Wendy L. Kliewer - US grants

[unreadable] DESCRIPTION (provided by applicant): [unreadable] A five-year NIDA Mentored Scientist Career Development Award (K01) is requested to support training and research intended to extend the candidate's previous work in violence exposure and coping in adolescents to the drug abuse and physiological stress responses to violence. In the long term, the candidate wishes to understand linkages between community violence exposure, physiological stress responses, and drug abuse, with attention to gender differences and familial contributions, using state of the art measures of stress response and state of the art statistical models. Formal training will be provided by bi-monthly meetings with the candidate's mentors, Drs. Dace Svikis and Albert Farrell, and by regular consultation with the three external consultants, Drs. Ken Winters, Howard Moss, and Gary Wand. In addition, she will attend two statistical courses offered by the Center for Statistical Consultation at the University of Michigan, one course in longitudinal analyses offered by the University of Virginia, and a training course in using biological markers in research offered by The Pennsylvania State University. The candidate's research is intended to answer a series of questions about associations between community violence exposure, stress responses produced by the Hypothalamus- Pituitary-Adrenal (HPA) axis, and drug use initiation and abuse through analysis of existing data and collection of new data. A community-based, longitudinal, prospective study that incorporates face-toface interviews and laboratory-based physiological assessments will be undertaken to achieve this aim. Two hundred fifty male and female early (10-11 yrs) and middle (14-15 yrs) adolescents from high violence areas in the Richmond, VA metropolitan area will be recruited. A variety of statistical methods and multivariate structural modeling techniques will be used to estimate relations between violence exposure, physiological stress responses, and drug use and abuse, and to examine whether these associations are moderated by gender or familial factors. [unreadable] [unreadable] [unreadable] [unreadable]

[unreadable] DESCRIPTION (provided by applicant): This longitudinal study is designed to examine the role of biological, environmental, and psychological factors hypothesized to influence the relation between exposure to various types of violence and drug use. Participants include 400 adolescents representing two cohorts of teens living in high violence, impoverished urban areas. Latent growth curve models will be used to test specific hypotheses regarding the potential role of various factors as mediators and moderators of key variables influencing drug use in adolescents. In particular, coping processes and physiological responses to stress will be evaluated as mediators or moderator of associations between violence exposure and drug use. This home interview study is novel in that it examines both peer victimization and exposure to community violence, assesses activation of the locus cerulus/autonomic (sympathetic) nervous system and the limbic hypothalamic-pituitary-adrenal (LHPA) axis, and includes youth and parent assessments of emotion regulation skill and coping processes, including coping goals, threat appraisals, coping behaviors, and coping self-efficacy. The study follows a cohort of 200 5th graders, with limited exposure to drugs, and a cohort of 200 8th graders, with substantial exposure to drugs, over a 2-year period through key transitions into middle and high school. Thus, factors associated with both the initiation and exacerbation of drug use will be studied. This study will provide important information on the interaction of biological, environmental, and psychological risk factors for drug use. It has potential to reduce the tremendous societal costs of drug use by identifying behavioral and physiological correlates of inflation and escalation of drug use in adolescence. [unreadable] [unreadable] [unreadable]

[unreadable] DESCRIPTION (provided by applicant): Exposure to community violence is related to many adjustment problems in youth, including psychological distress and aggressive behavior. Our preliminary research in Richmond, VA, suggests that expressive writing interventions are effective at reducing aggressive behavior and symptoms of anxiety and depression associated with violence exposure. The primary objective of the proposed research, which is guided by our emotion-regulation model of expressive writing, is to further develop and test the short- and long-term efficacy of an expressive writing intervention for youth exposed to violence. Secondary objectives include identifying mediators and moderators of the effects of the writing intervention and finding ways to maximize efficacy of the intervention. Tertiary objectives include identifying barriers and supports within the school for the effective adoption and implementation of the EW intervention, and developing guidelines for school systems interested in implementing evidence-based expressive-writing interventions. The research will be conducted in two cities with high levels of community violence Richmond, VA, and Philadelphia, PA in order to evaluate whether the interventions are effective in different school settings. Study 1 will use a randomized, three-group (standard expressive writing, standard expressive writing with booster sessions, control writing) repeated measures four-wave design to evaluate the relative efficacy of a novel, school- based expressive-writing intervention with and without booster sessions. Forty-eight 7th -8th grade classrooms will be randomized to one of the three writing conditions. In standard expressive writing with and without the booster, youth privately write about their deepest thoughts and feelings concerning violence or related stressors. Booster sessions are included to determine if the efficacy of the expressive writing intervention can be enhanced. Youth in the control condition will write about non-emotional topics, unrelated to violence. Study 2 is a qualitative focus group study with students, teachers, school counselors and administrators designed to identify the potential barriers and available supports for adopting the expressive writing intervention as part of the school health education curricula. Finally, we will use the intervention findings, as well as data from the focus groups, to design dissemination guidelines for investigators and school systems interesting in implementing expressive writing interventions in school settings. [unreadable] [unreadable] PUBLIC HEALTH RELEVANCE PARAGRAPH: Witnessing and experiencing community violence negatively affects the psychological and behavioral adjustment of millions of children. Expressive writing interventions, which have proven effective for adults, may be a cost-effective way to reduce the negative consequences associated with community violence exposure, yet little systematic evaluation has been conducted on this intervention strategy. The proposed studies will provide data on the short- and long-term efficacy of a school-based expressive writing intervention, identify who is most likely to benefit from the intervention and why, and identify potential barriers and supports within the school for the effective adoption and implementation of the expressive writing intervention. [unreadable] [unreadable] [unreadable]