HPA Reactivity and Diurnal Patterns Associated with Adolescent Anxiety/Depression

HPA 反应性和昼夜模式与青少年焦虑/抑郁相关

• 批准号: 7627408
• 负责人: Marilyn J Essex
• 金额: $ 18.56万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7627408
• 关键词: 18 year old; Acute; Address; Adolescence; Adolescent; Adolescent Development; Adrenal Glands; Adult; Age; Anxiety; Anxiety Disorders; Attention; Basic Science; Biological; Birth; Characteristics; Child; Childhood; Cognitive; Communities; Comorbidity; Corticotropin; Data; Development; Diagnostic; Disease; Emotions; Equilibrium; Evaluation; Family; Family Study; Functional disorder; Gender; Goals; Home environment; Hormonal; Hydrocortisone; Hypothalamic structure; Impairment; Individual; Interview; Laboratories; Length; Life; Life Experience; Major Depressive Disorder; Mental Health; Methods; Modeling; Mothers; Neurosecretory Systems; Pattern; Physiological; Pilot Projects; Pituitary Gland; Prevalence; Prevention; Process; Prospective Studies; Psychopathology; Public Health; Questionnaires; Randomized; Recording of previous events; Recovery; Recruitment Activity; Regulation; Research; Research Design; Risk Factors; Salivary; Sex Characteristics; Stress; Symptoms; System; Testing; Translational Research; Trier Social Stress Test; Wisconsin; Work; base; biobehavior; biological adaptation to stress; clinically significant; cognitive change; contextual factors; depression; depressive symptoms; early experience; indexing; informant; insight; psychosocial; public health relevance; response; stressor

DESCRIPTION (provided by applicant): The proposed research aims to systematically investigate the associations of adolescent anxiety, depression, and their comorbidity with hypothalamic-pituitary-adrenal (HPA) function, considering potential differences by context, gender, early life experiences, and individual biobehavioral factors. Research design and methods: This project will focus especially on HPA reactivity (indexed by salivary cortisol) to an acute psychosocial stressor. Using a newly-developed exportable adolescent version of the Trier Social Stress Test (TSST), this study will distinguish reactivity during anticipatory, task, and recovery periods and in unfamiliar vs. familiar contexts. During Grade 12 (approximate age 18 years), adolescents (n=96) will be recruited from the Wisconsin Study of Families and Work, a longitudinal community study of child/adolescent development (N=417). Based on levels of anxiety and/or depression symptoms averaged over Grades 9, 10 and 11, half (n=48) will be selected for high levels of anxiety and/or depression symptoms; the other half (n=48) will be randomly selected from the lower half of both distributions. Each group of 48 will be randomly assigned to assessments conducted either in the laboratory (unfamiliar context; n=24) or home (familiar context; n=24), balanced for gender. HPA basal activity also will be assessed over 3 days to characterize diurnal patterns. Interviews and questionnaires with adolescents and their mothers will ascertain recent life stressors, adolescent cognitive attributions/biases, and adolescent mental health symptoms and impairments. Full diagnostic psychiatric evaluations (K-SADS) will be obtained. Specific aims: (1) to investigate (a) the associations of HPA diurnal patterns (overall levels and daily slope of cortisol) and reactivity to an acute psychosocial stressor (TSST), differentiating anticipatory, task, and recovery components, and (b) differences by context (unfamiliar laboratory vs familiar home) and gender; (2) to investigate (a) the associations of HPA activity (diurnal and reactive, as defined in Aim 1) with adolescent anxiety and/or depression, and (b) differences by context and gender; and (3) to explore (a) differences in the associations found in Aims 1 and 2 by adolescents' earlier histories of stress exposure, HPA diurnal patterns, and temperamental inhibition, and (b) differences by context and gender. This application is consistent with the goals of PAR-06-473, "Translational Research on the Relationship of Anxiety and Depression". It is interdisciplinary, addressing questions integrating biological, neuroendocrine stress-response systems with contextual and individual factors; it is exploratory, including a newly-developed adolescent version of the TSST that is exportable to field settings; and, it is translational, integrating basic science research with the study of adolescent mental health. PUBLIC HEALTH RELEVANCE: By looking at hypothalamic-pituitary-adrenal (HPA) function, the proposed project will provide insight into the underlying pathophysiology of comorbid anxiety and depression in adolescence, which has relevance for the development of effective pharmacological and other treatments. Further, by taking advantage of the longitudinal data available in the Wisconsin Study of Families and Work, the proposed project can look at the development of comorbid anxiety/depression and what early experiences and child characteristics are risk factors for these later processes, work that is important for the development of early prevention efforts.

描述（由申请人提供）：拟议的研究旨在系统地研究青春期焦虑，抑郁症及其合并症与下丘脑 - 垂体 - 肾上腺肾上腺功能（HPA）功能的关联，考虑上下文，性别，早期生活经验和个体生物行为因素的潜在差异。研究设计和方法：该项目将特别关注HPA反应性（由唾液皮质醇索引）对急性社会心理压力源。本研究使用Trier社会压力测试（TSST）的新发达的青少年版本，将在预期，任务和恢复期间以及在陌生和熟悉的环境中区分反应性。在12年级（大约18岁）期间，将从威斯康星州的家庭和工作研究中招募青少年（n = 96），这是对儿童/青少年发展的纵向社区研究（n = 417）。根据焦虑症和/或抑郁症状的水平，在9、10和11年级的焦虑症状下，将针对高水平的焦虑和/或抑郁症状选择一半（n = 48）；另一半（n = 48）将从两个分布的下半部分随机选择。每组48组将随机分配到在实验室（不熟悉的环境； n = 24）或家庭（熟悉的环境; n = 24）中进行的评估，并为性别保持平衡。 HPA基础活性也将在3天内进行评估，以表征昼夜模式。对青少年及其母亲的访谈和问卷将确定最近的生活压力源，青少年认知归因/偏见以及青少年的心理健康症状和障碍。将获得完整的诊断精神病评估（K-SADS）。具体目的：（1）调查（a）HPA昼夜模式的关联（皮质醇的总体水平和每日坡度）以及对急性社会心理压力源（TSST）的反应性，预期，任务和恢复组件的区分，任务和恢复组件，以及（b）差异（b）上下文（陌生的实验室vs熟悉的家庭）和性别； （2）研究（a）HPA活性的关联（AIM 1中定义的昼夜和反应性）与青少年焦虑和/或抑郁症的关联，以及（b）通过上下文和性别差异； （3）探索（a）青少年早期的压力暴露历史，HPA昼夜模式和气质抑制以及（b）通过上下文和性别差异的差异。该应用与PAR-06-473的目标是“焦虑与抑郁关系的转化研究”。它是跨学科的，解决了将生物学，神经内分泌压力反应系统与上下文和个人因素相结合的问题；它是探索性的，包括新开发的TSST青少年版本，可导出到现场设置；而且，它是转化的，将基础科学研究与青少年心理健康研究相结合。公共卫生相关性：通过查看下丘脑 - 垂体 - 肾上腺（HPA）功能，该提议的项目将洞悉青春期合并症焦虑和抑郁的潜在病理生理学，这与有效的药理和其他治疗方面的发展相关。此外，通过利用威斯康星州家庭和工作研究中可用的纵向数据，拟议的项目可以研究合并焦虑/抑郁症的发展以及这些早期的经历和儿童特征是这些后期过程的风险因素，这对于早期预防努力的发展至关重要。