Adolescent Family Stress and Early Cardiovascular Risk: Psychosocial and Behavioral Pathways

项目总结

Project Summary Growing up in a stressful family environment - marked by conflict, insensitive parenting, chaos, dysfunction and a lack of warmth - increases risk for medical problems across the lifespan. The strongest evidence for these risks is in the realm of cardiovascular disease (CVD), although early-life family stress also heightens vulnerability to other chronic illnesses, including diabetes and cancer. Collectively, these chronic conditions affect half of the adult population in the US, and as such constitute a major public health burden. Presently there is limited mechanistic understanding of how these risks arise, but insights about underlying pathways could facilitate risk stratification and preventive efforts. In that regard, adolescence is a particularly important period to consider, given that the adolescent years are marked by significant changes in psychosocial and biobehavioral processes important to health. Adolescence is also when preclinical signs of chronic diseases emerge. However, there is a paucity of research focusing on how the family context during adolescence confers early disease risk, especially within prospective designs. As such, we know little about underlying mechanisms. Furthermore, whether these processes occur similarly across ethnic groups is unknown, despite evidence of significant cultural differences in health risks, family values, and psychosocial processes. To address these issues, the proposed research of this application aims to: 1) examine the prospective relations between adolescent family experiences and a multi-layer inflammatory phenotype and metabolic endpoints during adolescence and adulthood; 2) determine whether these associations are mediated by poor social relationships, greater threat vigilance, unhealthy eating, and physical inactivity; and 3) investigate the potential moderating role of ethnicity in these processes. These questions will be addressed using two separate longitudinal studies of adolescence. This program of research will advance our understanding of how the adolescent family context mechanistically impacts health across ethnic groups, which can inform the development of culturally tailored prevention and intervention efforts aimed at reducing risk for adverse health outcomes. In addition to addressing a public health concern, execution of the proposed studies will foster the applicant's development as a researcher investigating the interplay between the family and cultural contexts and psychosocial and behavioral processes during adolescence and their contributions to early disease risk. More specifically, it will support the applicant's training goals of deepening her understanding of how early stress confers early risk for poor long-term health via the immune system, acquiring laboratory skills for measuring basic immunologic processes, developing and applying quantitative skills in longitudinal and path analysis of epidemiological data, and establishing a publication record in these areas.