Intergenerational Transmission of Neglect and Abuse

说明(由申请人提供)：本修订申请寻求资金，以便对忽视和虐待的代际传播进行第一次大规模的前瞻性评估(G1-&>；G2-->G3)，使用已证实的儿童忽视和虐待案例和一个对照小组(根据年龄、性别、种族/族裔和大致的家庭社会阶层匹配)，一直跟踪到成年。根据忽视儿童评估(RFA-OD-99-006)，我们目前正在进行一项“被忽视儿童三十年跟踪调查”(HD40774)，评估医疗和健康状况、经济后果、服务利用模式(过去和现在)、童年被忽视的回忆以及家庭中的环境毒素。作为一种竞争的延续，这一应用程序继续关注童年忽视的后果，现在建议跟踪最初参与者的孩子。关于身体虐待的代际传播的预期证据很少，关于童年忽视的传播更是鲜为人知。利用在前几波研究中和在NICHD最初资助期间收集的数据，我们建议收集新的信息，以解决围绕忽视和虐待的代际传播的复杂问题。我们将G1一代定义为自1986年以来一直研究的忽视和/或虐待G2个体的父母和非父母肇事者。因此，我们希望确定在童年时期被忽视或虐待的G2个体是否会继续虐待他们的G3后代(G1-&gt；G2-&gt；G3)。我们主要关注G2的S对生物G3后代的行为，但我们也包括非生物G3儿童。我们还包括没有子女的G2个人，以避免高估或低估传播程度。研究的主要目标有五个：(1)检验忽视和虐待存在代际传递的假设；(2)检验儿童忽视和虐待代际传递的潜在机制，并确定这些机制与虐待相比是否对忽视和虐待的传递有所不同；(3)评估G3后代的某些特征是否与G2父母忽视和虐待的风险增加有关；(4)确定G2父母的假设保护因素是否提供了缓冲，以防止忽视和虐待的传递；以及(5)确定某些生物指标(皮质醇反应性、爱泼斯坦-巴尔病毒抗体和C-反应蛋白)是否可以作为与G3后代童年忽视或虐待相关的压力的潜在生物标志物。使用多种方法和信息来源来确定忽视和虐待，我们建议对所有有子女(N=753)和子女子组(G3)(N=1406)的G2成年人(被忽视、被虐待和对照)进行面对面访谈。还将对没有子女的G2个人(N=143)进行电话访谈。使用一种新的采血技术，我们将评估G3儿童的皮质醇反应性、EB病毒抗体和C反应蛋白(CRP)。我们还将从儿童保护系统机构收集有关G2个人或针对G3的其他人虐待儿童的官方记录信息。这项研究的队列设计允许发现对干预和预防计划的发展具有明确影响的结果。关于打破虐待循环的个人的调查结果对于儿童虐待的治疗和预防具有实际意义，对于理解代际传播所涉及的机制和过程具有重要的理论意义。鉴于人们对理解“身心”联系的兴趣与日俱增，这项对G3后代的生物测量的评估可能会进一步洞察这些童年经历的影响。

DESCRIPTION (provided by applicant): This revised application seeks funds to conduct the first large scale, prospective assessment of the interqenerational transmission of neglect and abuse (G1->G2->G3), using substantiated cases of childhood neglect and abuse and a comparison group (matched on the basis of age, sex, race/ethnicity, and approximate family social class) who have been followed up into adulthood. Under the Neglect RFA (RFA-OD-99-006), we are currently conducting a "Thirty-Year Follow-Up of Neglected Children" (HD40774), assessing medical and health status, economic consequences, service utilization patterns (past and current), recollections of childhood neglect, and environmental toxins in the home. As a competing continuation, this application maintains its focus on the consequences of childhood neglect and now proposes to follow the children of the original participants. Little prospective evidence of the intergenerational transmission of physical abuse exists and even less is known about the transmission of childhood neglect. Using data already collected during previous waves of the study and during the initial NICHD funding period, we propose to collect new information to address complex questions surrounding the intergenerational transmission of neglect and abuse. We define the G1 generation as parents and non-parent perpetrators of neglect and/or abuse toward the G2 individuals we have been studying since 1986. Thus, we hope to determine if G2 individuals who were neglected or abused in childhood in turn will continue the cycle of maltreatment toward their G3 offspring (G1->G2->G3). We focus primarily on G2's behavior toward biological G3 offspring, but we include non-biological G3 children as well. We also include G2 individuals without children in order not to over- or under-estimate the extent of transmission. There are five broad goals: (1) to test the hypothesis that there is an intergenerational transmission of neglect and abuse; (2) to examine potential mechanisms in the intergenerational transmission of childhood neglect and abuse and to determine whether these mechanisms differ for the transmission of neglect as compared to abuse; (3) to assess whether certain G3 offspring characteristics are associated with increased risk for neglect and abuse by G2 parents; (4) to determine whether hypothesized protective factors in G2 parents provide a buffer against the transmission of neglect and abuse; and (5) to determine whether certain biomeasures (cortisol reactivity, Epstein-Barr Virus antibodies, and C-reactive protein) serve as potential biomarkers for the stress associated with childhood neglect or abuse in the G3 offspring. Using multiple methods and sources of information to determine neglect and abuse, we propose to conduct in-person interviews with all G2 adults (neglected, abused, and controls) who have children (N =753) and a subset of their children (G3) (N = 1406). Telephone interviews will also be conducted with G2 individuals who do not have children (N = 143). Using a new sampling technique for blood collection, we will assess cortisol reactivity, Epstein-Barr Virus (EBV) antibodies, and C-reactive protein (CRP) in G3 children. We will also collect official record information from child protection system agencies regarding maltreatment by G2 individuals or others directed at G3. This study's cohort design permits discovery of results with clear implications for the development of intervention and prevention programs. Findings regarding individuals who break the cycle of abuse have practical implications for the treatment and prevention of child maltreatment and theoretical importance for understanding the mechanisms and processes involved in the intergenerational transmission. Given the increasing interest in understanding the "mind-body" connection, this assessment of biomeasures in the G3 offspring may provide further insight into the impact of these childhood experiences.