Pathways to Anxiety Disorders: Adversity, Immune Function, and HPA-Axis Activity

焦虑症的途径：逆境、免疫功能和 HPA 轴活动

• 批准号: 8164970
• 负责人: Lilly Shanahan
• 金额: $ 7.18万
• 依托单位: UNIVERSITY OF NORTH CAROLINA GREENSBORO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8164970
• 关键词: Address; Adolescence; Adolescent; Adrenal Glands; Adult; Age; Antibodies; Anxiety; Anxiety Disorders; Behavioral; Biological; Biological Markers; Biosocial; C-reactive protein; Child; Childhood; Communities; Competence; Data; Dehydroepiandrosterone Sulfate; Development; Diagnosis; Diagnostic; Diagnostic and Statistical Manual; Disease; Environmental Risk Factor; Epidemiology; Etiology; Event; Exhibits; Exposure to; Female; Generalized Anxiety Disorder; Heterogeneity; Human Herpesvirus 4; Hydrocortisone; Hypothalamic structure; Individual; Inflammatory Response; Intervention Studies; Life; Life Cycle Stages; Light; Link; Longitudinal Studies; Measures; Mediating; Mental Depression; Mental disorders; Modeling; Nature; Odds Ratio; Panic Disorder; Participant; Pathway interactions; Personal Satisfaction; Persons; Phase; Physiological; Pituitary Gland; Play; Post-Traumatic Stress Disorders; Prevention Research; Prevention program; Reporting; Research; Research Personnel; Risk; Risk Factors; Role; Sample Size; Sampling; Separation Anxiety Disorder; Sex Characteristics; Social Phobia; Staging; Stress; Symptoms; System; Testing; Time; acronyms; acute stress; base; design; environmental stressor; immune function; improved; intervention program; male; novel; response; social; stressor; young adult

DESCRIPTION (provided by applicant): Anxiety disorders are among the most common and impairing psychiatric disorders for children, adolescents, and young adults. Nevertheless, the roles that stressors (i.e., extraorganismic challenging circumstances or events) and stress (i.e., the intraorganismic, physiological response to stressors) play in the etiology of anxiety in the early life course are not well understood. A social stressor-based model posits that higher rates of exposure to stressors increase anxiety and a physiological response-based model highlights the distinct physiological profiles of individuals with anxiety. The proposed research joins these explanations to elucidate mechanisms by which stress mediates the impact of stressors on anxiety. Measures of stressors and stress include major environmental risk candidates and key indicators of immuno-competence, inflammatory response, and HPA-axis reactivity. First, are associations among stressors, stress, and anxiety the same within childhood, adolescence, and young adulthood and across these phases of life? Second, building on these analyses, do multiple markers of several key biological stress systems separately and jointly predict anxiety? And third, does the proposed stressor ` stress ` anxiety model differ for different types of anxiety? In answering these fundamental questions, sex differences will be examined. Data come from the nation's largest ongoing, community-representative, prospectively longitudinal, DSM-based, diagnostic study, the Great Smoky Mountains Study (GSMS). The GSMS has assessed stressors, stress, and anxiety on each participant on up to ten occasions spanning ages 9 to 27, providing an unparalleled opportunity to study the etiology of anxiety disorders. The proposed research will reveal the multifaceted pathways that give rise to anxiety; shed new light on the role of biological stress systems in anxiety at different phases of the early life course; use configurations of stressors and stress and consider separate anxiety disorder symptoms to clarify links in the stressor` stress`anxiety chain; and discover sex differences in these mediating chains. Results from the proposed research will have implications for both prevention and intervention research, for basic biosocial research, and, generally speaking, for improving young people's well-being. PUBLIC HEALTH RELEVANCE: The proposed research is the first to comprehensively examine the role of multiple indicators of environmental stressors (i.e., risk factors) and biological stress in the etiology of anxiety in its different manifestations in childhood, adolescence and young adulthood. Understanding how stressors and stress additively and interactively give rise to this common group of disorders is essential to the design of effective prevention and intervention programs for young people at risk for anxiety, and for informing next steps in biosocial research.

描述（由申请人提供）：焦虑症是儿童、青少年和年轻人最常见且损害性的精神疾病之一。然而，应激源（即有机体外的挑战性环境或事件）和压力（即有机体内对应激源的生理反应）在生命早期焦虑的病因中所起的作用尚不清楚。基于社会压力的模型认为，较高的压力源暴露率会增加焦虑，而基于生理反应的模型则强调焦虑个体的独特生理特征。拟议的研究将这些解释结合起来，以阐明压力调节压力源对焦虑的影响的机制。压力源和压力的测量包括主要环境风险候选者和免疫能力、炎症反应和 HPA 轴反应性的关键指标。首先，在童年、青春期和成年早期以及生命的这些阶段，压力源、压力和焦虑之间的关联是否相同？其次，在这些分析的基础上，几个关键生物应激系统的多个标记是否可以单独和联合预测焦虑？第三，所提出的压力源“压力”焦虑模型对于不同类型的焦虑是否有所不同？在回答这些基本问题时，将考察性别差异。数据来自全国最大的正在进行的、具有社区代表性的、基于 DSM 的前瞻性纵向诊断研究——大烟山研究 (GSMS)。 GSMS 对每位参与者的压力源、压力和焦虑进行了多达 10 次评估，年龄跨度为 9 至 27 岁，为研究焦虑症的病因提供了无与伦比的机会。拟议的研究将揭示引起焦虑的多方面途径；揭示了生物应激系统在生命早期不同阶段的焦虑中的作用；使用压力源和压力的配置，并考虑单独的焦虑症症状，以澄清压力源“压力”焦虑链中的链接；并发现这些中介链中的性别差异。拟议研究的结果将对预防和干预研究、基础生物社会研究以及一般而言对改善年轻人的福祉产生影响。 公共健康相关性：本研究首次全面研究了环境压力源（即风险因素）和生物压力的多个指标在儿童、青少年和成年早期不同表现形式的焦虑病因中的作用。了解压力源和压力如何叠加和交互地导致这一类常见疾病对于为有焦虑风险的年轻人设计有效的预防和干预计划以及为生物社会研究的后续步骤提供信息至关重要。