Understanding the interplay of social context and physiology on psychological outcomes in trauma-exposed adolescents: a protocol and baseline data report.

Background

Adolescence is a period of increased risk for trauma, with a subset of adolescents developing post-traumatic stress disorder (PTSD). Research has explored the interplay of biology (e.g. heart rate, skin conductance) and social context as critical influences in the early development of PTSD. Prior research is limited, however, by assessments at discrete points and reliance on self-report. Research is needed to model the dynamic interplay of social context and biology.Method: We have developed an integrated ecological method for characterizing biosocial processes using: (1) wristband health trackers; (2) the Electronically Activated Recorder (EAR), which samples ambient sounds to capture social context; and (3) adolescents' own use of online social networks (OSNs). Participants consist of 191 adolescents (13-18 years) recruited in-hospital after traumatic injury (e.g. physical assault, serious vehicular accident). For 2 weeks post-discharge, participants wore a wristband health tracker and the EAR (later coded for social environment, interaction, affect, content, and behavioural indicators of acute threat construct). At the 2 week follow-up, they returned the devices, permitting download of OSN activity, and participated in a clinical interview. At 6 weeks, 6 months, and 9 months post-trauma, participants provided an OSN download of the prior 2 weeks, completed laboratory procedures to characterize fear learning and physiological reactivity indicators, and underwent semi-structured interviews of stress-sensitive disorders and self-reported measures of social context. In vivo social context was captured through the EAR/OSN, and will be modelled in concert with heart rate and skin conductance to reflect the dynamic process of biomarkers and social processes over time.

Results

The research protocol and cohort characteristics are described herein.

Conclusion

The combination of ecological and laboratory-based methods used here provides rich, clinically relevant characterization of interindividual and intraindividual biopsychosocial predictors and correlates of post-trauma adjustment, with direct implications for theory and intervention.