Prospective predictors of risk and resilience trajectories of mental health in US youth during COVID-19

COVID-19 期间美国青少年心理健康风险和复原力轨迹的前瞻性预测因素

• 批准号: 10655685
• 负责人: Ran Barzilay
• 金额: $ 26.7万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10655685
• 关键词: 13 year old; Address; Adolescence; Adolescent; Age; Anxiety; Back; Black race; Brain; COVID-19; COVID-19 pandemic; Chronic; Chronic stress; Clinical; County; Data; Data Analyses; Development; Dimensions; Early Intervention; Emotional; Environment; Environmental Exposure; Environmental Risk Factor; Exposure to; Financial Hardship; Fostering; Future; Genes; Genetic; Genotype; Global Warming; Goals; Growth; Health; Height; Household; Individual; Intervention; Life; Longitudinal Studies; Measures; Mental Depression; Mental Health; Mental disorders; Modeling; Neighborhoods; Neurocognitive; Outcome; Participant; Pattern; Persons; Phenotype; Post-Traumatic Stress Disorders; Preventive measure; Process; Psychiatry; Psychopathology; Research; Risk; Risk Factors; Risk Marker; SARS-CoV-2 infection; Sampling Studies; Schools; Social Interaction; Source; Stress; Symptoms; System; Teenagers; Time; Trauma; Youth; child depression; childhood anxiety; clinical phenotype; cognitive development; cohort; comparison group; coronavirus disease; deprivation; emotion regulation; experience; genetic information; improved; inter-individual variation; male; pandemic disease; pandemic stress; peer; pre-pandemic; preventive intervention; promote resilience; prospective; psychologic; recruit; resilience; resilience factor; response; risk stratification; sex; stress related disorder; stressor; structural determinants; substance use; suicidal behavior; trait; young adult

The COVID-19 pandemic has had substantial effects on youth in multiple aspects of life, raising concern about its impact on youth mental health. Indeed, mounting data suggest that youth depression and anxiety rates have increased compared to the pre-pandemic era. A key challenge is to recognize prospective predictors that can help identify youth at risk for serious mental health sequelae following COVID-19 and to disentangle the factors that contribute to resilient trajectories. Resilience, often defined as an adaptive outcome (i.e., low symptoms levels) following adversity, is driven by multiple systems including individual- and structural-level environmental factors, neurocognitive traits, and genetic factors. One approach to study resilience is to identify inter-individual variation in mental health trajectories following the pandemic, and use data collected prospectively before and early in the pandemic to better understands what determines variability in mental health trajectories under stress. The Adolescent Brain Cognitive Development (ABCD) Study (N~12,000, 52% male, recruited at age 9-10 years, 20% Black) follows diverse US youth longitudinally since 2017. The study collected multidimensional (i.e., environment, clinical, neurocognitive, genetic) data before the pandemic, and participants were ~12-13 years old when the pandemic hit. Between May 2020 to June 2021, the study team collected data on mental health and on COVID-19 related exposures at multiple time points from ~9,500 participants and will continue following participants into late adolescence. Therefore, ABCD Study creates a unique opportunity to disentangle risk and resilience factors collected prospectively in youth who were in early-mid adolescence when the pandemic hit, a critical developmental window when stress related disorders become more prevalent. In the current project, we propose to leverage the multi-dimensional ABCD Study data to identify factors that contribute to variability in mental health trajectories in US youth during the COVID-19 pandemic. We will first use latent growth mixture modeling to identify trajectories of internalizing symptoms over time. Thereafter, we will characterize the individual stressors and the structural (based on geocoded address) environmental exposures- before and early in the pandemic- that contribute to trajectories of risk and resilience (Aim 1). In addition, we will leverage the deep phenotyping that was conducted pre-COVID-19 to identify clinical and neurocognitive risk and resilience factors (Aim 2). Lastly, we will explore whether participants' genetic information (i.e., polygenic risk for psychiatric disorders) can help explain variability in mental health trajectories during the pandemic (Aim 3). The proposed research will identify what factors contribute to resilience (i.e., resilience factors); and who will show risk or resilience trajectory in response to chronic (pandemic-imposed) stress. The study addresses key gaps that are critical considering the expected chronic stress that is (and will likely keep being) imposed on youth due to the pandemic and other future adversities. Findings will improve risk stratification in youth exposed to chronic adversity and will identify targets for interventions aimed at enhancing resilience.

在生活的多个方面，COVID-19的大流行对年轻人产生了重大影响，引起了人们对 它对青年心理健康的影响。确实，安装数据表明青年抑郁症和焦虑率有 与流行前时代相比增加。一个关键挑战是认识到可以的预测指标 帮助确定与19年之后有严重心理健康后遗症风险的年轻人，并消除因素 这有助于弹性轨迹。弹性，通常被定义为适应性结果（即低症状 在逆境之后的级别）由多个系统驱动，包括个人和结构级环境 因素，神经认知性状和遗传因素。一种研究弹性的方法是识别个体间 大流行后心理健康轨迹的差异，并在前及 在大流行的早期，可以更好地理解压力下心理健康轨迹变异性的原因。 青少年脑认知发展（ABCD）研究（n〜12,000，52％男性，在9-10岁时招募 自2017年以来，年度为20％的黑色）遵循多样化的美国青年。该研究收集了多维 （即，大流行之前的环境，临床，神经认知，遗传）数据，参与者为〜12-13 大流行袭击时的年龄。在2020年5月至2021年6月之间，研究团队收集了有关心理的数据 健康和COVID-19与约9,500名参与者的多个时间点相关暴露，并将继续 跟随参与者进入青春期晚期。因此，ABCD研究创造了一个独特的机会 在早期青春期的青年中预期收集的疏散风险和弹性因素 当大流行袭击时，当压力相关疾病变得更加普遍时，关键的发育窗口。 在当前项目中，我们建议利用多维ABCD研究数据来确定因素 在COVID-19大流行期间，美国青年的心理健康轨迹变异性有助于。我们将首先使用 潜在生长混合物建模，以鉴定随着时间的推移内在症状的轨迹。此后，我们会的 表征单个压力源和结构（基于地理地址）的结构环境暴露 - 大流行的早期和早期，促进了风险和韧性的轨迹（AIM 1）。此外，我们将 利用前卵路前进行的深层表型，以识别临床和神经认知风险以及 弹性因素（目标2）。最后，我们将探讨参与者的遗传信息（即多基因风险 精神疾病）可以帮助解释大流行期间心理健康轨迹的变异性（AIM 3）。这 拟议的研究将确定哪些因素有助于弹性（即弹性因素）；谁将显示 响应慢性（大流行）应力的风险或韧性轨迹。该研究解决了关键差距 考虑到预期的慢性压力（并且可能会一直）对年轻人的预期压力至关重要 大流行和其他未来的逆境。调查结果将改善暴露于慢性的青年的风险分层 逆境并将确定旨在增强弹性的干预措施的目标。