Phase 1
CIRCA Investigators
2016 - 2022
Research Project Leaders
"Dyadic Inter-Brain Signaling Project (DIBS): Parent-Child Inter-Brain Emotion Regulation as a Predictor of Adolescent Depressive Symptoms"
Depression and emotion regulation problems contribute to significant public health problems and adolescence and adulthood. Despite evidence that parenting plays an important role in risk and resilience processes related to emotion regulation and depression, extant research has focused primarily on intra-individual emotion regulation and has not examined inter-individual emotion regulation, or how parents' emotion regulation impacts adolescents' emotion regulation and related mental health. Little is known about the impact of parenting on the neurocircuitry underlying adolescents' emotionality and depressive symptomology. To address these gaps knowledge, this study integrated (a) a developmental approach, (b) functional neuroimaging, (c) longitudinal clinical research to examine how risk and resilience for depression relate to the activity of the amygdala, lateral PFC, and other limbic and regulatory brain regions during interactions between adolescents and their parents.
"Food and Alcohol Behavior Study (FAB)" - Examining the Epidemiology of Folate Status Attributable to Alcohol Use"
Inadequate Folate status is associated with negative sequelae in pregnancy, and impaired development of the central nervous system manifesting in neural tube defects and behavioral disturbances in childhood. This study sought to understand how alcohol use may contribute to or exacerbate inadequate folate status among adolescent girls.
"HATCH Project: Holistic Assessment of Tulsa Children's Health"
The primary goal of this study was to rapidly increase maternal-fetal bonding, a strong predictor of maternal health practices during pregnancy, through an intervention, BLOOM (Babies and Moms, connected by Love, Openness, and Opportunity). Specifically, the investigators examined change in maternal-fetal bonding across pregnancy and implications for change in maternal smoking during pregnancy using a randomized clinical trial design in a longitudinal, multi-ethnic cohort study of 160 women (ages 18 or older) who were 12-16 weeks pregnant. Participants were randomly assigned into one of two groups for the intervention; the control group received treatment as usual. Participants assigned to the treatment group received texted attachment/mindfulness exercises. Participants completed an in-depth initial assessment that includes sociodemographic measures as well as a battery to capture maternal-fetal bonding and self-reported smoking. Pre- and post-tests were used to assess maternal-fetal bonding and smoking before and after the intervention, to allow for examination of change across pregnancy. The positive impacts of this work included information that will be used to reduce the impact of unintended pregnancy for adverse infant health outcomes.​
"Neurotropic Indicators of Cognition, Executive Skills, Plasticity, and Adverse Childhood Experiences Study"
Adverse childhood experiences (ACEs) are repeatedly shown to predict negative biopsychosocial health outcomes, including obesity. High rates of ACEs in communities are often paralleled by high obesity rates, and higher ACEs, such as child abuse, have been shown to positively predict later obesity and use of unhealthy weight control behaviors. Thus, in light of the high prevalence of and potential causal links between early-life stress and obesity, there is a critical need to further explore the ACEs-obesity relationship in order to understand and to improve obesity outcomes. Given the adverse impact of ACEs and obesity on brain health, two potential high impact treatment targets of the ACEs-obesity relationship were explored in this pilot study: 1) markers of neurocognition (i.e., executive function; EF) and, 2) brain health/plasticity (i.e., neurotrophins like brain-derived neurotropic factor; BDNF and glial cell derived neurotrophic factor; GDNF).
"Juntos Se Puede (Together We Can)"
Juntos Se Puede (Together We Can) is a community-based, culturally-appropriate, psychoeducational intervention that shows significant promise to reduce stress and ATOD (alcohol, tobacco and other drugs) use among Latino youth in new settlement areas. Before an efficacy trial is conducted, a feasibility trial is designed to answer two sets of questions. First, what are the most efficient recruitment and retention strategies for Latino immigrant families? What engages parents and youth in the program? Second, how will Latino youth and their families respond to requests to provide biomarkers used to determine cumulative stress burden, as assessed by allostatic load? What relationships exist between common psychosocial factors and allostatic load among Latino youth?
Pilot Project Leaders
"Childhood Adversity Neurocognitions in Substance Use Disorder"
Early life adversity is strongly correlated with a number of negative life outcomes, including increased risk for development of a substance use disorders (SUDs) and other mental health disorders. Persons with childhood trauma, overall, have lower intellectual, memory, and executive functioning, as well as lower academic achievement. This is also found in persons with SUDs. It has been hypothesized that cognitive impairment and other early neurocognitive changes caused by early life adversity produce a specific vulnerability to later development of SUDs. Brain-derived neurotrophic factor (BDNF) is a neurochemical that is essential for neuronal development, neurogenesis, and cognitive function. BDNF levels have been found to be abnormal in patients with PTSD and mood disorders and has been hypothesized to be a mechanism by which the cognitive disruption symptoms of those disorders operate. BDNF levels have also been found to be altered in substance abuse animal models and patient populations and to affect levels of drug craving and withdrawal. Because of its role in neurogenesis and cognitive functioning, BDNF may be a mechanism by which early life adversity causes people to be more vulnerable to addiction. This study will investigate the possible BDNF--cognitive impairment--substance abuse pathway by measuring serum BDNF levels (proBDNF and mature BDNF) and cognitive performance in patients who are undergoing residential treatment for substance abuse. Measurements will be taken at entry into the program (post-detoxification), at 4 weeks, and at 8 weeks. Repeated measurement is important due to the spontaneous improvement that can occur during early abstinence. Changes in cognitive functioning and BDNF levels will be assessed. It is expected that level of early life adversity will moderate the level of improvement, with higher number of adverse events leading to lower levels of brain recovery.
It is anticipated that this pilot study will contribute to the understanding of the causal mechanisms by which childhood adversity leads to persistent negative life outcomes. Because BDNF levels are known to be malleable, primarily through diet, exercise, and cognitive stimulation, a number of possible avenues for treatment and prevention of adversity-related cognitive changes could be explored, including targeted cognitive rehabilitation, nutrition, and physical activity interventions, with the long-term goal of improving general health outcomes and reducing rates of substance abuse.
"Dyadic Neurofeedback for Emotion Regulation in Youth With Maternal Adversity"
Maternal adverse childhood experiences (ACEs) are associated with elevated rates of behavioral and mental health problems in adolescents. A likely mechanism for this link is through intergenerational continuity of difficulties in emotion regulation (ER). ACEs are associated with ER difficulties, which in turn affect parenting behaviors and adolescents' own ER development. Breaking the intergenerational cycle of the effects of ACEs requires novel, neuroscience-informed approaches aimed at improving parenting practices as they relate to emotion socialization. The current study will determine the effects of a real-time functional magnetic resonance imaging dyadic neurofeedback (rtfMRI-DNF) protocol that will train mothers with a history of ACEs to regulate adolescents' activation in the anterior insular cortex (aIC) - a key brain region for ER. The proposed study will test a maternal history of adversity. The proposed study will test the efficacy of this protocol to promote healthy ER-related neurodevelopment in adolescents with a maternal history of adversity. The proposed study will use DNF to provide neurofeedback from the adolescent's aIC to the parent as the parent and adolescent engage in an emotion task together. Parents and adolescents (n=10 dyads) will communicate via microphones and noise-canceling headphones while the adolescent is undergoing fMRI scanning. Specific aims of the current study are: (1) to determine the brain response to aIC DNF adolescents, and (2) to determine effects of DNF on parenting behaviors. This study is significant because engaging with parents in DNF can promote positive ER development in adolescents at risk due to the intergenerational effects of ACEs. Adolescence is a sensitive period for the development of ER, and adaptive changes in neurocircuitry and the parent-adolescent relationship could promote resilience to later mental health problems. This study is innovative in that DNF is a novel neurobehavioral approach with the potential to simultaenously affect both parenting behavior and adolescent neurobiology. The study employs an experimental paradigm with naturalistic aspects that are often lacking in fMRI studies, thus increasing the generalizability of DNF effects outside the scanner. The overall impact of the study will be the evaluation of a novel neurobehavioral approach to the promotion of adaptive ER skills in adolescents that can inform future prevention and intervention efforts for psychiatric disorders.
"Effects of Exercise on Young Adult Women with ACEs: An Integrative Pilot Study"
Early life stress (ELS) is associated with a number of psychiatric and medical conditions later in life, thought to be caused by subsequent disruptions in biological processes involved in regulation of stress responses. Given that these alterations have long-lasting effects, there is a great need for effective preventative interventions. The long-term goal of this project is to identify early interventions that may most powerfully mitigate risk for psychiatric illness among adolescents with exposure to early life stress (ELS), with a focus on interventions that can be widely and effectively implemented, have the potential for long-lasting benefits, and can effectively engage targeted neurobiological processes and networks. The specific aims of the present study are to 1) examine how ELS impacts biological processes associated with regulation of stress, and 2) identify how MBI impacts affective symptoms and biological processes dysregulated by ELS.The proposed study will utilize a multi-method design to examine the effect of mindfulness on biological processes (i.e., stress responses) disrupted by exposure to ELS among adolescents age 14 to 16. Adolescents will first complete self-report measures of childhood adverse experiences, trauma, and neglect. Forty eligible adolescents will be next randomly assigned to either a six-week mindfulness-based stress reduction (MBSR) intervention or treatment as usual (TAU). Pre- and post-intervention assessment will include (a) self-report measures of symptoms and emotion regulation, (b) a blood draw for assessment of inflammatory markers and gene expression, and (c) a stress task with saliva cortisol collected before and after this task. This study supports the efforts to reduce the effects of early adversity in children by testing an impact of an effective psychological intervention on disrupted biological processes caused by early adversity. Successful achievement of the proposed aims will contribute to a) the knowledge base needed to reduce the effects of trauma and stress in children and families and b) the development of easily implemented and disseminated preventative interventions.
"Effects of Mindfulness Biological Processes Disrupted by Early Life Stress"
The process by which the body responds to stressors to maintain homeostasis is called allostasis and is dependent on the integrated function of the nervous, endocrine, and immune systems. ACEs adversely affect these system, cause allostatic load, and can modify development of allostatic systems. However, our central hypothesis is that exercise can reduce allostatic load by positively augmenting function of each of these three systems. No previous studies have examined the effects of structured exercise interventions in individuals with ACEs. We are proposing an integrative, pilot study to investigate the effects of 8-weeks of structured resistance and aerobic exercise on biomarkers related to nervous, endocrine, immune, and metabolic function and several clinical outcomes in young adult women with ACEs. Our specific aims will test several hypotheses, and are as follows: SPECIFIC AIM 1: We will conduct a feasibility study to explore whether progressive, structured exercise can help mitigate the adverse physiological effects of stress and trauma early in life. SPECIFIC AIM 2: We will determine whether progressive, structured exercise can help improve health related quality of life, anxiety, and traits like hope, self-efficacy, or self-control, resilience. SPECIFIC AIM 3: We will determine whether the type and timing of exposure to ACEs has a significant influence on the severity of psychopathology and long-term physiological response to ACEs. This contribution is significant because exercise has been shown to be a powerful stimulus capable of augmenting physiological function and improving health. These data will lay the foundation for testing exercise-based interventions in populations that are especially susceptible to the effects of ACEs, such as in childhood development (e.g., unstructured exercise programs in children such as an afterschool sports program), and can inform public health policy and provide data supporting larger scale studies using costlier, more time-consuming measurements related to immune function and inflammation, neurocognition, skeletal muscle health and function, or cardiovascular disease risk.
"School-Based Mental Health Consultation Through a Trauma-Informed Lens"
This project looks to show improvements in emotional wellbeing in teachers and ultimately students by providing education in trauma informed care and mindfulness-based stress reduction strategies. Training in MBSR will lead to improvement in measures indicated by the Freiberg Mindfulness Inventory and the Cohen's Perceived Stress scale. Our professional development and reflective supervision will show improvements in perceived behaviors in the classroom, as evidenced by improvement in the ARTIC scale. Ultimately, these improvements will benefit children in the classroom as evidenced by reduction in teacher absenteeism along with student suspension, detentions and early dismissals secondary to behavior.
"The Food Independence, Security and Health (FISH) Study: Phase II"
Designed as a four-phase project, the Food Independence, Security, and Health (FISH) Study is a community-based research initiative to identify, prioritize, and address the critical drivers of chronic food insecurity and poor health outcomes among families accessing charitable food assistance programs in Oklahoma. This study’s second phase explores how the relationships among distinct domains of household risk, including socioeconomic deprivation, poor adult psychological health, and avoidant coping behaviors, may contribute to adult- and child-level food insecurity (Aim 1), which are associated with poor biological, cognitive, and socioemotional outcomes among children with known intergenerational consequences. This study will further develop a “Family Adversity Scale”, comprised of subscales representing distinct domains of modifiable cumulative risk, to predict adult- and child-level food insecurity (Aim 2). In collaboration with community food bank stakeholders, our analyses will then guide the development of a “Family Needs Assessment” intervention framework to improve food security among families accessing charitable food programs in Oklahoma (Aim 3) for pilot implementation and longitudinal evaluation during subsequent phases of the FISH Study. This research prioritizes the identification of modifiable household and caregiver level factors that contribute to food insecurity risk, which will equip food bank service providers and other community stakeholders with the knowledge needed to develop new comprehensive charitable food assistance programs that address the fundamental causes of household food insecurity.
"Sleep and Mother-Baby Regulation (SLMBR)"
Childhood trauma, especially adverse childhood experiences (ACEs), has been associated with vulnerability to psychiatric disorders but understudied in relation to perinatal mental health. Sleep disturbance, a common perinatal complication, has been linked to childhood trauma as well as poor health outcomes for mothers and infants, including perinatal mood and anxiety disorders (PMAD) and infant sleep disturbance. Few studies have examined childhood trauma, sleep, inflammation, and PMAD in a prospective perinatal study, and no known studies have included the association with infant sleep regulation. The long-term goal is to understand the role of maternal sleep and inflammation in PMAD, and the influence on infant sleep regulation. The objective of this grant is to identify patterns of perinatal sleep and inflammation that may contribute to symptoms of PMAD and infant sleep disturbance. The central hypothesis is that disrupted prenatal sleep contributes to inflammation, PMAD, and infant sleep disturbance, particularly for women with childhood trauma.
"Biological Mechanisms in the Link Between Stress and Emerging Adult Mental Health"
The main goal of this project is to examine biological mechanisms underlying the link between risky environment factors and psychopathology among emerging adults from low-income backgrounds. This project is relevant to the major NIH goals as it focuses on how daily stressful experiences shape both physical and mental health. During a laboratory visit during Week 1, participants will complete a series of questionnaires assessing ecological risk (e.g., neighborhood violence, economic strain), daily stress, discrimination and racism. In addition, the participants will engage in a stress test with multiple saliva samples collected (before and after the task) for the assessment of the stress hormone cortisol. In Week 2, participants will complete daily online surveys assessing daily stress and discrimination using a smart phone app. During Week 2, the emerging adults also will provide and mail in saliva samples (to assess cortisol) twice a day on three days. In Week 3, the participants will return to the laboratory for blood spot collections for the assessment of proinflammatory cytokines (IL-6). During a three-month follow-up, the emerging adults will complete questionnaires in the laboratory to assess depressive and anxiety symptoms. Collecting these data using a sample of emerging adults from low-income families will provide (a) preliminary data for an eventual NIH grant submission and (b) important information that can aid in the development of intervention and community outreach programs focused on physical and mental health factors which cost Oklahoma millions of dollars in terms of programs and lost productivity.
"Fetal Alcohol Syndrome: Evaluation Potential for Nutrition Intervention"
Micronutrient supplementation can improve health and prevent developmental disorders in specific populations at risk for nutritional deficiencies. However, many studies have failed to show health benefits of multivitamin supplementation in human subjects with replete micronutrient status. Thus, correct targeting of populations with micronutrient deficiencies is an important prerequisite for the implementation of nutritional interventions. Fetal alcohol spectrum disorders can cause permanent intellectual disabilities and neurobehavioral impairments which contribute significantly towards early life adversity at the earliest stages of life. Alcohol use during pregnancy is increased in populations with more adverse childhood events, which increases the risks of infants born with fetal alcohol spectrum disorders. Iron is a critical nutrient for fetal and infant brain development, and the requirement for iron increases significantly during pregnancy. Iron deficiency is more common in populations with health disparities associated with low socioeconomic status. We will use the Cerner Health Facts and National Health And Nutrition Examination Survey to determine if iron status is lower in newborns diagnosed with fetal alcohol syndrome and pregnant women who consume alcohol. Completion of this study is expected to identify populations at risk for infants born with fetal alcohol syndrome and high rates of iron deficiency and may benefit from iron supplementation. The knowledge gained from these studies may lead to nutrition strategies to prevent or mitigate the teratogenic effects of alcohol during pregnancy and decrease the incidence of fetal alcohol spectrum disorders.
"Fathers’ Contribution to Mother-Infant Biosocial Health"
Fathers play a critical role in infant development. Their specific role in supporting the mother-infant relationship, an important factor for infant outcomes, is significantly under researched. Adrenocortical attunement between mother and infant is a key indicator of healthy infant development. A major limitation of past research is the failure to capture the influence of other family members on this developmental psychobiological cascade. The long-term goal is to understand the early life experiences for infants that promote resilience. The central objective is to identify patterns of father involvement associated with positive and negative outcomes for mother-infant dyads during the first 6 months of life. Based on strong preliminary data showing that father involvement moderates mother-infant adrenocortical attunement, the research will test the central hypothesis that low levels of father involvement will result in greater mother-infant asynchrony when mothers are low in sensitivity. With a more complete understanding of fathers' contributions to mother-infant attunement, findings may inform intervention programs focusing on optimizing support for the mother-infant dyad. We will test the hypothesis with the following specific aims: 1) Determine if father social involvement moderates the relationship between maternal sensitivity and adrenocortical attunement in the first six months of life; and 2) Determine if father involvement is directly associated with mother-infant attunement The expected outcome is identification of patterns of father involvement associated with maternal sensitivity and optimal biopsychosocial outcomes for infants. The positive impacts include informing interventions to promote positive parental interactions and social support, broadening the focus to fathers.