Prospective predictors of risk and resilience trajectories of mental health in US youth during COVID-19

COVID-19 期间美国青少年心理健康风险和复原力轨迹的前瞻性预测因素

• 批准号: 10655685
• 负责人: Ran Barzilay
• 金额: $ 26.7万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10655685
• 关键词: 13 year old; Address; Adolescence; Adolescent; Age; Anxiety; Back; Black race; Brain; COVID-19; COVID-19 pandemic; Chronic; Chronic stress; Clinical; County; Data; Data Analyses; Development; Dimensions; Early Intervention; Emotional; Environment; Environmental Exposure; Environmental Risk Factor; Exposure to; Financial Hardship; Fostering; Future; Genes; Genetic; Genotype; Global Warming; Goals; Growth; Health; Height; Household; Individual; Intervention; Life; Longitudinal Studies; Measures; Mental Depression; Mental Health; Mental disorders; Modeling; Neighborhoods; Neurocognitive; Outcome; Participant; Pattern; Persons; Phenotype; Post-Traumatic Stress Disorders; Preventive measure; Process; Psychiatry; Psychopathology; Research; Risk; Risk Factors; Risk Marker; SARS-CoV-2 infection; Sampling Studies; Schools; Social Interaction; Source; Stress; Symptoms; System; Teenagers; Time; Trauma; Youth; child depression; childhood anxiety; clinical phenotype; cognitive development; cohort; comparison group; coronavirus disease; deprivation; emotion regulation; experience; genetic information; improved; inter-individual variation; male; pandemic disease; pandemic stress; peer; pre-pandemic; preventive intervention; promote resilience; prospective; psychologic; recruit; resilience; resilience factor; response; risk stratification; sex; stress related disorder; stressor; structural determinants; substance use; suicidal behavior; trait; young adult

The COVID-19 pandemic has had substantial effects on youth in multiple aspects of life, raising concern about its impact on youth mental health. Indeed, mounting data suggest that youth depression and anxiety rates have increased compared to the pre-pandemic era. A key challenge is to recognize prospective predictors that can help identify youth at risk for serious mental health sequelae following COVID-19 and to disentangle the factors that contribute to resilient trajectories. Resilience, often defined as an adaptive outcome (i.e., low symptoms levels) following adversity, is driven by multiple systems including individual- and structural-level environmental factors, neurocognitive traits, and genetic factors. One approach to study resilience is to identify inter-individual variation in mental health trajectories following the pandemic, and use data collected prospectively before and early in the pandemic to better understands what determines variability in mental health trajectories under stress. The Adolescent Brain Cognitive Development (ABCD) Study (N~12,000, 52% male, recruited at age 9-10 years, 20% Black) follows diverse US youth longitudinally since 2017. The study collected multidimensional (i.e., environment, clinical, neurocognitive, genetic) data before the pandemic, and participants were ~12-13 years old when the pandemic hit. Between May 2020 to June 2021, the study team collected data on mental health and on COVID-19 related exposures at multiple time points from ~9,500 participants and will continue following participants into late adolescence. Therefore, ABCD Study creates a unique opportunity to disentangle risk and resilience factors collected prospectively in youth who were in early-mid adolescence when the pandemic hit, a critical developmental window when stress related disorders become more prevalent. In the current project, we propose to leverage the multi-dimensional ABCD Study data to identify factors that contribute to variability in mental health trajectories in US youth during the COVID-19 pandemic. We will first use latent growth mixture modeling to identify trajectories of internalizing symptoms over time. Thereafter, we will characterize the individual stressors and the structural (based on geocoded address) environmental exposures- before and early in the pandemic- that contribute to trajectories of risk and resilience (Aim 1). In addition, we will leverage the deep phenotyping that was conducted pre-COVID-19 to identify clinical and neurocognitive risk and resilience factors (Aim 2). Lastly, we will explore whether participants' genetic information (i.e., polygenic risk for psychiatric disorders) can help explain variability in mental health trajectories during the pandemic (Aim 3). The proposed research will identify what factors contribute to resilience (i.e., resilience factors); and who will show risk or resilience trajectory in response to chronic (pandemic-imposed) stress. The study addresses key gaps that are critical considering the expected chronic stress that is (and will likely keep being) imposed on youth due to the pandemic and other future adversities. Findings will improve risk stratification in youth exposed to chronic adversity and will identify targets for interventions aimed at enhancing resilience.

COVID-19 大流行对青少年生活的多个方面产生了重大影响，引起了人们的关注 其对青少年心理健康的影响。事实上，越来越多的数据表明，青少年的抑郁和焦虑率已经 与疫情前相比有所增加。一个关键的挑战是识别可以预测的未来预测因素 帮助识别在 COVID-19 后面临严重心理健康后遗症风险的青少年并理清这些因素 有助于形成弹性轨迹。复原力，通常被定义为适应性结果（即低症状 水平）在逆境之后，是由多个系统驱动的，包括个人和结构层面的环境 因素、神经认知特征和遗传因素。研究复原力的一种方法是确定个体之间的 大流行后心理健康轨迹的变化，并使用在大流行之前和之前前瞻性收集的数据 在大流行早期，更好地了解决定压力下心理健康轨迹变化的因素。 青少年大脑认知发展 (ABCD) 研究（N~12,000 人，52% 男性，招募年龄 9-10 岁） 年，20% 黑人）自 2017 年以来纵向追踪多元化的美国青少年。该研究收集了多维数据 大流行之前的（即环境、临床、神经认知、遗传）数据，参与者约为 12-13 流行病来袭时已经几岁了。 2020年5月至2021年6月期间，研究小组收集了心理数据 大约 9,500 名参与者在多个时间点的健康状况和与 COVID-19 相关的暴露情况，并将继续 跟踪参与者进入青春期后期。因此，ABCD 研究创造了一个独特的机会 理清在青春期早期中期青少年中前瞻性收集的风险和复原力因素 当大流行来袭时，这是与压力相关的疾病变得更加普遍的关键发育窗口。 在当前项目中，我们建议利用多维 ABCD 研究数据来确定影响因素 导致 COVID-19 大流行期间美国青少年心理健康轨迹的变化。我们将首先使用 潜在生长混合模型，用于识别内化症状随时间变化的轨迹。此后，我们将 描述个体压力源和结构性（基于地理编码地址）环境暴露的特征- 在大流行之前和早期——这有助于确定风险和复原力的轨迹（目标 1）。此外，我们将 利用在 COVID-19 之前进行的深度表型分析来识别临床和神经认知风险， 弹性因素（目标 2）。最后，我们将探讨参与者的遗传信息（即多基因风险）是否 精神疾病）可以帮助解释大流行期间心理健康轨迹的变化（目标 3）。这 拟议的研究将确定哪些因素有助于恢复力（即恢复力因素）；谁将展示 应对慢性（流行病造成的）压力的风险或恢复轨迹。该研究解决了关键差距 考虑到预期的长期压力（并且可能会继续）施加给年轻人，这是至关重要的 应对大流行和其他未来的逆境。研究结果将改善暴露于慢性病的青少年的风险分层 逆境，并将确定旨在增强复原力的干预措施目标。