Preventing Internalizing Psychopathology in Preadolescents Exposed to Chronic Stress

防止暴露于慢性压力的青春期前儿童内化精神病理学

• 批准号: 9893921
• 负责人: MARTHA E WADSWORTH
• 金额: $ 68.58万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-11 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9893921
• 关键词: Address; Adolescent; Affect; Anxiety; Basic Science; Behavioral; Benchmarking; Biological; Brain; Child; Childhood; Chronic; Chronic stress; Cognitive; Communities; Coping Skills; Critical Pathways; Discrimination; Disease; Down-Regulation; Economics; Educational process of instructing; Exposure to; Face; Growth; Iatrogenesis; Individual; Intervention; Intervention Trial; Lead; Learning; Life; Link; Measures; Mediating; Mental Depression; Mental Health; Nature; Outcome; Phase; Phased Innovation Awards; Physiological; Plant Roots; Population; Poverty; Prevention; Prevention program; Problem Solving; Process; Psychopathology; Race; Research; Risk; Risk Factors; Signal Transduction; Stress; Stress and Coping; Symptoms; System; Testing; Thinking; Time; Violence; Wolves; Work; Youth; anxiety symptoms; base; biological adaptation to stress; body system; combat; coping; coping mechanism; design; developmental plasticity; distraction; efficacy trial; emotion regulation; ethnic minority population; evidence base; experimental study; functional outcomes; health disparity; hypothalamic-pituitary-adrenal axis; improved; intervention effect; intervention program; physical conditioning; post-traumatic stress; post-traumatic symptoms; preadolescence; prevent; psychobiologic; psychological outcomes; psychological symptom; public health relevance; racial disparity; racial minority; repaired; response; showing emotion; skills; socioeconomic disparity; socioeconomics; stem; stress disorder; stressor; therapy design; violence exposure; violence victimization

 DESCRIPTION (provided by applicant): Mental health problems are proportionately affect racial and ethnic minority populations, as well as populations that face chronic economic hardship (Evans, Wolf & Adler, 2012). There is clear evidence that (1) the processes that lay the groundwork for mental health disparities is laid during childhood (e.g., Chen & Miller, 2012) and (2) that damage to and dysregulation of the physiologic stress response is a powerful mechanism of the effects of chronic stress such as that associated with poverty on psychopathology (e.g., Evans & Kim, 2012). To contribute solutions to mental health disparities, we need interventions capable of affecting the systems that confer the risk. Since the psychobiologic stress response system (e.g., hypothalamic-pituitary- adrenal axis; HPA) is a central mechanism linking health disparities to chronic stress, the stress response is a critical system to target. Improving children's ability to cope with stress and regulate their reactivity ha the potential to break the cycle of damage, especially if the coping strategies and regulatory processes that we target have effects at the physiologic level. Preliminary evidence from the PIs research lab has emerged showing that different types of coping are evident at the level of the HPA-it is, therefore, time to evaluate whether a coping intervention designed for children facing chronic stress will both (a) improve children's ability to use primary and secondary control coping, and (b) have sustained effects at the physiologic level. We have developed just such an intervention, which builds on these exciting new findings and is designed to address core underlying mechanisms of risk and repair in the highly stressful context of poor, urban youths' lives. Preadolescence is a crucial time during which children's ability to recognize stress and it causes matures, and repertoires for coping with stress grow in both size and complexity. In addition, preadolescence is a time of increased brain changes and growth in key self-regulatory organs and systems. Preadolescents are, therefore, at a ripe stage to benefit from coping-based prevention and the plasticity of this developmental period suggests that such changes have the potential to be long-lasting. Our new prevention program is designed to prevent the onset of anxiety, depression, and post-traumatic stress symptoms in preadolescent children facing chronic stress. Two mechanisms of action are targeted in this project. First, the project seeks to demonstrate that children facing chronic stress stemming from poverty, discrimination, and violence exposure can acquire and utilize new ways of coping that are adaptive in a wide variety of circumstances. Second, the project will examine the extent to which improved coping resulting from the intervention engages the physiologic intermediate mechanism of the HPA. Finally, the project aims to link changes in coping and the HPA to changes in internalizing symptoms that would signal prevention of the emergence of new or worsening of existing symptoms. Discovery of ways to prevent and/or halt this progression of damage to a child's stress response system that leads to psychopathology can offer new directions for combatting health disparities.

 描述（由申请人提供）：心理健康问题是比例影响种族和少数民族人口，以及人口面临长期经济困难（埃文斯，沃尔夫和阿德勒，2012年）。有明确的证据表明，（1）奠定心理健康差异基础的过程是在童年时期（例如，Chen &米勒，2012）和（2）生理应激反应的损伤和失调是慢性应激（例如与贫困相关的慢性应激）对精神病理学的影响的有力机制（例如，Evans & Kim，2012）。为了解决心理健康差异，我们需要能够影响风险系统的干预措施。由于心理生物学应激反应系统（例如，下丘脑-垂体-肾上腺轴（HPA）是连接健康差异与慢性应激的中心机制，应激反应是一个关键的目标系统。提高儿童科普压力和调节其反应的能力有可能打破伤害的循环，特别是如果我们针对的应对策略和调节过程在生理水平上产生影响。来自PI研究实验室的初步证据显示，不同类型的应对在HPA水平上是明显的，因此，是时候评估为面临慢性压力的儿童设计的应对干预是否既能（a）提高儿童使用初级和二级控制的能力 应对，和（B）在生理水平上具有持续的影响。我们已经开发了这样一种干预措施，它建立在这些令人兴奋的新发现的基础上，旨在解决贫困城市青年生活中高度紧张的风险和修复的核心潜在机制。 青春前期是一个关键时期，在此期间，儿童认识压力的能力和它导致成熟，应对压力的能力在规模和复杂性方面都有所增长。此外，青春期前是大脑变化和关键自我调节器官和系统增长的时期。因此，青春前期儿童正处于成熟阶段，可以从基于应对的预防中受益，这一发育期的可塑性表明，这种变化有可能是持久的。我们新的预防计划旨在预防面临慢性压力的青春期前儿童出现焦虑、抑郁和创伤后压力症状。该项目针对两种行动机制。首先，该项目旨在表明，面临来自贫困、歧视和暴力的长期压力的儿童可以获得和利用适应各种情况的新的应对方式。第二，该项目将研究在何种程度上改善应对所产生的干预从事HPA的生理中间机制。最后，该项目旨在将应对和HPA的变化与内化症状的变化联系起来，这些变化将标志着预防新症状的出现或现有症状的恶化。发现预防和/或阻止这种导致精神病理学的对儿童应激反应系统的损害的进展的方法可以为对抗健康差异提供新的方向。