measure two markers of cardiovascular disease risk: total cholesterol and HDL, and glycosylated hemoglobin (HbA1c). Capillary serum collection will be used for laboratory analyses of two markers of immune function selected to represent different arms of the immune response: Epstein-Barr virus antibody, an indicator of cell-mediated immune function, which has been shown to increase with both acute and chronic stress exposure, and c-reactive protein, an indicator of both chronic and acute inflammation. Remaining serum volume not used for these assays will be retained for future analyses. We will study each marker separately and in multi-biomarker algorithms consistent with definitions of allostatic load and biological age to assess physiological dysregulation across multiple systems. Data collection will also include a short self-report survey on health and illnesses, pain, and functional disability, as well as service use and help-seeking behaviors, sleep, physical activity, and diet (eating habits and nutrition) to replicate and expand existing measures. With existing and newly collected data, we will analyze: (1) the long-term health effects of child maltreatment subtypes in biomarkers of emerging chronic illnesses and self-reports of poor health and functional impairment; (2) developmental sensitivity to stress and its relation to child maltreatment and adult health; (3) protective effects of early (childhood) resilience and adaptive coping; and (4) gender differences. This project will increase understanding of emerging chronic illness in vulnerable adults when some have subclinical disease symptoms that go unreported, and when lifestyle changes can still mitigate risk for the onset of serious health conditions that become deeply rooted and intractable.

抽象的 儿童虐待的长期身体健康影响已在自我报告中得到充分记录，主要是 回顾性，研究。但是，几乎没有客观，纵向，多方法和性别 关于压力的生理反应和与慢性疾病有关的症状发作的平衡研究， 从而减慢了预防和干预计划的进步。建立在四个先前的波浪中 数据，拟议的研究将解决有关社会决定因素的研究文献的关键差距和 通过将生物标志物数据添加到包含的广泛纵向数据集中，对压力的生物嵌入 全面的，前瞻性的虐待子类型，压力，应对和韧性的衡量标准 作为健康报告。生物标志物包括对血压和脉搏率的现场测量；高度 和计算BMI和体内脂肪百分比的重量；以及毛细血管血清收集和护理点测试 测量心血管疾病风险的两个标记：总胆固醇和HDL，以及糖基化 血红蛋白（HBA1C）。毛细血管血清的收集将用于实验室分析，对两个免疫标记 选择代表免疫反应的不同臂的功能：爱泼斯坦 - 巴尔病毒抗体，指标 细胞介导的免疫功能，已显示出随着急性和慢性应激的增加 暴露和C反应蛋白，这是慢性炎症和急性炎症的指标。剩余的血清 未用于这些测定的数量将保留以进行将来的分析。我们将分别研究每个标记 以及在多种生物标志物算法中，与同种异体负载和生物年龄的定义一致 多个系统的生理失调。数据收集还将包括简短的自我报告调查 关于健康和疾病，疼痛和功能障碍以及服务使用和寻求帮助的行为， 睡眠，体育锻炼和饮食（饮食习惯和营养）复制和扩大现有措施。和 现有和新收集的数据，我们将分析：（1）儿童虐待的长期健康影响 新兴慢性疾病的生物标志物以及健康和功能障碍的自我报告的亚型； （2）对压力及其与儿童虐待和成人健康的关系的发育敏感性； （3）保护性 早期（儿童）韧性和适应性应对的影响； （4）性别差异。这个项目将 当一些人患有亚临床疾病时 未报告的症状，当生活方式改变时，仍然可以减轻健康的风险 植根于根深蒂固且棘手的条件。

项目成果

Examining the Association Between Trauma Characteristics and Adult Depression and Anxiety: Analysis of Types, Variety, Repetition, and Timing of Past Trauma.

检查创伤特征与成人抑郁和焦虑之间的关联：分析过去创伤的类型、种类、重复和时间。

• DOI: 10.1177/08862605231198056
• 发表时间: 2024
• 期刊: Journal of interpersonal violence
• 影响因子: 2.5
• 作者: Hong,SunghyunH;Yu,Chi-Lin;Rousson,AshleyN;Bender,AnnaE;Fedina,Lisa;Herrenkohl,ToddI
• 通讯作者: Herrenkohl,ToddI