Impact of Neighborhood Characteristics on Conversion to Psychosis among Youth at Clinical High Risk for Psychosis

社区特征对临床精神病高危青少年转化为精神病的影响

• 批准号: 10429549
• 负责人: Benson Ku
• 金额: $ 19.41万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10429549
• 关键词: Address; Age; Air Pollution; American; Anterior; Area; Brain; Brain region; Censuses; Characteristics; Child Sexual Abuse; Childhood; Cities; Computer software; Consensus; County; Data; Development; Early Intervention; Elements; Environmental Exposure; Environmental Impact; Environmental Risk Factor; Equation; Ethnic Origin; Family history of; Geography; Goals; Health Resources; Hippocampus (Brain); Human; Individual; Insula of Reil; Intervention; Interview; Investigation; Lead; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Mediating; Mediator of activation protein; Mental Health; Mental disorders; Mentors; Methodology; Modeling; Neighborhoods; Neurobiology; Neurodevelopmental Disorder; Outcome; Patients; Persons; Population Density; Poverty; Prevalence; Proxy; Psychoses; Psychosocial Deprivation; Psychotic Disorders; Public Health; Publishing; Qualitative Methods; Race; Research; Research Design; Research Personnel; Research Training; Risk; Risk Factors; Schizophrenia; Site; Social isolation; Subgroup; Testing; Thalamic structure; Walkers; Work; Youth; base; brain behavior; cingulate cortex; clinical high risk for psychosis; design; emotional neglect; experience; first episode psychosis; follow-up; gray matter; high risk; low socioeconomic status; novel; peer; physical abuse; predictive test; prevent; psychosis risk; psychosocial; rural area; sex; social; social relationships; social stress

Project Summary/Abstract The proposed research and training plan are designed to promote my development as an independent investigator in the field of neighborhood characteristics as they relate to conversion to psychosis through neurobiological and psychosocial mediators among youth at clinical high risk for psychosis (CHR-P). Urban upbringing (growing up in cities as compared to rural areas) is one of the strongest environmental risk factors for schizophrenia. More recent studies have suggested that social stress might explain this association. In particular, neighborhood residential instability (NRI) has been used to measure social fragmentation and has also been associated with increased schizophrenia rates and prevalence. In addition, my published work found that NRI predicts an earlier age at onset of psychosis among individuals with first-episode psychosis even after controlling for known risk factors. Furthermore, my preliminary data indicate that county-level residential instability (a rough proxy for NRI) during childhood 1) predicts conversion to psychosis and 2) predicts smaller corticolimbic gray matter volume (GMV) among a subset of youth at CHR-P who never moved. Dr. Walker (one of my mentors) has shown that psychosocial deprivation as measured by reduced childhood peer relationships, parental absence, and emotional neglect is associated with smaller corticolimbic GMV, whereas threat (defined as exposures that involve harm; e.g., childhood sexual and physical abuse) is not. Based on these findings, I hypothesize that NRI leads to psychosocial deprivation, which in turn contributes to smaller corticolimbic GMV, which ultimately increases risk for psychosis. To test this hypothesis, I propose the following Specific Aims: (1) Test the association between NRI and conversion to psychosis and corticolimbic GMV, including the cortical, perigenual anterior cingulate cortex, and hippocampal GMV and control regions including insula and thalamus. (2) Test the association between NRI and psychosocial deprivation and threat. (3) Explore the experiences and circumstances of youth at CHR-P living in residential areas that differ in NRI, from very unstable to highly stable. The proposed studies will provide a novel integration of multiple levels of investigation including public health, developmental studies in humans, and the impact of environmental factors on the brain and behavior to discover novel targets for intervention both at the individual and neighborhood levels to prevent or mitigate psychosis conversion in high-risk individuals. Future research will further elucidate the relationship of neighborhood characteristics with the psychosocial and neurobiological factors associated with risk for psychosis, such as investigating whether NRI exposure at specific developmental periods and regional brain changes would have a differential impact on psychosis. If NRI leads to psychosocial deprivation and neurobiological changes, for example, targeted psychosocial interventions could then be designed for youth at risk. In addition, geographic identification of at-risk groups could guide allocation of mental health resources to areas with greater psychosis risk for early intervention.

项目摘要/摘要 拟议的研究和培训计划旨在促进我作为独立的发展 与转化为精神病有关的邻里特征领域的研究者 在临床精神病高风险（CHR-P）的青年中，神经生物学和社会心理介体。城市的 成长经历（与农村地区相比在城市中成长）是最强大的环境风险因素之一 对于精神分裂症。最近的研究表明，社会压力可能解释了这种关联。在 特别是，邻里住宅不稳定（NRI）已用于衡量社会分裂，并具有 还与精神分裂症率提高和患病率有关。此外，我已发表的作品找到了 NRI预测，即使在 控制已知危险因素。此外，我的初步数据表明县级住宅 不稳定（NRI的粗略代理）在儿童时期1）预测转化为精神病，2）预测较小 CHR-P的一部分从未搬家的年轻人中的Corticolimbic灰质体积（GMV）。沃克博士（一个 在我的导师中）表明，通过减少儿童同伴来衡量的社会心理剥夺 关系，父母缺席和情感忽视与较小的Corticolimbic GMV有关 威胁（定义为涉及伤害的暴露；例如，儿童性和身体虐待）不是。基于 这些发现，我假设NRI导致了社会心理剥夺，这反过来又有助于较小 Corticolimbic GMV，最终增加了精神病的风险。为了检验这一假设，我提出了 以下特定目的：（1）测试NRI与转化为精神病和Corticolimbic之间的关联 GMV，包括皮质，周围的前扣带回皮质和海马GMV和控制区 包括岛和丘脑。 （2）测试NRI与社会心理剥夺与威胁之间的关联。 （3）探索居住在NRI不同的Chr-P年轻人的经验和环境， 从非常不稳定到高度稳定。拟议的研究将提供多个级别的新型整合 调查包括公共卫生，人类的发展研究以及环境的影响 大脑和行为的因素，发现个人和个人干预的新目标 邻里水平，以预防或减轻高风险个体的精神病转化。未来的研究将 进一步阐明邻里特征与社会心理和神经生物学的关系 与精神病风险相关的因素，例如研究NRI是否在特定 发育时期和区域大脑变化将对精神病产生不同的影响。如果NRI领先 例如，对社会心理剥夺和神经生物学的改变，例如针对性的社会心理干预措施 然后可以为有风险的年轻人设计。此外，处于风险组的地理识别可以指导 将心理健康资源分配给具有更大精神病风险的地区早期干预的领域。