Risk Profiles and Mechanisms of Disease in Maltreated Children

受虐待儿童的风险概况和疾病机制

基本信息

批准号：
9355216
负责人：
AUDREY TYRKA
金额：
$ 60.63万
依托单位：
BUTLER HOSPITAL (PROVIDENCE, RI)
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-21 至 2021-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9355216
关键词：
Accelerometer Adult Adverse event Affective Age Allergic rhinitis Anti-Inflammatory Agents Anti-inflammatory Anxiety Anxiety Disorders Asthma Attenuated Behavioral Biogenesis Biological Biological Markers Blood Pressure Cardiovascular Diseases Caregivers Cell Aging Cell Death Cellular Stress Characteristics Child Child Abuse and Neglect Child Rearing Childhood Chronic Clinical Cognitive Data Depressive disorder Development Diabetes Mellitus Diagnosis Diet Dilatation - action Disease Disease Outcome Dose Endocrine Enzymes Epigenetic Process Exercise Future Genes Glucocorticoids Goals Health Home environment Homelessness Hunger Hydrocortisone Inflammatory Interleukin-1 beta Intervention Interview Lead Life Link Literature Lung Measures Mediating Mediator of activation protein Medical Medical Records Metabolic Metabolic syndrome Metabolism Methylation Mitochondria Mitochondrial DNA Modeling Mood Disorders Moods Nature Neighborhoods Neurobiology Nursery Schools Obesity Outcome Outcome Measure Pathway interactions Pharmaceutical Preparations Plasma Population Poverty Prevention Process Proteins Public Health Public Health Practice Publishing Pulmonary function tests Questionnaires Research Resources Respiratory Chain Risk Risk Factors Salivary Sampling Satiation Signal Transduction Sleep Social Work Social support Socioeconomic Factors Statistical Models Stress System Telomere Shortening Testing Time Tissues Translations Trauma United States Virulent Work aged allostatic load behavior influence behavioral health biological systems clinical practice cognitive task cognitive testing computerized cost cytokine depressive symptoms diet and exercise dietary supplements disability early onset disorder environmental tobacco smoke exposure experience follow up assessment follow-up glucose metabolism high risk indexing insight maltreated children maltreatment metabolic rate mitochondrial dysfunction novel pre-clinical productivity loss programs prospective public health relevance pulmonary function resilience social stress related disorder

Accelerometer Adult Adverse event Affective Age Allergic rhinitis Anti-Inflammatory Agents Anti-inflammatory Anxiety Anxiety Disorders Asthma Attenuated Behavioral Biogenesis Biological Biological Markers Blood Pressure Cardiovascular Diseases Caregivers Cell Aging Cell Death Cellular Stress Characteristics Child Child Abuse and Neglect Child Rearing Childhood Chronic Clinical Cognitive Data Depressive disorder Development Diabetes Mellitus Diagnosis Diet Dilatation - action Disease Disease Outcome Dose Endocrine Enzymes Epigenetic Process Exercise Future Genes Glucocorticoids Goals Health Home environment Homelessness Hunger Hydrocortisone Inflammatory Interleukin-1 beta Intervention Interview Lead Life Link Literature Lung Measures Mediating Mediator of activation protein Medical Medical Records Metabolic Metabolic syndrome Metabolism Methylation Mitochondria Mitochondrial DNA Modeling Mood Disorders Moods Nature Neighborhoods Neurobiology Nursery Schools Obesity Outcome Outcome Measure Pathway interactions Pharmaceutical Preparations Plasma Population Poverty Prevention Process Proteins Public Health Public Health Practice Publishing Pulmonary function tests Questionnaires Research Resources Respiratory Chain Risk Risk Factors Salivary Sampling Satiation Signal Transduction Sleep Social Work Social support Socioeconomic Factors Statistical Models Stress System Telomere Shortening Testing Time Tissues Translations Trauma United States Virulent Work aged allostatic load behavior influence behavioral health biological systems clinical practice cognitive task cognitive testing computerized cost cytokine depressive symptoms diet and exercise dietary supplements disability early onset disorder environmental tobacco smoke exposure experience follow up assessment follow-up glucose metabolism high risk indexing insight maltreated children maltreatment metabolic rate mitochondrial dysfunction novel pre-clinical productivity loss programs prospective public health relevance pulmonary function resilience social stress related disorder

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项目摘要

Childhood maltreatment is a major public health problem that is linked to high rates of mood and anxiety disorders, and a growing literature documents risk for conditions such as obesity, cardiovascular disease, asthma, and diabetes. These conditions are often chronic and severe, and they exact tremendous costs in terms of suffering, disability, treatment, and loss of productivity. Existing social services programs for maltreated children suffer from a lack of available data regarding which children are at risk for which psychiatric outcomes and from a lack of focus on risk for other adverse health conditions. In order to develop more targeted and specific interventions and treatments, we need to better understand the trajectory and mechanisms of risk and protective factors. There is evidence that the pathophysiological effects of adversity begin early in life, and that clinical or sub-clinical effects of major adversity can be seen in childhood. Maltreated children, particularly those living in poverty, are at especially high risk for early-onset disorders, but childhood maltreatment is usually clandestine and therefore very difficult to study. This study involves a 5-year follow up assessment of a sample of impoverished maltreated preschool-aged children and demographically matched non-maltreated children. Existing data include details of maltreatment experiences, socioeconomic factors and neighborhood characteristics, and additional adversities such as parental loss, homelessness, and traumas. Data on protective factors include home and neighborhood resources, parenting, and social services. In our initial work, adverse experiences were linked to depressive symptoms and blunted cortisol levels, and epigenetic changes to glucocorticoid signaling genes were significant mediators of these relationships. We also found that levels of salivary inflammatory cytokine IL-1β increased as a function of stress exposure. In our work with healthy un-medicated adults, we have shown that attenuated plasma cortisol concentrations are linked to several indices of the metabolic syndrome, and that childhood stress and psychiatric conditions are associated with telomere shortening and a measure of mitochondrial DNA proliferation, indicators of cellular stress and aging. In the proposed 5-year follow-up, we will test a model of risk and resilience for medical and psychiatric outcomes obtained from medical records, from interviews and questionnaires completed by children and caregivers, and tests of cognitive/affective, metabolic, endovascular, and pulmonary function. Behavioral, social, and biological mechanisms of risk and resilience will be examined. Statistical models will be aimed at identifying profiles of risk and protective factors and biological mechanisms that are most likely to be useful targets for intervention.

儿童虐待是一个主要的公共卫生问题，与高情绪和动画率有关疾病和越来越多的文献记录了肥胖，心血管疾病等疾病的风险，哮喘和糖尿病。这些条件通常是慢性且严重的，它们的巨大成本苦难，残疾，治疗和生产力丧失的条款。现有的社会服务计划受虐待的儿童缺乏有关哪些儿童处于精神病的风险的缺乏的数据结果以及缺乏对其他不良健康状况的风险的关注。为了发展更多有针对性和特定的干预措施和治疗，我们需要更好地了解轨迹和风险和保护因素的机制。有证据表明广告的病理生理影响从生命的早期开始，在童年时期可以看到主要广告的临床或临床效应。受虐待的儿童，特别是生活在贫困中的孩子，患有早发疾病的风险尤其高，但是儿童虐待通常是秘密的，因此很难研究。这项研究涉及5年后续评估贫困的虐待虐待学龄前儿童和人口统计学样本匹配的未熟食儿童。现有数据包括虐待经历的详细信息，社会经济因素和邻里特征，以及其他逆境，例如父母丧失，无家可归和创伤。有关保护因素的数据包括家庭和邻里资源，育儿和社会服务。在我们最初的工作中，不良经历与抑郁症状和蓝色皮质醇水平有关，以及糖皮质激素信号基因的表观遗传学变化是这些关系的重要介体。我们也是发现唾液炎性细胞因子IL-1β水平随着压力暴露而增加。在我们的与健康的非药物成年人一起工作，我们表明血浆皮质醇浓度是与代谢综合征的几个指数有关，童年的压力和精神病疾病是与端粒缩短和线粒体DNA增殖的量度相关，细胞指标压力和衰老。在拟议的5年随访中，我们将测试一种对医疗的风险和韧性模型从医疗记录中获得的精神病结果，来自儿童完成的访谈和问卷调查和护理人员，以及认知/情感，代谢，血管内和肺功能的测试。行为，将检查风险和弹性的社会和生物学机制。统计模型将针对确定最有可能有用的风险和保护因素和生物机制的概况干预的目标。