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

项目摘要 暴露在创伤中的青少年面临着一系列有害后果的风险，特别是对压力敏感 如急性应激障碍(ASD)、创伤后应激障碍(PTSD)、抑郁、焦虑和 物质使用障碍。理论和现有证据指出两个特别重要的影响 创伤后应激障碍的发展：(1)个体应激反应(特别是心率(HR)、皮肤电导(SC))和 (2)社会背景(面对面和通过在线社交网络(OSN)进行的互动)。鉴于之前 研究广泛地指向自我报告的社会背景或生物标记物的单一测量，目前 调查使用自然生态抽样方法，允许对社会进行更客观的编码 行为和背景，并使用连续的生物测定采样来允许对耦合的个体进行建模 压力反应和社会背景。目前的调查，翻译为干预的含义，将 纵向模拟早期生物标志物与影响症状的社会背景的相互作用过程 200名创伤暴露青少年(13-17岁)的发育。青年将立即入院招募 在对创伤(即身体攻击、严重车祸)进行医学评估后，足够的生命 威胁要激活创伤小组。他们将被要求佩戴：(I)腕带健康跟踪器，用于 两周；(Ii)耳朵，持续两周(后来根据社会环境、互动、情感、内容进行编码)。在2：00- 一周的后续行动，青年将：(I)允许通过两周的后续行动下载创伤前2周的OSN； (Ii)参加半结构化临床访谈，以评估应激敏感障碍的症状；及(Iii) 开发了完整的实验室程序来表征对压力至关重要的社会和生物过程- 敏感型障碍。在创伤后6周、6个月和9个月，年轻人将下载发生在 两周前以及完成(一)实验室程序，(二)半结构化诊断性面谈 应激敏感障碍和(Iii)社会背景的自我报告测量。目前的调查将提供 创伤后个体间和个体内预测因素和相关性的丰富的临床相关特征 调整。

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.