Collaborative Studies

The Effects of Addressing Children’s Early Life Social Needs on Behavioral Health

Brad Gaynes, MD, MPH; Rushina Cholera, MD, MPH

Adverse childhood experiences and early life behavioral health problems increase the risk for poor physical and mental health across the lifespan. North Carolina is the site of an innovative new program called NC Integrated Care for Kids (NCInK), which provides “family navigators” to children and caregivers who are enrolled in free or low-cost health insurance. The present study will collect data on behavioral health and social needs from families who receive NCInk services and from a comparison group of families in surrounding counties who do not receive NCInk services. The goal of the present study is to evaluate the impact of early life case management and supportive services on behavioral health outcomes in children, and the potential mechanisms through which the program may be exerting benefits.

Probing the Neurophysiological Mechanisms Underlying Sex-Specific Testosterone-Mood Relationships During Puberty: A Randomized Controlled Trial Using a Smartphone-Based Training Program

Elizabeth Andersen, PhD

The pubertal transition marks an abrupt divergence between the sexes in rates of depression and other internalizing disorders. The COVID-19 pandemic has further widened the gender gap in adolescent mental health, with a concerning escalation in depression, anxiety and suicide attempts in female adolescents. A differential effect of sex hormones (e.g., testosterone) on symptom expression may underlie these sex differences in adolescent psychopathology. The present study will examine sex differences in the neurophysiology underlying mood sensitivity to weekly changes in testosterone in at-risk peripubertal male and female adolescents. Additionally, we will use a smartphone-based training program (Healthy Minds Program), designed to improve emotion regulation and coping skills, to test neural correlates of emotion regulation as a target mechanism underlying the relationship between testosterone change and psychological symptoms during the pubertal transition.

Integrated Digital Health Platform to Assess and Respond to Mental Health Crises in Children and Adolescents

Aysenil Belger, PhD

The gold standard in youth mental health care is to evaluate the well-being of individuals in clinicians’ offices or through telemedicine using surveys and self-reports that assess their current and past experiences retrospectively and subjectively. Yet, recommendations for effective mental health treatment are designed with the “real-world” in mind, often in environments that may be very different from clinicians’ offices. In collaboration with NCSU and RTI, our multidisciplinary team of clinicians, psychologists, neuroscientists, engineers, programmers, and statisticians will develop a Digital Health Platform (DHP) that integrates new wearable sensors technology with mobile ecological assessments in order to gather real-time physiological and psychological stress and wellbeing data. This pilot project will provide a foundation for larger studies that allow us to a) gather data on individuals’ cognitive, behavioral, and neurophysiological responses to stressors as they emerge within youths’ daily environments and b) deliver interventions that support healthy coping responses in real time. Our goal is to overcome existing limitations to the development, scaling, and widespread adoption of wearable health devices to address adolescent mental health challenges.