The aim of the Psychosocial Risk for Cardiovascular Disease in Youth Project (PRCVDYP) is to use three ongoing general population studies of youth as basis for examining the development of psychosocial risk for CVD. In relation to the Program Project as a whole, the PRCVDYP will address and expand upon Programmatic Objective 2 in examining the questions of whether and how harsh environments in childhood and adolescence (e.g., poverty and negative parenting styles) lead to negative psychosocial risk profiles (hostility, depression, and social isolation), and in turn whether and how such psychosocial risks translate into more proximal risks for CVD (heart rate and blood pressure indicaes, adiposity, smoking and alcohol use). We will use (a) ethnically diverse, (b) representative general population samples aged 9 - 16 and their parents to study (c) cross-generational predicators of (d) multiple components of (e) hostility, (f) depression and (g) social isolation, (h) over repeated waves of measurement. We will pay particular attention to the possibility that (1) different patterns of risk evolve in males and females at (j) puberty. The PRCVDYP builds on three current, NIH-funded studies: The Great Smoky Mountains Study (GSMS), a longitudinal study of risk for psychiatric disorder in a representative population-based sample of 1,072 youth in western North Carolina; The American Indian Study (AIS), which uses the same design and methods to study 354 American Indian (Cherokee) youth from the same geographic area as the GSMS; and Caring for Children in the Community Study (CCCS), a similar study of 1,200 youth set in an area of eastern North Carolina where 50 percent of the population are African American. In each sample, approximately 50 percent are female. Socio-economic status, social adversity, social isolation, depression, weight, height, pubertal status (morphological and hormonal), family functioning, and harsh parenting style are measured in these studies over three waves of data collection. Funds are requested to add to the ongoing studies in the following ways: 1. to analyze the audiotapes of the GSMS, AIS and CCCS interviews of parents and children, using the interpersonal Hostility Assessment Technique (IHAT), which uses vocal stylistics to assess underlying hostility; 2. to administer the Cook-Medley Hostility Scale to assess cynical, angry and aggressive attitudes in 800 parents and youth from the CCCS; 3. to assess SNS and PNS tone and reactivity to physical (assuming upright posture) and mental (attentional task) challenges to 800 youth from the CCCS; and 4. to repeat all three additional studies in two follow-up waves of 180 youth from the CCCS sample, selected for being at high and low CVD risk. We hypothesize that (1) low SES youth will wxhibit, in addition to increased levels of the psychosocial and behavioral risk factors under study, increased SNS tone and reactivity to mental challenge, as well as decreased INS tone; (2) Depression, social isolation, and harsh parenting will interact with low SES to increase CVD risk.
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