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Risk Profiles and Mechanisms of Disease in Maltreated Children

受虐待儿童的风险概况和疾病机制

基本信息

批准号：
9355216
负责人：
AUDREY TYRKA
金额：
$ 60.63万
依托单位：
BUTLER HOSPITAL (PROVIDENCE, RI)
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-21 至 2021-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9355216
关键词：
Accelerometer Adult Adverse event Affective Age Allergic rhinitis Anti-Inflammatory Agents Anti-inflammatory Anxiety Anxiety Disorders Asthma Attenuated Behavioral Biogenesis Biological Biological Markers Blood Pressure Cardiovascular Diseases Caregivers Cell Aging Cell Death Cellular Stress Characteristics Child Child Abuse and Neglect Child Rearing Childhood Chronic Clinical Cognitive Data Depressive disorder Development Diabetes Mellitus Diagnosis Diet Dilatation - action Disease Disease Outcome Dose Endocrine Enzymes Epigenetic Process Exercise Future Genes Glucocorticoids Goals Health Home environment Homelessness Hunger Hydrocortisone Inflammatory Interleukin-1 beta Intervention Interview Lead Life Link Literature Lung Measures Mediating Mediator of activation protein Medical Medical Records Metabolic Metabolic syndrome Metabolism Methylation Mitochondria Mitochondrial DNA Modeling Mood Disorders Moods Nature Neighborhoods Neurobiology Nursery Schools Obesity Outcome Outcome Measure Pathway interactions Pharmaceutical Preparations Plasma Population Poverty Prevention Process Proteins Public Health Public Health Practice Publishing Pulmonary function tests Questionnaires Research Resources Respiratory Chain Risk Risk Factors Salivary Sampling Satiation Signal Transduction Sleep Social Work Social support Socioeconomic Factors Statistical Models Stress System Telomere Shortening Testing Time Tissues Translations Trauma United States Virulent Work aged allostatic load behavior influence behavioral health biological systems clinical practice cognitive task cognitive testing computerized cost cytokine depressive symptoms diet and exercise dietary supplements disability early onset disorder environmental tobacco smoke exposure experience follow up assessment follow-up glucose metabolism high risk indexing insight maltreated children maltreatment metabolic rate mitochondrial dysfunction novel pre-clinical productivity loss programs prospective public health relevance pulmonary function resilience social stress related disorder

项目摘要

Childhood maltreatment is a major public health problem that is linked to high rates of mood and anxiety disorders, and a growing literature documents risk for conditions such as obesity, cardiovascular disease, asthma, and diabetes. These conditions are often chronic and severe, and they exact tremendous costs in terms of suffering, disability, treatment, and loss of productivity. Existing social services programs for maltreated children suffer from a lack of available data regarding which children are at risk for which psychiatric outcomes and from a lack of focus on risk for other adverse health conditions. In order to develop more targeted and specific interventions and treatments, we need to better understand the trajectory and mechanisms of risk and protective factors. There is evidence that the pathophysiological effects of adversity begin early in life, and that clinical or sub-clinical effects of major adversity can be seen in childhood. Maltreated children, particularly those living in poverty, are at especially high risk for early-onset disorders, but childhood maltreatment is usually clandestine and therefore very difficult to study. This study involves a 5-year follow up assessment of a sample of impoverished maltreated preschool-aged children and demographically matched non-maltreated children. Existing data include details of maltreatment experiences, socioeconomic factors and neighborhood characteristics, and additional adversities such as parental loss, homelessness, and traumas. Data on protective factors include home and neighborhood resources, parenting, and social services. In our initial work, adverse experiences were linked to depressive symptoms and blunted cortisol levels, and epigenetic changes to glucocorticoid signaling genes were significant mediators of these relationships. We also found that levels of salivary inflammatory cytokine IL-1β increased as a function of stress exposure. In our work with healthy un-medicated adults, we have shown that attenuated plasma cortisol concentrations are linked to several indices of the metabolic syndrome, and that childhood stress and psychiatric conditions are associated with telomere shortening and a measure of mitochondrial DNA proliferation, indicators of cellular stress and aging. In the proposed 5-year follow-up, we will test a model of risk and resilience for medical and psychiatric outcomes obtained from medical records, from interviews and questionnaires completed by children and caregivers, and tests of cognitive/affective, metabolic, endovascular, and pulmonary function. Behavioral, social, and biological mechanisms of risk and resilience will be examined. Statistical models will be aimed at identifying profiles of risk and protective factors and biological mechanisms that are most likely to be useful targets for intervention.

儿童虐待是一个主要的公共卫生问题，与高情绪和焦虑率有关