Early Traumatic Stress Exposure: Neurodevelopmental Mechanisms of Clinical Risk

早期创伤性应激暴露：临床风险的神经发育机制

基本信息

批准号：
8644902
负责人：
Margaret J Briggs-Gowan
金额：
$ 60.89万
依托单位：
UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-08 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8644902
关键词：
Accounting Affect Affective Aggressive behavior Anger Anxiety Anxiety Disorders Attention Behavior Behavioral Behavioral Sciences Bipolar Disorder Brain Brain region Characteristics Child Child Development Child Mental Health Childhood Clinical Clinical Pathways Cognitive Communities Cues Descriptor Development Developmental Process Diagnosis Dimensions Disease Disruptive Behavior Disorder Emotions Environment Environmental Risk Factor Event-Related Potentials Exposure to Face Face Processing Family Family Violence Fostering Foundations Funding General Population Human Impairment Intervention Interview Laboratories Learning Life Life Stress Link Measurable Measures Mediating Mental disorders Methods Minor Modeling Mood Disorders Morbidity - disease rate National Institute of Mental Health Neurocognitive Nursery Schools Parenting behavior Parents Pattern Perception Phenotype Population Post-Traumatic Stress Disorders Preschool Child Primates Probability Procedures Process Psychopathology Reaction Time Reporting Research Research Design Risk Role Sampling Scientific Advances and Accomplishments Severities Specific qualifier value Strategic Planning Stratification Stress Structure Symptoms Syndrome Task Performances Testing Time To specify Trauma Treatment outcome Variant Victimization Violence Visit Work base brain behavior child physical abuse clinical effect clinical risk cohort early childhood early experience emotion regulation experience follow-up functional disability indexing informant maltreatment neglect neural circuit neurodevelopment neuromechanism neuropsychiatry novel population based post-traumatic stress public health relevance relating to nervous system skills social stressor two-dimensional

项目摘要

DESCRIPTION (provided by applicant): Exposure to extreme stressors in early life is thought to substantially increase the risk of developmental psychopathology in children through effects of trauma processes on neurodevelopment. The aim of this proposal is to elucidate the neurodevelopmental and clinical sequelae of one particularly common and pernicious form of early traumatic stress, i.e., family violence exposure. Both inter-parental violence and child- directed violence have considerable empirical linkage to increased clinical risk, as indicated by broad-band externalizing and internalizing problems and post-traumatic stress symptoms in clinical and community samples. Recent evidence from neuroscientific studies using small samples of extreme group contrasts (e.g., comparing maltreated vs. non-maltreated children) provides strong empirical grounding for postulating candidate neurodevelopmental mechanisms by which violence exposure exerts its effects, including atypical patterns of cognitive processing of emotion reflecting heightened sensitivity to anger and threat cues. Building on this foundational work, we employ a community-based sampling approach to amplify and extend this work along the full spectrum of family violence exposure and test applications to the broader population during the critical early childhood period. Specific aims are to: (1) identify the optimal scaling of family violence exposure with a dimensional approach, which reflects variations in severity and forms of child violence exposure (from normative to extreme); (2) test the relationship of extent of violence exposure to specific patterns of preschool disruptive behavior, anxiety, and impairment; and (3) test whether atypical emotion processing characteristics mediate the link between exposure extent and psychopathology symptoms and functioning over time and establish whether these patterns are specific to violence exposure or are a more general effect of stress. We capitalize on a large pediatric sample (N=2,200) to be ascertained for the recently funded MAPS study on developmentally-sensitive characterization of preschool disruptive behavior (R01MH082830, Wakschlag, PI). From the sociodemographically stratified MAPS cohort, we draw a sample (N=300) enriched for family violence exposure and non-violent family stressors, but otherwise representative of the overall stratification. Parallel to the procedures of the MAPS study, a multi-informant, multi-method, developmentally-sensitive approach will be employed to assess preschool disruptive behavior and anxiety in a baseline laboratory visit and 6-month follow-up. In a second laboratory visit, family violence exposure will be assessed via an in-depth interview and preschoolers' emotion processing will be assessed with neurocognitive tasks (e.g., affective dot probe). Patterns of brain reactivity will be directly assessed during face processing using event-related potentials (ERPs) for a subset of 160 children. This approach shows promise for elucidating the role of traumatic stress exposure in the emergence of psychopathology and for providing a basis for broadly-applicable, novel interventions that can reduce the burden of mental disorder associated with early traumatic experiences.

描述（由申请人提供）：生命早期暴露于极端压力源被认为会通过创伤过程对神经发育的影响而大大增加儿童发展性精神病理学的风险。该提案的目的是阐明一种特别常见且有害的早期创伤应激形式（即家庭暴力暴露）的神经发育和临床后遗症。临床和社区样本中广泛的外化和内化问题以及创伤后应激症状表明，父母间暴力和针对儿童的暴力与临床风险增加具有相当大的经验联系。最近使用极端群体对比的小样本（例如，比较受虐待儿童与未受虐待儿童）的神经科学研究证据，为假设暴力暴露发挥作用的候选神经发育机制提供了强有力的经验基础，包括反映情绪的认知处理的非典型模式对愤怒和威胁暗示的敏感性提高。在这项基础工作的基础上，我们采用基于社区的抽样方法，将这项工作扩大并扩展到家庭暴力暴露的全范围，并将测试应用到关键的幼儿时期的更广泛人群。具体目标是：（1）采用维度方法确定家庭暴力暴露的最佳尺度，反映儿童暴力暴露的严重程度和形式的变化（从正常到极端）； (2) 测试暴力暴露程度与学前破坏性行为、焦虑和障碍的特定模式之间的关系； (3) 测试非典型情绪处理特征是否介导暴露程度与精神病理学症状和功能之间的联系，并确定这些模式是否是暴力暴露所特有的，还是压力的更普遍的影响。我们利用大量儿科样本 (N=2,200) 来确定最近资助的关于学前破坏性行为的发育敏感特征的 MAPS 研究 (R01MH082830, Wakschlag, PI)。从社会人口统计学分层的 MAPS 队列中，我们抽取了一个样本 (N=300)，该样本丰富了家庭暴力暴露和非暴力家庭压力源，但在其他方面代表了整体分层。与 MAPS 研究程序并行，将采用多信息、多方法、发育敏感的方法来评估基线实验室访问和 6 个月随访中的学前破坏性行为和焦虑。在第二次实验室访问中，将通过深入访谈评估家庭暴力暴露，并通过神经认知任务（例如情感点探针）评估学龄前儿童的情绪处理。在面部处理过程中，将使用事件相关电位 (ERP) 对 160 名儿童的大脑反应模式进行直接评估。这种方法有望阐明创伤性应激暴露在精神病理学出现中的作用，并为广泛适用的新颖干预措施提供基础，这些干预措施可以减轻与早期创伤经历相关的精神障碍的负担。