Preventing Adult Mental Health Problems from Early Childhood in the Contexts of Genetic Susceptibility, Poverty, Racism, and the COVID-19 Pandemic

摘要 早期成年人经历了高比例的心理健康问题，包括焦虑、抑郁、自杀和 精神错乱。NIMH资助的R01早期多站点家长基金的总体目标是检查 随机化对2-10岁儿童是否接受家庭体检的影响 从儿童早期到成年早期的发展路径，重点是精神健康障碍和 新兴成人的症状学。与早期父母助学金的第三个目标相一致，“审查 在贫困中成长的背景下，FCU对精神健康的长期预防作用 补编建议扩大这一目标，特别侧重于#年生活贫困的各个方面。 儿童早期(照顾者的收入、就业、教育和经济压力)作为独立贡献者 在青春期和成年早期有自我报告的精神健康症状的风险，如果这些 母性抑郁和儿童时期的照顾者能力是调节人际关系的两个因素，而 FCU的干预。我们还计划用精神卫生保健的使用来检验这一模式，对于那些 经历心理健康问题，以青春期和成年期为结局。这项研究的发现将 有助于理解在贫困中成长的具体方面可能会如何加剧或改善 青春期和成年期的心理健康症状学，以及FCU如何缓冲 儿童贫困对后期心理健康和心理卫生保健利用的影响。总体而言，研究和 作为多样性补充的一部分，Chirimwami博士将接受的培训将加速他向 独立研究科学家通过扩大他在儿童贫困方面的专业知识，与贫困人口合作 社区，FCU干预的影响，纵向建模，以及学术和拨款写作。

ABSTRACT Early adults are experiencing high rates of mental health issues, including anxiety, depression, suicidality, and psychosis. The overall goal of the NIMH-funded R01 Early Steps Multisite parent grant is to examine the impact of randomization to receipt of the Family Check-Up (FCU), or not, from child ages 2 to 10 on developmental pathways from early childhood to early adulthood, focusing on mental health disorders and symptomatology in emerging adults. Aligned with the third aim of the Early Steps parent grant, “to examine the long-term preventive effects of the FCU on mental health, in the context of growing up in poverty,” this supplement proposes an extension of this aim, specifically focusing on various aspects of living in poverty in early childhood (caregiver income, employment, education, and financial stress) as independent contributors to risk for self-reported mental health symptomology in adolescence and early adulthood, and if these relationships are mediated by maternal depression and caregiver competence in childhood, and moderated by the FCU intervention. We also plan to examine this model with mental health care utilization, for those experiencing mental health issues, in adolescence and adulthood as the outcome. Findings from this study will contribute to understanding of how specific aspects of growing up in poverty may exacerbate or ameliorate mental health symptomatology in adolescence and adulthood, and how the FCU may buffer the impact of childhood poverty on later mental health and utilization of mental health care. Overall, the research and training Dr. Chirimwami will receive as part of this diversity supplement will accelerate his transition to an independent research scientist by expanding his expertise in childhood poverty, work with underserved communities, the impact of the FCU intervention, longitudinal modeling, and scholarly and grant writing.