Chronic Stress, Inflammation, and Resilience: Predictors of Social Integration in Recently Housed Black and White Veterans

慢性压力、炎症和复原力：最近安置的黑人和白人退伍军人社会融合的预测因素

基本信息

批准号：
10640731
负责人：
Derek Matthew Novacek
金额：
--
依托单位：
VA GREATER LOS ANGELES HEALTHCARE SYSTEM
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-05-01 至 2028-04-30
项目状态：
未结题

项目摘要

Despite the VA’s considerable success in reducing the number of homeless Veterans through permanent supportive housing, a fundamental problem remains. Permanent housing is necessary, but not sufficient, for successful social integration. Many Veterans remain isolated and without adequate social support after being housed. Black Veterans disproportionately experience homelessness yet remain understudied in psychological science. A better understanding of racial differences in risk and protective factors of social integration in recently housed Black and White Veterans could inform the development of novel rehabilitative interventions. This Career Development Award (CDA-2) proposes to utilize an innovative, multimodal approach to examine the contributions of stress, inflammation, and resilience to social integration in recently housed Black and White Veterans. Homelessness is extremely stressful and Black Veterans may experience additional stressors due to systemic inequities that could impede social integration. Furthermore, psychosocial stress is associated with an inflammatory response in the body. Inflammation could, in turn, exacerbate problems with social integration given the increasing evidence of its effect on social behavior. However, previous work finds better social integration in homeless Black Veterans compared to White Veterans, suggesting the presence of protective factors that mitigate the effects of stressors on social integration in Black Veterans. Resilience is a modifiable trait that might help buffer the negative consequences of stress and inflammation on social integration. The extent to which these factors differentially impact social integration in recently housed Black and White Veterans is relatively unknown. The overall goal of this longitudinal study is to examine racial differences in the effects of stress, inflammation, and resilience on social integration in recently housed Black and White Veterans. First, we will examine the cross-sectional and longitudinal associations of stress, inflammation, and resilience with social integration. Second, we will examine whether race moderates these associations. As an exploratory aim, we will examine an integrative longitudinal model of social integration, including the risk and protective factors listed above and psychiatric symptoms, in recently housed Black and White Veterans. Findings from this study have the potential to advance our understanding of risk and protective mechanisms of social integration in recently housed Black and White Veterans and inform innovative rehabilitative treatments that mitigate the effects of stress and inflammation to improve social integration. This CDA will provide the applicant, Derek M. Novacek, PhD, with the training in the areas of: (1) social integration and Veteran homelessness; (2) stress and inflammation, including multiple methods to assess inflammatory markers; and (3) racial health disparities in Veterans. The applicant’s career goal is to become a VA research psychologist, working to improve social integration in homeless Veterans and develop culturally congruent interventions. The training outlined in this CDA application will lay the groundwork for the applicant to develop an independent research program within the VA focused on determinants of social integration in homeless Veterans. The VA RR&D Center on Enhancing Community Integration for Homeless Veterans (THRIVe), VISN 22 Mental Illness Research, Education, and Clinical Center (MIRECC) at the VA Greater Los Angeles Healthcare System (GLA), and the University of California, Los Angeles (UCLA) provide an excellent environment and infrastructure to complete the proposed study. The primary mentor will be Michael F. Green, PhD, the Director of THRIVe, Director of the VISN 22 MIRECC Treatment Unit, and an established researcher in Veteran homelessness. The applicant will also receive specialized training from an expert in research with vulnerable Veterans (Lillian Gelberg, MD, MPH), a leading researcher in inflammation (Steven W. Cole, PhD), and a renowned scholar in racial health disparities in Veterans (Donna L. Washington, MD, MPH). The applicant will also receive statistical consultation from biostatistician, Catherine A. Sugar, Ph.D.

尽管退伍军人事务部通过永久政策在减少无家可归退伍军人数量方面取得了相当大的成功支持性住房，一个根本问题仍然存在，永久住房是必要的，但还不够。许多退伍军人在成功融入社会后仍然处于孤立状态，没有足够的社会支持。黑人退伍军人不成比例地经历过无家可归，但心理方面的研究仍然不足。更好地了解社会融合的风险和保护因素中的种族差异。最近安置的黑人和白人退伍军人可以为新型康复干预措施的发展提供信息。该职业发展奖（CDA-2）建议利用创新的多模式方法来审查压力、炎症和复原力对最近居住的黑人和黑人群体的社会融合的贡献无家可归的白人退伍军人压力极大，而黑人退伍军人可能会遇到额外的压力。由于系统性的不平等可能会阻碍社会融合。此外，社会心理压力也与之相关。体内的炎症反应反过来又会加剧社交问题。越来越多的证据表明整合对社会行为有影响。然而，之前的工作发现了更好的结果。与白人退伍军人相比，无家可归的黑人退伍军人的社会融合情况表明存在减轻压力源对黑人退伍军人社会融合影响的保护因素是一种恢复力。可改变的特征可能有助于缓解压力和炎症对社交的负面影响这些因素对最近居住的黑人的社会融合产生不同程度的影响。这项纵向研究的总体目标是考察种族。压力、炎症和复原力对最近居住的黑人社会融合的影响存在差异首先，我们将研究压力的横向和纵向关联，其次，我们将研究种族是否会调节这些。作为探索性目标，我们将研究社会融合的综合纵向模型，包括上面列出的风险和保护因素以及精神症状，在最近安置的黑人和这项研究的结果有可能增进我们对风险和风险的理解。最近安置的黑人和白人退伍军人的社会融合保护机制，并为创新提供信息减轻压力和炎症影响以改善社会融合的康复治疗。该 CDA 将为申请人 Derek M. Novacek 博士提供以下领域的培训：(1) 社交融合和退伍军人无家可归；(2) 压力和炎症，包括多种评估方法炎症标志物；(3) 退伍军人的种族健康差异。退伍军人管理局研究心理学家，致力于改善无家可归退伍军人的社会融合并促进文化发展本 CDA 申请中概述的培训将为申请人奠定基础。在 VA 内制定一个独立的研究计划，重点关注社会融合的决定因素无家可归的退伍军人。 VA RR&D 中心加强无家可归退伍军人的社区融合。 (THRIVe)、VISN 22 退伍军人管理局大洛斯精神疾病研究、教育和临床中心 (MIRECC) 洛杉矶医疗系统 (GLA) 和加州大学洛杉矶分校 (UCLA) 提供出色的医疗服务完成拟议研究的主要导师是 Michael F. Green，博士、THRIVe 主任、VISN 22 MIRECC 治疗中心主任、资深研究员退伍军人无家可归者还将接受研究专家的专门培训。弱势退伍军人（Lillian Gelberg，医学博士、公共卫生硕士），炎症领域的领先研究员（Steven W. Cole，博士），以及退伍军人种族健康差异方面的著名学者（Donna L. Washington，医学博士、公共卫生硕士）。申请人还将接受生物统计学家 Catherine A. Sugar 博士的统计咨询。