Context and Ethnic Diversity: Children's Responses to 9/11

 描述(由申请人提供)：了解9/11等大规模创伤对受影响青年的发展和心理健康结果的影响是公共卫生的首要任务。之前的研究，包括我们自己的小组纽约市教育委员会研究(NYC-BOE，PI：HOVEN)，记录了9·11事件发生六个月后，一些学龄儿童中明确定义(DSM-IV)精神健康障碍的发生率增加。尽管一些暴露于创伤中的儿童以韧性应对创伤，并继续正常的成人发育，但另一些儿童仍受到持续的心理问题的困扰。然而，对于儿童在创伤事件期间所处的环境背景如何潜在地影响创伤对他们的长期和短期功能结果的影响，人们知之甚少。如果要显著改善灾后干预，我们需要更多地了解哪些情况应该在灾后立即接受干预。精神病学的两个最新进展支持重新评估纽约-京东方的数据，以帮助回答这些问题：1)对种族/民族在心理健康中所起作用的更具情境性的观点，如需求侧管理-5‘S“文化形成访谈”(CFI)。CFI捕捉到丰富的互动背景，将种族/民族置于经验丰富的文化和物理环境的更广泛框架中。应用这一框架不仅将我们的注意力集中在创伤及其结果上，而且还将注意力集中在可能显著影响创伤最终如何影响功能结果的介入性环境体验上。2)从简单的诊断性分类转向对心理功能的更全面、更多维度的看法，NIMH于2010年发起的研究领域标准项目(RDoC)就是一个例证。RDOCS方法鼓励评估一组更全面的情绪和行为困难，而不是仅仅通过明确的诊断标准所捕获的困难。 这项拟议的创伤、结果背景和(TOC)研究将使用来自NYC-BOE研究的数据(包括关于家庭特征的广泛信息)以及其他关于社区和学校特征的数据集，来研究种族/民族如何与儿童的环境(家庭、学校和社区)相互作用，以影响创伤对9/11事件下青少年心理功能结果的影响。我们的最终目标是了解这些背景因素如何影响创伤后通向不同功能结果的途径。因此，这项研究将有助于对纽约市儿童在9/11事件后的功能有一个新的、更全面的了解。

 DESCRIPTION (provided by applicant): Understanding the effects of mass trauma, such as 9/11, on the development and mental health outcomes of exposed youth is a Public Health priority of the first order. Previous studies, including a study by our own group, the New York City Board of Education Study (NYC-BOE, PI: Hoven), documented increased rates of categorically defined (DSM-IV) mental health disorders in some school children six months after 9/11. While some exposed children respond to trauma with resilience and go on to normal adult development, others are plagued by ongoing psychological issues. Yet, relatively little is known about how the environmental context in which children live during a traumatic event, potentially impacts the effect that the trauma has on their long- and short-term functional outcomes. If post-disaster interventions are to significantly improve, we need to know more about which contexts should receive immediate interventions post-disaster. Two very recent advances in psychiatry support a reassessment of the NYC-BOE data to help answer these questions: 1) The development of a more contextualized view of the role that race/ethnicity play in mental health, as exemplified by the DSM-5's "Cultural Formulation Interview" (CFI). The CFI captures the rich interactive contexts which place race/ethnicity in a broader framework of the experienced cultural and physical environment. Applying this framework focuses our attention, not only on trauma and its outcome, but on the intervening environmental experience that may significantly influence how the trauma ultimately affects functional outcomes. 2) There is a movement away from simple diagnostic categorization and towards a more comprehensive, dimensional view of mental functioning, as exemplified by the Research Domain Criteria project (RDoC) launched by NIMH in 2010. The RDoCs approach encourages evaluating a more comprehensive set of emotional and behavioral difficulties than those captured by categorical diagnostic criteria alone. This proposed Trauma, Outcomes Context and (TOC) Study will use data from the NYC-BOE Study (which includes extensive information on family characteristics) in conjunction with additional datasets on neighborhood and school characteristics, to examine how race/ethnicity interacts with the child's environment (family, school and neighborhood) to affect the impact of trauma on dimensional mental functioning outcomes among youth exposed to 9/11. Our ultimate goal is to understand how these contextual factors influence a post-traumatic pathway to different functional outcomes. This research will therefore facilitate a new and more complete understanding of post-9/11 functioning of NYC's children.