The Role of Sleep in the Relationships Among Adverse Childhood Experiences, Mental Health Symptoms, and Persistent/Recurrent Pain during Adolescence

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PROJECT SUMMARY The goal of this fellowship is to prepare the applicant, Thea Senger-Carpenter, as a nurse-scientist studying relationships among adolescent sleep, adverse childhood experiences (ACEs), and associated symptoms and outcomes. To that end, the proposed fellowship consists of two complementary components: (1) a training plan comprising formal training, mentorship, hands-on research, manuscript publication, and professional development activities and (2) a research project that will further our understanding of how sleep affects the relationships among ACEs, mental health symptoms and persistent or recurrent pain (PRP) during adolescence. The applicant will be supported by a strong mentorship team with sponsors at the University of Michigan School of Nursing and Yale School of Nursing. Together, the mentorship team provides expertise in adolescent sleep, pain and associated symptoms, and ACE exposure. The training program will help the applicant develop: a) expertise in adolescent sleep, PRP, and the sequelae of ACE exposure, b) methodological skills in longitudinal, multivariate data analysis and c) engage in the dissemination of research findings and professional networking activities. Sleep deficiency affects up to two-thirds of American adolescents and is a risk factor for PRP, anxiety, and depression. ACE exposure is similarly prevalent, affecting around half of U.S. teens, and has been associated with both PRP and mental health symptoms. Importantly, sleep deficiency may moderate the effect of ACE exposure on other health outcomes. However, little is known about how sleep deficiency impacts the relationships among ACE exposure, mental health symptoms, and PRP across adolescence nor how these relationships differ by race, ethnicity, socioeconomic status (SES), and sex. Thus, the aims of the proposed project are 1) to determine whether and how sleep deficiency moderates the indirect effect of ACEs on PRP through mental health symptoms and 2) to describe how these relationships differ by race, ethnicity, SES, and sex. All aims will be investigated using the Adolescent Brain Cognitive Development Study, an ongoing NIH- funded longitudinal study of youth development in the United States. This proposed project integrates the research lenses of health equity and population and community health outlined in the National Institute of Nursing Research's strategic plan. By identifying sleep as a modifiable target for intervention, our findings have the potential to reduce the symptom burden of adolescents exposed to ACEs and mitigate racial, ethnic, socioeconomic, and sex-based inequities in health outcomes.