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.

项目概要/摘要 尽管心血管疾病 (CVD) 多年来一直是美国和世界范围内的首要死亡原因 20世纪，传统危险因素（如糖尿病、血压、胆固醇）仅占50% 四十多年的研究提供了强有力的、可重复的、一致的证据表明 心理压力与心血管疾病的结果以及行为和生物学风险路径相关。 迫切需要了解压力如何“深入皮肤”并导致 CVD。 对压力如何经历并意味着风险的生态学有效理解。 广义不安全压力理论 (GUTS) 将压力概念化为一种“默认状态” 情绪与伴随的生理后遗症通过证明而支持 GUTS 框架。 情境安全结构指标、急性应激反应特征和心脏病风险之间的关联 另一个主要的当代模型，社会安全理论（SST），也指出了疾病的重要性。 SST 强调人类的社会参与倾向，并提出了这一点。 暴露于感知到的社会威胁会驱动生理应激反应和对可用社交的感知 安全线索可以缓和这种压力反应。大量的工作支持社会安全和认知。 暴露于社会威胁是与 CVD 相关的炎症应激反应模式的促成因素 这两种理论都表明人类处于环境安全评估的持续状态或 “警惕”影响一系列行为、生理和心理反应。 该提案的总体目标是首次研究一个统一模型，将压力详细描述为 我将使用 NHLBI 资助的 R01 的现有纵向数据来确定 CVD 的生态有效风险决定因素。 通过三个目标来实现这一目标，在目标 1 下，我研究了环境安全、 社会安全、日常社会警惕性和颈动脉内膜中层厚度 (cIMT) 的 2 年变化作为临床前指标 对于目标 2，我研究了社会警惕性在多大程度上介导了 CVD 之间的关联。 环境安全、社会安全和 cIMT 的 2 年变化 最后通过探索性目标 3，我。 描述血压和炎症标志物如何解释环境之间的关系 安全、社会安全、日常社会警惕以及 cIMT 的 2 年变化 一支经验丰富的导师团队。 的研究人员将支持我的研究和培训，以成为领先的心理社会机制科学家 通过拟议的培训机会，有助于了解心血管疾病的非传统决定因素。 我将：1）加深对与心血管健康相关的当代压力模型的概念理解； 发展对从压力到疾病的关键途径的方法论理解；3）获得以下方面的高级知识： CVD 病因学；4) 加强我的专业发展和研究传播；4) 提高我的水平； 资助技能并申请未来的资助支持。