Biomarkers of Risk and Resilience to Trauma in Syrian Refugee Youth

项目摘要/摘要 对创伤后应激障碍(PTSD)的研究，更具体地说是在遭受创伤的难民中 主要集中在成年人身上。我的共同赞助人(贾万巴赫特博士)进行了阿拉伯国家的第一项心理健康研究。 在美国重新安置的难民(成人和儿童)，评估流行率、遗传、表观遗传学和 与创伤相关的心理结果的环境相关性。我的赞助人(约万诺维奇博士)开创了 使用皮肤电导反应(SCR)和恐惧强化惊吓对青年创伤的纵向研究 (FPS)以了解精神病理学的生理相关性。此应用程序的目标是扩展 我的赞助商在量化青年难民中创伤后应激障碍的神经生理生物标记物方面的工作。 暴露在压力和创伤下激活一条关键的适应性通路--交感肾上腺髓质 系统(SAM)。交感神经反应性的增加可以通过非侵入性方法测量到。皮肤电导 当描述创伤时，反应(SCR)升高，并可以预测暴露后6个月的创伤后应激障碍。FPS 量化安全学习中的损害以及过度泛化的恐惧。促性腺激素水平升高- 炎症成分被认为与创伤后应激障碍和焦虑等更严重的病理有关。建议数 该项目将测量创伤后应激障碍及其症状群与Scr、FPS和炎症之间的关系 在叙利亚难民青年中，他们遭受了平民战争的创伤，并已被评估为可能 焦虑症。这将为学员提供一个机会：i)提高与多元文化打交道的技能 临床研究中的人群，ii)学习FPS范式以及如何分析肌电图 记录(肌电；测量惊吓反应的工具)和SCR，以及iii)提高收集、存储、 和分析促炎蛋白，同时扩大了对神经生理学基础的理解 青少年创伤后应激障碍的风险，这方面的研究严重不足。科学前提：生物标志物，如Scr，FPS， 炎症(即急性时相蛋白C反应蛋白(CRP))将是创伤后应激障碍的量化相关因素 在叙利亚难民青年中。这些生物标记物在筛查呈阳性的人中将显著升高。 与那些没有焦虑症的人相比，这是一种焦虑症。意义：我们的方法将有助于调查 与青年创伤后应激障碍的心理生理病理相关的合理的神经生物学机制，提供数据 来自心理健康研究中代表性很低的群体--中东难民。 潜在的未来研究将：a)调查体积和功能神经成像的相关性 与儿童和青少年创伤相关的行为、炎症和电生理变化； B)利用该信息建立结合炎症状态基线测量的预测模型， 自主神经唤醒，脑结构和心理症状，以确定预后和 青年进步；以及c)扩大这些机械性调查方法，用于评估以身体为重点的 治疗方式和结果，特别是基于运动和正念的干预。

Project Summary/Abstract Research in posttraumatic stress disorder (PTSD), more specifically in traumatized refugees, has primarily focused on adults. My Co-Sponsor (Dr. Javanbakht) has conducted the first mental health study of Arab refugees (adults and children) resettling in the United States that evaluates prevalence, genetic, epigenetic, and environmental correlates of trauma-related psychological outcomes. My Sponsor (Dr. Jovanovic) has pioneered longitudinal studies of trauma in youth, employing skin conductance response (SCR) and fear-potentiated startle (FPS) to understand physiological correlates of psychopathology. The goal of this application is to expand my Sponsors’ work to quantify neurophysiological biomarkers of PTSD in youth refugees. Exposure to stress and trauma activates a key adaptive pathway—the sympathetic adrenomedullary system (SAM). Increased sympathetic reactivity is measurable through non-invasive methods. Skin conductance response (SCR) rises when recounting trauma and can predict PTSD 6 months following exposure. FPS quantifies impairments in safety learning as well as overgeneralization of fear. Elevated levels of pro- inflammatory components have been linked to more severe pathology of PTSD and anxiety. The proposed project will measure the relationship between PTSD and its symptom clusters, and SCR, FPS, and inflammation in Syrian refugee youth who have been exposed to civilian war trauma and have been assessed for possible anxiety disorder. This will provide the trainee with an opportunity to i) enhance skills engaging with multicultural populations in clinical research, ii) learn the FPS paradigm as well as how to analyze electromyography recordings (EMG; tool to measure startle response) and SCR, and iii) to enhance skills in collection, storage, and analysis of pro-inflammatory proteins, all while expanding the understanding of the neurophysiological basis of PTSD in youth, which has been grossly underexplored. Scientific premise: Biomarkers such as SCR, FPS, and inflammation (namely acute phase protein C-reactive protein (CRP)) will be quantifiable correlates of PTSD in Syrian refugee youth. Such biomarkers will be significantly elevated in those who have screened positive for an anxiety disorder compared to those who have not. Significance: Our approach will facilitate investigation of plausible neurobiological mechanisms associated with psychophysiopathology of PTSD in youth, providing data from a largely underrepresented group in mental health research—Middle Eastern refugees. Potential future research would: A) investigate volumetric and functional neuroimaging correlates of the behavioral, inflammatory, and electrophysiological changes associated with trauma in children and adolescents; B) leverage this information to build a predictive model combining baseline measures of inflammatory state, autonomic arousal, brain structure, and psychological symptoms in order to determine prognosis and progression in youth; and C) expand these methods of mechanistic inquiry for use in assessing body-focused treatment modalities and outcomes, particularly exercise and mindfulness-based interventions.