The impact of HAI on typical and atypical child development and health

项目总结/摘要 焦虑是最常见的儿童心理健康障碍（Kessler 2012）。因为 儿童焦虑症可以致残，并经常持续到成年，解决这些问题， 儿童早期疾病是二级预防的一个重要目标。最近 据报道，从2005年到2010年，12 - 17岁的青少年中重度抑郁症增加了51%。 2017年（8.7%至13.2%）（Twenge 2019）强调了解决心理健康问题的重要性 (MH)这个年龄段的问题。目前尚不清楚宠物对亚阈值或作为 尚未确诊的儿童行为和情绪问题，或MH障碍的发展。 因为宠物狗可能是儿童情感发展的重要因素， 童年焦虑或情绪障碍通过依恋。如果是这样，积极的儿童与狗的互动 可以防止这些问题在青春期演变成成熟的MH障碍， 后来的生活。我们先前由NICHD资助的跨部门人类动物相互作用研究表明， 有宠物狗的孩子的焦虑分数（分离和社交焦虑）低于有宠物狗的孩子。 没有宠物狗的孩子目前的研究将对这些儿童进行为期7.5年的随访， 现在年龄在11 - 17岁之间。在原始样本中，85%（544）至少有一个 在过去的一年里，我们访问了我们的农村卫生网络，这使我们能够联系和跟踪这些 青年使用电子病历（EMR），我们将确定是否与宠物狗的青年 相对于对照组，暴露组7.5年后MH诊断的患病率较低 无宠物犬暴露组。我们还将分析父母或青少年自我报告的症状 使用经验证的仪器在随访时确定的措施，以检测亚阈值水平的 情绪障碍或阈值水平，但尚未识别或诊断的MH问题， 到严重损伤。由于缺乏关于宠物猫对健康影响的信息， 儿童时期的MH和发展，同样的分析将适用于青少年与宠物猫 与没有宠物的年轻人相比。此R21应用程序利用了我们之前的RO-3结果 对宠物狗或猫之间的关系进行自然主义的纵向分析， 暴露和随后的青少年MH症状和疾病的发展。本随访研究 捕获从阈下到未识别的阈值MH的精神疾病的全谱 这些青少年的症状到MH诊断。分析将包括调整大量 潜在的协变量。这些结果将使未来的研究重点放在特定的MH上 诊断和/或病理学作为阐明HAI潜在机制的下一步， 以及制定基于证据的建议，临床医生可以转达给父母。

Project Summary/Abstract Anxiety is the most prevalent childhood mental health disorder (Kessler 2012). Because childhood anxiety disorders can be disabling and often persist into adulthood, addressing these conditions early in childhood is an important target for secondary prevention. The recently reported 51% increase in major depressive disorder among teens ages 12-17 from 2005 to 2017 (8.7% to 13.2%) (Twenge 2019) underscores the importance of addressing mental health (MH) problems in this age group. It is not known what impact pets have on sub-threshold or as yet undiagnosed child behavioral and emotional problems, or the development of MH disorders. Because pet dogs may be salient agents for child emotional development, they may ameliorate childhood anxiety or mood disorders through attachment. If so, positive child-dog interactions could prevent the evolution of these problems into full-fledged MH disorders in adolescence or later life. Our prior cross-sectional human animal interaction study funded by NICHD showed that children with pet dogs had lower anxiety scores (for separation and social anxiety) than children without pet dogs. The current study will be a 7.5 year follow-up of these children who now range in age from 11-17 years. Of the original sample, 85% (544) have had at least one visit in our rural health network in the past year, which enables us to contact and follow-up these youth. Using the electronic medical record (EMR), we will determine whether youth with pet dog exposure have a lower prevalence of MH diagnoses 7.5 years later relative to the comparison group without pet dog exposure. We will also analyze parent or youth self-reported symptom measures ascertained at follow-up using validated instruments to detect subthreshold levels of mood disorders or threshold level but as yet unrecognized or diagnosed MH problems that lead to significant impairment. Given the lack of information about the effects of a pet cat on childhood MH and development, the same analysis will be applied to youth with pet cat exposure compared to youth without pets. This R21 application leverages our prior RO-3 results to conduct a naturalistic, longitudinal analysis of the relationship between pet dog or cat exposure and subsequent development of teen MH symptoms and illness. This follow-up study captures the full spectrum of mental illness from subthreshold to unrecognized threshold MH symptoms to MH diagnosis in these teens. Analysis will include adjustment for a large number of potential covariates. The results will enable future research studies to focus on specific MH diagnosis and/or symptomatology as a next step in elucidating underlying mechanisms in HAI, as well as develop evidence based advice that clinicians can relay to parents.