Childhood socioeconomic disadvantage, cumulative Adverse Childhood Experiences, and adolescent depression and anxiety symptoms

项目摘要/摘要。 累积不良童年经历(ACE)和童年社会经济劣势(SED) 每个人都被确定为青少年心理健康不良的主要贡献者，并与 彼此之间的关系。然而，关于累积A和儿童SED是如何共同作用的，我们知之甚少 影响青少年心理健康，导致儿童逆境研究人员意见不一。如果没有 更清楚地理解这种复杂的关系，我们可能会忽视在很大程度上具有影响力的社会因素，即 影响青少年的健康和福祉，我们解决当前青少年心理健康危机的努力将 被阻挠。 本次Ruth L.Kirschstein国家研究服务奖(NRSA)个人预赛的目的是 护理研究博士学位(F31)的申请是为申请者的职业生涯做准备 独立调查员专注于扩大我们对社会风险因素的集体知识，并向 与儿童逆境和青少年心理健康有关的初级预防战略。建议数 研究金由两个相辅相成的部分组成：1)旨在发展申请人的 方法熟练程度、实质性专业知识和角色成就；以及2)一个研究项目，它将促进我们的 了解儿童SED、ACE暴露与青春期抑郁的关系 焦虑。一个强大的导师团队，包括来自密歇根大学的赞助商和合作者 护理、公共卫生和社会工作学院，以及密歇根大学贫困解决方案和 公共政策学院将提供儿童逆境/创伤、儿童贫困、 青年心理健康、政策宣传、干预措施实施和先进的统计技术。 拟议的研究项目将利用收集的数据作为大型、多样化、纵向 研究脆弱家庭和儿童从出生到15岁的幸福状况。具体目标是：调查 关于儿童早期ACE暴露的不同特征以及儿童SED如何预测 档案成员；1b)检查不同的ACE档案与青少年抑郁之间的关联，以及 焦虑，以及童年自闭症是否缓和了这些联系；以及2)调查ACE个人资料中的转变 儿童早期的成员资格，童年的SED如何影响个人资料的转变，以及转变是如何 与心理健康有关。将进行额外的探索性分析，以评估 健康的其他社会决定因素，包括种族/族裔和生物性别。 这项研究与NINR更新的战略计划保持一致，通过这项研究解决卫生公平问题 健康和福祉的关键社会决定因素。这项研究的发现对塑造未来至关重要 政策和研究议程，稀缺资源的分配，以及更好地识别 心理健康状况差的风险更大的临床环境。

Project Summary/Abstract. Cumulative Adverse Childhood Experiences (ACEs) and childhood socioeconomic disadvantage (SED) have each been identified as major contributors to poor adolescent mental health and have been associated with one another. However, less is known about how cumulative ACEs and childhood SED operate together to influence adolescent mental health, resulting in disagreement among childhood adversity researchers. Without a clearer understanding of this complex relationship, we risk overlooking largely impactful social factors that influence adolescent health and well-being and our efforts to address the current youth mental health crisis will be hindered. The purpose of this Ruth L. Kirschstein National Research Service Award (NRSA) Individual Pre- Doctoral Fellowship in Nursing Research (F31) application is to prepare the applicant for a career as an independent investigator focused on expanding our collective knowledge of social risk factors and informing primary prevention strategies related to childhood adversity and adolescent mental health. The proposed fellowship consists of two complementary components: 1) a training plan aimed at developing the applicant’s methods proficiency, substantive expertise, and role attainment; and 2) a research project that will further our understanding of the relationship between childhood SED, ACE exposure, and adolescent depression and anxiety. A strong mentorship team that includes sponsors and collaborators from the University of Michigan’s Schools of Nursing, Public Health, and Social Work, as well as consultants from UM’s Poverty Solutions and School of Public Policy will provide interdisciplinary expertise in childhood adversity/trauma, child poverty, youth mental health, policy advocacy, intervention implementation, and advanced statistical techniques. The proposed research project will utilize data collected as part of the large, diverse, longitudinal Fragile Families and Child Wellbeing Study from birth through age 15. The specific aims are to: 1a) Investigate for the presence of distinct profiles of ACE exposure during early childhood and how childhood SED predicts profile membership; 1b) Examine the association between distinct ACE profiles and adolescent depression and anxiety, and if childhood SED moderates these associations; and 2) Investigate for transitions in ACE profile membership during early childhood, how childhood SED influences profile transitions, and how transitions are associated with mental health. Additional exploratory analyses will be conducted to assess the influence of additional social determinants of health, including race/ethnicity and biological sex. This study aligns with the NINR’s updated strategic plan by addressing health equity through the study of key social determinants of health and well-being. Findings from this study are critical for shaping future policy and research agendas, the allocation of scarce resources, and better identifying subpopulations in the clinical setting that are at greater risk for poor mental health.