Posttraumatic Stress and Cardiovascular Risk in Women: Tests of Biological Mechanisms

女性创伤后应激和心血管风险：生物机制测试

• 批准号: 9389535
• 负责人: Jennifer A Sumner
• 金额: $ 16.97万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-12-15 至 2020-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9389535
• 关键词: Accounting; Acute; Address; American Heart Association; American Stroke Association; Angioplasty; Atherosclerosis; Autonomic nervous system; Biological; Biological Markers; Biological Models; Biological Testing; Blood; Cardiac; Cardiovascular Diseases; Cardiovascular system; Caring; Cause of Death; Cessation of life; Chronic; Cohort Studies; Complex; Coronary Artery Bypass; Data; Data Analyses; Development; Diagnosis; Dimensions; Disease; Distal; Elements; Enrollment; Epidemiology; Event; Female; Fright; Functional disorder; Galvanic Skin Response; Genetic Risk; Goals; Health; Heart Rate; Hospitalization; Hospitals; Hypertension; Impairment; Incidence; Inflammation; Intervention; Interview; K-Series Research Career Programs; Knowledge; Lead; Length of Stay; Master of Science; Measurement; Measures; Mental Depression; Mental disorders; Mentors; Methods; Modeling; Myocardial Infarction; Neurologic; New York; Nurses' Health Study; Outcome; Pathway interactions; Patient Self-Report; Patients; Physiological; Physiology; Post-Traumatic Stress Disorders; Presbyterian Church; Prevention; Preventive Intervention; Prospective Studies; Psychopathology; Psychophysiology; Publishing; Reaction; Recurrence; Reporting; Research; Research Activity; Research Personnel; Research Training; Risk; Stress; Stroke; Symptoms; Testing; Thrombophilia; Time; Training; Training Activity; Trauma; Universities; Woman; Women' s Health; acute coronary syndrome; base; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; career; clinical application; clinical development; clinical epidemiology; design; dysphoria; effective intervention; epidemiologic data; epidemiology study; experience; follow-up; hospital readmission; meetings; men; multidisciplinary; patient oriented research; post-traumatic stress; predicting response; programs; prospective; psychologic; public health relevance; response; skills; trauma exposure

 DESCRIPTION (provided by applicant): This K01 Career Development Award will provide Dr. Jennifer Sumner with the necessary skills to establish an independent research career focused on elucidating the psychological and biological mechanisms by which traumatic experiences contribute to cardiovascular disease (CVD) in women, the leading cause of death worldwide. Posttraumatic stress disorder (PTSD), the quintessential stress-related mental disorder, prospectively predicts increased CVD incidence. However, PTSD is a complex and heterogeneous disorder, and the aspects of PTSD that drive CVD risk are unknown. Mechanistic knowledge, particularly in women, is also lacking. These limitations impede the development of clinical applications to offset CVD risk. The overall aim of this K01 proposal is to begin to test a theoretically based biological model by which a core element of PTSD-posttraumatic fear responses (e.g., hypervigilance, re-experiencing)- relates to CVD and intermediate markers of cardiovascular health in women. Supported by a multidisciplinary team of expert mentors, Dr. Sumner will examine how posttraumatic fear responses (measured across self- report and psychophysiological levels of analysis) relate to cardiovascular health in women. The training plan will provide Dr. Sumner with required background and skills in several domains in order to become an independent investigator with an integrative research program on the mechanisms by which the psychological sequelae of trauma contribute to CVD in women. Through coursework, hands-on training, and mentored meetings, Dr. Sumner will address prior gaps in training and develop skills in 1) cardiovascular, neurological, and clinical epidemiology, 2) quantitative methods for analyzing epidemiologic and longitudinal data, 3) CVD- related physiology and biomarkers, and 4) psychophysiological measures of fear responses. The training plan also includes completion of a Master's of Science degree in Patient-Oriented Research from Columbia University. The proposed research program harnesses two richly characterized ongoing cohort studies to test how posttraumatic fear responses relate to cardiovascular risk in women. Using data from the Nurses' Health Study II (NHS II), a longitudinal epidemiologic study of women's health, Dr. Sumner will determine if self- reported posttraumatic fear symptoms relate to hypertension and CVD incidence and CVD-related biomarkers. In the REactions to Acute Care and Hospitalization (REACH) study, a study of risk for PTSD after acute coronary syndrome and its relation to recurrent cardiac events at New York-Presbyterian Hospital, Dr. Sumner will collect data to test associations between fear responses at multiple levels of analysis-self-report symptoms and psychophysiological indicators (i.e., skin conductance and heart rate)-with hospital readmission and cardiac event recurrence. These research and training activities will inform an R01 application that will comprehensively test the biological mechanisms by which posttraumatic fear symptoms across multiple levels of analysis contribute to CVD in women.

 描述（由适用提供）：该K01职业发展奖将为詹妮弗·萨姆纳（Jennifer Sumner）博士提供必要的技能，以建立独立的研究职业，专注于阐明创伤经历在全球范围内导致妇女的心血管疾病（CVD）促进心血管疾病（CVD）的心理和生物学机制。创伤后应激障碍（PTSD），典型的与压力相关的精神障碍，前瞻性地预测了CVD风险增加。但是，PTSD是一种复杂且异质性的疾病，驱动CVD风险的PTSD的方面尚不清楚。机械知识，尤其是在女性中，也缺乏。这些限制阻碍了临床应用的发展以抵消CVD风险。该K01提案的总体目的是 开始测试一个基于神圣的生物学模型，通过该模型，PTSD-Posttraumatic恐惧反应的核心元素（例如，高维护，重新体验）与女性心血管健康的CVD和中间标记相关。在由专家导师的多学科团队的支持下，萨姆纳博士将研究创伤后的恐惧反应（跨自我报告和心理生理学分析水平的衡量）与女性心血管健康有关。培训计划将为Sumner博士提供几个领域所需的背景和技能，以便成为一名独立研究者，并通过综合研究计划，涉及创伤的心理后遗症对女性的CVD贡献。通过课程工作，动手培训和修改会议，Sumner博士将解决1）心血管，神经和临床流行病学的培训和发展技能的差距，2）用于分析流行病学和纵向数据的定量方法，3）CVD相关的物理学和生物标记物以及4）精神病学评分。该培训计划还包括哥伦比亚大学以患者为导向的研究的理学硕士学位。拟议的研究计划利用了两个持续的队列研究来测试创伤后恐惧反应与女性心血管风险有关的方式。护士健康研究II（NHS II）的数据是妇女健康的纵向流行病学研究。 In the REactions to Acute Care and Hospitalization (REACH) study, a study of risk for PTSD after acute coronary syndrome and its relation to recurrent cardiac events at New York-Presbyterian Hospital, Dr. Sumner will collect data to test associations between fear responses at multiple levels of analysis-self-report symptoms and psychophysiological indicators (i.e., skin conductance and heart rate)-with hospital readmission and cardiac event recurrence.这些研究和培训活动将为R01应用提供信息，该应用将全面测试生物学机制，通过这些机制，多个分析的创伤后恐惧症状有助于女性CVD。