Mindfulness-based Intervention for Trauma-exposed, Homeless Women

对遭受创伤的无家可归妇女进行正念干预

基本信息

批准号：
10544328
负责人：
Dana Rose Garfin
金额：
$ 13.59万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-05-06 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10544328
关键词：
Address Adrenal Glands Age Area Award Biological Biological Assay Biological Sciences C-reactive protein California Cardiovascular Diseases Clinical Clinical Trials Cognitive Communities Control Groups Data Depressed mood Disparity Educational workshop Focus Groups Foundations Grant Guidelines Health Promotion Homelessness Hydrocortisone Hypothalamic structure Immunosuppression Impairment Imprisonment Individual Inflammation Intervention Knowledge Link Literature Low income Maintenance Measures Mental Depression Mental Health Mentors Methods Minority Minority Groups Obesity Occupational Outcome Participant Persons Phase Physiological Pituitary Gland Population Post-Traumatic Stress Disorders Psychopathology Psychosocial Assessment and Care Public Health Randomized Recording of previous events Reduce health disparities Regulation Reporting Research Research Methodology Risk Factors Salivary Sampling Services Stress Substance Use Disorder Symptoms System Testing Training Trauma Treatment outcome Universities Veterans Vulnerable Populations Woman alcohol abstinence arm attentional control barrier to care biological adaptation to stress biopsychosocial clinically significant comorbidity comparison control cost depressive symptoms design diagnostic criteria drug abstinence epidemiology study experience follow up assessment group intervention health care service health disparity high risk hypothalamic-pituitary-adrenal axis immune function implementation intervention improved inclusion criteria inflammatory marker intimate partner violence low socioeconomic status mindfulness mindfulness intervention mindfulness-based stress reduction minority communities neighborhood disadvantage open label physical conditioning primary outcome programs psychologic psychosocial randomized, clinical trials responsible research conduct saliva sample secondary outcome sexual assault sexual violence social stigma substance use success symptomatology tool trauma exposure treatment response

项目摘要

ABSTRACT Posttraumatic stress disorder (PTSD) is a major public health concern that disproportionately effects minorities and those with low-socioeconomic status, such as homeless women, creating a critical health disparity. PTSD has been linked with dysregulated hypothalamic-pituitary-adrenal (HPA) functioning and increased inflammation, which can lead to long-term physical-health problems and PTSD-symptom maintenance, exacerbating disparities. Mindfulness-based interventions, including Mindfulness-based Stress Reduction (MBSR), have shown promise as a complementary tool for addressing PTSD in veterans and with low-income, minority populations, but homeless women have not been examined adequately. MBSR may improve PTSD symptomatology and help modulate the dysregulated stress response common in individuals with PTSD, improving physical and mental health concurrently. This project proposes a mixed-methods, open-label, parallel, randomized-clinical trial of a modified-MBSR intervention to reduce PTSD symptoms in homeless women and to explore physiological correlates of treatment-response. Inclusion criteria will be currently homeless women, age 18-64, with clinically-significant PTSD as defined by standard guidelines. Phase I will be a qualitative study to refine MBSR for cultural-appropriateness in a high-minority community and to address the specific needs of homeless women. In Phase II, participants will be randomly assigned to the MBSR-based intervention or a health promotion attention-control group. At baseline, women will complete psychosocial assessments (e.g., depression, substance use, trauma history) and participate in a brief stress task, providing salivary samples before and after the task (which will be assayed for cortisol and C-reactive protein, a marker of inflammation). Women will then participate in the 9-week MBSR-based program or health-promotion control group. Follow-up assessments that include psychosocial and biological data will occur immediately after final intervention session and again 6-months later. Clinically-meaningful improvements in PTSD (primary outcome) and secondary outcomes (e.g., depression, substance use, inflammation, cortisol reactivity) will then be examined. The candidate’s training plan capitalizes on the expertise of a diverse mentoring team, integrating advanced training in mixed-methods research, community-based clinical trials, mindfulness-based interventions, and salivary biosciences. The plan includes didactic courses and on-one-one mentoring at the University of California, Irvine (mixed-methods, qualitative design, clinical trials, and salivary bioscience) and Loma Linda University (MBIs), both in Southern California. The training plan also includes in-depth workshops in each substantive area and in training in the responsible conduct of research. The candidate will complete the K01 with expertise in mixed- methods, biopsychosocial approaches to address PTSD in populations with high health-disparities.

抽象的创伤后应激障碍 (PTSD) 是一个主要的公共卫生问题，对少数群体的影响尤为严重以及那些社会经济地位较低的人，例如无家可归的妇女，造成了严重的创伤后应激障碍。与下丘脑-垂体-肾上腺（HPA）功能失调和炎症增加有关，这可能导致长期的身体健康问题和创伤后应激障碍（PTSD）症状持续，加剧基于正念的干预措施，包括基于正念的减压（MBSR），存在差异。作为解决退伍军人和低收入少数族裔创伤后应激障碍（PTSD）问题的补充工具，有望成为一种补充工具人群，但无家可归的妇女尚未得到充分检查，MBSR 可能会改善 PTSD。症状并帮助调节 PTSD 患者常见的失调应激反应，该项目提出了一种混合方法、开放标签、并行、改良 MBSR 干预措施的随机临床试验，以减少无家可归妇女和妇女的 PTSD 症状探索治疗反应的生理相关性，纳入标准将是目前无家可归的妇女，年龄 18-64 岁，患有标准指南定义的具有临床意义的 PTSD，第一阶段将是一项定性研究。完善 MBSR，使其适合少数族裔社区的文化，并满足少数族裔群体的具体需求在第二阶段，参与者将被随机分配接受基于 MBSR 的干预或健康干预。在基线时，女性将完成心理社会评估（例如，抑郁症、药物滥用、创伤史）并参与简短的压力任务，提供唾液样本任务前后（将检测皮质醇和 C 反应蛋白（炎症标志物））。然后，女性将参加为期 9 周的基于 MBSR 的计划或健康促进对照组。包括心理社会和生物数据的评估将在最终干预会议后立即进行 6 个月后，PTSD（主要结果）和次要结果再次出现临床意义的改善。然后将检查结果（例如抑郁、物质使用、炎症、皮质醇反应性）。候选人的培训计划利用多元化指导团队的专业知识，整合高级培训混合方法研究、基于社区的临床试验、基于正念的干预措施和唾液该计划包括加州大学欧文分校的教学课程和一对一指导。（混合方法、定性设计、临床试验和唾液生物科学）和洛马琳达大学 (MBI)，培训计划还包括在每个实质性领域和地区举办的深入研讨会。候选人将完成 K01 的混合专业知识。方法、生物心理社会方法来解决健康差异较大的人群中的创伤后应激障碍。

项目成果

期刊论文数量（17）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Technology as a coping tool during the coronavirus disease 2019 (COVID-19) pandemic: Implications and recommendations.

技术作为 2019 年冠状病毒病 (COVID-19) 大流行期间的应对工具：影响和建议。

DOI：
发表时间：
2020
期刊：
影响因子：
0
作者：
Garfin; Dana Rose
通讯作者：
Dana Rose

The unfolding COVID-19 pandemic: A probability-based, nationally representative study of mental health in the United States.

正在展开的 COVID-19 大流行：一项基于概率、具有全国代表性的美国心理健康研究。

DOI：
发表时间：
2020
期刊：
影响因子：
13.6
作者：
Holman, E Alison;Thompson, Rebecca R;Garfin, Dana Rose;Silver, Roxane Cohen
通讯作者：
Silver, Roxane Cohen

Media exposure, risk perceptions, and fear: Americans' behavioral responses to the Ebola public health crisis.

媒体曝光、风险认知和恐惧：美国人对埃博拉公共卫生危机的行为反应。

DOI：
发表时间：
2022-07
期刊：
影响因子：
0
作者：
Garfin, Dana Rose;Holman, E Alison;Fischhoff, Baruch;Wong;Silver, Roxane Cohen
通讯作者：
Silver, Roxane Cohen

Media Exposure and Post-traumatic Stress Symptoms in the Wake of the November 2015 Paris Terrorist Attacks: A Population-Based Study in France.

2015 年 11 月巴黎恐怖袭击后的媒体曝光和创伤后应激症状：法国基于人口的研究。

DOI：
发表时间：
2021
期刊：
影响因子：
0
作者：
Robert, Maëlle;Stene, Lise Eilin;Garfin, Dana Rose;Vandentorren, Stéphanie;Motreff, Yvon;du Roscoat, Enguerrand;Pirard, Philippe
通讯作者：
Pirard, Philippe

Distortions in time perception during collective trauma: Insights from a national longitudinal study during the COVID-19 pandemic.

集体创伤期间时间感知的扭曲：来自 COVID-19 大流行期间一项全国纵向研究的见解。