The Physiological and Relational Bases of Persistent Posttraumatic Stress in Latino Immigrant Youth

项目摘要/摘要 在过去的五年里，美国移民家庭的数量迅速增加，尤其是 中美洲拉美裔美国人的增长(USCBP，2016)。在拉美裔移民青年中，创伤后 压力症状(PSS)是一个主要的公共卫生问题--我们自己的试点数据显示，60%的 相比之下，移民儿童和青少年经历了具有临床意义的PSS(Venta&Mercado，2018) 在非移民群体中的比例降至15%以下(Foa等人，2011年)。我们的数据表明，PSS的平均水平是 移民青年比之前估计的非移民青年高出161%-204%(Venta&Mercado，2018年)。 经验和元分析结果支持PSS的炎症性假说：全身性升高 创伤后的炎性生物标志物增加了持续性、损伤性PSS的风险(Gill等人，2009年)。 相反，亲密的关系--比如父母和孩子之间的关系--反复出现 与减少全身炎症有关(Fagundes等人，2011年)。而创伤暴露的水平 移民儿童在移民前的经历是PSS的静态风险因素，即炎症性 相反，回应代表了一个动态的风险因素，可以通过密切的关系来缓解， 降低迁移后持续PSS的可能性。这项提案的主要目的是研究 生理性(即炎症反应增强)和关系(即作为缓冲的亲子关系) 持续性PSS的基础，这种情况在拉丁裔移民中被大大夸大了。这项研究 建议招募N=100个拉丁裔新移民家庭进行新的纵向研究，研究范围涵盖12个 月份。方法评估多个层次的分析：照顾者心脑化的实验任务，半 对照顾者-儿童依恋安全、自我和照顾者的结构化访谈-关于PSS的报告，以及两次 点状唾液炎症反应试验。具体目标1是测试一个基于炎症的假说 PSS。创伤暴露、炎症反应(通过应激前后收集的唾液测量 )，PSS将在基线时评估；PSS将在6个月和12个月后再次评估- 向上。预计创伤暴露将与基线时更大的炎症反应相关， 这又将与持久的PSS相关联。具体目标2是检查潜在的保护 亲子关系在PSS炎症性假说中的作用亲子关系 将在基线上评估和检查因素(即，照顾者心理化和照顾者与儿童的依恋) 作为目标1中假设的风险假设的调节器。总而言之，在本研究中收集的新数据将测试 存在显著健康差距的生理机制--拉美裔移民青年 不成比例地受到PSS的影响-以及测试假定干预目标的保护作用(即， 亲子关系)来改善持续性PSS的风险。拟议的研究将加强研究 为研究生和本科生提供机会，通过在高影响力研究中担任有偿、亲身实践的角色。

PROJECT SUMMARY/ABSTRACT The number of immigrant families in the U.S. has rapidly increased across the last five years, with particular growth among Latinos from Central America (USCBP, 2016). Among Latino immigrant youth, posttraumatic stress symptoms (PSS) are a major public health concern—with our own pilot data showing that 60% of immigrant children and adolescents experience clinically significant PSS (Venta & Mercado, 2018), in contrast to less than 15% in non-immigrant groups (Foa et al., 2011). Our data indicate that the mean level of PSS is 161% - 204% higher in immigrant youth than prior estimates in non-immigrants (Venta & Mercado, 2018). Empirical and meta-analytic findings support an inflammatory hypothesis of PSS: elevations in systemic inflammatory biomarkers following trauma increase risk for persistent, impairing PSS (Gill et al., 2009). Conversely, close relationships—like those between parents and their children—have been repeatedly associated with reduced systemic inflammation (Fagundes et al., 2011). While the level of trauma exposure that immigrant children experience prior to migration represents a static risk factor for PSS, inflammatory response, in contrast, represents a dynamic risk factor that may be mitigated through close relationships, reducing likelihood of persistent PSS after migration. The broad aim of this proposal is to examine the physiological (i.e., increased inflammatory response) and relational (i.e., parent-child relationship as a buffer) bases of persistent PSS, a condition that is dramatically overrepresented in Latino immigrants. The study proposes to recruit N = 100 Latino recent immigrant families for new longitudinal research spanning twelve months. Methods assess multiple levels of analysis: an experimental task of caregiver mentalizing, a semi- structured interview of caregiver-child attachment security, self- and caregiver-reports of PSS, and a two-time point salivary test of inflammatory response. Specific Aim 1 is to test an inflammation-based hypothesis of PSS. Trauma exposure, inflammatory response (measured via saliva collected before and after a stress induction), and PSS will be assessed at baseline; PSS will be assessed again at six- and twelve-month follow- up. It is expected that trauma exposure will be associated with greater inflammation response at baseline, which, in turn, will be associated with persistent PSS. Specific Aim 2 is to examine the potential protective effects of the parent-child relationship in the inflammation-based hypothesis of PSS. Parent-child relationship factors (i.e., caregiver mentalizing and caregiver-child attachment) will be assessed at baseline and examined as moderators of the risk hypothesis posited in Aim 1. In sum, novel data collected in this study will test a physiological mechanism underlying a significant health disparity—that Latino immigrant youth are disproportionately affected by PSS— as well as test the protective role of putative intervention targets (i.e., parent-child relationships) in ameliorating risk for persistent PSS. The proposed study will enhance research opportunities for graduate and undergraduate students via paid, hands-on roles in high-impact research.