PTSD and Depression in Parents of Children with Cancer

癌症儿童父母的创伤后应激障碍和抑郁症

• 批准号: 6622070
• 负责人: DOROTHY A GLOVER
• 金额: $ 14.73万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-02-15 至 2007-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6622070
• 关键词: behavioral /social science research tag; brain morphology; child (0-11); clinical research; cortisol; depression; hippocampus; human subject; hypothalamic pituitary adrenal axis; interview; longitudinal human study; magnetic resonance imaging; model design /development; neoplasm /cancer diagnosis; parent offspring interaction; pediatric neoplasm /cancer; posttraumatic stress disorder; psychological aspect of cancer; psychological stressor; social psychology; urinalysis

DESCRIPTION (provided by applicant): This revised Mentored Career Development application outlines a program of career development and research to study the relationship between hypothalamic-pituitary-adrenal (HPA) axis activity and hippocampal status in acute and chronic stress. Research subjects will consist of parents of children recently diagnosed with cancer. This population is unique because some will develop posttraumatic stress disorder (PTSD) and some will not, but all will undergo chronic stress during the year that they are followed as their child undergoes active cancer treatment Thus, it will be possible to study HPA-axis activity and hippocampal size and morphology in relation to PTSD status and chronic stress over time. I already have a theoretical and applied background in learning, behavior and anxiety. The career development and research plans are designed to enable me to develop proficiency and expertise in the use, analysis and application of neuroendocrinology to measure human stress responses and neuroimaging to address mechanisms of these responses. I will develop and test a theoretical model that examines the interaction between early structural and neuroendocrme abnormalities and subsequent traumatic experiences in a longitudinal design. Mentors include 1) a professor of neurology and director of a neuroimaging center; 2) a psychoneuroendocrinologist with special expertise in the psychobiology of stress and 3) a psychiatrist who is expert in medical trauma anxiety Relevant coursework and laboratory rotations from the curriculum of the Neuroscience Ph.D. program will be completed and mentors will direct in vivo training. Little is known about the time course of human HPA-axis dysregulation associated with exposure to extreme stress. Although previous studies have shown lower cortisol and hippocampal volume reductions in individuals with chronic PTSD, none have assessed HPA status and brain morphology concurrently. In addition, studies have been limited by single assessments often conducted years after the precipitating traumatic event. This proposal aims to investigate immediate and long-term HPA-axis activity and its relation to hippocampal size and morphology in recent-onset trauma. Cancer parents (both genders) with and without PTSD will be assessed within 1 month of the cancer diagnosis, then 12 months post-diagnosis for a) PTSD, depression, and other disorders); b) abnormal neuroendocrine activity (24-hour urinary cortisol) and c) abnormal hippocampal size and morphology (via Magnetic Resonance Imaging). The study will provide much-needed longitudinal data on HPA-axis and hippocampal abnormalities in acute and chronic stress.

描述（由申请人提供）：经过修订的指导职业发展 应用概述了一个职业发展和研究计划，以研究 下丘脑 - 垂体 - 肾上腺（HPA）轴活动与 急性和慢性应激的海马状态。研究对象将组成 最近被诊断出患有癌症的孩子的父母。这个人口是 独特，因为有些会发展创伤后应激障碍（PTSD），有些会出现 不会，但是在这一年中，所有人都会承受慢性压力 紧随其后的是他们的孩子接受活跃的癌症治疗，因此 可以研究HPA轴活动以及海马大小和形态 随着时间的流逝，与PTSD状态和慢性压力有关。我已经有一个 在学习，行为和焦虑方面的理论和应用背景。这 职业发展和研究计划旨在使我能够发展 熟练和专业知识在使用，分析和应用的 神经内分泌学测量人类压力反应和神经影像学对 解决这些响应的机制。我将开发并测试理论 检查早期结构和神经内管op虫之间相互作用的模型 纵向设计中的异常和随后的创伤经历。 导师包括1）神经病学教授和神经影像学主任 中心; 2）具有特殊专业知识的心理内分泌学家 压力的心理生物学和3）精神病医生是医学创伤专家 焦虑相关的课程和实验室轮换 神经科学博士计划将完成，导师将指导体内 训练。关于人类HPA轴失调的时间过程知之甚少 与暴露于极端压力有关。尽管以前的研究有 显示患有患者的皮质醇和海马体积减少 慢性PTSD，没有人同时评估HPA状态和脑形态。 此外，研究受到经常进行的单一评估的限制 促进创伤事件的几年。该建议旨在 研究直接和长期HPA轴活动及其与之的关系 最近发作的创伤中的海马大小和形态。癌症父母（俩人 genders）有和没有PTSD的情况将在癌症后的1个月内评估 诊断，然后在诊断后12个月a）PTSD，抑郁症和其他 疾病）； b）神经内分泌活性异常（24小时尿皮质醇）和 c）海马大小和形态异常（通过磁共振成像）。 该研究将提供有关HPA轴和的急需纵向数据 急性和慢性应激的海马异常。