Web-Based Intervention for Disaster-Affected Adolescents and Families

针对受灾青少年和家庭的网络干预

• 批准号: 8039046
• 负责人: ANANDA B AMSTADTER
• 金额: $ 21.38万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-19 至 2012-09-27
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8039046
• 关键词: Web; Based; Intervention; Disaster; Affected

DESCRIPTION (provided by applicant): Posttraumatic Stress Disorder (PTSD) among adolescents exposed to disasters is prevalent and increases health morbidity and mortality. Although PTSD is common among youth exposed to traumatic stressors, is not present among all exposed youth. Disaster-exposed youth, in comparison to adults, are at significantly greater risk for PTSD, with symptoms often persisting for many months and years post-disaster; however, youth are drastically under-represented in post-disaster studies. Considerable effort, primarily in the adult literature, has been given to identify variables related to PTSD risk, but only about 20 percent of variance has been explained by psychosocial variables; thus, there has been interest in including genetic determinants into studies of PTSD. Despite moderate heritability estimates (30 percent) for PTSD, modern studies of genetic risk factors for PTSD are relatively few in number and psychiatric genetic investigations have been mixed in their ability to identify direct effects of genotypes on disorder phenotypes. Notably, there are no existant genetically informed studies of adolescent PTSD, a critical developmental phase. Therefore, the need is high for novel approaches to examining genetic and environmental moderators to inform models of risk and resilience in disaster exposed youth. Therefore, we are responding to Notice Number (NOT-OD-10-032) Title: 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). The primary objective of this project, directly in accordance with the research priorities of the NIH OppNet (NOT-OD-10- 032), is to add genetic sampling to a funded R01 investigation of disaster-exposed youth. The parent project will recruit a population-based sample of 3,000 disaster exposed youth and their parents participating in an NIH-funded longitudinal, web-based intervention study (R01MH081056). Youth and parent participants will complete an initial phone-based assessment, where information regarding disaster exposure, other traumatic event experiences and incident characteristics, family-related variables, and PTSD and other mental health symptomatology will be gathered. OppNet funding will be used to expand the interview to include a larger range of possible environmental modifiers. During the baseline interview, adolescents will be asked to provide saliva samples for DNA analysis, which will also be conducted through use of OppNet funding. Participants will be sent a collection kit that they return via U.S. mail, methods we have successfully executed in a previous disaster-focused study. DNA will be extracted from saliva samples and candidate genes will be examined via the tagging SNP method and by assying specific variable number tandem repeats of genes reported in the extant literature to be relevant for PTSD. By examining GxE interactions this project will assess whether relations between candidate genes and PTSD are moderated by aspects of the environment. This project, by harnessing the behavioral and social data from the R01 with the biologic data from the OppNet funding, will afford a deeper understanding of the interplay between the environment and biology in the aftermath of a traumatic stressor. Additionally, this project has potential public health benefits of informing the knowledge of pathophysiology of PTSD which may lead to improved pharmacologic treatment targets. PUBLIC HEALTH RELEVANCE: Many youth are exposed to disasters and other potentially traumatic events that can produce posttraumatic stress disorder (PTSD); however, not all exposed individuals develop PTSD, so information is needed about how biologic and environmental factors interact to increase or decrease risk of PTSD post-disaster. This project addresses this issue by collecting DNA from adolescents who were exposed to a disaster, allowing for examination of gene by environment interactions for adolescent PTSD. By testing whether relevant candidate genes and features of the environment modify the impact of exposure to traumatic events, we will advance basic science knowledge that will deepen our understanding of the causes of pediatric PTSD, which may inform secondary prevention or intervention of PTSD in youth.

描述（由申请人提供）：创伤后应激障碍（PTSD）在暴露于灾难的青少年中很普遍，并增加了健康发病率和死亡率。虽然创伤后应激障碍在暴露于创伤性压力源的青年中很常见，但并不存在于所有暴露的青年中。与成年人相比，灾难暴露的年轻人患创伤后应激障碍的风险要大得多，症状往往在灾难发生后持续数月甚至数年;然而，青年人在灾后研究中的代表性严重不足。相当大的努力，主要是在成人文献中，已经给出了识别变量相关的创伤后应激障碍的风险，但只有约20%的方差已被解释的心理变量，因此，有兴趣在包括遗传因素的研究创伤后应激障碍。尽管PTSD的遗传率估计值为中等（30%），但现代对PTSD遗传风险因素的研究相对较少，精神病学遗传学研究在识别基因型对疾病表型的直接影响方面的能力参差不齐。值得注意的是，目前还没有关于青少年创伤后应激障碍的遗传学研究，这是一个关键的发展阶段。因此，迫切需要新的方法来检查遗传和环境调节因子，以告知灾害暴露青年的风险和复原力模型。因此，我们正在回应通知编号（NOT-OD-10-032）标题：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。该项目的主要目标，直接根据美国国立卫生研究院OppNet（NOT-OD-10- 032）的研究重点，是增加遗传抽样到一个受资助的R 01调查暴露于灾害的青年。该母项目将招募3,000名灾害暴露青年及其父母参加NIH资助的纵向网络干预研究（R 01 MH 081056）。青少年和家长参与者将完成一个初步的电话评估，其中有关灾害暴露，其他创伤事件的经验和事件的特点，家庭相关的变量，创伤后应激障碍和其他心理健康诊断学的信息将被收集。OppNet的资金将用于扩大采访范围，包括更大范围的可能的环境修饰剂。在基线访谈期间，青少年将被要求提供唾液样本进行DNA分析，这也将通过使用OppNet资金进行。参与者将收到一个收集工具包，他们通过美国邮件返回，我们在以前的一项以灾害为重点的研究中成功地执行了这种方法。将从唾液样本中提取DNA，并通过标记SNP方法和通过分析现存文献中报道的与PTSD相关的基因的特定可变数目串联重复序列来检查候选基因。通过检查GxE相互作用，该项目将评估候选基因和PTSD之间的关系是否受到环境因素的调节。该项目通过利用R 01的行为和社会数据以及OppNet资助的生物数据，将更深入地了解创伤性压力源后环境和生物学之间的相互作用。此外，该项目还具有潜在的公共卫生益处，可以提供创伤后应激障碍病理生理学知识，从而可能改善药物治疗目标。 公共卫生相关性：许多年轻人暴露于灾难和其他可能产生创伤后应激障碍（PTSD）的潜在创伤事件;然而，并非所有暴露的个体都会发展PTSD，因此需要有关生物和环境因素如何相互作用以增加或减少灾后PTSD风险的信息。该项目通过收集暴露于灾难的青少年的DNA来解决这个问题，允许检查青少年PTSD的基因与环境的相互作用。通过测试相关的候选基因和环境特征是否会改变暴露于创伤事件的影响，我们将推进基础科学知识，加深我们对儿童创伤后应激障碍原因的理解，这可能会为青少年创伤后应激障碍的二级预防或干预提供信息。