Developmental Effects of Prenatal Cocaine Exposure

描述（由申请人提供）：本修订申请是对NOT-OD-10-032的回应：NIH宣布通过NIH基本行为和社会科学机会网络（OppNet）为竞争性修订申请（R 01，R 03，R15，R21，R21/R33和R37）提供恢复法案资金。 很少有前瞻性研究直接评估压力反应对后期心理适应的影响。为了填补这一关键的空白，本研究旨在探讨早期和后期皮质醇反应的压力，其关系到心理调整的样本低收入，内城青少年。 该提案涉及对一项正在进行的研究“产前暴露对发育的影响”（R 01 DA 07109）的纵向数据进行检查，以及增加新数据。父母补助金的最初目的集中在产前接触可卡因对发育的影响。在这项研究中，我们将扩大原来的范围的父母补助金，以解决更广泛的问题，有关的影响，高风险的环境，这一样本。对于这个建议，考虑到时间限制和问题的性质，我们将只检查我们样本中那些在子宫内没有接触可卡因的儿童。 拟议的研究将实现几个重要目标。首先，我们将研究早期皮质醇对压力的反应如何影响随后的心理调整。我们将通过分析先前在4岁至13岁的8个时间点收集的数据，并在17岁时收集新的压力和心理调整措施，来研究皮质醇反应的个体模式是否先于情绪和行为问题的发作。其次，我们将研究早期皮质醇对压力的反应是否与后期皮质醇对压力的反应有关。很少有研究考察了个体在生命早期的发育阶段内或整个发育阶段对压力的皮质醇反应模式，这些研究的结果是不一致的。因此，我们将能够调查随着时间的推移，HPA活动的发展变化和变化，使用新的连续性和变化的分析模型。我们的第三个目标是确定是否后期皮质醇反应的压力调解早期皮质醇反应和后期心理调整之间的关系。 初步研究表明，特里尔儿童社会压力测试（TSST-C）既适合年龄，又能有效地引发压力反应。在一项初步研究中，TSST-C给药后平均皮质醇水平升高。早期的初步数据分析表明，有重要的个体差异皮质醇反应性以及变异性的措施，随后的心理调整之间的子样本的青少年低收入，市中心的环境。很少有其他研究在前瞻性纵向设计中整合HPA对急性应激和心理健康的反应。此外，很少有研究探讨了低收入，内城青少年人群中HPA轴反应模式的年龄相关变化，同时考虑到环境风险。

DESCRIPTION (provided by applicant): This Revision Application is in response to NOT-OD-10-032: NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications (R01, R03, R15, R21, R21/R33, and R37) through the NIH Basic Behavioral and Social Science Opportunity Network (OppNet). There are few prospective studies directly assessing the impact of stress responsivity on later psychological adjustment. To fill this critical gap, this study seeks to examine early and later cortisol response to stress on its relation to psychological adjustment in a sample of low income, inner-city adolescents. This proposal involves the examination of longitudinal data from an ongoing study, "Developmental Effects of Prenatal Cocaine Exposure" (R01 DA07109), as well as the addition of new data. The original aims of the parent grant focused on the developmental effects of prenatal cocaine exposure. In this study, we will expand the original scope of the parent grant to address broader questions relating to the impact of high risk environments from which this sample is taken. For this proposal, given the time constraints and the nature of the problem, we will examine only those children in our sample who were not exposed to cocaine in utero. The proposed study will accomplish several important goals. First, we will examine how early cortisol response to stress impacts on subsequent psychological adjustment. We will examine whether individual patterns of cortisol response precede the onset of emotional and behavioral problems by analyzing data previously collected at 8 time points from ages 4 to 13 and collecting new measures of stress and psychological adjustment at age 17. Second, we will examine whether early cortisol response to stress is related to later cortisol response to stress. Few studies have examined individual patterns of cortisol response to stress within or across developmental periods early in life, and the results from these are inconsistent. Thus, we will be able to investigate both developmental change and variation in HPA activity over time, using novel analytic models of continuity and change. Our third aim is to determine whether later cortisol response to stress mediates the relation between early cortisol response and later psychological adjustment. Preliminary studies have shown that the Trier Social Stress Test for Children (TSST-C) is both age- appropriate and effective in eliciting a stress response. In a pilot study, mean cortisol levels increased after administration of the TSST-C. Preliminary data analyses at earlier ages indicate that there are important individual differences in cortisol reactivity as well as variability in measures of subsequent psychological adjustment among this subsample of adolescents from low-income, inner-city environments. Few other studies have integrated HPA response to acute stress and psychological health within a prospective longitudinal design. In addition, few studies have examined age-related changes in patterns of HPA axis reactivity within a low-income, inner-city adolescent population, taking environmental risk into account.