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大流行在生活的多个方面对青年产生了重大影响，引起了人们对以下问题的关注： 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前瞻性的预测因素， 帮助识别2019冠状病毒病后有严重精神健康后遗症风险的青少年，并理清各种因素 有助于形成弹性轨迹。复原力，通常被定义为一种适应性结果（即，低症状 在逆境之后，由多个系统驱动，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。研究弹性的一种方法是识别个体间的 流行病后心理健康轨迹的变化，并使用流行病前和流行病后前瞻性收集的数据， 在大流行病早期，更好地了解是什么决定了压力下心理健康轨迹的可变性。 青少年大脑认知发展（ABCD）研究（N~ 12，000，52%男性，招募年龄为9-10岁 自2017年以来，20%的黑人）纵向跟踪了不同的美国青年。该研究收集了多方面的 (i.e.,环境，临床，神经认知，遗传）数据，参与者约为12-13 10岁的时候流行病爆发了。在2020年5月至2021年6月期间，研究小组收集了有关精神疾病的数据， 健康和COVID-19相关暴露在多个时间点从约9，500名参与者，并将继续 跟踪参与者到青春期后期。因此，ABCD研究创造了一个独特的机会， 在青少年早期和中期前瞻性收集的风险和弹性因素 当大流行病来袭时，这是一个关键的发展窗口，与压力有关的疾病变得更加普遍。 在目前的项目中，我们建议利用多维ABCD研究数据来确定 在COVID-19大流行期间，导致美国青年心理健康轨迹的变化。我们将首先使用 潜在的增长混合建模，以确定随着时间的推移内化症状的轨迹。此后，我们将 描述个人压力源和结构性（基于地理编码地址）环境暴露- 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，我们将 利用COVID-19前进行的深度表型分析来识别临床和神经认知风险， 弹性系数（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）。的 拟议的研究将确定哪些因素有助于恢复力（即，弹性因素）;以及谁将显示 应对慢性（流行病造成的）压力的风险或复原力轨迹。该研究报告述及关键差距 考虑到预期的长期压力（并可能继续）强加给年轻人， 应对大流行病和其他未来逆境。研究结果将改善暴露于慢性 将确定旨在加强复原力的干预措施的目标。