Insomnia Treatment and Cardiometabolic Health in Older Adults with Posttraumatic Stress Disorder

患有创伤后应激障碍的老年人的失眠治疗和心脏代谢健康

• 批准号: 10594398
• 负责人: Monica R Kelly
• 金额: $ 18.93万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10594398
• 关键词: Address; Age; Aging; Arousal; Behavioral; Biological Markers; Cardiometabolic Disease; Cause of Death; Circadian Rhythms; Clinical Investigator; Clinical Psychology; Clinical Sciences; Clinical Trials; Clinical Trials Design; Cognitive; Cognitive Therapy; Comorbid Insomnia; Data; Diabetes Mellitus; Disease Management; Disease remission; Doctor of Philosophy; Dyslipidemias; Education; Elderly; Environment; Evidence based intervention; Failure; Fellowship; Foundational Skills; Funding; Geriatrics; Gerontology; Glycosylated hemoglobin A; Goals; Health; Healthcare Systems; Heart Diseases; Hyperglycemia; Hypertension; Individual; Insulin; Insulin Resistance; Intervention; Knowledge; Licensure; Link; Lipids; Measures; Mediating; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Morbidity - disease rate; Multi-Institutional Clinical Trial; Neurobehavioral Manifestations; Obesity; Older Population; Outcome; Participant; Patients; Pilot Projects; Play; Population; Post-Traumatic Stress Disorders; Professional Competence; Psychotherapy; Quality of life; Randomized; Randomized, Controlled Trials; Research; Research Methodology; Research Personnel; Residual state; Resources; Risk; Risk Factors; Role; Severities; Sleep; Sleep Apnea Syndromes; Sleep disturbances; Sleeplessness; Stress; Stroke; Symptoms; Training; Translational Research; Trauma; United States National Institutes of Health; Veterans; Vietnam; Work; cardiometabolic risk; cardiometabolism; career; career development; clinical care; clinical center; cognitive benefits; cohort; disorder risk; effective therapy; evidence base; experience; falls; fasting glucose; follow-up; functional disability; high risk; improved; improvement on sleep; individualized medicine; medical schools; military veteran; modifiable risk; mood symptom; mortality; physical conditioning; poor health outcome; poor sleep; professor; programs; randomized trial; skill acquisition; theories; trauma exposure; trial design; young adult

Project Summary/Abstract Monica Kelly, PhD is an Adjunct Assistant Professor at the David Geffen School of Medicine at UCLA. She is fully committed to becoming an independently funded investigator specializing in the study and treatment of sleep, cardiometabolic health and posttraumatic stress disorder (PTSD) in older adults. Dr. Kelly is an ideal candidate for this field of research with over 10 years of sleep and PTSD research experience, advanced geriatrics fellowship training, and licensure in clinical psychology. This K23 award will provide foundational career development skills for achieving her long-term goal of understanding and improving mental and physical health outcomes for older adults with insomnia and PTSD. Data collected will provide the basis of a larger, randomized controlled trial designed to examine the most effective treatment sequencing for mental health and cardiometabolic disease risk outcomes among older adults with comorbid insomnia disorder and PTSD. Career Development and Training Plan: The proposed work will be carried out at the UCLA and take advantage of available resources within the VAGLAHS, providing a rich training environment and the ability to conduct the proposed research and training plans. Dr. Kelly's team of nationally renowned mentors include Drs. Jennifer Martin (primary mentor; behavioral sleep interventions expert; K24 awardee), Cathy Alessi (geriatric sleep and health expert), Peter Liu (cardiometabolic health and sleep expert; K24 awardee), and Thomas Neylan (PTSD and sleep expert). Available resources include UCLA's Clinical and Translational Science Institute (CTSI), Multicampus Program in Geriatric Medicine and Gerontology (MPGMG), and the Geriatric Research, Education and Clinical Center (GRECC). Her training plan features carefully curated didactic and experiential training aligning her research and training goals in 1) clinical trials, 2) cardiometabolic health, 3) circadian rhythms, and 4) career skills necessary to become an independent clinical investigator. Research Plan: The proposed pilot randomized controlled trial will address a gap in knowledge related to addressing modifiable risk factors for cardiometabolic disease through treating residual insomnia in the context of PTSD in older adults. This project utilizes evidence-based interventions and standard clinical care measures. The study will evaluate the benefits of 5 sessions of Cognitive Behavioral Therapy for Insomnia (CBT-I) versus control, following 12 sessions of Cognitive Processing Therapy (CPT) for PTSD in older Veterans, an expanding group of individuals at elevated risk for PTSD, insomnia and cardiometabolic disease morbidity and mortality. The aims of this project are to 1) Evaluate the added benefits of CBT-I versus control on sleep, PTSD, and cardiometabolic risk biomarkers; 2) Evaluate CBT-I versus control following CPT on cardiometabolic risk biomarkers and quality of life; and 3) Evaluate the durability of the sleep, cardiometabolic and quality of life benefits of CBT-I following CPT versus control following CPT at 6-month follow-up.

项目概要/摘要 莫妮卡·凯利博士是加州大学洛杉矶分校大卫·格芬医学院的兼职助理教授。她是 完全致力于成为一名独立资助的研究者，专门从事研究和治疗 老年人的睡眠、心脏代谢健康和创伤后应激障碍 (PTSD)。凯利博士是一个理想的人 该研究领域的候选人，拥有超过 10 年的睡眠和 PTSD 研究经验，高级 老年病学进修培训和临床心理学执照。该 K23 奖项将提供基础 实现理解和改善身心的长期目标的职业发展技能 患有失眠和创伤后应激障碍的老年人的健康结果。收集到的数据将为更大规模的、 随机对照试验旨在检查对心理健康和健康最有效的治疗顺序 患有失眠症和创伤后应激障碍 (PTSD) 的老年人的心脏代谢疾病风险结果。 职业发展和培训计划：拟议的工作将在加州大学洛杉矶分校进行，并采取 利用 VAGLAHS 内的可用资源，提供丰富的培训环境和能力 开展拟议的研究和培训计划。凯利博士的全国知名导师团队包括 博士。 Jennifer Martin（主要导师；行为睡眠干预专家；K24 获奖者），Cathy Alessi （老年睡眠与健康专家）、Peter Liu（心脏代谢健康与睡眠专家；K24 获奖者）和 Thomas Neylan（创伤后应激障碍和睡眠专家）。可用资源包括加州大学洛杉矶分校的临床和转化 科学研究所 (CTSI)、老年医学和老年学多校区项目 (MPGMG) 以及 老年研究、教育和临床中心 (GRECC)。她的训练计划经过精心策划 教学和体验式培训使她在 1) 临床试验、2) 心脏代谢方面的研究和培训目标保持一致 健康，3) 昼夜节律，以及 4) 成为独立临床研究者所需的职业技能。 研究计划：拟议的试点随机对照试验将解决相关知识的空白 通过治疗残余失眠来解决心脏代谢疾病的可改变危险因素 老年人的 PTSD。该项目采用循证干预措施和标准临床护理 措施。该研究将评估 5 次认知行为疗法治疗失眠的益处 (CBT-I) 与对照，针对老年人 PTSD 进行 12 次认知加工治疗 (CPT) 退伍军人是一个不断扩大的创伤后应激障碍、失眠和心脏代谢疾病风险较高的人群 发病率和死亡率。该项目的目标是 1) 评估 CBT-I 相对于控制的额外好处 关于睡眠、创伤后应激障碍和心脏代谢风险生物标志物； 2) 评估 CBT-I 与 CPT 后的对照 心脏代谢风险生物标志物和生活质量； 3) 评估睡眠、心脏代谢的持久性 以及 6 个月随访时 CPT 后 CBT-I 与 CPT 后对照相比的生活质量益处。