The Problem

               We live in a highly stressful world that has resulted in an unprecedented incidence of stress-related mental and physical illnesses. Research in the neurosciences has made significant progress in identifying the role of environmental stressors (e.g. violence, abuse, disasters, neglect, harassment, discrimination) in the development of illness. There is particularly striking evidence that one’s interpersonal environment can shape and modify neurobiological factors that subsequently result in health problems. There is also growing evidence to indicate the role of psychosocial and behavioral interventions in modifying these neurobiological factors. Yet little research has focused on translating this exciting knowledge into evidence-based interventions to prevent and treat adverse effects of stress on health.  Although highly relevant to adults, psychosocial/behavioral interventions for stress-related illness have particular importance for children whose brains and other organ systems are more vulnerable to adverse effects of biological treatments. In addition, early interventions with children have the potential to address emerging problems before they develop into more severe disease.  

Current Approaches

               The importance of stress reduction is widely recognized.  However, there is a significant gap between advances in the neurosciences regarding allostatic load, psychoneuroimmunology, or epigenetics and their application to the development and testing of psychosocial/behavioral interventions that can attenuate or modify the neurobiological effects of stress on the nervous system. Studies are needed to assess the impact of these interventions on neuroplasticity and to examine how neurobiological outcomes of these therapies relate to psychological and physical symptoms across stress-related disorders.

Proposed Approach

               The UCSF CTSI can create a targeted program that encourages the translation of basic neuroscientific knowledge into the development and testing of psychotherapeutic and behavioral interventions for stress-related illnesses. This would involve 2 key components: 1) develop a centralized infrastructure that will bring together investigators in the field to share their expertise and facilitate collaboration of researchers across stress-related health problems. This infrastructure could also include innovative subject recruitment programs, a sample repository specific to stress-related biomarkers, and a repertoire of interventions that show promise in enhancing therapeutic neuroplasticity and reducing stress-related neurobiological deficits or injury; and 2) provide funding for pilot studies to test psychosocial/behavioral interventions that build on neuroscientific findings and measure the impact of these interventions on biomarkers specific to these findings.

Potential Partners

               There are many opportunities for collaboration. One of our strong community partners - Children’s Hospital and Research Center in Oakland – is submitting this idea in collaboration with UCSF. There would also be interest from our partners at SF General Hospital, SF Child and Behavioral Health Services, and CHILD at UCB. On a national level, there could be collaboration with the National Network of Depression Centers (of which our UCSF Depression Center is a member) and their CTSIs/CTSAs. This initiative would have important links to many of our CTSI’s programs, including Recruitment and Study Management Services, Strategic Opportunities Support, Community Engagement and Health Policy, and Early Translational Research.

Projected Impact and Innovation

               The initiative will foster collaboration among different disciplines at UCSF, with our community partners, and with colleagues nationally to achieve a much greater impact than would the efforts of individual investigative teams. It could provide a model infrastructure for an innovative field of research that other CTSIs and research institutions could use to advance the prevention and treatment of stress-related illnesses. It will also provide support to interdisciplinary, investigative teams in conducting important pilot work that will serve as the basis for applications to acquire extramural funding.  The initiative is highly congruent with NIH interests in fostering multi-disciplinary and biobehavioral research.