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: 7792416
• 负责人: Marilyn J Essex
• 金额: $ 22.28万
• 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 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7792416
• 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 Depression; 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; 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调查青少年焦虑、抑郁及其合并症与下丘脑-垂体-肾上腺（HPA）功能的关联，考虑环境、性别、早期生活经历和个人的潜在差异生物行为因素。研究设计和方法：该项目将特别关注 HPA 对急性社会心理压力源的反应性（以唾液皮质醇为指标）。这项研究使用新开发的可出口青少年版特里尔社会压力测试（TSST），将区分预期期、任务期和恢复期以及陌生与熟悉环境中的反应。在 12 年级（大约 18 岁）期间，青少年 (n=96) 将从威斯康星州家庭和工作研究中招募，这是一项关于儿童/青少年发展的纵向社区研究 (N=417)。根据 9、10 和 11 年级平均焦虑和/或抑郁症状水平，将选择一半 (n=48) 患有高水平焦虑和/或抑郁症状的学生；另一半 (n=48) 将从两个分布的下半部分中随机选择。每组 48 人将被随机分配到实验室（不熟悉的环境；n=24）或家里（熟悉的环境；n=24）进行评估，性别平衡。 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调查将确定近期的生活压力源、青少年认知归因/偏见以及青少年心理健康症状和障碍。将获得完整的精神诊断评估（K-SADS）。具体目标：(1) 调查 (a) HPA 昼夜模式（皮质醇的总体水平和每日斜率）与对急性心理社会压力源 (TSST) 的反应性的关联，区分预期、任务和恢复成分，以及 (b)环境（陌生的实验室与熟悉的家庭）和性别的差异； (2) 调查 (a) HPA 活动（昼夜活动和反应性活动，如目标 1 中定义）与青少年焦虑和/或抑郁的关联，以及 (b) 环境和性别差异； (3) 探索 (a) 目标 1 和 2 中发现的与青少年早期压力暴露史、HPA 昼夜模式和气质抑制相关的差异，以及 (b) 背景和性别的差异。该应用程序与 PAR-06-473“焦虑与抑郁关系的转化研究”的目标一致。它是跨学科的，解决将生物、神经内分泌应激反应系统与背景和个人因素相结合的问题；它是探索性的，包括新开发的青少年版本的 TSST，可以导出到现场环境；而且，它是转化性的，将基础科学研究与青少年心理健康研究相结合。公共健康相关性：通过观察下丘脑-垂体-肾上腺（HPA）功能，拟议项目将深入了解青春期焦虑和抑郁共病的潜在病理生理学，这与开发有效的药理学和其他治疗方法相关。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共病焦虑/抑郁的发展，以及哪些早期经历和儿童特征是这些后期过程的风险因素，即对于开展早期预防工作具有重要意义。