Cumulative environmental risk exposure in youth at clinical high-risk for psychosis

精神病临床高危青少年的累积环境风险暴露

• 批准号: 10254288
• 负责人: Teresa Vargas
• 金额: $ 3.83万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10254288
• 关键词: Adolescence; Affect; Area; Attenuated; Behavioral; Bypass; Censuses; Characteristics; Clinical; Computer software; Conflict (Psychology); Data; Development; Disease; Environmental Risk Factor; Etiology; Evaluation; Exhibits; Exposure to; Family Violence; Functional Imaging; Future; Health; Health Policy; Imaging technology; Incidence; Individual; Intervention; Interview; Life Style; Link; Literature; Measures; Modeling; Neighborhoods; Occupational; Onset of illness; Outcome; Participant; Pharmaceutical Preparations; Population; Prevention; Psychoses; Psychotic Disorders; Public Health; Regulation; Research Support; Resistance; Resources; Risk; Risk Factors; Role; Schools; Severities; Socioeconomic Status; Source; Stress; Structure; Substance abuse problem; Symptoms; System; Testing; Time; Victimization; Work; Youth; allostatic load; base; behavioral outcome; bullying; delivery complications; experience; follow up assessment; healthy volunteer; high risk; improved; interest; neural network; neurodevelopment; neuromechanism; novel; predictive modeling; prospective; relating to nervous system; social; social observations; stressor; violent crime; young adult

Project Summary Understanding the effects of environmental risk exposure on neural and behavioral development is essential for targeting intervention and prevention efforts in public health policy. This is especially the case for psychotic disorders, which have a 1% incidence in the population, and are highly debilitating and treatment resistant (1). However, current understanding of environmental influences in the clinical high-risk (CHR) period immediately leading up to psychotic disorder onset is limited (2). Specifically, neural mechanisms underlying the effects of cumulative environmental risk factor exposure are poorly understood. Importantly, (a) allostatic load and aggregate dysregulation models of stress exposure suggest there are strong benefits in studying cumulative risk, as different types of risk exposure may have similar developmental consequences (3, 4) and (b) cumulative models have been shown to be more powerful in addition to offering an increased prospective prediction advantage (3-5). Nonetheless, in regards to environmental risk exposure, the literature has often focused on a single predictor. Measuring the effects of multiple types of environmental risk exposure on neural and behavioral outcomes is essential for targeting intervention and prevention efforts, as well as for informing future allocation of treatment and prevention resources in this population. The current proposal will measure cumulative risk exposure in 50 CHR and 50 healthy volunteers at an individual and structural level, in addition to predicting candidate neural mechanisms, symptoms, and social/occupational functioning longitudinally. First, this study aims to determine whether CHR individuals experience greater exposure to cumulative environmental risk (Aim 1). Cumulative environmental risk will be measured at an individual and structural level with structured interviews, multiple rater systematic social observation (SSO) software (6-9) and geocoding of Census data. Then, the proposal will seek to determine whether cumulative environmental risk exposure differentially affects neural connectivity in regions implicated in stress and affect regulation in CHR and typically developing individuals, using structural and functional imaging technology (Aim 2). Finally, the proposed project will examine whether cumulative environmental risk models are associated with symptoms and functioning, and whether they predict the course of these features longitudinally in CHR individuals (Aim 3). Notably, exploratory analyses will be conducted to analyze whether exposure during different developmental periods differentially predicts neural connectivity in areas of interest. Exploratory analyses will also examine exposure to individual versus structural environmental risk factors separately with regards to group differences and neural connectivity.

项目摘要 了解环境风险暴露对神经和行为发育的影响， 这对于在公共卫生政策中有针对性地开展干预和预防工作至关重要。尤其如此 精神障碍，在人群中的发病率为1%，并且高度衰弱， 耐药（1）。然而，目前对临床高危期环境影响的认识 立即导致精神障碍发作的可能性有限（2）。具体来说， 人们对累积环境风险因素暴露的影响知之甚少。重要的是，（a）非稳态 压力暴露的负荷和总体失调模型表明，研究 累积风险，因为不同类型的风险暴露可能具有相似的发育后果（3，4）， (b)累积模型已被证明是更强大的，除了提供增加的前景， 预测优势（3 - 5）。尽管如此，关于环境风险暴露，文献往往 专注于一个单一的预测。测量多种类型的环境风险暴露对神经系统的影响 和行为结果对于有针对性的干预和预防工作以及告知 未来在这一人群中的治疗和预防资源分配。目前的提案将衡量 此外，在个人和结构水平上， 预测候选神经机制，症状，和社会/职业功能纵向。第一、 这项研究旨在确定是否有更多的人接触到累积的 环境风险（目标1）。累积环境风险将在个人和结构上进行衡量。 使用结构化访谈、多评分者系统社会观察（SSO）软件（6 - 9）和 人口普查数据的地理编码。然后，该建议将寻求确定是否累积环境风险 暴露对应激相关区域神经连接的影响不同，并影响神经元的调节。 并通常使用结构和功能成像技术（目标2）开发个人。最后 拟议的项目将研究累积环境风险模型是否与症状有关 和功能，以及他们是否预测这些功能的过程中纵向的个人（目的 3）。值得注意的是，将进行探索性分析，以分析不同时间段的暴露是否 发育时期差异预测感兴趣的区域的神经连接。探索性分析 还检查暴露于个人与结构性环境风险因素分别关于 群体差异和神经连接。