Emotional and Physiological Regulation Linking Child Maltreatment to Health Risk

项目摘要/摘要 每年约有70万名美国儿童被确认为虐待和证据的受害者 这表明只有5%的虐待案件被举报。众所周知，孩子们经历了 虐待是发展成精神疾病以及重大医疗疾病的高风险。 包括肥胖、糖尿病和心血管疾病。新出现的证据表明，生理学上 神经内分泌和免疫系统的改变是虐待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 虐待在于了解它最初是如何出现的，最重要的是，哪些因素预测了生物学 疾病的前兆。自我调节，包括情绪和生理成分，规定了 个体有意识或无意识地控制自己对压力的反应的努力，因此可能是一个关键 将虐待与生物前体--炎症、细胞因子基因甲基化以及 心脏代谢症状--与未来的健康状况有关。到目前为止，还没有一项研究关注情绪 调节和生理唤醒作为中枢的、可改变的机制 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 在自然主义环境中测量的调节和生理唤醒将童年虐待与 炎性蛋白、细胞因子基因的表观遗传变化，以及心脏代谢症状。这是一项创新 研究将确定自我调节和生物标记物如何促使脆弱的 人口。重要的是，自我监管是可以改变的，因此是未来的明确切入点 预防和干预方案，以支持有虐待史的儿童。这项研究将利用 对虐待儿童行为的全面评估、自我管理的新方法和黄金标准 生物前体的量度。这一高度结构化的培训计划非常适合执行 建议的研究项目。具体地说，申请者将接受(1)发展和 虐待儿童的生物心理社会方法，(2)自然观察和情绪编码 生理唤醒的调节和测量与分析，(3)炎症和表观遗传调节 免疫系统，(4)心脏代谢风险，(5)高级统计分析技能，以及(6)传播， 稿件准备和助学金写作技巧。培训将由一支出色的指导团队指导， 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 研究计划以及精神病学和人类学部丰富的培训环境 布朗大学阿尔伯特医学院/布拉德利医院的行为将为申请人提供 这些经历帮助她实现了成为一名独立调查员的最终目标。

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.