Developmental Effects of Prenatal Cocaine Exposure

描述（由申请人提供）：此修订申请是对NOT-OD-10-032的回应：NIH宣布通过NIH基础行为和社会科学机会网络（OppNet）为竞争性修订申请（R01, R03, R15, R21， R21/R33和R37）提供恢复法案资金。直接评估应激反应对后期心理适应影响的前瞻性研究很少。为了填补这一关键的空白，本研究试图检查早期和后期皮质醇对压力的反应，其与心理调整的关系在低收入，内城青少年的样本。这项建议包括对一项正在进行的研究“产前可卡因暴露对发育的影响”（R01 DA07109）的纵向数据进行检查，以及增加新的数据。父母补助金的最初目的是关注产前可卡因暴露对发育的影响。在这项研究中，我们将扩大父母资助的原始范围，以解决与高风险环境影响有关的更广泛的问题，该样本取自高风险环境。鉴于时间限制和问题的性质，我们将只检查我们样本中在子宫内未接触过可卡因的儿童。拟议的研究将实现几个重要目标。首先，我们将研究早期皮质醇对压力的反应如何影响随后的心理调整。我们将通过分析从4岁到13岁的8个时间点收集的数据，并收集17岁时压力和心理调整的新测量数据，来研究个体皮质醇反应模式是否先于情绪和行为问题的发生。其次，我们将研究早期皮质醇对压力的反应是否与后期皮质醇对压力的反应有关。很少有研究调查了个体皮质醇在生命早期或整个发育阶段对压力的反应模式，这些结果是不一致的。因此，我们将能够使用新的连续性和变化分析模型来研究HPA活动随时间的发展变化和变化。我们的第三个目的是确定后期皮质醇对压力的反应是否介导早期皮质醇反应与后期心理调节之间的关系。初步研究表明，特里尔儿童社会压力测试（TSST-C）既适合年龄，又能有效地引发压力反应。在一项初步研究中，服用TSST-C后，平均皮质醇水平升高。早期的初步数据分析表明，在来自低收入城市环境的青少年亚样本中，皮质醇反应性存在重要的个体差异，随后的心理调整测量也存在可变性。很少有其他研究在前瞻性纵向设计中整合了HPA对急性应激和心理健康的反应。此外，考虑到环境风险，很少有研究调查了低收入城市青少年中HPA轴反应模式的年龄相关变化。

DESCRIPTION (provided by applicant): This Revision Application is in response to NOT-OD-10-032: NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications (R01, R03, R15, R21, R21/R33, and R37) through the NIH Basic Behavioral and Social Science Opportunity Network (OppNet). There are few prospective studies directly assessing the impact of stress responsivity on later psychological adjustment. To fill this critical gap, this study seeks to examine early and later cortisol response to stress on its relation to psychological adjustment in a sample of low income, inner-city adolescents. This proposal involves the examination of longitudinal data from an ongoing study, "Developmental Effects of Prenatal Cocaine Exposure" (R01 DA07109), as well as the addition of new data. The original aims of the parent grant focused on the developmental effects of prenatal cocaine exposure. In this study, we will expand the original scope of the parent grant to address broader questions relating to the impact of high risk environments from which this sample is taken. For this proposal, given the time constraints and the nature of the problem, we will examine only those children in our sample who were not exposed to cocaine in utero. The proposed study will accomplish several important goals. First, we will examine how early cortisol response to stress impacts on subsequent psychological adjustment. We will examine whether individual patterns of cortisol response precede the onset of emotional and behavioral problems by analyzing data previously collected at 8 time points from ages 4 to 13 and collecting new measures of stress and psychological adjustment at age 17. Second, we will examine whether early cortisol response to stress is related to later cortisol response to stress. Few studies have examined individual patterns of cortisol response to stress within or across developmental periods early in life, and the results from these are inconsistent. Thus, we will be able to investigate both developmental change and variation in HPA activity over time, using novel analytic models of continuity and change. Our third aim is to determine whether later cortisol response to stress mediates the relation between early cortisol response and later psychological adjustment. Preliminary studies have shown that the Trier Social Stress Test for Children (TSST-C) is both age- appropriate and effective in eliciting a stress response. In a pilot study, mean cortisol levels increased after administration of the TSST-C. Preliminary data analyses at earlier ages indicate that there are important individual differences in cortisol reactivity as well as variability in measures of subsequent psychological adjustment among this subsample of adolescents from low-income, inner-city environments. Few other studies have integrated HPA response to acute stress and psychological health within a prospective longitudinal design. In addition, few studies have examined age-related changes in patterns of HPA axis reactivity within a low-income, inner-city adolescent population, taking environmental risk into account.