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The Intergenerational Transmission of Trauma from Terror: A Developmental Perspec

恐怖创伤的代际传递：发展视角

基本信息

批准号：
8101835
负责人：
STEPHEN V FARAONE
金额：
$ 34.21万
依托单位：
UPSTATE MEDICAL UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-11-01 至 2013-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8101835
关键词：
Accounting Address Affect African American Behavioral Biological Birth Birth Weight Candidate Disease Gene Chronic Cities Communities Developed Countries Development Discipline of obstetrics Environment Environmental Risk Factor Ethics Etiology Event Exposure to Family Fetal Development Fetal Growth Fetus Genes Genetic Genetic Risk Genetic Variation Genotype Gestational Age Goals Head circumference Health Health behavior Heart Rate Home environment Individual Differences Israel Laboratories Life Measures Mothers NIH Program Announcements National Institute of Mental Health Neonatal Neurosecretory Systems Not Hispanic or Latino Outcome Outcome Measure Persons Physiology Post-Traumatic Stress Disorders Pregnant Women Premature Birth Process Property Psychopathology Psychosocial Stress Public Health Regulation Reproductive Health Risk Risk Factors Sampling Shelter facility Stress Symptoms Testing Time Trauma Variant Violence War Woman Work base cohort experience fetal gene environment interaction indexing infant outcome intergenerational limb movement maternal depression meetings neurodevelopment offspring psychosocial public health relevance stressor transmission process

项目摘要

DESCRIPTION (provided by applicant): The proposed work addresses a key goal of NIMH Program Announcement PA-07-312, which seeks to enhance scientific understanding about the etiology of psychopathology related to violence and trauma". The almost 4000 missiles that fell within Northern Israel in the summer of 2006, the damage suffered by property and persons, and the confinement of many families in bomb shelters during the terror period created a unique 'naturalistic' laboratory for assessing the effects of PTSD caused by exposure to a circumscribed period of terror. Within this context, we will examine the health and behavior of fetuses and birth parameters of pregnant women who were residents of the North at the time of the war and test for gene and environmental moderation of fetal and birth measures. We will study two groups: (1) 150 women who are residents of cities attacked during the "war" and who meet full criteria for posttraumatic stress disorder (PTSD) as a result of their exposure to attacks, and (2) 150 women from the same cohort, who show no symptoms of PTSD. The study will be the first study to examine fetal health and behavior in pregnant women with PTSD and the first study to test for gene-based vulnerabilities and Gene x Environment on these measures. The study speaks to the impact of terror induced PTSD on fetal development, the potential transmission of biological events associated with PTSD from mother to fetus, and environmental and genetic factors that may exacerbate fetal risk. The specific aims of the study are: Aim 1. Fetal health and behavior will be adversely affected by maternal PTSD. Hypothesis 1 asserts that fetuses of mothers exposed to terror and suffer from PTSD will show signs of poorer health (stunted fetal growth measures, atypical reactivity and regulation of heart rate and torso/limb movement to challenge, and complications) and poorer birth/neonatal parameters (birth weight, head circumference, gestational age at delivery, and complications) than women who were exposed to terror, but who do not develop PTSD. We also predict an association between posttraumatic stress symptoms and outcome measures, across the sample. Aim 2. Psychosocial stresses and maternal depression predict fetal health, behavior, and stress reactivity and regulation. Hypothesis 2 posits that, among women with PTSD, psychosocial stressors (life events, chronic stressors) and maternal depression will add significant risk to their fetus. Hypothesis 3 predicts that, in the full sample, psychosocial stress and maternal depression will moderate the effects of maternal PTSD. Aim 3. Analyses of candidate gene associations with fetal/neonatal outcomes. We will evaluate the association between offspring's genotype (indexed by a battery of candidate genes) and fetal/neonatal outcomes. Hypothesis 4 predicts that variants of these genes will have main effects on infant outcomes. Hypothesis 5 predicts we will find gene-environment interactions as follows: a) risk variants implicated in hypothesis 4 will moderate the impact that mothers' PTSD and mother's psychosocial stress each have on fetal/neonatal outcomes (i.e., we expect to observe gene-environment interactions). PUBLIC HEALTH RELEVANCE PARAGRAPH: The violence outside the home, as experienced in some US communities (sporadic and frequent) can affect anyone near by. Information regarding the relation between exposure to violence and PTSD on fetal development and birth outcome is important for understanding the processes that can promote developmental risk in communities with such violence. In this regard, the distribution of adverse reproductive health outcomes in the US and other developed nations is characterized by large racial/ethic disparities (Anachebe 2003). In the US, an almost two-fold disparity persists in the rate of premature birth between African American and non-Hispanic White women, even after accounting for obstetric, socio demographic, and behavioral risk factors (Collins & Hammond 1996; MacDorman et al 2002); and it has been suggested that differences in risk may be related to variations in stress and stress physiology (Wadwa et al 2001). The results of the proposed study, which examines genetic and environmental risk in relation to fetal health, can further understanding of individual differences in psycho- neuroendocrine processes that underlie or contribute to the risk of pre maturity and adverse neurodevelopment, and both represent major public health issues in the US.

描述（由申请人提供）：拟议的工作解决了NIMH计划公告PA-07-312的一个关键目标，该目标旨在加强对与暴力和创伤有关的精神病理学病因学的科学理解。2006年夏天，近4000枚导弹落在以色列北方，财产和人员遭受损失，许多家庭在恐怖时期被限制在防空洞里，这创造了一个独特的“自然主义”实验室，用于评估暴露于有限的恐怖时期所造成的创伤后应激障碍的影响。在此背景下，我们将研究胎儿的健康和行为以及战争期间居住在北方的孕妇的出生参数，并测试胎儿和出生措施的基因和环境调节。我们将研究两组：（1）150名妇女，她们是“战争”期间受到袭击的城市居民，由于受到袭击，她们符合创伤后应激障碍（PTSD）的全部标准;（2）来自同一队列的150名妇女，她们没有表现出PTSD的症状。这项研究将是第一项研究，以检查胎儿的健康和行为的孕妇与创伤后应激障碍和第一项研究，以测试基于基因的脆弱性和基因x环境对这些措施。该研究谈到了恐怖诱导的PTSD对胎儿发育的影响，与PTSD相关的生物事件从母亲到胎儿的潜在传播，以及可能加剧胎儿风险的环境和遗传因素。研究的具体目标是：目标1。胎儿的健康和行为将受到母亲PTSD的不利影响。假设1断言，与暴露于恐怖但未发展为PTSD的妇女相比，暴露于恐怖并患有PTSD的母亲的胎儿将显示出更差的健康迹象（发育不良的胎儿生长措施，心率和躯干/肢体运动的非典型反应和调节，以及并发症）和更差的出生/新生儿参数（出生体重，头围，分娩时的胎龄和并发症）。我们还预测了样本中创伤后应激症状和结果测量之间的关联。目标2.社会心理压力和母亲抑郁症可预测胎儿健康、行为、压力反应和调节。假设2假定，在患有PTSD的女性中，心理社会压力源（生活事件，慢性压力源）和母亲抑郁会增加胎儿的风险。假设3预测，在整个样本中，心理社会压力和母亲抑郁会缓和母亲创伤后应激障碍的影响。目标3.候选基因与胎儿/新生儿结局相关性的分析我们将评估后代的基因型（由一组候选基因索引）和胎儿/新生儿结局之间的关联。假设4预测这些基因的变异将对婴儿的结局产生主要影响。假设5预测我们将发现基因-环境相互作用如下：a）假设4中涉及的风险变体将缓和母亲的创伤后应激障碍和母亲的心理社会压力各自对胎儿/新生儿结局的影响（即，我们期望观察基因-环境相互作用）。公共卫生相关段落：家庭外的暴力，正如美国一些社区所经历的那样（零星和频繁），可以影响附近的任何人。关于暴露于暴力和创伤后应激障碍对胎儿发育和出生结果之间的关系的信息是很重要的，了解的过程，可以促进发展风险的社区与这种暴力。在这方面，美国和其他发达国家不良生殖健康结果的分布特点是种族/民族差异很大（Anachebe 2003）。在美国，非裔美国人和非西班牙裔白色女性之间的早产率仍然存在几乎两倍的差异，即使在考虑了产科、社会人口统计学和行为风险因素后也是如此（柯林斯和哈蒙德，1996年; MacDorman等人，2002年）;并且已经表明风险差异可能与压力和压力生理学的变化有关（Wadwa等人，2001年）。拟议研究的结果检查了与胎儿健康有关的遗传和环境风险，可以进一步了解心理神经内分泌过程的个体差异，这些差异是早产和不良神经发育风险的基础或原因，两者都代表了美国的主要公共卫生问题。