Emotional and Physiological Regulation Linking Child Maltreatment to Health Risk - PROJECT SUMMARY/ABSTRACT
Each year approximately 700,000 American children are identified as victims of maltreatment and evidence
suggests that as few as 5% of abuse cases are reported. It is well established that children who experience
maltreatment are at high risk for the development of psychiatric disorders, as well as major medical conditions
including obesity, diabetes, and cardiovascular disease. Emerging evidence suggests that physiological
change to neuroendocrine and immune systems is a major mechanism of the lasting impact of maltreatment
on health. It is difficult to alter the trajectory of biological dysfunction in children and adults already diagnosed
with health conditions, which suggests that a solution to the problem of mental and physical illness following
maltreatment lies in understanding how it first emerges, and most importantly, which factors predict biological
precursors to disease. Self-regulation, including emotional and physiological components, dictates an
individual’s conscious or unconscious efforts to control their response to stress, and thus may be a critical
mechanism linking maltreatment to biological precursors—inflammation, methylation of cytokine genes, and
cardiometabolic symptoms—associated with future health conditions. No study to date has focused on emotion
regulation and physiological arousal as central, modifiable mechanisms of the association between
maltreatment and these three biological precursors. The overall aims of this study are to test whether emotion
regulation and physiological arousal measured in naturalistic settings link childhood maltreatment to
inflammatory proteins, epigenetic change of cytokine genes, and cardiometabolic symptoms. This innovative
study will identify how self-regulation and biological markers precipitate the onset of disease in a vulnerable
population. Importantly, self-regulation can be altered, and thus serves as a clear point of entry for future
prevention and intervention programs to support children with a maltreatment history. This study will utilize
comprehensive assessments of child maltreatment, novel approaches to self-regulation, and gold-standard
measures of biological precursors. This highly structured training plan is ideally suited to allow for execution of
the proposed research project. Specifically, the applicant will receive training in (1) developmental and
biopsychosocial approaches to child maltreatment, (2) naturalistic observation and coding of emotion
regulation and measurement and analysis of physiological arousal, (3) inflammation and epigenetic regulation
of the immune system, (4) cardiometabolic risk, (5) advanced statistical analysis skills, and (6) dissemination,
manuscript preparation and grant writing skills. Training will be guided by an outstanding mentorship team with
highly relevant expertise and a long-standing history of collaboration. Therefore, the proposed training and
research plans along with the rich training environment available at the Department of Psychiatry and Human
Behavior of the Alpert Medical School of Brown University/Bradley Hospital will provide the applicant with
experiences tailored to help her reach her ultimate goal of becoming an independent investigator.