Preventing Adult Mental Health Problems from Early Childhood in the Contexts of Genetic Susceptibility, Poverty, Racism, and the COVID-19 Pandemic

在遗传易感性、贫困、种族主义和 COVID-19 大流行的背景下，从幼儿期预防成人心理健康问题

• 批准号: 10566839
• 负责人: Jazmin Brown-Iannuzzi
• 金额: $ 80.02万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10566839
• 关键词: 2019-nCoV; Adolescence; Adult; Age; American; Anxiety; Attention; Behavioral; Buffers; COVID-19; COVID-19 pandemic; Characteristics; Child; Communities; Data; Data Set; Deterioration; Development; Disease; Early Intervention; Ecology; Economics; Emotional; Environmental Risk Factor; Ethnic Origin; Ethnic Population; Exposure to; Family; Future; Gender Identity; Genetic; Genetic Predisposition to Disease; Genetic Risk; Genotype; Geographic Locations; Geography; Glean; High Prevalence; Home; Individual; Inequality; Infant; Informal Social Control; Institutional Racism; Intervention; Interview; Link; Long-Term Effects; Longitudinal Studies; Mediating; Mental Depression; Mental Health; Minority Groups; Neighborhoods; Outcome; Parents; Participant; Poverty; Predictive Factor; Prevention; Prevention trial; Preventive; Problem behavior; Psychoses; Public Health; Race; Randomized; Reporting; Research; Risk; Risk Factors; Rural; Sampling; Shock; Site; Social Identification; Social isolation; Socialization; Societies; Suicide; Support System; Surveys; Symptoms; Testing; Time; United States; Vocation; Woman; age group; biological sex; caucasian American; checkup examination; clinical diagnostics; coping; design; dietary supplements; early childhood; emerging adult; emerging adulthood; ethnic disparity; ethnic diversity; ethnic identity; ethnic minority; experience; genetic testing; health assessment; health inequalities; higher education; intervention effect; lower income families; pandemic disease; pandemic potential; pandemic stress; perceived discrimination; physical conditioning; polygenic risk score; pre-pandemic; prevent; prospective; protective effect; protective factors; racial discrimination; racial disparity; racial diversity; racial minority; racial population; racism; recruit; resilience; resilience factor; risk mitigation; social culture; social determinants; social factors; sociocultural determinant; sociodemographics; socioeconomics; stressor; suburb; suicidal; young adult

ABSTRACT As Americans enter the third year of the COVID-19 pandemic, we are also in a mental health crisis. Emerging adults in particular are experiencing a high prevalence of anxiety, depression, suicidality, and psychosis compared to pre-pandemic levels. A slowed economy, increased social isolation, loss of typical support systems, and financial instability abruptly hit just as emerging adults were transitioning from adolescence to adulthood, potentially disrupting typical milestones such as leaving home, pursuing higher education, starting vocations, and becoming financially independent. The pandemic has also underscored persistent health inequalities that exist between White Americans and racial/ethnic minorities, due at least in part to experiences of discrimination. Living in poverty is an additional risk factor for mental health problems, and is a vastly different experience for White and minoritized individuals due to environmental and social factors afforded to different racial/ethnic groups. In addition, neighborhood characteristics and community type (i.e., rural, urban) can intersect with racial/ethnic identity to increase risk or offer protection from mental health problems. The genetically-informative Early Steps Multisite (ESM) study of 731 racially/ethnically diverse low-income families presents a unique opportunity to examine how a sample of at-risk emerging adults, prospectively followed since age two and now in their early twenties, are coping within the context of the pandemic. The ESM sample was recruited at Women, Infant, and Children centers in three geographically, socioeconomically, and racially/ethnically diverse communities: Eugene, OR; Pittsburgh, PA; and Charlottesville, VA. Participating families were randomly assigned to receive the Family Check-Up (FCU) intervention annually from child age 2 to 10.5, or to participate in study assessments without intervention. Assessments continued at child ages 14, 16, and 19, including two pandemic-related surveys focused on mental health, and participant genotyping. Recruited from diverse sites, the ESM can examine community- and neighborhood-level effects on mental health risk and resilience. Continuing this longitudinal study, we will assess participants at ages 22 and 24, including a clinical diagnostic interview of depression, anxiety, and psychosis. With a wealth of prospective data on neighborhood risk, experiences of discrimination, and mental health, we propose to examine direct, interactive, and cascading effects on mental health outcomes. Our first aim is to investigate whether race/ethnicity and discriminatory experiences shift the developmental trajectories of mental health, and whether protective ecological factors mitigate these risks. Our second aim is to test genetic moderation of risk and resilience on emerging adult mental health. Our third aim is to examine the long-term preventive effects of the FCU on mental health, in the context of growing up in poverty, and, more recently, the pandemic, while focusing on who is able to glean the largest benefit from this intervention. Following this emerging adult sample would provide unique data on the persistence of intervention effects on mental health during the transition to adulthood in the context of a pandemic.

摘要 随着美国人进入新冠肺炎疫情的第三个年头，我们也陷入了心理健康危机。新兴 尤其是成年人，焦虑、抑郁、自杀和精神病的发病率很高。 与大流行前的水平相比。经济放缓，社会孤立加剧，失去典型的支持系统， 就在新兴成年人从青春期过渡到成年期之际，金融不稳定突然袭来， 潜在地破坏了典型的里程碑，如离家、接受高等教育、开始职业生涯、 并在经济上变得独立。这场大流行还突显了持续存在的健康不平等， 美国白人和种族/族裔少数群体之间存在歧视，至少部分是由于受到歧视的经历。 生活在贫困中是精神健康问题的另一个风险因素，对于 由于不同种族/民族的环境和社会因素造成的白人和少数族裔个人 组。此外，社区特征和社区类型(即农村、城市)可以与 种族/民族认同，以增加风险或提供保护，免受心理健康问题的影响。基因信息量大的 早期步骤多地点(ESM)对731个种族/民族多样化的低收入家庭的研究呈现了一个独特的 有机会研究从两岁起到现在，有风险的新兴成年人样本是如何进行跟踪的 20岁出头的人正在应对大流行的背景下。ESM样本是在女性中心招募的， 婴儿和儿童中心位于三个地理、社会经济和种族/民族多元化的地区 社区：俄勒冈州尤金、宾夕法尼亚州匹兹堡和弗吉尼亚州夏洛茨维尔。参与的家庭是随机的 被分配从2岁到10.5岁的儿童每年接受家庭检查(FCU)干预，或参与 在没有干预的情况下进行研究评估。评估继续在14岁、16岁和19岁的儿童进行，其中包括两个 与大流行相关的调查重点是精神健康和参与者的基因分型。从不同的网站招募， ESM可以检查社区和社区层面对心理健康风险和韧性的影响。 继续这项纵向研究，我们将评估22岁和24岁的参与者，包括临床诊断 关于抑郁、焦虑和精神病的访谈。有了大量关于邻里风险的预期数据， 歧视的经历和心理健康，我们建议考察直接、互动和级联 对心理健康结果的影响。我们的第一个目标是调查种族/民族和歧视 经验改变了心理健康的发展轨迹，以及保护性生态因素 缓解这些风险。我们的第二个目标是测试风险和恢复力的遗传适度性对新出现的成年人心理的影响 健康。我们的第三个目标是检查FCU对精神健康的长期预防效果，在 在贫穷中长大，以及最近的大流行，同时关注谁能够收集到最大的 从这种干预中受益。跟踪这个新出现的成人样本将提供关于持久性的独特数据 在大流行的背景下，在向成年期过渡期间，干预对心理健康的影响。