Web-Based Intervention for Disaster-Affected Adolescents and Families

针对受灾青少年和家庭的网络干预

• 批准号: 8039046
• 负责人: ANANDA B AMSTADTER
• 金额: $ 21.38万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-19 至 2012-09-27
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8039046
• 关键词: Web; Based; Intervention; Disaster; Affected

DESCRIPTION (provided by applicant): Posttraumatic Stress Disorder (PTSD) among adolescents exposed to disasters is prevalent and increases health morbidity and mortality. Although PTSD is common among youth exposed to traumatic stressors, is not present among all exposed youth. Disaster-exposed youth, in comparison to adults, are at significantly greater risk for PTSD, with symptoms often persisting for many months and years post-disaster; however, youth are drastically under-represented in post-disaster studies. Considerable effort, primarily in the adult literature, has been given to identify variables related to PTSD risk, but only about 20 percent of variance has been explained by psychosocial variables; thus, there has been interest in including genetic determinants into studies of PTSD. Despite moderate heritability estimates (30 percent) for PTSD, modern studies of genetic risk factors for PTSD are relatively few in number and psychiatric genetic investigations have been mixed in their ability to identify direct effects of genotypes on disorder phenotypes. Notably, there are no existant genetically informed studies of adolescent PTSD, a critical developmental phase. Therefore, the need is high for novel approaches to examining genetic and environmental moderators to inform models of risk and resilience in disaster exposed youth. Therefore, we are responding to Notice Number (NOT-OD-10-032) Title: NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications (R01, R03, R15, R21, R21/R33, and R37) through the NIH Basic Behavioral and Social Science Opportunity Network (OppNet). The primary objective of this project, directly in accordance with the research priorities of the NIH OppNet (NOT-OD-10- 032), is to add genetic sampling to a funded R01 investigation of disaster-exposed youth. The parent project will recruit a population-based sample of 3,000 disaster exposed youth and their parents participating in an NIH-funded longitudinal, web-based intervention study (R01MH081056). Youth and parent participants will complete an initial phone-based assessment, where information regarding disaster exposure, other traumatic event experiences and incident characteristics, family-related variables, and PTSD and other mental health symptomatology will be gathered. OppNet funding will be used to expand the interview to include a larger range of possible environmental modifiers. During the baseline interview, adolescents will be asked to provide saliva samples for DNA analysis, which will also be conducted through use of OppNet funding. Participants will be sent a collection kit that they return via U.S. mail, methods we have successfully executed in a previous disaster-focused study. DNA will be extracted from saliva samples and candidate genes will be examined via the tagging SNP method and by assying specific variable number tandem repeats of genes reported in the extant literature to be relevant for PTSD. By examining GxE interactions this project will assess whether relations between candidate genes and PTSD are moderated by aspects of the environment. This project, by harnessing the behavioral and social data from the R01 with the biologic data from the OppNet funding, will afford a deeper understanding of the interplay between the environment and biology in the aftermath of a traumatic stressor. Additionally, this project has potential public health benefits of informing the knowledge of pathophysiology of PTSD which may lead to improved pharmacologic treatment targets. PUBLIC HEALTH RELEVANCE: Many youth are exposed to disasters and other potentially traumatic events that can produce posttraumatic stress disorder (PTSD); however, not all exposed individuals develop PTSD, so information is needed about how biologic and environmental factors interact to increase or decrease risk of PTSD post-disaster. This project addresses this issue by collecting DNA from adolescents who were exposed to a disaster, allowing for examination of gene by environment interactions for adolescent PTSD. By testing whether relevant candidate genes and features of the environment modify the impact of exposure to traumatic events, we will advance basic science knowledge that will deepen our understanding of the causes of pediatric PTSD, which may inform secondary prevention or intervention of PTSD in youth.

描述（由申请人提供）：暴露于灾难的青少年中创伤后应激障碍（PTSD）是普遍的，并且会增加健康的发病率和死亡率。尽管PTSD在暴露于创伤性压力源的青年中很常见，但并非所有暴露的青年中都存在。与成年人相比，遭受灾难暴露的青年对PTSD的风险明显更大，症状通常会在疾病后数月和几年持续存在。但是，在灾后研究中，青年人的人数差不多。主要在成人文献中，已经为识别与PTSD风险有关的变量而付出了巨大的努力，但是只有20％的差异已通过社会心理变量来解释。因此，人们有兴趣将遗传决定因素纳入PTSD研究。尽管PTSD的遗传力估计中等（30％），但对PTSD的遗传危险因素的现代研究相对较少，精神病遗传研究已经混合在其鉴定基因型对疾病表型的直接影响的能力上。值得注意的是，没有关于青少年PTSD的遗传知识研究，这是一个关键的发育阶段。因此，需要新的方法来检查遗传和环境主持人的新方法，以告知灾难暴露的青年风险和韧性模型。因此，我们正在回应通知号（NOT-OD-10-032）标题：NIH宣布通过NIH基本行为和社交科学机会网络（OPPNET）宣布竞争性修订应用程序（R01，R03，R15，R21，R21/R33和R37）的恢复法基金（R01，R03，R15，R21，R21/R33和R37）。该项目的主要目的直接符合NIH OPPNET的研究优先事项（NOT-OD-10-032），是为了在对灾难暴露的青年的资助R01调查中添加遗传抽样。该家长项目将招募一个基于人群的3,000名灾难暴露的青年及其父母参加的基于NIH资助的基于网络的干预研究（R01MH081056）。青年和家长参与者将完成基于电话的最初评估，其中将收集有关灾难暴露，其他创伤事件经验和事件特征，与家庭有关的变量以及PTSD以及其他心理健康症状学的信息。 OPPNET资金将用于扩展访谈，以包括更多可能的环境修饰符。在基线访谈中，将要求青少年提供唾液样本进行DNA分析，这也将通过使用OPPNET资金来进行。将向参与者发送收集套件，他们通过美国邮件返回，这是我们在以前以灾难为中心的研究中成功执行的方法。将从唾液样品中提取DNA，并通过标记SNP方法研究候选基因，并通过评估特定的可变数量串联重复序列，该基因在现有文献中报道的基因重复序列与PTSD相关。通过检查GXE相互作用，该项目将评估候选基因与PTSD之间的关系是否受环境方面的调节。通过利用R01的行为和社交数据，通过OPPNET资助的生物数据来利用行为和社会数据，将在创伤性压力源后更深入地了解环境与生物学之间的相互作用。此外，该项目具有潜在的公共卫生益处，可以为PTSD的病理生理学知识提供信息，这可能会导致改善药理治疗靶标。 公共卫生相关性：许多年轻人暴露于灾难和其他可能引起创伤后应激障碍（PTSD）的可能创伤事件；但是，并非所有暴露的人都会发展PTSD，因此需要有关生物和环境因素如何相互作用以增加或降低PTSD后疾病后风险的信息。该项目通过从暴露于灾难的青少年那里收集DNA来解决这个问题，从而可以通过青少年PTSD的环境相互作用来检查基因。通过测试相关的候选基因和环境的特征是否会改变暴露于创伤事件的影响，我们将提高基础科学知识，从而加深我们对小儿PTSD原因的理解，这可能会为PTSD在青年中的二级预防或干预提供信息。