An Affective Intervention to Reverse the Biological Residue of Low Childhood SES

扭转儿童社会经济地位低下生物残留的情感干预

• 批准号: 8796508
• 负责人: BARBARA LEE FREDRICKSON
• 金额: $ 17.33万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-30 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8796508
• 关键词: Accounting; Adult; Affect; Affective; Aging; American; Arthritis; Attention; Behavioral; Biological; C-reactive protein; Cardiac; Cardiovascular Diseases; Childhood; Chronic; Chronic Disease; Chronic stress; Communicable Diseases; Disadvantaged; Educational process of instructing; Effectiveness; Elderly; Emotional; Environment; Evidence based intervention; Experimental Designs; Future; Gene Expression; Genes; Goals; Health; Household; Immune system; Impulsivity; Individual; Inflammation; Inflammatory; Intervention; Learning; Length; Leukocytes; Life; Life Style; Love; Malignant Neoplasms; Mediator of activation protein; Meditation; Mental Depression; Mental Health; Metabolic; Molecular Profiling; Outcome; Participant; Pathway interactions; Placebo Control; Population; Positioning Attribute; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Risk; Risk Factors; Sampling; Socioeconomic Status; Testing; Time; Up-Regulation; Ursidae Family; Viral Antibodies; Work; base; biobehavior; blind; burden of illness; cardiovascular disorder risk; design; discounting; experience; gene repression; immune activation; improved; inclusion criteria; indexing; innovation; low socioeconomic status; meetings; middle age; mindfulness meditation; mortality; novel; physical conditioning; positive emotional state; psychologic; public health relevance; skills; socioeconomics; telomere; theories

 DESCRIPTION (provided by applicant): Individuals raised in low socioeconomic (SES) households have been found to bear 20%-40% increased risk of costly chronic and infectious diseases and all-cause mortality, even after accounting for adulthood SES. Illuminating the biological mechanisms of these health risks, recent research has determined that severe and chronic stress endured early in life can embed a decades-long "biological residue" within the immune system, as reflected in leukocyte basal gene expression profiles, leukocyte telomere length, and levels of chronic inflammation indexed by C-reactive protein. These biological risk factors are further exacerbated by behavioral proclivities, namely, impulsivity (indexed by delay discounting) and mistrust, which are also more probable among those reared in low SES households. The overarching goal of the proposed research is to investigate whether and how this identified biological residue can be reversed in midlife. An innovative upward spiral theory o lifestyle change positions warm and empathic emotional states as key pathways to unlocking the body's inherent plasticity to reverse entrenched biological risk factors. The PI's team has identified an affective intervention - the ancient practice of loving-kindness meditation (LKM) - that produces salubrious biological effects in healthy midlife adults. The innovation of the present study lies in testing this affective intervention in a sample of midlife adults on poor health trajectories by virtue of having low childhood SES plus present-day pathogenic behavioral tendencies (i.e., impulsivity and mistrust). A dual-blind placebo-controlled randomized controlled trial (RCT) is designed to provide proof of principle that early-established biological risks factors are mutable, not permanent. It targets three Specific Aims: (1) To test whether LKM, through its effects on positive emotions, can reverse the biological residue of low childhood SES as reflected in (a) leukocyte basal gene expression (up-regulation of pro-inflammatory genes and down-regulation of antiviral and antibody genes), (b) leukocyte telomere length, and (c) C-reactive protein; (2) to identify plausible behavioral and biological moderators of the hypothesized benefits of LKM in this at-risk sample, with candidate moderators being (a) time spent meditating and (b) metabolic profile; and (3) to identify plausible biological, behavioral, and psychological mediators of the hypothesized biological benefits of LKM-induced positive emotions in this at-risk sample, with candidate mediators being improvements in (a) cardiac vagal tone, (b) delay discounting, and (c) mistrust. This research stands to identify evidence-based interventions to drastically reduce the disease burden that disproportionately affects Americans raised in low SES households.

 描述（由申请人提供）：研究发现，即使在考虑了成年社会经济地位 (SES) 后，在低社会经济 (SES) 家庭中长大的个人患昂贵的慢性病和传染病以及全因死亡率的风险也会增加 20%-40%。最近的研究阐明了这些健康风险的生物学机制，确定生命早期承受的严重和慢性压力可能会在免疫系统中嵌入长达数十年的“生物残留物”，这反映在白细胞基础基因表达谱、白细胞端粒长度和以 C 反应蛋白为索引的慢性炎症水平中。这些生物风险因素因行为倾向而进一步加剧，即冲动（以延迟贴现为指标）和不信任，这些行为在社会经济地位较低的家庭中长大的人也更容易出现。拟议研究的总体目标是调查这种已识别的生物残留物是否以及如何在中年时期被逆转。生活方式改变的创新螺旋上升理论将温暖和同理心的情绪状态视为释放身体固有可塑性以扭转根深蒂固的生物风险因素的关键途径。 PI 的团队已经确定了一种情感干预——古老的慈爱冥想 (LKM) 实践——可以对健康的中年成年人产生有益的生物效应。本研究的创新之处在于，在健康状况不佳的中年成年人样本中测试这种情感干预，这些中年成年人的童年社会经济地位较低，加上目前的致病行为倾向（即冲动和不信任）。双盲安慰剂对照随机对照试验 (RCT) 旨在提供原理证明，证明早期确定的生物风险因素是可变的，而不是永久性的。它针对三个具体目标：(1) 测试 LKM 是否可以通过其对积极情绪的影响，逆转儿童社会经济地位低下的生物残留，如 (a) 白细胞基础基因表达（促炎基因上调以及抗病毒和抗体基因下调）、(b) 白细胞端粒长度和 (c) C 反应蛋白所反映； (2) 在此风险样本中确定 LKM 假设益处的合理行为和生物调节因素，候选调节因素是 (a) 冥想时间和 (b) 代谢状况； (3) 确定该高危样本中 LKM 诱导的积极情绪的假设生物益处的合理的生物、行为和心理中介因素，候选中介因素是 (a) 心脏迷走神经张力、(b) 延迟贴现和 (c) 不信任方面的改善。这项研究旨在确定基于证据的干预措施，以大幅减轻对低社会经济地位家庭长大的美国人的疾病负担。