Primary-Care Based Mindfulness Intervention for Chronically Traumatized Individuals

针对慢性创伤个体的初级保健正念干预

基本信息

批准号：
10219160
负责人：
Abigail Powers Lott
金额：
$ 13.08万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10219160
关键词：
Adult African American Arousal Autonomic Dysfunction Autonomic nervous system Awareness Behavior Control Biological Caring Chronic Clinic Clinical Control Groups Cues Data Data Analytics Data Collection Development Emotional Exposure to Frequencies Galvanic Skin Response Goals Growth Health Impairment Individual Integrative Medicine Intervention Interview Knowledge Learning Low income Major Depressive Disorder Measurement Measures Medical Mental Depression Mental Health Mental disorders Methods Mind-Body Intervention Mindfulness Training Minority Modeling Outcome Parasympathetic Nervous System Patient Self-Report Physiological Population Populations at Risk Post-Traumatic Stress Disorders Primary Health Care Process Program Development Psychophysiology Public Health Public Hospitals Randomized Controlled Trials Reporting Research Research Design Research Infrastructure Risk Risk Factors Services Stress Sympathetic Nervous System Symptoms Techniques Therapeutic Intervention Time Training Training Activity Trauma Treatment outcome Underserved Population Urban Community Waiting Lists acceptability and feasibility barrier to care base behavioral health behavioral health intervention biopsychosocial career career development comorbidity depressive symptoms design emotion dysregulation emotion regulation ethnic minority population experience follow-up group intervention health care settings health disparity health service use high risk improved interest mindfulness mindfulness based cognitive therapy mindfulness intervention minority communities parent project post intervention primary care setting programs psychiatric symptom psychologic reduce symptoms response satisfaction screening statistics success symptom management trauma exposure traumatic stress treatment research trial design urban minority urban setting

项目摘要

Project Summary/Abstract Rates of repeated exposure to trauma and levels of trauma-related psychiatric disorders in low-income, urban minority communities far exceed national averages. Despite this, inadequate access and substantial barriers to treatment in urban traumatized populations remain. Mindfulness-based interventions may target emotion dysregulation and dysfunction of the autonomic nervous system, mechanisms that contribute to trauma-related psychiatric outcomes like posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). In line with the strategic goals of the NCCIH to improve care for hard-to-manage symptoms, the purpose of this study is to pilot a primary-care based mindfulness intervention for chronically traumatized African Americans screening positive for PTSD and MDD in primary care clinics within an urban public hospital. The study will utilize a randomized controlled trial (RCT) design along with a multi-method psychological and physiological assessment approach to establish the feasibility and acceptability of a [mindfulness-based cognitive therapy intervention for primary care (MBCT)] versus wait-list control in African Americans with chronic trauma exposure and comorbid PTSD and MDD. Also in line with the strategic goal of NCCIH to advance understanding of mechanisms underlying mind-body intervention approaches, preliminary mechanisms of action and change in outcomes associated with MBCT including emotion dysregulation, autonomic function, and PTSD and MDD symptoms will be evaluated. The data collection and [8-session] group intervention will take place in primary care clinics within an urban public hospital serving primarily low-income, minority individuals (>80% African American). Training activities will take place in an academic medical setting under the umbrella of a broader project aimed at understanding psychological and biological risk factors for PTSD. Training goals for this K23 project include 1) learning how to design, implement, and evaluate the outcomes of complementary and integrative behavioral health interventions, 2) [gaining enhanced training in mindfulness and integrated care], 3) learning longitudinal data analytic techniques, and 4) gathering and analyzing psychophysiological variables and integrating psychophysiological data into treatment research. Ultimately, career goals for the applicant include working to improve treatment for underserved civilian trauma populations in urban settings by taking a complementary integrative health perspective and enhance understanding of mechanisms of change in the context of trauma-related treatment. Bringing measures of objective physiological markers like autonomic function into primary care settings in the context of behavioral health treatments will also aid in our understanding of the biological mechanisms that may change as a result of these treatments and how those underlying biological mechanisms can positively impact health outcomes long term.

项目概要/摘要低收入城市中反复遭受创伤的比率以及创伤相关精神疾病的水平少数民族社区远远超过全国平均水平。尽管如此，仍存在准入不足和巨大障碍城市受创伤人群的治疗仍然存在。基于正念的干预措施可能针对情绪自主神经系统的失调和功能障碍，导致创伤相关的机制精神疾病，如创伤后应激障碍（PTSD）和重度抑郁症（MDD）。排队 NCCIH 的战略目标是改善难以管理症状的护理，本研究的目的是为长期遭受创伤的非裔美国人试点基于初级保健的正念干预在城市公立医院的初级保健诊所进行 PTSD 和 MDD 筛查呈阳性。该研究将利用随机对照试验 (RCT) 设计以及多种心理和生理方法建立基于正念的认知疗法的可行性和可接受性的评估方法初级保健干预（MBCT）]与患有慢性创伤的非裔美国人的等待名单控制暴露以及共病 PTSD 和 MDD。也符合NCCIH推进的战略目标了解身心干预方法的基本机制、初步机制与 MBCT 相关的行动和结果变化，包括情绪失调、自主神经功能、并将评估 PTSD 和 MDD 症状。数据收集和[8次]小组干预将在城市公立医院内的初级保健诊所进行，主要服务于低收入、少数族裔个人（>80% 非裔美国人）。培训活动将在学术医疗环境中进行这是一个更广泛的项目，旨在了解创伤后应激障碍的心理和生物风险因素。该 K23 项目的培训目标包括 1) 学习如何设计、实施和评估结果补充性和综合性行为健康干预措施，2) [获得正念强化训练和综合护理]，3）学习纵向数据分析技术，4）收集和分析心理生理变量并将心理生理数据整合到治疗研究中。最终，申请人的职业目标包括努力改善对服务不足的平民创伤人群的治疗在城市环境中，采取互补的综合健康观点并增强对创伤相关治疗背景下的变化机制。采取客观措施在行为健康背景下将自主神经功能等生理标志纳入初级保健环境治疗也将有助于我们理解可能因这些原因而改变的生物机制治疗以及这些潜在的生物机制如何对健康结果产生长期积极影响。

项目成果

期刊论文数量（5）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Associations Between Emotion Dysregulation Dimensions and Parenting Behaviors in Trauma-Exposed African American Mothers.

遭受创伤的非裔美国母亲的情绪失调维度与养育行为之间的关联。

DOI：
发表时间：
2022-02
期刊：
影响因子：
5.1
作者：
Powers, Abigail;Hunnicutt, Kallio;Stenson, Anais;Jovanovic, Tanja;Kaslow, Nadine;Bradley, Bekh
通讯作者：
Bradley, Bekh

Primary care-based mindfulness intervention for posttraumatic stress disorder and depression symptoms among Black adults: A pilot feasibility and acceptability randomized controlled trial.

针对黑人成人创伤后应激障碍和抑郁症状的初级保健正念干预：一项试点可行性和可接受性随机对照试验。

DOI：
发表时间：
2023-07
期刊：
影响因子：
0
作者：
Powers, Abigail;Lathan, Emma C;Dixon, H Drew;Mekawi, Yara;Hinrichs, Rebecca;Carter, Sierra;Bradley, Bekh;Kaslow, Nadine J
通讯作者：
Kaslow, Nadine J

Identifying latent profiles of emotion dysregulation in a sample of primarily Black women with trauma exposure.

识别主要是遭受创伤的黑人女性样本中情绪失调的潜在特征。

DOI：
发表时间：
2022-12
期刊：
影响因子：
4.8
作者：
Kuzyk, Eva;Mekawi, Yara;Michopoulos, Vasiliki;Powers, Abigail
通讯作者：
Powers, Abigail

The mediating role of emotion dysregulation in the association between trait mindfulness and PTSD symptoms among trauma-exposed adults.

情绪失调在遭受创伤的成年人特质正念与 PTSD 症状之间的关联中的中介作用。

DOI：
发表时间：
2021-09
期刊：
影响因子：
3.6
作者：
Powers, Abigail;Dixon, H Drew;Guelfo, Alfonsina;Mekawi, Yara;Bradley, Bekh;Kaslow, Nadine;Fani, Negar
通讯作者：
Fani, Negar

Evaluating the Performance of the Primary Care Posttraumatic Stress Disorder Screen for DSM-5 (PC-PTSD-5) in a Trauma-Exposed, Socioeconomically Vulnerable Patient Population.

评估初级保健创伤后应激障碍筛查 DSM-5 (PC-PTSD-5) 在遭受创伤、社会经济脆弱的患者群体中的表现。

DOI：
发表时间：
2023-12
期刊：
影响因子：
2.2
作者：
Lathan, Emma C;Petri, Jessica M;Haynes, Tamara;Sonu, Stan C;Mekawi, Yara;Michopoulos, Vasiliki;Powers, Abigail
通讯作者：
Powers, Abigail