Child Abuse and Trauma Related Psychopathology: Multiple Levels of Analysis

描述（由申请人提供）：虐待儿童是一种对儿童施加的暴力形式，是一个复杂的、潜在的问题，尽管在贫困家庭中更常见，但它遍及社会各个领域。虐待儿童给人类带来的代价是一连串可能持续一生的生理和心理悲剧。美国社会的经济成本是天文数字，数十亿美元花费在精神病学、社会服务、教育和司法系统上，以及一代受虐待儿童的生产力下降。在这些受创伤的儿童中发现精神病理学和恢复力发展的潜在过程，为将这些发现转化为预防、干预和社会政策举措提供了巨大的希望。儿童虐待是一种致病的关系经历，代表了儿童面临的最不利和最紧张的挑战之一。在开发有效的治疗方法之前，需要清楚地了解启动和维持受虐儿童适应不良和精神障碍的发育途径的机制和过程。发现有助于受虐儿童避免精神障碍的过程可以在指导转化研究和治疗发展方面提供非常有用的信息。由于对儿童虐待的原因和后果的研究主要集中在单一层次的分析上，因此本应用程序通过实施多层次的分析视角来解决文献中的这一重大空白。在一个研究日营的背景下，两组8至10岁的受虐待和未受虐待的儿童（N = 500）将在四年中连续两个夏天接受评估。本研究将检视遗传、神经内分泌、神经生理、神经认知、自我系统、人际关系和情绪调节等领域的相互关系，以阐明对受虐儿童创伤相关精神病理的综合理解。测量方法多种多样，包括访谈、观察、实验范例、儿童和成人报告，以及生物和行为功能的分子遗传学、神经生理学、神经内分泌和神经认知评估。这种多层次、多测量、多信息的方法将使研究人员能够理解受虐儿童适应和不适应的全范围复杂性。拟议的研究通过注意受虐待儿童之间预期的个体差异，将强调对创伤经历的各种适应模式以及促成这些不同模式的相关生物和心理过程。这些发现将增加关于儿童虐待后遗症和创伤性精神病理学病因的知识基础，所获得的知识将为预防和干预措施提供信息，使受虐待儿童免于发展与创伤相关的精神病理学，并有助于减轻受创伤儿童的精神疾病负担。与公共卫生有关：虐待儿童，包括性虐待、身体虐待和情感虐待，对儿童的生理和心理发展造成有害影响，使他们更容易受到社区暴力的伤害和创伤，并且在整个生命过程中出现精神障碍的风险更高。本应用程序中对受虐待和未受虐待儿童进行的短期纵向调查所获得的结果将加强对受虐待儿童精神病理和恢复力的生物学和心理学途径的理解。重要的是，他们还将通过告知预防和干预举措来指导转化研究，旨在转移受虐待儿童的精神病理学，减轻这些受创伤儿童的精神疾病负担。

DESCRIPTION (provided by applicant): Child abuse, a form of violence inflicted on children, is a complex, insidious problem that, although occurring more frequently in families residing in poverty, cuts across all sectors of society. The human costs of child abuse are a litany of biological and psychological tragedies that may last a lifetime. The economic costs for American society are astronomical, with billions of dollars spent in psychiatric, social services, educational, and justice system costs, as well as lessened productivity for a generation of abused children. Discovering the processes underlying the development of psychopathology and resilience among these traumatized children offers great promise for translating these findings to inform prevention, intervention, and social policy initiatives. Child abuse is a pathogenic relational experience that represents one of the most adverse and stressful challenges confronting children. Before effective treatments can be developed, a clear understanding of the mechanisms and processes that initiate and maintain the developmental pathways to maladaptation and mental disorder in abused children is needed. The discovery of processes that contribute to abused children averting mental disorder can be very informative in guiding translational research and treatment development. Because research on the causes and consequences of child abuse has largely focused on a single level of analysis, the present application addresses this significant gap in the literature through implementing a multiple levels of analysis perspective. In the context of a research day camp, two cohorts of 8- to 10-year-old abused and nonmaltreated children (N = 500) will be assessed in two consecutive summers over four years. The interrelations among genetic, neuroendocrine, neurophysiological, neurocognitive, self-system, inter- personal, and emotion regulation domains will be examined in order to elucidate an integrative understanding of trauma-related psychopathology in abused children. The measurement battery is diverse and is comprised of interviews, observations, experimental paradigms, child and adult reports, and molecular genetic, neurophysiological, neuroendocrine and neurocognitive assessments of biological and behavioral functioning. This multi-level, multi-measure, multi-informant approach will enable researchers to comprehend the complexity of the full range of adaptation and maladaptation in abused children. The proposed research, through attention to expected individual differences among abused children, will emphasize varied patterns of adaptation to traumatic experiences and associated biological and psychological processes contributing to these differentiated patterns. The findings will augment the knowledge base regarding the sequelae of child abuse and the etiology of trauma-based psychopathology, and the knowledge gained will inform prevention and intervention initiatives to divert abused children from the development of trauma-related psychopathology and contribute toward reducing the burden of mental illness in traumatized children. PUBLIC HEALTH RELEVANCE: Child abuse, including sexual, physical, and emotional abuse, exerts a pernicious toll on the biological and psychological development of children, rendering them likely to be more vulnerable to being subjected to and traumatized by community violence and to be at heightened risk for the emergence of mental disorders across the life course. The findings obtained in the shot-term longitudinal investigation of abused and nonmaltreated children describe in this application will enhance understanding of the biological and psychological pathways to psychopathology and resilience in abused children. Importantly, they also will guide translational research through informing preventive and intervention initiatives aimed at diverting abused children from psychopathology and reducing the burden of mental illness in these traumatized children.