An Integrated Model of Contextual Safety, Social Safety, and Social Vigilance as Psychosocial Contributors to Cardiovascular Disease

情境安全、社会安全和社会警惕作为心血管疾病社会心理因素的综合模型

• 批准号: 10749134
• 负责人: Riley Maria O'Neill
• 金额: $ 4.77万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2024
• 资助国家: 美国
• 起止时间: 2024-01-24 至 2026-01-23
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10749134
• 关键词: Address; Anxiety; Award; Awareness; Behavior; Behavioral; Behavioral Research; Biological; Biomedical Research; Blood; Blood Pressure; Cardiovascular Diseases; Cause of Death; Cholesterol; Clinical Research; Communities; Crime; Cues; Data; Diabetes Mellitus; Disease; Disease Outcome; Disease Progression; Ecological momentary assessment; Emotions; Environment; Environmental Risk Factor; Etiology; Evaluation; Event; Exposure to; Fasting; Funding; Future; Goals; Grant; Health; Hostility; Human; Individual; Individual Differences; Inflammation; Inflammatory; Knowledge; Life; Link; Mediating; Mentorship; Methodology; Methods; Modeling; Monitor; National Heart, Lung, and Blood Institute; Outcome; Parents; Pathway interactions; Patient Self-Report; Pattern; Perception; Personal Satisfaction; Physiological; Politics; Process; Psyche structure; Psychological Stress; Reaction; Research; Research Personnel; Research Support; Resources; Risk; Risk Factors; Role; Safety; Scientist; Security; Skin; Social Environment; Social Perception; Stigmatization; Stress; Surveys; Testing; Time; Training; United States; United States National Institutes of Health; Woman; Work; acute stress; biobehavior; biological adaptation to stress; cardiovascular health; carotid intima-media thickness; experience; follow-up; heart disease risk; improved; inflammatory marker; innovation; interpersonal conflict; member; perceived stress; pre-clinical; protective factors; psychologic; psychosocial; research and development; research data dissemination; skills; social; social engagement; social factors; socioenvironmental factor; stress reactivity; theories; training opportunity; vigilance

PROJECT SUMMARY/ABSTRACT Despite cardiovascular disease (CVD) being the leading cause of death in the U.S. and worldwide for over a century, traditional risk factors (e.g., diabetes, blood pressure, cholesterol) account for only 50% of the variance in CVD outcomes. Over four decades of research provide robust, replicated, consistent evidence that psychological stress is linked to CVD outcomes and hypothesized behavioral and biological paths of risk. Thus, there is a critical need for understanding how stress gets “under the skin” to cause CVD. This work begins with an ecologically valid understanding of how stress is experienced and connotes risk. One major contemporary theory, the Generalized Unsafety Theory of Stress (GUTS), conceptualizes stress as a “default state” of emotion with concomitant physiological sequelae. Robust data supports GUTS framework by demonstrating associations between structural indicators of contextual safety, acute stress reactivity profiles, and risk of heart disease. Another major contemporary model, Social Safety Theory (SST), also points to the importance of perceived indicators of security. SST emphasizes the human propensity for social engagement, positing exposure to perceived social threat drives physiological stress reactivity and perception of available social safety cues moderates such stress responses. Extensive work supports perception of social safety and exposure to social threat as contributors to inflammatory stress response patterns associated with CVD progression. Both theories suggest humans are in a constant state of environmental safety evaluation or “vigilance” influencing a constellation of behavioral, physiological, and psychological reactions. The overarching goal of this proposal is to investigate, for the first time, a harmonized model detailing stress as an ecologically valid risk determinant of CVD. I will use existing longitudinal data from an NHLBI-funded R01 to address this goal through three aims. Under aim 1, I investigate the relationship between environmental safety, social safety, daily social vigilance, and 2-year change in carotid intima-media thickness (cIMT) as a preclinical marker of CVD. With aim 2, I examine the extent to which social vigilance mediates associations between environmental safety, social safety, and 2-year change in cIMT. Finally through exploratory aim 3, I characterize how blood pressure and inflammatory markers account for relationships among environmental safety, social safety, daily social vigilance, and 2-year change in cIMT. A highly experienced mentorship team of investigators will support my research and training to become a leading psychosocial mechanism scientist contributing to understanding nontraditional determinants of CVD. Through the proposed training opportunities, I will: 1) deepen conceptual understanding of contemporary stress models related to cardiovascular health; 2) develop methodological understanding of key pathways from stress to disease; 3) gain advanced knowledge in CVD etiology; 4) enhance my professional development and research dissemination; and 4) improve my grantsmanship skills and apply for future grant support.

项目摘要/摘要 尽管心血管疾病（CVD）是美国和全球死亡的主要原因 世纪，传统危险因素（例如糖尿病，血压，胆固醇）仅占50％ CVD结果的差异。超过四十年的研究提供了强大的，复制的，一致的证据 心理压力与CVD结局以及假设的行为和生物学风险路径有关。那， 迫切需要了解压力如何“在皮肤下”引起CVD。这项工作始于 对压力的经历并表示风险的生态有效理解。一个主要的当代 理论是一般的不安全压力理论（肠道），将压力概念化为作为一种“默认状态” 与伴随物理后遗症的情感。强大的数据通过演示来支持肠道框架 背景安全性，急性压力反应性概况的结构指标与心脏风险之间的关联 疾病。另一个主要的当代模型社会安全理论（SST）也表明了 感知的安全指标。 SST强调人类在社会参与，定位方面的改善 暴露于感知的社会威胁会促进身体压力反应性和对可用社会的感知 安全提示缓和了这种压力反应。广泛的工作支持对社会安全和 接触社会威胁，作为与CVD相关的炎症压力反应模式的贡献者 进展。这两种理论都表明人类处于环境安全评估的恒定状态或 “警惕”影响了一系列行为，生理和心理反应。这 该提案的总体目标是首次调查一个统一的模型，将压力详细介绍为 确定CVD的生态有效风险。我将使用来自NHLBI资助的R01的现有纵向数据 通过三个目标解决这个目标。在AIM 1下，我调查了环境安全之间的关系， 社会安全，日常社会警惕和颈动脉内膜媒体厚度（CIMT）的两年变化作为临床前 CVD的标记。与AIM 2一起，我研究了社会警惕性介导的关联的程度 环境安全，社会安全和CIMT的两年变化。最后，通过探索性目标3，我 表征血压和炎症标志物如何解释环境之间的关系 CIMT的安全，社会安全，日常社会警惕和2年变化。一支经验丰富的精神训练团队 研究人员将支持我的研究和培训成为领先的社会心理机制科学家 有助于了解CVD的非传统决定者。通过拟议的培训机会， 我将：1）加深对与心血管健康有关的当代压力模型的概念理解； 2） 对从压力到疾病的关键途径进行方法论上的理解； 3）获得高级知识 CVD病因； 4）加强我的专业发展和研究传播； 4）改善我的 授予技巧，并申请未来的赠款支持。