From risk to resilience: understanding and altering profiles of multisystem stress physiology to protect children vulnerable to internalizing disorders

项目摘要/摘要 内化性障碍是儿童早期最常见的精神病理形式之一， 在整个生命过程中持续存在的负面后果。尽管父母抑郁会增加患抑郁症的风险 儿童的内化问题，有相当大比例的高危子女不会发展成精神病态。 在父母抑郁的背景下，使儿童处于危险之中或增强韧性的因素仍然很差。 理解，尤其是，很少有研究探索生理调节因素之间的关系 父母抑郁与儿童内化。儿童综合多系统应激的变化 生理学和亲子生理同步性可能会区分那些有弹性的儿童和那些 会受到父母抑郁的不利影响。此外，压力敏感的生理通路是一种 有希望，但研究不足的治疗目标，可以帮助阐明儿童内化的病因 并有助于采取更有效的干预措施。这个K23奖项建立在候选人以前的基础上 提供培训和经验，以填补发展精神病理学和精神生物学领域的重大空白， 恢复力和干预研究。首先，候选人将考察纵向的交易关系 基于深度数据的父母抑郁症状与儿童内化症状的关系 来自两个独特的、现存的纵向社区儿童样本，这些样本在年龄和风险暴露方面各不相同。 其次，候选人将测试儿童的多系统压力反应性，作为这些关系的调节因素 同样的两个队列。最后，候选人将检查依恋和生物行为的可行性 对抑郁和内化程度升高的亲子二人组先导性样本的追赶(ABC)干预 并评价ABC对儿童多系统生理和功能的初步影响。 亲子生理同步性。使用NIMH实验疗法进行干预 发展，候选人将测试ABC干预是否改善了这些生理调节 这些因素是最终减少儿童内化症状的潜在机制。《ABC报》 该计划是一种有经验支持的生物行为干预，非常适合于减弱 生理失调可能是父母抑郁和子女抑郁之间关系的基础 内化症状，但到目前为止，它只提供给寄养中心和儿童福利机构的儿童 系统。这项新的先导性研究将首次测试对患有高血压病的父母和儿童的干预 并将探讨其对更广泛的生理结果的影响。这 研究将促进对父母抑郁、孩子和亲子之间动态关系的理解 应激生理，使儿童在生命早期内化，并将有助于发展创新能力 预防和治疗方案。通过拟议的培训和研究，候选人将做出贡献 致力于在高危儿童和家庭中促进积极心理健康结果的前沿研究。

PROJECT SUMMARY/ABSTRACT Internalizing disorders are among the most prevalent forms of psychopathology in early childhood with negative consequences that persist across the life course. Although parental depression heightens risk for children's internalizing problems, a significant proportion of at-risk offspring do not develop psychopathology. The factors that render children at risk or confer resilience in the context of parental depression remain poorly understood and in particular, scarce research has explored physiological moderators of the relations between parental depression and children's internalizing. Variations in children's integrated, multisystem stress physiology and parent-child physiological synchrony may distinguish children who are resilient from those who are adversely affected by parental depression. Moreover, stress-sensitive physiological pathways are a promising, but understudied target of treatments that can help elucidate the etiology of children's internalizing disorders and contribute to more effective interventions. This K23 Award builds upon the candidate's prior training and experience to fill critical gaps in the areas of developmental psychopathology and psychobiology, resilience, and intervention research. First, the candidate will examine the longitudinal, transactional relations between parental depressive symptoms and children's internalizing symptoms using in-depth data collected from two unique, extant longitudinal community samples of children that vary in age and exposure to risk. Second, the candidate will test children's multisystem stress reactivity as a moderator of these relations in the same two cohorts. Finally, the candidate will examine the feasibility of the Attachment and Biobehavioral Catch-up (ABC) intervention in a pilot sample of parent-child dyads with elevated depressive and internalizing symptoms, respectively, and assess the preliminary effects of ABC on children's multisystem physiology and parent-child physiological synchrony. Using the NIMH experimental therapeutics approach to intervention development, the candidate will test whether the ABC intervention improves regulation of these physiological factors as potential mechanisms by which to ultimately reduce children's internalizing symptoms. The ABC program is an empirically-supported biobehavioral intervention that is well-suited to attenuate patterns of physiological dysregulation that may underlie relations between parental depression and children's internalizing symptoms, but to date, it has only been delivered to children in foster care and the child welfare system. This novel pilot study will be the first to test the intervention among parents and children with elevated mental health symptoms and will explore its effects on a broader range of physiological outcomes. This research will advance understanding of the dynamic relations among parent depression, child and parent-child stress physiology, and child internalizing early in life, and will contribute to the development of innovative prevention and treatment programs. Through the proposed training and research, the candidate will contribute to cutting-edge research that promotes positive mental health outcomes among at-risk children and families.