Understanding the Interplay of Social Context and Physiology on Psychological Outcomes in Trauma-Exposed Adolescents

项目摘要 创伤暴露的青少年面临着许多有害后果的风险，特别是压力敏感性 例如急性应激障碍（ASD）、创伤后应激障碍（PTSD）、抑郁症、焦虑症和 物质使用障碍理论和现有的证据表明，两个特别重要的影响， PTSD的发展：（1）个体应激反应（特别是心率（HR），皮肤电导（SC））和 (2)社交环境（通过个人和在线社交网络（OSN）进行的互动）。而现有 研究广泛地指向自我报告的社会背景或生物标志物的单一测量， 调查使用自然生态抽样方法，允许更客观的编码的社会 行为和背景，并使用连续的生物统计采样，以允许耦合的个人建模 压力反应和社会背景。目前的调查，翻译干预的影响，将 纵向模拟生物标志物和社会背景影响症状的早期相互作用过程 在200创伤暴露青少年（13 - 17岁）的发展。将立即在医院招募青年 在对创伤性损伤进行医学评估（即，人身攻击、严重交通事故） 威胁要启动创伤小组他们将被要求佩戴：（i）腕带健康追踪器， 两周;（ii）两周的社交活动（后来按社会环境、互动、情感、内容进行编码）。下午2点- （i）允许从创伤前2周到2周随访期间下载OSN; (ii)参与半结构化临床访谈以评估应激敏感性障碍的症状，以及（iii） 开发了完整的实验室程序，以表征对压力至关重要的社会和生物过程- 敏感性疾病在创伤后6周、6个月和9个月，青少年将下载OSN， 2周前以及完成（i）实验室程序，（ii）半结构化诊断访谈， 压力敏感性障碍和（iii）社会背景的自我报告措施。目前的调查将提供 丰富的，临床相关的表征个体间和个体内的预测因子和相关的创伤后 加强结构性改革

Project Summary Trauma-exposed adolescents are at risk for a host of deleterious outcomes, particularly stress sensitive disorders such as acute stress disorder (ASD), posttraumatic stress disorder (PTSD), depression, anxiety, and substance use disorders. Theory and available evidence point to two particularly important influences on the development of PTSD: (1) individual stress response (particularly heart rate (HR), skin conductance (SC)) and (2) social context (interactions occurring in person and through online social networking (OSN)). Whereas prior studies broadly point to self reported social context or single measurements of biomarkers, the present investigation uses naturalistic ecological sampling approaches that permit more objective coding of social behaviors and context and uses continuous biometrical sampling to permit the modeling of coupled individual stress responses and social context. The present investigation, translational in implications for intervention, will longitudinally model the course of early interplay of biomarkers and social context influencing symptom development in 200 trauma-exposed adolescents (13-17 years). Youth will be recruited in-hospital immediately after medical evaluation for traumatic injury (i.e., physical assault, serious vehicular accident) sufficiently life threatening to warrant trauma team activation. They will be asked to wear: (i) a wristband health tracker, for two weeks; (ii) the EAR, for two weeks (later coded for social environment, interaction, affect, content). At 2- week follow-up, youth will: (i) permit download of OSN from 2-weeks pre-trauma through the 2-week follow-up; (ii) participate in a semi-structured clinical interview to assess symptoms of stress-sensitive disorders, and (iii) complete laboratory procedures developed to characterize social and biological processes critical to stress- sensitive disorders. At 6-weeks, 6-months, and 9-months post-trauma, youth will download OSN occurring in the 2 weeks prior as well as complete (i) laboratory procedures, (ii) semi-structured diagnostic interviews of stress-sensitive disorders and (iii) self-report measures of social context. The present investigation will provide rich, clinically relevant characterization of the inter- and intra-individual predictors and correlates of post-trauma adjustment.