Posttraumatic Stress Disorder & Childhood Sexual Abuse: Psychobiology

创伤后应激障碍

• 批准号: 7115829
• 负责人: Michael Damingo De Bellis
• 金额: $ 62.72万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-09 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7115829
• 关键词: Address; Adolescent; Adrenal Glands; Adult; Affect; Age; Age of Onset; Amygdaloid structure; Animals; Anterior; Appendix; Area; Base of the Brain; Behavioral; Biological; Brain; Brain region; Buffers; Caring; Catecholamines; Cerebrum; Characteristics; Child; Child Abuse; Child Abuse and Neglect; Child Sexual Abuse; Childhood; Chronic; Clinical; Cognitive; Cognitive deficits; Complex; Corpus Callosum; Cross-Sectional Studies; Data; Development; Diagnosis; Disclosure; Disease remission; Domestic Violence; Environment; Event; Family history of; Female; Follow-Up Studies; Functional disorder; Glucocorticoids; Growth; HPSE gene; Hippocampus (Brain); Hour; Human; Hydrocortisone; Impairment; Infant; Intervention; Investigation; Lead; Life; Literature; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Measures; Medial; Mediating; Mental disorders; Monkeys; Mothers; N-acetylaspartate; Neurobiology; Neurons; Outcome; Outcome Measure; Physiological; Pilot Projects; Post-Traumatic Stress Disorders; Prefrontal Cortex; Prevalence; Primates; Process; Psychopathology; Rate; Rattus; Regulation; Reporting; Risk Factors; Secondary to; Severities; Sexual abuse; Social support; Socioeconomic Status; Steroids; Stress; Structure; Study Section; Symptoms; System; Time; Trauma; Traumatic Stress Disorders; aged; association cortex; base; cognitive function; deprivation; developmental disease; disorder control; experience; family genetics; follow-up; frontal lobe; gene interaction; hypothalamic-pituitary-adrenal axis; infancy; lateral ventricle; male; maltreated children; maltreatment; morphometry; neurogenesis; neuron loss; neuropsychological; neurotoxic; prospective; psychobiologic; psychobiology; psychologic; psychosocial; resilience; social; urinary

DESCRIPTION (provided by applicant): This application is a 5-year cross-sectional investigation with a one-year prospective follow-up to non-invasively examine the psychobiology of childhood posttraumatic stress disorder (PTSD) secondary to sexual abuse. In cross-sectional studies, we reported that clinically referred maltreated children with PTSD had elevated 24-hour urinary catecholamine and free cortisol levels and smaller intracranial and cerebral volumes, smaller midsaggital areas of the corpus callosum. and larger ventricles compared to non-abused controls. PTSD trauma for the majority of these children was sexual abuse. Earlier age of onset of abuse, longer duration of abuse, and greater PTSD symptoms each were associated with more extreme difference from normals on these measures. Animal studies suggest that elevated levels of catecholamines and cortisol during development may lead to adverse brain development. Our pilot study did not address to what extent our results were PTSD specific or the result of abuse. We will examine the diagnosis and severity of PTSD on outcomes of biological stress system regulation and brain maturation. We will study 3 groups of 70 children (35 males/35 females), aged 6 to 12 years: children with PTSD secondary to sexual abuse, sexually abused children without PTSD, and non-traumatized age and sociodemographically comparable controls. Biological stress system regulation will be assessed by 24-hour urinary catecholamine and free cortisol levels. Brain maturation will be assessed by: magnetic resonance spectroscopy-based brain N-acetylaspartate concentrations, which reflect neuronal integrity, magnetic resonance imaging-based brain morphometry (cerebral, amygdala/hippocampal volumes and corpus callosum area), and cognitive function. This study includes a cross-sectional component at entry (Time-01) and a one-year follow-up (Time-02). Study entry for abused subjects is within 3 months of abuse disclosure. Time-01 and -02 assessments measure known risk factors for the development of PTSD. Specific aims are to determine the relationship between sexual abuse with PTSD and without PTSD and these outcomes at Time-01 and to determine the one-year effects of sexual abuse with PTSD and sexual abuse without PTSD on these same children's biological stress systems and neuropsychological function. Secondary aims are: to identify the psychobiological predictors of the persistence of PTSD and resiliency to PTSD at the one-year period after abuse disclosure (Time-02). We hypothesize that sexually abused children with PTSD will show evidence of alterations in biological stress systems and brain maturation at Time-01 and Time-02. We further hypothesize that certain risk factors at Time-01 (e.g. age of onset of abuse, adverse life events, and biological measures) will predict the persistence of PTSD at Time-02.

描述（由申请人提供）：本申请为期 5 年 横断面调查和为期一年的前瞻性随访 非侵入性地检查儿童创伤后应激的心理生物学 继发于性虐待的精神障碍（PTSD）。在横断面研究中，我们 报道称，临床转诊的受虐待儿童的 PTSD 发病率升高 24小时尿儿茶酚胺和游离皮质醇水平以及较小的颅内 和脑容量，胼胝体中矢状区域较小。和 与未滥用对照相比，心室更大。大多数人都有创伤后应激障碍 (PTSD) 创伤 这些儿童遭到性虐待。虐待发生年龄越早、越长 虐待持续时间和更严重的 PTSD 症状均与更多 这些措施与正常情况存在极大差异。动物研究表明 发育过程中儿茶酚胺和皮质醇水平升高可能会导致 大脑发育不良。我们的试点研究并没有解决我们的问题在多大程度上 结果是特定于 PTSD 或虐待的结果。我们将检查 PTSD 的诊断和严重程度对生物应激系统结果的影响 调节和大脑成熟。我们将研究 3 组，每组 70 名儿童（35 男性/35 名女性），年龄 6 至 12 岁：继发于性行为的 PTSD 儿童 虐待、没有创伤后应激障碍 (PTSD) 的受性虐待儿童以及未受创伤的年龄和 社会人口统计学上的可比控制。生物应激系统调节 将通过 24 小时尿儿茶酚胺和游离皮质醇水平进行评估。 大脑成熟度将通过以下方式进行评估： 基于磁共振波谱 脑内 N-乙酰天冬氨酸浓度，反映神经元完整性， 基于磁共振成像的脑形态测量（大脑、 杏仁核/海马体积和胼胝体区域）和认知功能。 本研究包括入口处的横截面成分 (Time-01) 和 一年随访（Time-02）。受虐待受试者的研究入学时间在 3 以内 数月的滥用行为披露。 Time-01 和-02 评估衡量已知风险 PTSD 发展的因素。具体目标是确定 伴有 PTSD 和不伴有 PTSD 的性虐待与这些结果之间的关系 在 Time-01 确定性虐待对 PTSD 的一年影响 没有创伤后应激障碍的性虐待对这些儿童的生物压力系统的影响 和神经心理功能。次要目标是：确定 PTSD 持续性和 PTSD 恢复力的心理生物学预测因素 在滥用行为披露后的一年内 (Time-02)。我们假设 患有创伤后应激障碍 (PTSD) 的受性虐待儿童将表现出 Time-01 和 Time-02 的生物压力系统和大脑成熟。我们 进一步假设 Time-01 的某些危险因素（例如发病年龄） 滥用、不良生活事件和生物措施）将预测 PTSD 在 Time-02 持续存在。

项目成果

Behavioral risk elicits selective activation of the executive system in adolescents: clinical implications.

行为风险引起青少年执行系统的选择性激活：临床意义。

• DOI: 10.3389/fpsyt.2011.00068
• 发表时间: 2011
• 期刊: Frontiers in psychiatry
• 影响因子: 4.7
• 作者: Yaxley,RichardH;VanVoorhees,ElizabethE;Bergman,Sara;Hooper,StephenR;Huettel,ScottA;DeBellis,MichaelD
• 通讯作者: DeBellis,MichaelD

Intellectual, neurocognitive, and academic achievement in abstinent adolescents with cannabis use disorder.

• DOI: 10.1007/s00213-014-3463-z
• 发表时间: 2014-04
• 期刊: PSYCHOPHARMACOLOGY
• 影响因子: 3.4
• 作者: Hooper, Stephen R.;Woolley, Donald;De Bellis, Michael D.
• 通讯作者: De Bellis, Michael D.