There is increasing evidence for a profound and persistent impact of childhood stress and trauma on psychological and physical health outcomes over the lifespan. The strength and consistency of these associations has led to a paradigm shift in approaching adult disease in which addressing the early childhood origins of health and disease is considered to be equal to if not more critical than intervention efforts with adults. However, despite the magnitude of risk associated with adverse childhood experiences, there is limited understanding of the precise mechanisms by which early adversity impacts health. We propose to establish a Phase I Center of Biomedical Research Excellence (COBRE) for Stress, Trauma, and Resilience (STAR) at The Miriam Hospital to address this critical gap. The STAR COBRE is unified by a conceptual framework focused on (a) isolating/disentangling specific stress exposures and traumas, and (b) identifying proximal mechanisms of risk and resilience with in-vivo ecological sampling that will lead rapidly to novel and actionable intervention targets to improve health. The COBRE incorporates a life course approach, with an emphasis on sensitive periods of development—pregnancy, childhood, and young adulthood. Three promising, early career Project Leaders, a junior faculty recruit with expertise in STAR, and a pilot project program funded by The Miriam Hospital form the nexus of the STAR COBRE. Co-mentorship by two leading NIH-funded scientists with complementary expertise will catalyze the transition of the Project Leaders to independent funding. Dr. Bublitz will utilize cutting-edge ecological methods to understand links between maternal history of childhood sexual abuse and hypertensive disorders of pregnancy. Dr. Evans will conduct a naturalistic experiment in children to elucidate the specific impact of food insecurity from other poverty-related stressors on diet, inflammatory and metabolic biomarkers and summer weight gain; Dr. Vergara-Lopez will utilize a novel dimensional approach to childhood maltreatment to contrast the impact of deprivation (neglect) vs. threat (abuse) on young adult emotion regulation strategies and mental health symptoms. To support Project Leaders and the STAR COBRE, we will establish an Administrative Core, including a community advisory board and a state-of-the art Mentoring and Education program, and two research cores: the Technology, Assessment, Data, and Analysis (TADA) Core will support methods harnessing cutting-edge technology, data management and statistics; the Community Collaborative (CC) Core will support recruitment/retention of underserved and diverse populations and community partnerships. The STAR COBRE will serve as the only research center in Rhode Island focused on stress, trauma, and resilience. Our long-term goal is to develop and sustain a critical mass of investigators to establish The Miriam Hospital as a vibrant regional and national hub for transformative research into mechanisms of risk and resilience following childhood exposure to stress, trauma, and adversity.

PROJECT NARRATIVE The Center of Biomedical Research Excellence (COBRE) for Stress, Trauma, and Resilience (STAR) will serve as the only research center in Rhode Island focused on stress, trauma, and resilience. The STAR COBRE will catalyze the development of promising, early career faculty to emerge as leading, independently- funded investigators conducting transformative research in stress, trauma, and resilience. Capacity and infrastructure created by the STAR COBRE will establish The Miriam Hospital as a vibrant regional and national hub for faculty development, transformative research focused on: isolating and disentangling biological and behavioral mechanisms of risk and resilience following exposure to stress, trauma and adversity during sensitive periods of development, with ecologically-valid in vivo measurements leading to novel and actionable intervention targets to improve health.