Multiple Levels of Analysis: Trauma, Violence and PTSD Among Youths'

多层次分析：青少年的创伤、暴力和创伤后应激障碍

• 批准号: 7660928
• 负责人: Paul Boxer
• 金额: $ 26.49万
• 依托单位: RUTGERS THE STATE UNIV OF NJ NEWARK
• 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/7660928
• 关键词: 14 year old; Accounting; Acute; Address; Adolescent; Affect; Age; Aggressive behavior; Anxiety; Archives; Area; Back; Behavior; Biological; Caregivers; Censuses; Characteristics; Child; Chronic; Classification; Clinical; Clinical Research; Clinical Sciences; Cluster Analysis; Cognitive; Communities; Conceptions; Crime; Data; Data Reporting; Data Sources; Development; Dimensions; Disease; Distal; Distress; Ecology; Emotional; Emotional Disturbance; Emotional disorder; Empirical Research; Equilibrium; Ethnic Origin; Ethnic group; Exposure to; Factor Analysis; Family; Foundations; Four-dimensional; Frequencies; Funding Mechanisms; Future; Gender; Goals; Health; Health Services Accessibility; Health Status; Hearing; Home environment; Human Resources; Individual; Intervention; Investigation; Knowledge; Life; Life Experience; Linear Models; Link; Literature; Measurement; Measures; Mental Health; Methods; Modeling; Nature; Neighborhoods; Outcome; Parents; Pathway interactions; Patient Self-Report; Pattern; Peer Group; Police; Population Study; Post-Traumatic Stress Disorders; Poverty; Prevention; Property; Protocols documentation; Psychometrics; Psychopathology; Race; Recommendation; Records; Regression Analysis; Reporting; Research; Rest; Risk; Sampling; Schools; Scientist; Severities; Shapes; Social Environment; Socialization; Source; Staging; Stress; Subgroup; Substance abuse problem; Symptoms; Techniques; Testing; Thinking; TimeLine; Translating; Trauma; Traumatic Stress Disorders; Urban Population; Variant; Victimization; Violence; Weight; Work; Youth; anti social; base; behavioral/social science; biological adaptation to stress; biopsychosocial; clinically significant; depression; design; effective intervention; emotional distress; high risk; indexing; informant; metropolitan; novel; novel strategies; portability; public health relevance; racial and ethnic; response; sex; social; social cognition; theories; trend; youth violence

DESCRIPTION (provided by applicant): Despite national trends showing declines in violent crime, studies show that violence remains alarmingly high in some communities as well as in homes, schools, and the media. The goal of this proposed R21 project is twofold: To develop a multi-informant, multi-method assessment of youths' exposure to violence in the social environment, anchored to youths' mental health; and to set a foundation for launching new research into the reduction and prevention of the deleterious mental health consequences of youth violence exposure. Our novel approach to assessment is driven by a four-dimensional conception of violence exposure based on the context (setting), content (impact), channel (mode of exposure), and chronicity (frequency of exposure) of specific acts of violence. Our measurement is tied to a comprehensive assessment of mental health (externalizing, internalizing, and traumatic stress disorders) to provide an overall assessment of the burden of violence exposure based on current theory in developmental psychopathology. This investigation will be conducted in socio-economically distressed urban neighborhoods comprising a range of projected risk for exposure to violence in a major metropolitan area of the Northeast. Our study population will be families with children between the ages of 11 and 14 inclusive; we will sample caregiver-youth pairs (dyadic N = 200) for a comprehensive protocol integrating information from the pairs directly with information from data sources across all levels of the social ecology. Our investigation is guided by five aims: 1) Develop and implement a cross-informant, mixed-method protocol for assessing youths' exposure to violence in the social environment; 2) Utilize our novel four-dimensional conception of violence exposure to evaluate the psychometric properties of the new individualized protocol and establish internal validity; 3) Apply a dual pathway model of how exposure to violence affects mental health outcomes to evaluate the criterion validity of the new protocol; 4) Employ multivariate modeling to analyze patterns of exposure and associated outcomes across meaningful subpopulations (e.g., low and high risk for exposure) to assess the generalizability of the new protocol; and 5) Analyze various combinations of reports in order to finalize a protocol for field testing in clinical research settings. Our investigation will provide information critical to understanding how violence exposure leads to negative health outcomes. Ultimately this knowledge will be essential to efforts at reducing the negative impact of exposure to violence. Our approach to measuring youths' exposure to violence is essential for formulating individualized assessment and intervention strategies for ameliorating the negative sequelae of exposure among children and adolescents. Further, the proposed investigation represents a necessary step in expanding our knowledge of how violence in the social ecology impacts individual mental health via biopsychosocial mechanisms. PUBLIC HEALTH RELEVANCE: Although a large body of research confirms detrimental effects of youths' exposure to violence in multiple social contexts on their mental health status, there have been no systematic efforts to develop a theoretically informed measure of exposure to violence across settings. Properly assessing exposure to violence along key dimensions including context as well as severity, frequency, and mode of exposure is an essential step in advancing our understanding of how violence affects youths' mental health outcomes. Better measurement of exposure also will translate into more precise and ultimately more effective intervention strategies. The proposed project aims to develop a new protocol for assessing youths' exposure to violence and exploring how different profiles of exposure account for different patterns of psychopathology.

描述（由申请人提供）：尽管国家趋势显示暴力犯罪的下降，但研究表明，某些社区以及家庭，学校和媒体的暴力行为仍然令人震惊。该拟议的R21项目的目标是双重的：对年轻人在社会环境中暴露暴露的多种知识，多方法评估，以基于年轻人的心理健康；并为减少和预防青年暴力暴露的有害心理健康后果的新研究奠定了基础。我们的新型评估方法是由基于上下文（设置），内容（影响），渠道（暴露方式）和慢性（暴露频率）的四维暴力暴露概念驱动的。我们的测量与对心理健康（外部化，内在化和创伤性压力障碍）的全面评估有关，以根据发展心理病理学中当前理论的暴力曝光负担提供总体评估。这项调查将在社会经济困扰的城市社区中进行，包括一系列预计在东北大都市地区暴露的风险。我们的研究人群将是有11至14岁儿童的家庭；我们将对一对护理人员对（Dyadic n = 200）进行采样，以全面的协议与来自社会生态各个层面的数据源的信息直接整合信息。我们的调查以五个目的为指导：1）开发和实施一项跨信息，混合方法协议，以评估年轻人在社会环境中暴力的暴露； 2）利用我们的新型暴力暴露概念来评估新的个性化协议的心理测量特性并建立内部有效性； 3）采用双重途径模型，即暴露暴力如何影响心理健康结果以评估新协议的标准有效性； 4）采用多元建模来分析有意义的亚群体（例如，暴露暴露的低风险和高风险）的暴露模式和相关结果，以评估新协议的普遍性； 5）分析报告的各种组合，以最终确定临床研究环境中的现场测试方案。我们的调查将为了解暴力暴露如何导致负面健康结果提供至关重要的信息。最终，这些知识对于减少暴露暴露的负面影响至关重要。我们衡量青年暴力暴露的方法对于制定个性化评估和干预策略，以改善儿童和青少年暴露的负后遗症。此外，拟议的调查代表了扩大我们对社会生态暴力如何通过生物心理社会机制影响个人心理健康的必要步骤。公共卫生相关性：尽管大量的研究证实了青年人在多种社会环境中暴力暴露对他们的心理健康状况的有害影响，但没有系统地努力制定理论上了解跨环境中暴力暴露的理解措施。正确评估沿关键维度（包括上下文，严重性，频率和暴露方式）的暴力暴露是促进我们对暴力如何影响青年心理健康成果的理解的重要步骤。更好地测量暴露也将转化为更精确，最终更有效的干预策略。拟议的项目旨在制定一种新的协议，以评估青年人对暴力的暴露，并探索不同的暴露概况如何解释精神病理学的不同模式。