Emotional and Physiological Regulation Linking Child Maltreatment to Health Risk

项目总结/摘要 每年大约有70万美国儿童被确认为虐待和证据的受害者 只有5%的虐待案件被报告。众所周知，经历过 受虐待的儿童患上精神疾病和严重疾病的风险很高 包括肥胖、糖尿病和心血管疾病。新出现的证据表明， 神经内分泌和免疫系统的变化是虐待产生持久影响的主要机制。 关于健康。很难改变已经确诊的儿童和成人的生物功能障碍的轨迹 健康状况，这表明，解决精神和身体疾病的问题， 虐待在于了解它是如何首先出现的，最重要的是，哪些因素预测生物学 疾病的前兆。自我调节，包括情绪和生理成分，决定了一个 个人有意识或无意识的努力来控制他们对压力的反应，因此可能是一个关键的 将虐待与生物学障碍物-炎症、细胞因子基因甲基化和 心脏代谢紊乱-与未来的健康状况有关。到目前为止还没有研究关注情绪 调节和生理唤醒作为中央，可修改的机制之间的关联 虐待和这三种生物前体。这项研究的总体目标是测试情绪是否 在自然环境中测量的调节和生理唤醒将童年虐待与 炎症蛋白、细胞因子基因的表观遗传变化和心脏代谢症状。这一创新 一项研究将确定自我调节和生物标志物是如何在脆弱人群中加速疾病发作的。 人口重要的是，自我调节是可以改变的，因此可以作为未来的一个明确的切入点。 预防和干预方案，以支持有虐待历史的儿童。本研究将使用 全面评估儿童虐待、自我调节的新方法和黄金标准 生物前体措施。这一高度结构化的培训计划非常适合执行 拟议的研究项目。具体而言，申请人将接受以下方面的培训：（1）发展和 儿童虐待的生物心理社会学研究方法;（2）自然主义的观察和情绪编码 生理唤醒的调节、测量和分析，（3）炎症和表观遗传调节 免疫系统，（4）心脏代谢风险，（5）先进的统计分析技能，和（6）传播， 论文撰写和授权书撰写技巧。培训将由一个优秀的导师团队指导， 高度相关的专业知识和长期的合作历史。因此，拟议的培训和 研究计划沿着丰富的培训环境，可在精神病学和人类学系 布朗大学阿尔珀特医学院/布拉德利医院的行为将为申请人提供 为帮助她实现成为独立调查员的最终目标而量身定制的经验。

PROJECT SUMMARY/ABSTRACT Each year approximately 700,000 American children are identified as victims of maltreatment and evidence suggests that as few as 5% of abuse cases are reported. It is well established that children who experience maltreatment are at high risk for the development of psychiatric disorders, as well as major medical conditions including obesity, diabetes, and cardiovascular disease. Emerging evidence suggests that physiological change to neuroendocrine and immune systems is a major mechanism of the lasting impact of maltreatment on health. It is difficult to alter the trajectory of biological dysfunction in children and adults already diagnosed with health conditions, which suggests that a solution to the problem of mental and physical illness following maltreatment lies in understanding how it first emerges, and most importantly, which factors predict biological precursors to disease. Self-regulation, including emotional and physiological components, dictates an individual’s conscious or unconscious efforts to control their response to stress, and thus may be a critical mechanism linking maltreatment to biological precursors—inflammation, methylation of cytokine genes, and cardiometabolic symptoms—associated with future health conditions. No study to date has focused on emotion regulation and physiological arousal as central, modifiable mechanisms of the association between maltreatment and these three biological precursors. The overall aims of this study are to test whether emotion regulation and physiological arousal measured in naturalistic settings link childhood maltreatment to inflammatory proteins, epigenetic change of cytokine genes, and cardiometabolic symptoms. This innovative study will identify how self-regulation and biological markers precipitate the onset of disease in a vulnerable population. Importantly, self-regulation can be altered, and thus serves as a clear point of entry for future prevention and intervention programs to support children with a maltreatment history. This study will utilize comprehensive assessments of child maltreatment, novel approaches to self-regulation, and gold-standard measures of biological precursors. This highly structured training plan is ideally suited to allow for execution of the proposed research project. Specifically, the applicant will receive training in (1) developmental and biopsychosocial approaches to child maltreatment, (2) naturalistic observation and coding of emotion regulation and measurement and analysis of physiological arousal, (3) inflammation and epigenetic regulation of the immune system, (4) cardiometabolic risk, (5) advanced statistical analysis skills, and (6) dissemination, manuscript preparation and grant writing skills. Training will be guided by an outstanding mentorship team with highly relevant expertise and a long-standing history of collaboration. Therefore, the proposed training and research plans along with the rich training environment available at the Department of Psychiatry and Human Behavior of the Alpert Medical School of Brown University/Bradley Hospital will provide the applicant with experiences tailored to help her reach her ultimate goal of becoming an independent investigator.