Harvard/Brown Anxiety Program (HARP)

哈佛/布朗焦虑项目 (HARP)

• 批准号: 8247817
• 负责人: MARTIN B KELLER
• 金额: $ 75.5万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-04-01 至 2014-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8247817
• 关键词: Accounting; Acculturation; Address; Adult; African American; Age; Age of Onset; Age-associated memory impairment; Aging; Alcohol or Other Drugs use; Anxiety; Anxiety Disorders; Binding; Caucasians; Caucasoid Race; Censuses; Cessation of life; Characteristics; Clinical; Clinical Data; Clinical Treatment; Conflict (Psychology); DSM-IV; Data; Dementia; Depressive disorder; Development; Diagnosis; Discrimination; Disease; Divorce; Economics; Elderly; Enrollment; Epidemiology; Ethnic Origin; Ethnic group; Event; Family; Functional disorder; Grant; Health; Hispanics; Household; Immigration; Impaired cognition; Impairment; Individual; Intake; Interview; Knowledge; Life; Literature; Longevity; Longitudinal Studies; Medical; Memory impairment; Mental Depression; Mental Health; Mood Disorders; Not Hispanic or Latino; Outcome; Outpatients; Phase; Population; Post-Traumatic Stress Disorders; Prevalence; Probability; Psychopathology; Public Health; Publishing; Recording of previous events; Recruitment Activity; Recurrence; Research; Research Personnel; Risk; Sampling; Sampling Studies; Severities; Signal Transduction; Social status; Social support; Socioeconomic Factors; Substance Use Disorder; Suggestion; Symptoms; Syndrome; Testing; Time; Time Study; Trauma; United States; Universities; Variant; Widowhood; Work; age related; base; cohort; comparative; depressive symptoms; design; environmental stressor; ethnic difference; ethnic minority population; evidence base; experience; follow-up; improved; indexing; insight; longitudinal design; member; minority subjects; partial recovery; programs; prospective; psychologic; psychopharmacologic; psychosocial; social; socioeconomics

DESCRIPTION (provided by applicant): Anxiety disorders are the most common class of mental health conditions in the United States. Substantial gaps exist in the literature with respect to the clinical course of anxiety disorders in particular groups of individuals who are continually increasing in prevalence in the U.S. population, particularly African American and Hispanic individuals, and individuals entering older age. Specifically, despite the increasing and substantial number of African American, Hispanic, and older adults in the population, there are no published data on the clinical course of anxiety disorders in these groups of individuals that have been collected using a prospective, short-interval interview, longitudinal, naturalistic design. In this application we propose two timely and needed studies within the Harvard/Brown Anxiety Research Program (HARP) to address these fundamental gaps in our understanding of the course of anxiety disorders in these understudied populations. First, we propose to expand our newly recruited and prospectively studied sample of African Americans and Hispanics with anxiety disorders to a total of 175 African Americans and 175 Hispanics, and to recruit a contemporaneous sample of 175 non-Hispanic Caucasians, comparable on socioeconomic indicators to the African American and Hispanic samples. The recruitment and prospective, short-interval follow-up of these individuals over the next 5 years will provide the first comprehensive description of the prospective naturalistic course of psychopathology and psychosocial outcomes associated with DSM-IV anxiety disorders and related culture-bound syndromes and symptoms in African American, Hispanic, and non-Hispanic Caucasian subjects that are comparable on socioeconomic indicators (AIM 1), as well as examination of predictors of course within each of these three ethnic groups (AIM 2). We will then conduct the first prospective longitudinal test of potential ethnic minority disparities in the course of anxiety disorders (AIM 3) along with the first examination of potential demographic, clinical, environmental stressor, and socio-cultural predictors of ethnic minority disparities in course (AIM 4). Second, we propose to continue observation of members of the original HARP cohort who have been studied for 15 years as they enter older adulthood (all 247 subjects who will reach or exceed the age of 61 during the proposed grant period) to provide new knowledge about the developmental changes that take place in the clinical course of anxiety disorders during the transition to older adulthood (AIMS 5 and 6). We will test the suggestion in the literature, based on epidemiological data, that the course of anxiety disorders improves during the transition to older adulthood; explore the extent to which indicators of declining physical and social wellness may be predictive of worsening course of anxiety disorders as subjects make the transition to older adulthood; and test the hypothesis that those individuals who have had an especially pernicious course of anxiety are at increased risk for age-related cognitive impairment. Taken together, this proposal will provide substantial new clinical knowledge about the course of anxiety disorders in understudied individuals in the population. PUBLIC HEALTH RELEVANCE: Despite the increasing numbers of both ethnic minorities and individuals entering older age in the United States, there is a dearth of substantial clinical knowledge about the course of anxiety disorders in these groups, including factors which place them at substantial risk for deleterious health consequences. This project will provide necessary in-depth prospective longitudinal study of the course of anxiety disorders in these groups, and holds promise for providing insight into the factors associated with the medical, psychological, and economic consequences of anxiety disorders in ethnic minorities and aging populations.

描述（由申请人提供）：焦虑症是美国最常见的一类心理健康状况。关于焦虑症的临床病程，文献中存在很大的空白，特别是在美国人口中患病率不断增加的特定人群中，特别是非裔美国人和西班牙裔个体以及进入老年的个体。具体来说，尽管人口中非裔美国人、西班牙裔和老年人的数量不断增加，但目前还没有通过前瞻性、短期访谈收集的有关这些人群焦虑症临床病程的公开数据，纵向，自然主义设计。在本申请中，我们在哈佛/布朗焦虑研究计划（HARP）中提出了两项​​及时且必要的研究，以解决我们对这些被研究人群的焦虑症病程理解中的根本差距。首先，我们建议将新招募和前瞻性研究的患有焦虑症的非裔美国人和西班牙裔样本扩大到总共 175 名非裔美国人和 175 名西班牙裔美国人，并招募 175 名非西班牙裔白种人的同期样本，其社会经济指标与非裔美国人和西班牙裔样本。未来 5 年对这些人的招募和前瞻性短期随访将首次全面描述与 DSM-IV 焦虑症和相关文化束缚综合症和症状相关的精神病理学和心理社会结果的前瞻性自然进程在非裔美国人、西班牙裔和非西班牙裔白种人受试者中，社会经济指标具有可比性（AIM 1），当然也对这三个种族群体中的每一个群体的预测变量进行检查（AIM 2）。然后，我们将对焦虑症过程中潜在的少数族裔差异进行首次前瞻性纵向测试（AIM 3），并首次检查少数族裔差异的潜在人口统计学、临床、环境压力源和社会文化预测因素（AIM 3）。目标 4)。其次，我们建议继续观察已经研究了 15 年的原始 HARP 队列成员进入老年期（所有 247 名受试者在拟议的资助期内将达到或超过 61 岁），以提供有关以下方面的新知识：向老年过渡期间焦虑症临床过程中发生的发育变化（AIMS 5 和 6）。我们将根据流行病学数据检验文献中的建议，即焦虑症的病程在向老年过渡期间会有所改善；探索随着受试者向老年过渡，身体和社会健康下降的指标在多大程度上可以预测焦虑症的恶化过程；并检验以下假设：那些经历过严重焦虑的人患与年龄相关的认知障碍的风险增加。总而言之，该提案将为人群中未被充分研究的个体的焦虑症病程提供大量新的临床知识。公共卫生相关性：尽管在美国，少数族裔和进入老年的人数不断增加，但对这些群体的焦虑症病程缺乏大量的临床知识，包括使他们面临严重有害健康风险的因素。健康后果。该项目将为这些群体的焦虑症病程提供必要的、深入的前瞻性纵向研究，并有望深入了解与少数族裔和老龄化人群中焦虑症的医学、心理和经济后果相关的因素。