Childhood socioeconomic disadvantage, cumulative Adverse Childhood Experiences, and adolescent depression and anxiety symptoms

项目概要/摘要。 累积不良童年经历（ACE）和儿童社会经济劣势（SED） 都被认为是青少年心理健康状况不佳的主要原因， 彼此之间。然而，关于累积ACE和儿童SED如何共同作用， 影响青少年心理健康，导致儿童逆境研究人员之间的分歧。没有 更清楚地了解这种复杂的关系，我们可能会忽视在很大程度上有影响力的社会因素， 影响青少年的健康和福祉，我们为解决目前的青少年心理健康危机所做的努力将 受到阻碍。 这个Ruth L的目的。Kirschstein国家研究服务奖（NRSA）个人 护理研究博士奖学金（F31）申请是为了准备申请人的职业生涯， 独立调查员专注于扩大我们对社会风险因素的集体知识， 与童年逆境和青少年心理健康有关的初级预防战略。拟议 奖学金包括两个相辅相成的组成部分：1）培训计划，旨在发展申请人的 方法熟练程度，实质性的专业知识和角色实现; 2）一个研究项目，将进一步我们的 了解儿童SED、ACE暴露和青少年抑郁症之间的关系， 焦虑一个强大的导师团队，包括来自密歇根大学的赞助商和合作者， 护理，公共卫生和社会工作学院，以及UM贫困解决方案的顾问， 公共政策学院将提供儿童逆境/创伤，儿童贫困， 青年心理健康、政策宣传、干预措施的实施和先进的统计技术。 拟议的研究项目将利用收集的数据作为大型，多样化，纵向 脆弱家庭和儿童福利研究从出生到15岁。具体目标是：（a）调查 儿童早期ACE暴露的不同特征以及儿童SED如何预测 1b）检查不同ACE谱与青少年抑郁症之间的关联， 焦虑，以及儿童SED是否调节这些关联;和2）调查ACE谱的转变 成员在幼儿期，如何童年SED影响个人资料的转变，以及如何过渡， 与心理健康有关。将进行额外的探索性分析，以评估 健康的其他社会决定因素，包括种族/族裔和生理性别。 这项研究通过研究解决健康公平问题，与NINR的最新战略计划保持一致 健康和福祉的关键社会决定因素。这项研究的结果对于塑造未来至关重要。 政策和研究议程，稀缺资源的分配，以及更好地确定 临床环境中，在更大的风险，为精神健康状况不佳。

Project Summary/Abstract. Cumulative Adverse Childhood Experiences (ACEs) and childhood socioeconomic disadvantage (SED) have each been identified as major contributors to poor adolescent mental health and have been associated with one another. However, less is known about how cumulative ACEs and childhood SED operate together to influence adolescent mental health, resulting in disagreement among childhood adversity researchers. Without a clearer understanding of this complex relationship, we risk overlooking largely impactful social factors that influence adolescent health and well-being and our efforts to address the current youth mental health crisis will be hindered. The purpose of this Ruth L. Kirschstein National Research Service Award (NRSA) Individual Pre- Doctoral Fellowship in Nursing Research (F31) application is to prepare the applicant for a career as an independent investigator focused on expanding our collective knowledge of social risk factors and informing primary prevention strategies related to childhood adversity and adolescent mental health. The proposed fellowship consists of two complementary components: 1) a training plan aimed at developing the applicant’s methods proficiency, substantive expertise, and role attainment; and 2) a research project that will further our understanding of the relationship between childhood SED, ACE exposure, and adolescent depression and anxiety. A strong mentorship team that includes sponsors and collaborators from the University of Michigan’s Schools of Nursing, Public Health, and Social Work, as well as consultants from UM’s Poverty Solutions and School of Public Policy will provide interdisciplinary expertise in childhood adversity/trauma, child poverty, youth mental health, policy advocacy, intervention implementation, and advanced statistical techniques. The proposed research project will utilize data collected as part of the large, diverse, longitudinal Fragile Families and Child Wellbeing Study from birth through age 15. The specific aims are to: 1a) Investigate for the presence of distinct profiles of ACE exposure during early childhood and how childhood SED predicts profile membership; 1b) Examine the association between distinct ACE profiles and adolescent depression and anxiety, and if childhood SED moderates these associations; and 2) Investigate for transitions in ACE profile membership during early childhood, how childhood SED influences profile transitions, and how transitions are associated with mental health. Additional exploratory analyses will be conducted to assess the influence of additional social determinants of health, including race/ethnicity and biological sex. This study aligns with the NINR’s updated strategic plan by addressing health equity through the study of key social determinants of health and well-being. Findings from this study are critical for shaping future policy and research agendas, the allocation of scarce resources, and better identifying subpopulations in the clinical setting that are at greater risk for poor mental health.