Child Abuse and Trauma Related Psychopathology: Multiple Levels of Analysis

描述（由申请人提供）：虐待儿童是对儿童施加的一种暴力形式，是一个复杂、隐蔽的问题，虽然在贫困家庭中发生得更频繁，但却贯穿社会的各个部门。虐待儿童的人类代价是一系列可能持续一生的生物和心理悲剧。美国社会的经济成本是天文数字，数十亿美元用于精神病，社会服务，教育和司法系统的成本，以及一代受虐待儿童的生产力下降。发现这些创伤儿童的心理病理学和复原力发展的潜在过程，为将这些发现转化为预防，干预和社会政策举措提供了很大的希望。虐待儿童是一种致病的关系体验，是儿童面临的最不利和最紧张的挑战之一。在开发有效的治疗方法之前，需要清楚地了解启动和维持受虐待儿童适应不良和精神障碍发展途径的机制和过程。发现有助于受虐待儿童避免精神障碍的过程可以在指导转化研究和治疗开发方面提供非常丰富的信息。由于对虐待儿童的原因和后果的研究主要集中在单一层次的分析上，因此本申请通过实施多层次的分析视角来解决文献中的这一重大差距。在研究日营的背景下，两个队列的8至10岁的虐待和非虐待儿童（N = 500）将在连续两个夏天超过四年进行评估。遗传，神经内分泌，神经生理学，神经认知，自我系统，人际关系和情绪调节领域之间的相互关系将被检查，以阐明在受虐儿童的创伤相关的精神病理学的综合理解。测量电池是多样化的，包括访谈，观察，实验范例，儿童和成人的报告，分子遗传，神经生理，神经内分泌和神经认知的生物和行为功能的评估。这种多层次、多尺度、多信息源的研究方法将使研究者能够全面理解受虐儿童适应和适应不良的复杂性。拟议的研究，通过关注受虐待儿童之间的预期个体差异，将强调各种模式的适应创伤的经验和相关的生物和心理过程有助于这些差异化的模式。研究结果将增加有关虐待儿童后遗症和创伤性精神病理学病因学的知识基础，所获得的知识将为预防和干预措施提供信息，以转移受虐待儿童与创伤相关的精神病理学的发展，并有助于减轻受创伤儿童的精神疾病负担。公共卫生相关性：虐待儿童，包括性虐待、身体虐待和情感虐待，对儿童的生理和心理发展造成有害的损害，使他们更容易遭受社区暴力并因社区暴力而受到创伤，在整个生命过程中出现精神障碍的风险更高。在短期的纵向调查中获得的结果虐待和nonmaltreated儿童描述在这个应用程序将提高理解的生物和心理途径的精神病理学和韧性虐待儿童。重要的是，他们还将通过提供预防和干预措施来指导转化研究，这些措施旨在将受虐待儿童从精神病理学中转移出来，并减轻这些受创伤儿童的精神疾病负担。

DESCRIPTION (provided by applicant): Child abuse, a form of violence inflicted on children, is a complex, insidious problem that, although occurring more frequently in families residing in poverty, cuts across all sectors of society. The human costs of child abuse are a litany of biological and psychological tragedies that may last a lifetime. The economic costs for American society are astronomical, with billions of dollars spent in psychiatric, social services, educational, and justice system costs, as well as lessened productivity for a generation of abused children. Discovering the processes underlying the development of psychopathology and resilience among these traumatized children offers great promise for translating these findings to inform prevention, intervention, and social policy initiatives. Child abuse is a pathogenic relational experience that represents one of the most adverse and stressful challenges confronting children. Before effective treatments can be developed, a clear understanding of the mechanisms and processes that initiate and maintain the developmental pathways to maladaptation and mental disorder in abused children is needed. The discovery of processes that contribute to abused children averting mental disorder can be very informative in guiding translational research and treatment development. Because research on the causes and consequences of child abuse has largely focused on a single level of analysis, the present application addresses this significant gap in the literature through implementing a multiple levels of analysis perspective. In the context of a research day camp, two cohorts of 8- to 10-year-old abused and nonmaltreated children (N = 500) will be assessed in two consecutive summers over four years. The interrelations among genetic, neuroendocrine, neurophysiological, neurocognitive, self-system, inter- personal, and emotion regulation domains will be examined in order to elucidate an integrative understanding of trauma-related psychopathology in abused children. The measurement battery is diverse and is comprised of interviews, observations, experimental paradigms, child and adult reports, and molecular genetic, neurophysiological, neuroendocrine and neurocognitive assessments of biological and behavioral functioning. This multi-level, multi-measure, multi-informant approach will enable researchers to comprehend the complexity of the full range of adaptation and maladaptation in abused children. The proposed research, through attention to expected individual differences among abused children, will emphasize varied patterns of adaptation to traumatic experiences and associated biological and psychological processes contributing to these differentiated patterns. The findings will augment the knowledge base regarding the sequelae of child abuse and the etiology of trauma-based psychopathology, and the knowledge gained will inform prevention and intervention initiatives to divert abused children from the development of trauma-related psychopathology and contribute toward reducing the burden of mental illness in traumatized children. PUBLIC HEALTH RELEVANCE: Child abuse, including sexual, physical, and emotional abuse, exerts a pernicious toll on the biological and psychological development of children, rendering them likely to be more vulnerable to being subjected to and traumatized by community violence and to be at heightened risk for the emergence of mental disorders across the life course. The findings obtained in the shot-term longitudinal investigation of abused and nonmaltreated children describe in this application will enhance understanding of the biological and psychological pathways to psychopathology and resilience in abused children. Importantly, they also will guide translational research through informing preventive and intervention initiatives aimed at diverting abused children from psychopathology and reducing the burden of mental illness in these traumatized children.