Child Abuse and Trauma Related Psychopathology: Multiple Levels of Analysis

说明(申请人提供)：虐待儿童是对儿童施加的一种形式的暴力，是一个复杂、隐蔽的问题，虽然在生活贫困的家庭中发生得更频繁，但涉及社会的各个阶层。虐待儿童的人类代价是一连串的生物和心理悲剧，可能会持续一生。美国社会的经济成本是天文数字，数十亿美元花在精神、社会服务、教育和司法系统的成本上，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、干预和社会政策倡议提供了巨大的希望。虐待儿童是一种致病的关系经历，代表了儿童面临的最不利和最有压力的挑战之一。在开发有效的治疗方法之前，需要清楚地了解启动和维持被虐待儿童适应不良和精神障碍的发育途径的机制和过程。有助于受虐儿童避免精神障碍的过程的发现，在指导转化性研究和治疗开发方面可以提供非常多的信息。由于对虐待儿童的原因和后果的研究主要集中在单一层次的分析上，本申请通过实施多层次的分析视角解决了文献中的这一重大差距。在研究日营的背景下，将在四年内连续两个夏天对8至10岁被虐待和未被虐待儿童(N=500)的两个队列进行评估。本课程将探讨遗传、神经内分泌、神经生理学、神经认知、自我系统、人际关系和情绪调节领域之间的相互关系，以期阐明对受虐儿童创伤相关精神病理学的综合理解。测量单元是多样化的，包括访谈、观察、实验范例、儿童和成人报告，以及对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、多措施、多信息者的方法将使研究人员能够理解受虐待儿童适应和适应不良的全面范围的复杂性。拟议的研究将通过关注受虐待儿童的预期个体差异，强调对创伤经历的不同适应模式，以及促成这些差异模式的相关生物和心理过程。这些发现将扩大关于虐待儿童的后遗症和基于创伤的精神病理学的病因学的知识基础，所获得的知识将为预防和干预举措提供信息，以转移被虐待儿童对与创伤相关的精神病理学的发展的注意力，并有助于减轻创伤儿童的精神疾病负担。公共卫生相关性：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的损害，使他们更容易受到社区暴力的伤害和创伤，并在整个生命过程中更有可能出现精神障碍。在本申请中描述的对受虐和未受虐待儿童的短期纵向调查中获得的结果将加强对受虐儿童心理病理学和复原力的生物和心理途径的理解。重要的是，他们还将通过宣传预防和干预举措来指导翻译研究，旨在转移受虐待儿童对精神病理学的兴趣，并减轻这些受到创伤的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.