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Early life adversities and the emergence of risk and resilience: a longitudinal study of child development

Award Number: R01HD075875
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 05/01/2014
PERIOD OF PERFORMANCE END DATE: 04/30/2026

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Early life adversities and the emergence of risk and resilience: a longitudinal study of child development - Abstract Exposure to maternal depression in early life increases the risk of socioemotional and cognitive (SEC) problems in childhood and over the lifecourse. This has led to the promotion of depression treatment as a critical early childhood intervention. However, there is insufficient evidence on whether depression treatments alone reduce offspring risk in low resource settings where other social and economic adversities are highly prevalent. The proposed study in rural Pakistan will, first, examine the impact of a cluster randomized intervention, extended to include both maternal depression and child development components, on child SEC outcomes at ages 5-8. Second, we will closely examine the psychosocial and biological processes through which maternal depression and other adversities lead to emerging SEC difficulties by continuing to follow the mothers and children, currently in our study from birth to age three, through early primary school years. Preliminary findings from our current study, consisting of a cluster-RCT examining the impact of a perinatal maternal depression intervention on child development within a population representative birth cohort design, have yielded several insights: (1) the “Thinking Healthy Program - Peer delivered” (THPP) shortened the initial maternal depression episode but its longer term impact is unclear; (2) although the THPP did not have an observable impact on SEC outcomes through age 2, it did favorably impact markers of hypothalamic–pituitary– adrenal (HPA)-axis function in children at 12 months of age; and (3) exposure to adversities (acute poverty, intimate partner violence (IPV), and low maternal social support) appear to be more impactful on child outcomes than maternal depression during the earliest developmental period, and child sex may influence the prevalence of certain adversity exposures after birth as well as their impact on child outcomes. The children of this cohort are about to embark on their first major life transition requiring significant adaptation – that into formal schooling. Following the children through this transition allows us to test key hypotheses linking the rich data already collected on multiple adversities beginning in pregnancy, potential psychosocial and biological mechanisms, and outcomes at this important stage of life course. This study will continue to follow our unique cohort until the children turn 8. The specific aims of the proposed study are to: (1) evaluate the impact of the ongoing and extended intervention (now called “THP Preschool” (THP-PS) on child socioemotional and cognitive (SEC) outcomes at ages 5 through 8, and determine the extent to which the impact is mediated by maternal depression trajectories; (2) examine how the type and timing of adversity exposures, including maternal depression, impacts HPA-axis dysregulation in children, and whether HPA-axis indicators mediate the effect of adversity exposures on child SEC indicators. As part of this aim we will also examine the impact of the ongoing intervention on child HPA-axis biomarkers; and (3) explore, through quantitative and qualitative inquiry, emerging child sex differences in exposure to adversities and their effects on child outcomes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $492,772 )
2024	2024	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	000	11	7/4/2024	NON-COMPETING CONTINUATION	$492,772
														Subtotal = $492,772

Issue Date FY: 2023 ( Subtotal = $564,810 )
2023	2023	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	001	10	5/16/2023	NON-COMPETING CONTINUATION	$564,810
2023	2022	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	000	9	10/26/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $564,810

Issue Date FY: 2022 ( Subtotal = $646,985 )
2022	2022	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	000	9	5/13/2022	NON-COMPETING CONTINUATION	$588,289
2022	2022	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	001	9	8/5/2022	SUPPLEMENT FOR EXPANSION	$58,696
														Subtotal = $646,985

Issue Date FY: 2021 ( Subtotal = $594,293 )
2021	2021	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	002	8	5/4/2021	NON-COMPETING CONTINUATION	$594,293
2021	2020	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	001	7	2/22/2021	COMPETING CONTINUATION	$3,238
2021	2018	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	000	6	2/22/2021	NON-COMPETING CONTINUATION	-$3,238
														Subtotal = $594,293

Issue Date FY: 2020 ( Subtotal = $661,094 )
2020	2020	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	000	7	4/22/2020	COMPETING CONTINUATION	$661,094
														Subtotal = $661,094

Issue Date FY: 2018 ( Subtotal = $425,881 )
2018	2018	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	000	6	4/26/2018	NON-COMPETING CONTINUATION	$425,881
														Subtotal = $425,881

Issue Date FY: 2017 ( Subtotal = $451,096 )
2017	2017	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	003	5	5/30/2017	NON-COMPETING CONTINUATION	$451,096
2017	2016	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	104 AIRPORT DR STE 2200	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	002	4	11/14/2016	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$68,140
2017	2016	DUKE UNIVERSITY	2200 W MAIN ST STE 710	DURHAM	NC	27708	DURHAM	USA	Child Health and Human Development Extramural Research	001	3	11/14/2016	NON-COMPETING CONTINUATION	-$17,802
2017	2015	DUKE UNIVERSITY	2200 W MAIN ST STE 710	DURHAM	NC	27708	DURHAM	USA	Child Health and Human Development Extramural Research	000	2	11/14/2016	NON-COMPETING CONTINUATION	-$50,338
														Subtotal = $451,096

Issue Date FY: 2016 ( Subtotal = $432,421 )
2016	2016	DUKE UNIVERSITY	BOX 104004	DURHAM	NC	27708	DURHAM	USA	Child Health and Human Development Extramural Research	000	3	4/14/2016	NON-COMPETING CONTINUATION	$432,421
2016	2016	DUKE UNIVERSITY	BOX 104004	DURHAM	NC	27708	DURHAM	USA	Child Health and Human Development Extramural Research	001	3	8/3/2016	NON-COMPETING CONTINUATION	-$414,619
2016	2016	UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL	440 WEST FRANKLIN ST, CB #1350	CHAPEL HILL	NC	27599	ORANGE	USA	Child Health and Human Development Extramural Research	002	4	8/8/2016	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$414,619
														Subtotal = $432,421

Issue Date FY: 2015 ( Subtotal = $433,650 )
2015	2015	DUKE UNIVERSITY	BOX 104004	DURHAM	NC	27708	DURHAM	USA	Child Health and Human Development Extramural Research	000	2	4/3/2015	NON-COMPETING CONTINUATION	$433,650
														Subtotal = $433,650

Issue Date FY: 2014 ( Subtotal = $528,400 )
2014	2014	DUKE UNIVERSITY	BOX 104004	DURHAM	NC	27708	DURHAM	USA	Child Health and Human Development Extramural Research	000	1	4/25/2014	NEW	$528,400
														Subtotal = $528,400

Grand Total All Awards = $5,231,402

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Early life adversities and the emergence of risk and resilience: a longitudinal study of child development

Award Number: R01HD075875

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 05/01/2014

PERIOD OF PERFORMANCE END DATE: 04/30/2026

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