Social and Biological Mechanisms Driving the Intergenerational Impact of War on Child Mental Health: Implications for Developing Family-Based Interventions

战争对儿童心理健康产生代际影响的社会和生物机制：对制定以家庭为基础的干预措施的影响

• 批准号: 10883852
• 负责人: Theresa Stichick Betancourt
• 金额: $ 6.39万
• 依托单位: BOSTON COLLEGE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-10 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10883852
• 关键词: Address; Adult; Affect; Africa South of the Sahara; Age; Anxiety; Area; Articulation; Automobile Driving; Autonomic nervous system; Behavior assessment; Behavioral; Biological; Biological Markers; Biophysics; Child; Child Development; Child Mental Health; Child Rearing; Childhood; Clinical assessments; Cognition; Collaborations; Collection; Communication; Communities; Conflict (Psychology); Data; Data Collection; Development; Early-life trauma; Ecology; Economic Development; Economics; Education; Emotional; Emotions; Ensure; Equation; Ethics; Exposure to; Family; Family Violence; Female; Funding; Generations; Government; Growth; Health; Heritability; Hospitals; Human Resources; Human Rights; Individual; Inflammation; Informal Social Control; Intervention; Investigation; Knowledge; Length; Life; Link; Longitudinal Studies; Measures; Mental Depression; Mental Health; Mental disorders; Migrant; Military Personnel; Modeling; National Institute of Child Health and Human Development; Outcome; Parent-Child Relations; Parents; Pathway interactions; Pattern; Physiological; Population; Population Heterogeneity; Prevention; Process; Psyche structure; Public Health; Recording of previous events; Refugees; Research; Research Domain Criteria; Research Personnel; Risk; Risk Factors; Sampling; Screening procedure; Security; Sierra Leone; Skin; Social Functioning; Social Work; Social support; Soldier; State Government; Stress; Techniques; Time; Trauma; United States; Universities; Violence; War; Woman; Youth; aged; biobehavior; biological adaptation to stress; cognitive function; cohort; coping; displaced person; emotion regulation; emotional functioning; improved; innovation; intergenerational; low and middle-income countries; male; mental development; modifiable risk; next generation; offspring; participant retention; physical conditioning; post-traumatic stress; preventive intervention; prospective; protective factors; social; social stigma; stress reactivity; stressor; substance use; support tools; telomere; trait; transmission process; trauma exposure; young adult

PROJECT SUMMARY Violence and humanitarian crises are common in the lives of children around the world, particularly in low- and middle-income countries. Exposure to war-related violence is detrimental to the mental health of parents and children, but research exploring mechanisms by which emotional and behavioral disruptions are transmitted to subsequent generations remains nascent, especially in Sub-Saharan Africa. To help address this gap, a study of war-affected youth has been underway since 2002 following a cohort of war-affected children—many, both male and female, former child soldiers—in Sierra Leone into young adulthood, and now parenthood. A prior NICHD-funded R01 (R01HD073349) demonstrated how childhood war-related trauma and loss contributed to mental health problems in adulthood. In 2017, a cross-sectional sample of intimate partners and biological offspring was added to the sample to examine linkages between early trauma exposure and both intimate partner and parent-child relationships. Knowledge to date of how war-related stressors “get under the skin,” to become heritable biophysical traits and the implications for the mental health of the next generation remain limited. Of relevance are the Research Domain Criteria-related constructs of self-regulation and stress reactivity and how they influence emotional, cognitive and social functioning of children. The proposed research comprises a significant advance in the 20-year history of this study by advancing understanding of potential biological embedding of stress responses intergenerationally. Building on four prior waves of data collection, biological measures of stress reactivity and self-regulation (autonomic nervous system reactivity, inflammation, telomere length) will be collected in a sample of parents exposed to significant trauma in childhood and extended also to intimate partners and offspring. Strong capacity-building collaborations with Sierra Leone’s University of Makeni (UNIMAK) and Kenema Government Hospital (KGH) will support the ethical collection of new stress biomarker data and clinical assessments of parent-child synchrony, health, and anthropometric data in biological offspring aged 7–24. Key study innovations are (a) rare prospective data on parental trauma exposure and longitudinal information on risk and protective factors operating across the social ecology; (b) data on biological embedding of stress responses related to parental trauma; and (c) the opportunity to examine both mental health and physiological outcomes in biological offspring in war-affected families over time. Advanced statistical techniques (e.g., latent class growth models, structural equation models, lagged effects models) will articulate mechanistic pathways and priority targets for intervention. Collaborations between investigators, UNIMAK, KGH, as well as community advisory boards will inform study implementation, ensure strong retention of participants, and provide channels for dissemination. Analyses will inform screening tools to identify families for preventive interventions. Intervention targets identified have implications not just for war-affected settings, but also for assisting diverse populations affected by violence and trauma, including migrants and refugees.

项目概要 暴力和人道主义危机在世界各地儿童的生活中很常见，特别是在低收入和低收入国家。 中等收入国家。接触与战争有关的暴力不利于父母和孩子的心理健康 儿童，但研究探索情绪和行为障碍传递给儿童的机制 后代仍处于新生阶段，特别是在撒哈拉以南非洲地区。为了帮助解决这一差距，一项研究 自 2002 年以来，针对一群受战争影响的儿童（其中许多人都 男性和女性，前儿童兵——在塞拉利昂进入青年期，现在为人父母。先前的 NICHD 资助的 R01 (R01HD073349) 展示了儿童战争相关创伤和损失如何导致 成年后的心理健康问题。 2017 年，亲密伴侣和生物的横断面样本 后代被添加到样本中，以检查早期创伤暴露与亲密关系之间的联系 伴侣和亲子关系。迄今为止关于战争相关压力因素如何“深入人心”的知识 成为可遗传的生物物理特征，对下一代心理健康的影响仍然存在 有限的。相关的是与研究领域标准相关的自我调节和压力结构 反应性以及它们如何影响儿童的情绪、认知和社会功能。拟议的 这项研究在 20 年的历史中取得了重大进展，通过增进对 代际应激反应的潜在生物嵌入。以之前四波数据为基础 收集、应激反应性和自我调节的生物测量（自主神经系统反应性、 炎症、端粒长度）将收集在遭受重大创伤的父母样本中 童年，也延伸到亲密伴侣和后代。与以下机构开展强有力的能力建设合作 塞拉利昂马克尼大学 (UNIMAK) 和凯内马政府医院 (KGH) 将支持 新压力生物标志物数据的伦理收集以及亲子同步性、健康和健康的临床评估 7-24 岁生物后代的人体测量数据。关键的研究创新是 (a) 罕见的前瞻性数据 父母的创伤暴露以及整个过程中风险和保护因素的纵向信息 社会生态学； (b) 与父母创伤相关的应激反应的生物嵌入数据； (c) 有机会检查受战争影响的生物后代的心理健康和生理结果 随着时间的推移，家庭。先进的统计技术（例如，潜在类别增长模型、结构方程 模型、滞后效应模型）将阐明干预的机制途径和优先目标。 研究人员、UNIMAK、KGH 以及社区咨询委员会之间的合作将为研究提供信息 落实，确保参与者的强大保留，并提供传播渠道。分析将 告知筛查工具以确定家庭进行预防性干预。确定的干预目标有 不仅对受战争影响的环境产生影响，而且对援助受暴力影响的不同人群也产生影响 和创伤，包括移民和难民。