The Life Course Approach to Caregiving for Aging Parents: Role of Adverse Childhood Experiences

项目总结/摘要 不良童年经历（ACE）已成为美国重要的公共卫生问题。 18岁以下儿童可能遭受的创伤性事件，包括各种类型的虐待、忽视， 以及暴露于家庭挑战（例如，与使用药物的家庭成员住在一起 紊乱）。不同的来源表明，50-60%的美国成年人报告至少有一个ACE，15-25%的报告 三个或更多。这些统计数据令人担忧，因为经历ACE已被证明是负面的， 影响成年人生活的各个方面，包括健康结果、人际关系以及经济和社会地位。 尽管这一既定的研究，ACE的影响还没有在研究的背景下， 年迈的父母广泛的先前研究已经确定了一个全面的风险和保护因素的清单， 照顾者压力;然而，这些因素往往是近端的，很少关注远端或早期生活 如ACE等因素。本研究以生命历程的观点为基础， ACE对老年父母育儿经验和结果的影响。在国内使用 来自美国中年（MIDUS）研究的代表性数据，次要数据分析将 进行，以解决前两个目标：1）描述的患病率和特点的孝顺照顾者， 经验丰富的ACE，和2）检查ACE的影响，在日常生活和短期之间的关联， 和长期的健康结果。第二个目标特别侧重于探索照顾者的生理 使用每日皮质醇水平成功地量化与子女生育相关的压力效应。在 此外，质性研究将针对第三个目的：3）探讨照顾者的经验， ACE和说明ACE是否以及如何影响他们的压力源方面的工作经验， 他们用来科普压力的策略。K 01奖将为孔周英博士提供 所需的培训，成为一个独立的学者和领先的专家在晚年的家庭关系， 为经历过童年创伤和逆境的成年人提供服务。拟议的培训计划将使 博士Kong接受指导和指导，以实现以下职业目标：1）增加 心理生物学的实质性知识; 2）获得定量研究方法的高级培训， 分析; 3）获得定性研究方法和分析的高级培训。K 01奖将引领 R 01拨款申请，该申请将建议进行初步数据收集，以进一步调查护理人员 通过孔博士新获得的实质性知识和方法论， skills.最终，这项研究将为新的计划和政策提供信息，以改善老年人的健康和福祉。 在老龄化社会中，家庭照顾者的作用越来越重要。

PROJECT SUMMARY/ABSTRACT Adverse Childhood Experiences (ACEs) have become a significant public health concern in the U.S. ACEs are potentially traumatic events that occur to children under the age of 18, including all types of abuse, neglect, and exposure to household challenges (e.g., having lived with a household member with substance use disorder). Varying sources suggest that 50-60% of U.S. adults report at least one ACE, and 15-25% report three or more. These statistics are concerning because experiencing ACEs has been shown to negatively affect various aspects of adult lives, including health outcomes, relationships, and financial and social status. Despite this established research, the impact of ACEs has not been studied in the context of caregiving for aging parents. Extensive prior studies have identified a comprehensive list of risk and protective factors related to caregiver stress; however, these factors tend to be proximal with little attention given to distal or early life course factors such as ACEs. Relying on the life course perspective, the proposed research aims to examine the effect that ACEs have on the experience and outcomes of caregiving for aging parents. Using nationally representative data from the Midlife in the United States (MIDUS) studies, secondary data analyses will be performed to address the first two aims: 1) Describe the prevalence and characteristics of filial caregivers who experienced ACEs, and 2) Examine the effect of ACEs in the association between daily caregiving and short- and long-term health outcomes. The second aim particularly focuses on exploring caregivers’ physiological functioning using daily cortisol levels to successfully quantify stress effects associated with filial caregiving. In addition, qualitative research will be conducted to address the third aim: 3) Explore caregivers’ experience of ACEs and illustrate whether and how ACEs affect their caregiving experience in terms of stress sources and the strategies they use to cope with caregiving stress. This K01 award would provide Dr. Jooyoung Kong with the training required to become an independent scholar and leading expert in later-life family relationships and caregiving for adults who experienced childhood trauma and adversity. The proposed training plan would allow Dr. Kong to receive instruction and mentorship toward meeting the following career goals: 1) Increase substantive knowledge in psychobiology; 2) Obtain advanced training in quantitative research methods and analysis; and 3) Gain advanced training in qualitative research methods and analysis. The K01 award will lead to an R01 grant application that will propose to conduct primary data collection to further investigate caregivers with histories of ACEs informed by Dr. Kong’s newly acquired substantive knowledge and methodological skills. Ultimately, this research will inform novel programs and policies to improve the health and well-being of family caregivers whose roles are becoming more significant in the current aging society.