Pediatric maltreatment-related PTSD: Psychobiology

儿科虐待相关的创伤后应激障碍：心理生物学

• 批准号: 7067198
• 负责人: Michael Damingo De Bellis
• 金额: $ 14.54万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-01 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7067198
• 关键词: behavioral /social science research tag; biomarker; brain imaging /visualization /scanning; catecholamines; child abuse; clinical research; cognitive behavior therapy; cortisol; human subject; human therapy evaluation; neuropharmacology; neuropsychological tests; neuropsychology; nuclear magnetic resonance spectroscopy; patient oriented research; pediatrics; posttraumatic stress disorder; psychobiology; psychotherapy; questionnaires; sertraline; sex abuse

DESCRIPTION (provided by applicant): This Midcareer Investigator Award in Patient-Oriented Research (K24) application is in response to program announcement (PA-99-133) "Career Development Awards: Child Abuse and Neglect Research." Pediatric maltreatment-related PTSD is associated with dysregulation of biological stress systems, adverse brain maturation, and medial prefrontal cortical dysfunction. Building on previous work in developmental traumatology, the aim of this K24 is to investigate the psychobiology of effective PTSD treatment for sexually-abused children. The objectives of the career development plan are to: 1) develop expertise in evidence-based psychosocial treatments i.e., cognitive behavioral therapy (CBT) and combined psychopharmacologic interventions for maltreated children with PTSD, 2) further the candidate's knowledge of developmental and cognitive neuroscience emphasizing the integration and translation of brain imaging measurement as it relates to neurodiagnostic assessment and treatment, 3) increase the candidate's practical and empirical knowledge in the conduct and design of relevant clinical trials for treatment development including advanced research design, methodology and statistical aspects of conducting longitudinal studies and clinical trials, and 4) emphasize knowledge dissemination of the translational components of this research by mentoring junior colleagues in child abuse and neglect research. The research plan is linked to an ongoing study using brain imaging to help elucidate neurobiological markers in sexually abused children with PTSD. The objective of the research plan is a CBT treatment study using non-invasive biological markers (24 hour urinary concentrations of cortisol and catecholamines, MRS-based brain NAA concentrations of medial prefrontal cortex, and measures of neuropsychological functioning), in a pre-post design to investigate the pathogenesis of PTSD in 30 sexually abused children, ages 6 to 12 years. Exploring these biological markers in trauma-focused CBT + Sertraline and CBT + placebo is also proposed.

描述（由申请人提供）：此以患者为导向的研究中的职业中期调查员奖 (K24) 申请是为了响应计划公告 (PA-99-133)“职业发展奖：虐待和忽视儿童研究”。儿科虐待相关的创伤后应激障碍 (PTSD) 与生物应激系统失调、大脑成熟不良和内侧前额皮质功能障碍有关。以之前的发展创伤学工作为基础，本 K24 的目的是研究对性虐待儿童进行有效 PTSD 治疗的心理生物学。职业发展计划的目标是：1）发展基于证据的心理社会治疗方面的专业知识，即认知行为疗法（CBT）和针对患有创伤后应激障碍（PTSD）的受虐待儿童的综合心理药物干预措施，2）进一步加深候选人对发展和认知神经科学的了解，强调与神经诊断评估和治疗相关的脑成像测量的整合和转化，3）增加候选人在治疗开发相关临床试验的进行和设计方面的实践和经验知识，包括进行纵向研究和临床试验的先进研究设计、方法论和统计方面，4) 通过指导儿童虐待和忽视研究的初级同事，强调本研究转化部分的知识传播。该研究计划与一项正在进行的研究相关，该研究使用脑成像来帮助阐明患有创伤后应激障碍（PTSD）的性虐待儿童的神经生物学标记。该研究计划的目标是使用非侵入性生物标志物（24 小时尿液中皮质醇和儿茶酚胺浓度、基于 MRS 的内侧前额皮质大脑 NAA 浓度以及神经心理功能测量）进行 CBT 治疗研究。旨在调查 30 名 6 至 12 岁受性虐待儿童的 PTSD 发病机制。还建议在针对创伤的 CBT + 舍曲林和 CBT + 安慰剂中探索这些生物标志物。