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.

摘要 虐待儿童对身体健康的长期影响在自我报告中有很好的记录，主要是 回顾，研究。然而，客观的、纵向的、多方法的和性别的-- 关于压力的生理反应和与慢性病相关的症状出现的平衡研究， 从而减缓了预防和干预计划的进展。建立在前四波 数据，拟议的研究将解决研究文献中关于社会决定因素和 通过将生物标记物数据添加到包含以下内容的扩展纵向数据集来生物嵌入压力 全面、前瞻性地衡量虐待儿童的亚型、压力、应对和复原力 作为健康状况的自我报告。生物标志物包括现场测量血压和脉率；身高 用于计算BMI和体脂百分比的体重；以及毛细血管血清采集和护理点测试 测量心血管疾病风险的两个标志物：总胆固醇和高密度脂蛋白，以及糖基化 血红蛋白(HbA1c)。毛细血管血清采集将用于免疫的两个标志物的实验室分析 选择代表不同免疫反应的功能：爱泼斯坦-巴尔病毒抗体，一种指示剂 细胞介导的免疫功能，已被证明随着急性和慢性应激而增加 以及C反应蛋白，这是慢性和急性炎症的指标。剩余血清 未用于这些分析的体积将被保留以供将来分析。我们将分别研究每个标记 并在符合不平衡负荷和生物年龄定义的多生物标志物算法中进行评估 跨多个系统的生理失调。数据收集还将包括一次简短的自我报告调查 关于健康和疾病、疼痛和功能残疾，以及服务使用和求助行为， 睡眠、体力活动和饮食(饮食习惯和营养)，以复制和扩大现有措施。使用 现有和新收集的数据，我们将分析：(1)虐待儿童对健康的长期影响 新出现的慢性病生物标志物中的亚型以及健康状况不佳和功能受损的自我报告； (2)对压力的发展敏感性及其与虐待儿童和成人健康的关系；(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，增加对易感人群新发慢性病的了解 未报告的症状，以及生活方式的改变仍然可以降低严重健康发作的风险 根深蒂固和难以处理的状况。

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