Preventing Adult Mental Health Problems from Early Childhood in the Contexts of Genetic Susceptibility, Poverty, Racism, and the COVID-19 Pandemic

在遗传易感性、贫困、种族主义和 COVID-19 大流行的背景下，从幼儿期预防成人心理健康问题

• 批准号: 10566839
• 负责人: Jazmin Brown-Iannuzzi
• 金额: $ 80.02万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10566839
• 关键词: 2019-nCoV; Adolescence; Adult; Age; American; Anxiety; Attention; Behavioral; Buffers; COVID-19; COVID-19 pandemic; Characteristics; Child; Communities; Data; Data Set; Deterioration; Development; Disease; Early Intervention; Ecology; Economics; Emotional; Environmental Risk Factor; Ethnic Origin; Ethnic Population; Exposure to; Family; Future; Gender Identity; Genetic; Genetic Predisposition to Disease; Genetic Risk; Genotype; Geographic Locations; Geography; Glean; High Prevalence; Home; Individual; Inequality; Infant; Informal Social Control; Institutional Racism; Intervention; Interview; Link; Long-Term Effects; Longitudinal Studies; Mediating; Mental Depression; Mental Health; Minority Groups; Neighborhoods; Outcome; Parents; Participant; Poverty; Predictive Factor; Prevention; Prevention trial; Preventive; Problem behavior; Psychoses; Public Health; Race; Randomized; Reporting; Research; Risk; Risk Factors; Rural; Sampling; Shock; Site; Social Identification; Social isolation; Socialization; Societies; Suicide; Support System; Surveys; Symptoms; Testing; Time; United States; Vocation; Woman; age group; biological sex; caucasian American; checkup examination; clinical diagnostics; coping; design; dietary supplements; early childhood; emerging adult; emerging adulthood; ethnic disparity; ethnic diversity; ethnic identity; ethnic minority; experience; genetic testing; health assessment; health inequalities; higher education; intervention effect; lower income families; pandemic disease; pandemic potential; pandemic stress; perceived discrimination; physical conditioning; polygenic risk score; pre-pandemic; prevent; prospective; protective effect; protective factors; racial discrimination; racial disparity; racial diversity; racial minority; racial population; racism; recruit; resilience; resilience factor; risk mitigation; social culture; social determinants; social factors; sociocultural determinant; sociodemographics; socioeconomics; stressor; suburb; suicidal; young adult

ABSTRACT As Americans enter the third year of the COVID-19 pandemic, we are also in a mental health crisis. Emerging adults in particular are experiencing a high prevalence of anxiety, depression, suicidality, and psychosis compared to pre-pandemic levels. A slowed economy, increased social isolation, loss of typical support systems, and financial instability abruptly hit just as emerging adults were transitioning from adolescence to adulthood, potentially disrupting typical milestones such as leaving home, pursuing higher education, starting vocations, and becoming financially independent. The pandemic has also underscored persistent health inequalities that exist between White Americans and racial/ethnic minorities, due at least in part to experiences of discrimination. Living in poverty is an additional risk factor for mental health problems, and is a vastly different experience for White and minoritized individuals due to environmental and social factors afforded to different racial/ethnic groups. In addition, neighborhood characteristics and community type (i.e., rural, urban) can intersect with racial/ethnic identity to increase risk or offer protection from mental health problems. The genetically-informative Early Steps Multisite (ESM) study of 731 racially/ethnically diverse low-income families presents a unique opportunity to examine how a sample of at-risk emerging adults, prospectively followed since age two and now in their early twenties, are coping within the context of the pandemic. The ESM sample was recruited at Women, Infant, and Children centers in three geographically, socioeconomically, and racially/ethnically diverse communities: Eugene, OR; Pittsburgh, PA; and Charlottesville, VA. Participating families were randomly assigned to receive the Family Check-Up (FCU) intervention annually from child age 2 to 10.5, or to participate in study assessments without intervention. Assessments continued at child ages 14, 16, and 19, including two pandemic-related surveys focused on mental health, and participant genotyping. Recruited from diverse sites, the ESM can examine community- and neighborhood-level effects on mental health risk and resilience. Continuing this longitudinal study, we will assess participants at ages 22 and 24, including a clinical diagnostic interview of depression, anxiety, and psychosis. With a wealth of prospective data on neighborhood risk, experiences of discrimination, and mental health, we propose to examine direct, interactive, and cascading effects on mental health outcomes. Our first aim is to investigate whether race/ethnicity and discriminatory experiences shift the developmental trajectories of mental health, and whether protective ecological factors mitigate these risks. Our second aim is to test genetic moderation of risk and resilience on emerging adult mental health. Our third aim is to examine the long-term preventive effects of the FCU on mental health, in the context of growing up in poverty, and, more recently, the pandemic, while focusing on who is able to glean the largest benefit from this intervention. Following this emerging adult sample would provide unique data on the persistence of intervention effects on mental health during the transition to adulthood in the context of a pandemic.

抽象的 随着美国人进入 COVID-19 大流行的第三个年头，我们也陷入了心理健康危机。新兴 尤其是成年人，焦虑、抑郁、自杀和精神病的患病率很高 与大流行前的水平相比。经济放缓、社会孤立加剧、典型支持系统丧失， 正当新兴成年人从青春期过渡到成年时，金融不稳定突然袭来， 可能会扰乱典型的里程碑，例如离开家、接受高等教育、开始职业、 并实现财务独立。这一流行病还凸显了持续存在的健康不平等现象， 美国白人和少数族裔之间存在这种矛盾，至少部分是由于遭受歧视的经历。 生活在贫困中是心理健康问题的另一个危险因素，对于人们来说是一种截然不同的经历 白人和少数族裔个体由于环境和社会因素而受到不同种族/民族的影响 组。此外，邻里特征和社区类型（即农村、城市）可以与 种族/族裔身份，以增加风险或提供针对心理健康问题的保护。遗传信息丰富 对 731 个种族/民族不同的低收入家庭进行的 Early Steps 多地点 (ESM) 研究提出了一个独特的研究 有机会检查从两岁到现在如何对处于危险中的新兴成年人样本进行前瞻性跟踪 他们二十岁出头，正在应对这一流行病。 ESM 样本是在 Women 招募的， 婴儿和儿童中心位于三个地理、社会经济和种族/民族多样化的地方 社区：俄勒冈州尤金；宾夕法尼亚州匹兹堡；和弗吉尼亚州夏洛茨维尔。参与家庭是随机的 被分配从 2 岁至 10.5 岁儿童每年接受家庭检查 (FCU) 干预，或参加 在没有干预的情况下进行研究评估。对 14、16 和 19 岁的儿童继续进行评估，其中包括两项 与大流行相关的调查侧重于心理健康和参与者基因分型。从不同的网站招募， ESM 可以检查社区和邻里层面对心理健康风险和复原力的影响。 继续这项纵向研究，我们将评估 22 岁和 24 岁的参与者，包括临床诊断 采访抑郁症、焦虑症和精神病。凭借大量有关邻里风险的前瞻性数据， 歧视的经历和心理健康，我们建议检查直接的、互动的和级联的 对心理健康结果的影响。我们的首要目标是调查种族/民族和歧视是否存在 经历改变了心理健康的发展轨迹，以及保护性生态因素是否 减轻这些风险。我们的第二个目标是测试新兴成人心理风险和复原力的遗传调节。 健康。我们的第三个目标是研究 FCU 对心理健康的长期预防作用 在贫困中成长，以及最近的流行病，同时关注谁能够收集到最大的 从这种干预中受益。跟踪这个新兴的成人样本将提供有关持久性的独特数据 在大流行背景下向成年过渡期间的干预措施对心理健康的影响。