Intergenerational Transmission of Neglect and Abuse

描述（由申请人提供）：本修订后的申请寻求资金，用于对忽视和虐待（G1- b> G2->G3）的代际传播进行第一次大规模的前瞻性评估，使用经证实的儿童忽视和虐待病例和对照组（根据年龄、性别、种族/民族和近似家庭社会阶层进行匹配），这些患者已被随访至成年。根据《被忽视儿童权利法案》（RFA- od -99-006），我们目前正在开展一项“被忽视儿童三十年随访”（HD40774），评估医疗和健康状况、经济后果、服务利用模式（过去和现在）、童年被忽视的回忆以及家庭中的环境毒素。作为一个竞争性的延续，这个应用程序保持了对儿童忽视后果的关注，现在提议遵循原始参与者的孩子。关于身体虐待的代际传播的前瞻性证据很少，关于童年忽视的传播的证据就更少了。利用在前几轮研究和NICHD最初资助期间收集的数据，我们建议收集新的信息，以解决有关忽视和虐待代际传播的复杂问题。我们将G1一代定义为父母和非父母忽视和/或虐待G2个体的肇事者，我们自1986年以来一直在研究G2个体。因此，我们希望确定在童年时期被忽视或虐待的G2个体是否会继续对他们的G3后代（G1->G2->G3）进行虐待循环。我们主要关注G2对G3后代的行为，但我们也包括非G3后代。为了不高估或低估传播的程度，我们还纳入了没有孩子的G2个体。有五个主要目标：(1)检验忽视和虐待存在代际传递的假设；(2)研究儿童忽视和虐待代际传递的潜在机制，并确定这些机制在忽视和虐待的传递中是否有所不同；(3)评估G3后代的某些特征是否与G2父母忽视和虐待的风险增加有关；(4)确定G2父母中假设的保护因素是否对忽视和虐待的传递起到缓冲作用；(5)确定某些生物测量（皮质醇反应性、爱泼斯坦-巴尔病毒抗体和c反应蛋白）是否可以作为G3后代与童年忽视或虐待相关的压力的潜在生物标志物。使用多种方法和信息来源来确定忽视和虐待，我们建议对所有有孩子的G2成年人（被忽视、被虐待和对照组）（N =753）及其孩子的一部分（G3） （N = 1406）进行面对面访谈。还将对没有子女的G2个人（N = 143）进行电话访谈。采用一种新的血样采集技术，我们将评估G3儿童的皮质醇反应性、eb病毒抗体和c反应蛋白（CRP）。我们还将从儿童保护系统机构收集有关G2个人或其他人针对G3的虐待的官方记录信息。本研究的队列设计允许发现对干预和预防项目发展具有明确含义的结果。关于打破虐待循环的个体的研究结果对治疗和预防儿童虐待具有实际意义，对理解代际传播的机制和过程具有理论意义。鉴于人们对理解“身心”联系的兴趣日益浓厚，对G3后代的生物测量的评估可能会进一步深入了解这些童年经历的影响。

DESCRIPTION (provided by applicant): This revised application seeks funds to conduct the first large scale, prospective assessment of the interqenerational transmission of neglect and abuse (G1->G2->G3), using substantiated cases of childhood neglect and abuse and a comparison group (matched on the basis of age, sex, race/ethnicity, and approximate family social class) who have been followed up into adulthood. Under the Neglect RFA (RFA-OD-99-006), we are currently conducting a "Thirty-Year Follow-Up of Neglected Children" (HD40774), assessing medical and health status, economic consequences, service utilization patterns (past and current), recollections of childhood neglect, and environmental toxins in the home. As a competing continuation, this application maintains its focus on the consequences of childhood neglect and now proposes to follow the children of the original participants. Little prospective evidence of the intergenerational transmission of physical abuse exists and even less is known about the transmission of childhood neglect. Using data already collected during previous waves of the study and during the initial NICHD funding period, we propose to collect new information to address complex questions surrounding the intergenerational transmission of neglect and abuse. We define the G1 generation as parents and non-parent perpetrators of neglect and/or abuse toward the G2 individuals we have been studying since 1986. Thus, we hope to determine if G2 individuals who were neglected or abused in childhood in turn will continue the cycle of maltreatment toward their G3 offspring (G1->G2->G3). We focus primarily on G2's behavior toward biological G3 offspring, but we include non-biological G3 children as well. We also include G2 individuals without children in order not to over- or under-estimate the extent of transmission. There are five broad goals: (1) to test the hypothesis that there is an intergenerational transmission of neglect and abuse; (2) to examine potential mechanisms in the intergenerational transmission of childhood neglect and abuse and to determine whether these mechanisms differ for the transmission of neglect as compared to abuse; (3) to assess whether certain G3 offspring characteristics are associated with increased risk for neglect and abuse by G2 parents; (4) to determine whether hypothesized protective factors in G2 parents provide a buffer against the transmission of neglect and abuse; and (5) to determine whether certain biomeasures (cortisol reactivity, Epstein-Barr Virus antibodies, and C-reactive protein) serve as potential biomarkers for the stress associated with childhood neglect or abuse in the G3 offspring. Using multiple methods and sources of information to determine neglect and abuse, we propose to conduct in-person interviews with all G2 adults (neglected, abused, and controls) who have children (N =753) and a subset of their children (G3) (N = 1406). Telephone interviews will also be conducted with G2 individuals who do not have children (N = 143). Using a new sampling technique for blood collection, we will assess cortisol reactivity, Epstein-Barr Virus (EBV) antibodies, and C-reactive protein (CRP) in G3 children. We will also collect official record information from child protection system agencies regarding maltreatment by G2 individuals or others directed at G3. This study's cohort design permits discovery of results with clear implications for the development of intervention and prevention programs. Findings regarding individuals who break the cycle of abuse have practical implications for the treatment and prevention of child maltreatment and theoretical importance for understanding the mechanisms and processes involved in the intergenerational transmission. Given the increasing interest in understanding the "mind-body" connection, this assessment of biomeasures in the G3 offspring may provide further insight into the impact of these childhood experiences.