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

新冠肺炎疫情对年轻人生活的多个方面产生了实质性影响，引发了人们对 它对青少年心理健康的影响。事实上，越来越多的数据表明，年轻人的抑郁症和焦虑率 与大流行前相比有所增加。一个关键的挑战是认识到能够 帮助识别新冠肺炎引发严重心理健康后遗症的高危青少年，并理清相关因素 这有助于形成有弹性的轨迹。恢复力，通常被定义为适应性结果(即低症状 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。研究韧性的一种方法是确定个体间的 在大流行后精神健康轨迹的变化，并使用在此之前和 在大流行的早期，以更好地了解是什么决定了压力下心理健康轨迹的变异性。 青少年脑认知发展(ABCD)研究(N~12,000，52%男性，9-10岁招募 自2017年以来，(20%是黑人)纵向跟踪了不同的美国年轻人。这项研究收集了多个维度 (即，大流行前的环境、临床、神经认知、遗传)数据，参与者为12-13人 当大流行来袭时，他已经六岁了。从2020年5月到2021年6月，研究小组收集了有关心理健康的数据 约9,500名参与者在多个时间点接触健康和新冠肺炎相关风险，并将继续 跟踪参与者进入青春期晚期。因此，zu chu学习创造了一个独特的机会 对青春期早期和中期青年前瞻性收集的风险和复原力因素进行分析 当大流行来袭时，当压力相关的疾病变得更加普遍时，这是一个关键的发展窗口。 在当前项目中，我们建议利用多维ABCD研究数据来确定 在新冠肺炎大流行期间，导致美国青年心理健康轨迹的变异性。我们将首先使用 潜伏生长混合模型，以确定随时间内化症状的轨迹。此后，我们将 确定个人应激源和结构性(基于地理编码地址)环境暴露的特征- 在大流行之前和早期--这有助于风险和复原力的轨迹(目标1)。此外，我们还将 利用新冠肺炎前进行的深度表型分析来识别临床和神经认知风险，并 复原力因素(目标2)。最后，我们将探讨参与者的遗传信息(即，多基因风险 精神障碍)有助于解释大流行期间精神健康轨迹的变异性(目标3)。这个 拟议的研究将确定哪些因素对复原力有贡献(即复原力因素)；以及谁将显示 应对慢性(大流行)压力的风险或复原力轨迹。这项研究解决了主要差距 考虑到对年轻人施加的预期慢性压力(并可能继续)，这是至关重要的 与大流行和其他未来的逆境有关。研究结果将改善暴露于慢性疾病的年轻人的风险分层 它还将确定旨在提高复原力的干预措施的目标。

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.