Biological Indicators of Trauma in Foster Youth: The Role of Social Support

虐待儿童是一个严重的公共卫生问题。童年时期受到虐待的人有患上 一生中有许多严重的精神和医疗问题。虐待行为加剧了 大量研究结果表明，由于免疫功能障碍而导致疾病的风险增加， 在童年遭受虐待的成年人中，全身炎症的生物标记物升高。还没有 儿童或青春期时全身炎症的程度尚不清楚。调查结果是 混合的，一些研究表明支持青少年虐待和炎症之间的关系， 以及其他显示为空的结果。然而，有一些经验证据表明，当社会支持 考虑到这一点，可以更好地解释年轻人全身炎症的差异。在青少年中 最近经历了一次负面的生活事件，那些几乎没有社会支持的人有明显更多的系统性 与有足够社会支持的青少年相比，青少年更容易患上炎症。这些发现提供了证据 社会支持是暴露在正常生活事件中的青年的保护因素。社会支持如何运作 对于患有非规范性、慢性和潜在威胁生命的创伤的年轻人来说，这是未知的。这是一个意义重大的 实地疏忽，因为患有严重和/或慢性虐待的青少年的健康风险最大 有问题。此外，这些青年可能会离开他们的家，被安置在多个寄养家庭，以及 在他们童年的过程中多次与生物照顾者团聚，导致起伏不定 社会支持条件。捕捉社会支持转移的模式对于理解 心理社会因素与寄养青年的全身炎症有关，寄养青年是一种流动人口，其一生 暴露在虐待中的风险远远超过了典型的水平，这使得他们现在和将来都面临着健康状况不佳的风险。 生活。拟议的研究将利用纵向结构方程建模框架来测试相互作用 随着时间的推移，虐待和社会支持对炎性生物标志物(即白细胞介素6和C反应)的影响 寄养青年(目标2)。参与者将从更大的、纵向的R01中抽出，标题为 儿童适应和复原力之路“(SPARK)，将包括220名10至18岁的青年。 参与者招募和数据收集将与赞助商的新R01协调进行， 还将利用以前的斯帕克家族。目前的研究将改进过去的方法缺陷。 通过包括经验衍生的测量模型和检验兴趣结构的相关性 作为协变量纳入(目标1)。这些发现将解决文献中的一个主要差距，并对 对于虐待如何增加代价高昂和毁灭性的精神和精神疾病的风险的问题，缺失了一部分 一生中的身体健康问题。

Child maltreatment is a critical public health concern. Individuals maltreated in childhood are at risk for a number of serious psychiatric and medical problems over the lifespan. The idea that maltreatment heightens risk for disease via immune dysfunction has been fueled by the results of numerous studies showing that, among adults exposed to maltreatment in childhood, biomarkers of systemic inflammation are elevated. Yet the extent to which systemic inflammation is present during childhood or adolescence is unclear. Findings are mixed, with some studies showing support for the relation between maltreatment and inflammation in youth, and others showing null results. There is some empirical evidence, however, that when social support is considered, the variance in systemic inflammation among youth is better explained. Among adolescents recently exposed to a negative life event, those with little social support had significantly more systemic inflammation compared to the adolescents with adequate social support. These findings provide evidence of social support as a protective factor for youth exposed to normative life events. How social support operates for youth with non-normative, chronic, and potentially life threatening trauma is unknown. This is a significant omission in the field given that youth with severe and/or chronic maltreatment are at greatest risk for health problems. Further, these youth may be removed from their homes, placed in multiple foster placements, and reunited with biological caregivers several times over the course of their childhoods, resulting in fluctuating social support conditions. Capturing the pattern of shifting social support is essential to understanding how psychosocial factors relate to systemic inflammation in foster youth, a transient population whose lifetime exposure to maltreatment greatly exceeds what is typical, putting them at risk for poor health now and later in life. The proposed study will utilize a longitudinal structural equation modeling framework to test the interaction of maltreatment and social support over time on inflammatory biomarkers (i.e., interleukin-6 and C-reactive protein) in foster youth (aim 2). Participants will be drawn from a larger, longitudinal R01, entitled “Studying Pathways to Adjustment and Resilience in Kids” (SPARK) and will include 220 youth ages 10 to 18 years. Participant recruitment and data collection will be conducted in coordination with the sponsor's new R01, which will also utilize previous SPARK families. The current study will improve on past methodological weaknesses by including empirically-derived measurement models and examining correlates of the constructs of interests for inclusion as covariates (aim 1). Findings will address a major gap in the literature and contribute a crucial missing piece to the question of how maltreatment confers risk for expensive and devastating mental and physical health problems over the life course.