PTSD, TBI, and Neuropsychological Factors in Partner Violence among Veterans

退伍军人伴侣暴力中的 PTSD、TBI 和神经心理因素

• 批准号: 8586865
• 负责人: CASEY T TAFT
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-01 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8586865
• 关键词: Accounting; Age; Agreement; Alcohol dependence; Anger; Area; Arousal; Behavioral; Belief; Boston; Clinical; Cognitive; Cognitive deficits; Cues; Data; Databases; Development; Diagnostic; Disease; Drug Addiction; Eligibility Determination; Executive Dysfunction; Family; Family member; Freedom; Funding; Health; Human Resources; Informed Consent; Inpatients; Intervention; Interview; Investigation; Knowledge; Laboratories; Laboratory Procedures; Life; Mails; Massachusetts; Measures; Methodology; Military Personnel; Modification; Moods; Nature; Occupational; Outcome; Outpatients; Participant; Patient Self-Report; Performance; Pharmaceutical Preparations; Population; Post-Traumatic Stress Disorders; Preventive Intervention; Principal Investigator; Procedures; Process; Psychotic Disorders; Questionnaires; Recording of previous events; Research; Research Design; Research Methodology; Risk; Role; Severities; Simulate; Source; Symptoms; Telephone; Testing; Thinking; Traumatic Brain Injury; Veterans; Work; anger management; combat; design; executive function; experience; improved; indexing; instrument; interest; intimate partner violence; male; meetings; mental state; neuropsychological; operation; partner violence; physical conditioning; prevent; programs; psychologic; psychological trauma; psychosocial; public health relevance; reading difficulties; response; screening; social; thought control; trait; violence prevention

DESCRIPTION (provided by applicant): This continuation application proposes to extend a funded CRS&D Merit Review project investigating the role of anger and cognitive deficits and biases with respect to the association between PTSD symptom severity and intimate partner violence (IPV) perpetration among Operation Iraqi Freedom (OIF)/ Operation Enduring Freedom (OEF) veterans. In the current application, we propose to examine the contribution of traumatic brain injury (TBI) and executive functioning with respect to these relationships. The primary objective of this study is to test the hypotheses that (a) TBI and executive functioning deficits will be positively and uniquely associated with higher physical and psychological IPV severity; and (b) TBI and executive functioning deficits will moderate the impacts of PTSD symptoms and cognitive deficits/biases on the IPV outcomes. Research Design and Methodology: Participants will be 150 male OEF/OIF veterans over the age of 18 who have been married or cohabitating with a partner for at least one year. Potential participants will be excluded if (a) reading difficulties prevent valid completion of the assessment instruments, (b) the mental status of a participant precludes the completion of study procedures, such as severe organicity, active psychosis, or impaired performance on the Mini-Mental Status Exam (c) the participant has taken any medication that is thought to have significant CNS effects, or (d) the participant meets criteria for current alcohol or drug dependence, OR has been in inpatient treatment or outpatient treatment for alcohol or drug dependence (e.g., AA, NA, or methodone treatment) within the past 60 days. Participants will be drawn from three sources: (a) flyers posted in the Boston area; (b) the already established National Center for PTSD subject recruitment database; and (c) a mass mailing to those on a roster of all male OEF/OIF veterans living in Massachusetts, held by the Defense Manpower Data Center (DMDC), and shared with the VA under a data use agreement signed by DMDC and the VACO. Participation will involve a phone screening and three laboratory sessions, spaced approximately one week apart. The initial screening with the participant will entail the determination of study eligibility. Session 1 will involve informed consent procedures and the administration of the Mini-Mental Status Examination, self-report questionnaires, and diagnostic interviews for PTSD and other Axis I disorders. Session 2 will include the Articulated Thoughts in Simulated Situations (ATSS) laboratory procedure to assess cognitive deficits and biases. This methodology assesses thoughts during anger arousal, since anger- related thoughts are more likely to be accessible and reportable if assessed when angry mood states are activated and relevant contextual cues present. Session 3 will involve the assessment of TBI and the neuropsychological variables of interest. Clinical Relationships: Study findings will potentially have consequences for program modification and development, specifically for anger management and IPV perpetration. Findings may highlight the need for cognitive-behavioral anger management strategies that take into account neuropsychological deficits and history of TBI. Study findings may also elucidate marker variables for IPV and the significance of specific neuropsychological factors that are particularly relevant for understanding and treating IPV in this population. Study findings will also inform the Principal Investigator's ongoing research program focused on developing interventions for the prevention and treatment of IPV. PUBLIC HEALTH RELEVANCE: Relevance to Veterans Health Intimate partner violence (IPV) alienates veterans from family members and negatively impacts support networks, placing the veteran at increased risk for various psychosocial and physical health problems and poor social and occupational functioning. It is critically important that we develop a better understanding of the nature and causes of IPV in this population in order to best prevent and treat such family problems. The current investigation proposes to examine the roles of traumatic brain injury and executive functioning deficits in IPV among returning veterans, as well as their interplay with symptoms of PTSD and cognitive deficits/biases in contributing to IPV. This work will inform the Principal Investigator's current funded efforts to develop and test primary and secondary IPV prevention interventions for veterans with PTSD.

描述（由申请人提供）： 该延续申请建议扩展一项资助的CRS＆D优异审查项目，该项目调查了PTSD症状严重程度与亲密伴侣暴力（IPV）在伊拉克自由（OIF）行动（OIF）/持久自由（OEF（OEF）的行动中，对PTSD症状严重程度与亲密伴侣暴力（IPV）持续性之间的关联的作用。在当前的应用中，我们建议检查创伤性脑损伤（TBI）和执行功能在这些关系方面的贡献。这项研究的主要目的是检验（a）（a）TBI和执行功能的赤字将与较高的身体和心理IPV严重程度呈正相关； （b）TBI和执行功能缺陷将减轻PTSD症状和认知缺陷/偏见对IPV结果的影响。研究设计和方法论：参与者将是18岁以上的150名男性OEF/OIF退伍军人，他们与伴侣结婚或同居至少一年。如果（a）阅读困难阻止评估工具的有效完成，（b）参与者的心理状况排除了研究程序的完成，例如严重的有机性，积极的精神病或诸如小型状态检查（c）参与者的任何药物均具有强大的cn ectornation of Crome of Crome of Crome of Crome of Crome of Crome of Crome of Crome of Crome of Crome of Crome of Crome of Crome of Crome of的研究程序的完成，或者是参与效果（d）。在过去60天内，住院治疗或门诊治疗（例如AA，NA或Metagone治疗）。参与者将来自三个来源：（a）在波士顿地区发布的传单； （b）已经成立的国家PTSD主题招聘数据库中心； （c）大规模邮寄给居住在马萨诸塞州的所有男性OEF/OIF退伍军人，由国防人力数据中心（DMDC）持有的所有男性OEF/OIF退伍军人，并根据DMDC和VACO签署的数据使用协议与VA共享。参与将涉及电话筛查和三个实验室会议，相距约一周。与参与者的最初筛选将需要确定研究资格。第1会议将涉及知情同意程序，以及针对PTSD和其他轴I疾病的迷你精神状态检查，自我报告问卷以及诊断访谈的管理。第2节将包括模拟情况（ATSS）实验室程序中的表达思想，以评估认知缺陷和偏见。该方法可以评估愤怒唤醒期间的思想，因为如果何时激活愤怒的情绪状态并存在相关的情境线索，则更有可能访问和报告。第3节将涉及对TBI的评估和感兴趣的神经心理学变量。临床关系：研究结果可能会对程序修改和开发产生影响，特别是对愤怒管理和IPV实施的影响。发现可能会强调需要考虑神经心理缺陷和TBI历史的认知行为愤怒管理策略的需求。研究结果还可能阐明IPV的标记变量以及特定神经心理学因素的重要性，这些因素与理解和治疗该人群中的IPV特别相关。研究结果还将为主要研究者正在进行的研究计划提供通知，旨在开发预防和治疗IPV的干预措施。 公共卫生相关性： 与退伍军人健康亲密伴侣暴力（IPV）相关，使退伍军人与家庭成员疏远，对网络产生负面影响，使退伍军人面临着各种心理社会和身体健康问题以及社会和职业功能不佳的风险。至关重要的是，我们要更好地了解该人群中IPV的性质和原因，以便最好地预防和治疗此类家庭问题。当前的调查提议研究返回退伍军人在IPV中创伤性脑损伤和执行功能缺陷的作用，以及它们与PTSD症状和认知缺陷/偏见在对IPV造成IPV中的症状。这项工作将为您目前的资金研究者提供了为使用PTSD的退伍军人开发和测试预防初级和次级IPV预防干预措施的努力。