Prediction of Alcohol Use Disorder and PTSD After Trauma in Adolescents

项目总结 急性创伤，由DSM-5标准A定义，诊断创伤后应激障碍(PTSD)为 暴露在实际或威胁死亡、严重伤害或性暴力的环境中， 酒精使用障碍(AUD)和创伤后应激障碍的发展众所周知，创伤后应激障碍患者 患澳元缺乏症的风险明显增加。此外，了解澳元在开发过程中的风险， 尤其是在青少年中是至关重要的，因为早期饮酒是终生饮酒的最高风险因素之一 上瘾。这项目前的建议旨在进一步探讨青少年的AUD和PTSD之间的关系 通过关注AUD和/或创伤后应激障碍发展的生物学预测因素，暴露于急性创伤。简而言之，500 青少年在创伤后立即在急诊科、医院诊所或 德克萨斯州奥斯汀(戴尔儿童医疗中心)和德克萨斯州加尔维斯顿(德克萨斯大学)的精神病学环境 德克萨斯州医学部(UTMB)附属医院)。使用新兴的统计技术和机器 基于学习的分析，我们将确定预测性：1。基因组和表观基因组，2。炎症性，3。 AUD和PTSD风险的心理生理学生物标记物。尽管已经确定了几个风险因素 在成年人中，对于这两种疾病的发展，相对较少的数据在青少年中可用。家庭和 双胞胎研究提供了AUD和PTSD的遗传风险估计分别为50%和30%-40%。我们 将利用这些疾病的最新AUD和PTSD多基因风险因素评分，以及表观基因组学 分析。以前的研究表明，AUD和PTSD以及WE患者的炎症反应均有改变 将在创伤发生后立即进行评估。最后，自主神经系统的测量 (包括通过心电图的皮肤电导反应[Scr]、心率和心率变异性[HRV] [心电])和中枢神经系统(通过肌电[EMG]评估声学惊厥反应) 反应能力将在创伤后医疗检查结束后立即进行评估。使用最新的统计方法 通过建模，我们将确定AUD和PTSD的生物学预测因素及其相互关系。这些数据将是 用来开发新的工具来预测哪些暴露在创伤中的青少年可能会患上AUD和/或 创伤后应激障碍，以便在发育的这个关键时刻进行早期干预。

PROJECT SUMMARY Acute trauma, defined by the DSM-5 criterion A for the diagnosis of post-traumatic stress disorder (PTSD) as exposure to actual or threatened death, serious injury or sexual violence, is associated with an increase in the development of both Alcohol Use Disorder (AUD) and PTSD. It is well established that patients with PTSD have a markedly increased risk for AUD. Furthermore, understanding risk for AUD during development, particularly in adolescents is critical, as early onset drinking is one of the highest risk factors for lifetime alcohol addiction. This current proposal seeks to further explore the relationship of AUD and PTSD in adolescents exposed to acute trauma by focusing on biological predictors of AUD and/or PTSD development. In brief, 500 adolescents will be studied in the immediate aftermath of trauma in emergency departments, hospital clinics or psychiatric settings in Austin, Texas (Dell Children’s Medical Center) and Galveston, Texas (University of Texas Medical Branch (UTMB) affiliated hospitals). Using emerging statistical techniques and machine learning-based analytics, we will identify predictive: 1. Genomic and epigenomic, 2. Inflammatory, and 3. Psychophysiological biomarkers of risk for AUD and PTSD. Although several risk factors have been identified in adults for the development of these two disorders, relatively little data is available in adolescents. Family and twin studies have provided estimates of genetic risk for AUD and PTSD of 50% and 30-40%, respectively. We will utilize the latest AUD and PTSD polygenic risk factor scores for these disorders, together with epigenomic analysis. Previous work has implicated alterations in inflammatory response in both AUD and PTSD and we will assess this in the immediate aftermath of the trauma. Finally, measures of autonomic nervous system (including skin conductance response [SCR], heart rate and heart rate variability [HRV] via electrocardiography [ECG]) and central nervous system (acoustic startle response assessed via electromyography [EMG]) reactivity will be assessed immediately after post-trauma medical clearance. Using state of the art statistical modeling, we will identify biological predictors of AUD and PTSD and their interrelationship. These data will be used to develop novel tools to predict which adolescents exposed to trauma will likely develop AUD and/or PTSD, allowing for early intervention at this critical time in development.