PTSD, Negative and Positive Emotion Dysfunction and Substance USE in IPV Victims

IPV 受害者的 PTSD、消极和积极情绪功能障碍以及药物使用

• 批准号: 9476531
• 负责人: Nicole Holland Weiss
• 金额: $ 15.21万
• 依托单位: UNIVERSITY OF RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9476531
• 关键词: Address; Advanced Development; Affect; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Area; Arousal; Behavior; Behavior assessment; Behavioral; Chronic; Clinical Sciences; Colorado; Communities; Connecticut; Cues; Data; Data Reporting; Development; Drug usage; Ego; Emotions; Environment; Ethics; Evidence based treatment; Exhibits; Functional disorder; Funding; Goals; HIV; HIV Seropositivity; Health; Healthcare; Individual; Institutes; Intervention; Literature; Maintenance; Manuscripts; Measures; Mediating; Mediation; Medical; Mentored Patient-Oriented Research Career Development Award; Mentors; Methodology; Methods; Modeling; National Institute of Drug Abuse; Neurosecretory Systems; Outcome; Pathogenesis; Pathology; Patient Self-Report; Pharmaceutical Preparations; Physiological; Population; Post-Traumatic Stress Disorders; Postdoctoral Fellow; Prevalence; Prevention; Prevention Research; Preventive Intervention; Process; Psychiatry; Public Health; Publishing; Recurrence; Reporting; Research; Research Design; Resources; Risk; Risk Behaviors; Risk-Taking; Role; Safety; Sampling; Severities; Sexual Partners; Smoker; Stimulus; Symptoms; System; Testing; Time; Tobacco; Tobacco use; Training; Translational Research; Trauma; United States National Institutes of Health; Universities; Veterans; Victimization; Woman; alcohol misuse; alternative treatment; associated symptom; base; career; clinically relevant; design; drug misuse; emotion regulation; emotional experience; experience; high risk; high risk population; indexing; innovation; interest; intimate partner violence; intravenous drug user; medical schools; multidisciplinary; novel; positive emotional state; prevent; programs; psychologic; reduced substance use; research and development; response; sex; sex risk; skill acquisition; skills; stem; substance abuse prevention; theories; virtual

PROJECT SUMMARY/ABSTRACT IPV is a pervasive and serious public health issue, affecting nearly one in three women nationally in their lifetime.1 IPV-exposed women have rates of drug and alcohol misuse that are 2–7 times higher than women nationally.2,3 As many as 70% are tobacco smokers.3 [IPV-exposed women have sex with more risky partners, including those who are HIV-positive, IV drug users, and nonmomgomous,4,5 and are more likely to engage in unprotected sex6-8 and trade sex,9 and report more sex partners.4,7] PTSD is highly prevalent among IPV-exposed women (31 to 84%),3,10 and IPV-related PTSD symptoms are positively associated with drug,11-13 alcohol,14,15 and tobacco use16,17 and HIV/sexual risk.18,19 Despite the clear clinical relevance of PTSD in this population, particularly with regard to substance use and risky sex, no studies have explicated mechanisms that may account for relations between PTSD symptoms and substance use and HIV/sexual risk behaviors among IPV-exposed women. Emotion dysfunction has been identified as a key mechanism in the pathogenesis of a wide range of psychological difficulties and maladaptive behaviors,20 including PTSD,21-24 substance use,25- 29 and HIV/sexual risk.25,30-32 Yet, research on mechanisms underlying these health outcomes generally, and the potential mechanism of emotion dysfunction in particular, is absent in this population. IPV-exposed women constitute a unique population distinct from other trauma-exposed populations. IPV is chronic; women are recurrently victimized by their partners and repeatedly exposed to potentially traumatic stimuli in their environment.33,34 This unique context poses increased risk for PTSD symptoms, emotion dysfunction, substance use, and HIV/sexual risk. Existing intervention models for treating PTSD and co-occurring substance use and/or risky sex (e.g., Seeking Safety,35 Project Connect36) were not developed for women who remain in unsafe situations, are seldom community-based, and do not have an integrated focus on IPV, PTSD, substance use, and HIV/sexual risk. Consistent with current initiatives (e.g., NIH strategic plans37), identifying mechanistic processes, across multiple systems (i.e., physiological and behavioral), underlying the relations among PTSD, substance use, and HIV/sexual risk in this population is a critical first step in developing targeted interventions that are safe for IPV-exposed women in the community.102,103 The proposed study addresses such critical gaps in the research with an innovative, context-specific, multi-method approach among 150 women currently experiencing IPV and using substances. Findings will [identify relations among physical, sexual, and psychological IPV and emotion dysfunction;] explicate the role of emotion dysfunction in PTSD symptoms and risk-taking propensity in the lab and substance use and HIV/sexual risk in the real-world; and test the convergent validity of lab and real-world data. The role of emotion dysfunction in PTSD symptoms and risk-taking propensity will be measured in the lab via a novel experimental paradigm and in the real world via daily assessments (i.e., experience sampling). Dr. Weiss is extremely well-qualified for the Mentored Patient-oriented Research Career Development Award from the National Institutes of Health. She is a highly productive NIDA-funded T32 Post-doctoral Fellow in Substance Abuse Prevention Research in the Department of Psychiatry at the Yale University School of Medicine. During the proposed training period, Dr. Weiss will be housed within the Department of Psychiatry at the Yale University School of Medicine. She will also draw from the rich resources provided through the Institute for Clinical and Translational Science at the University of Connecticut Health Center and the University of Colorado Denver Anschutz Medical Campus. Across these settings, she will have access to world-class expertise in research design, methodology, and analysis. Dr. Weiss' program of research focuses on the role of emotion dysfunction in posttraumatic stress disorder (PTSD) and related substance use and HIV/sexual risk. She has published [12] first-author and [8] co-author manuscripts on these topics. Her long- term goals are to be a leader in research aimed at preventing and reducing substance use and HIV/sexual risk among women with PTSD who experience intimate partner violence (IPV); to build strong multi-disciplinary partnerships to identify potential physiological mechanisms and behavioral processes underlying substance use and HIV/sexual risk among IPV-exposed women with PTSD; and to develop prevention and intervention efforts targeting substance use and HIV/sexual risk among IPV-exposed women with PTSD. Continued sponsorship, mentoring, and directed study will facilitate the development of advanced research skills so Dr. Weiss can be at the forefront of cutting-edge research in these areas. Short-term career objectives focus on the development of proficiency in (a) physiological (i.e., sympathetic, parasympathetic, and neuroendocrine) and behavioral assessments of negative and positive emotion dysfunction; (b) micro-longitudinal research design, methods, and analysis; and (c) [optimal design and implementation strategies, such as ethical and safety issues, pertinent to the conduct of research with women who experience IPV and use substances.]

项目概要/摘要 IPV 是一个普遍而严重的公共卫生问题，影响着全国近三分之一的女性 1 暴露于 IPV 的女性吸毒和滥用酒精的比例比男性高 2-7 倍 2,3 多达 70% 的人是吸烟者。3 [暴露于 IPV 的女性与更危险的人发生性行为 伴侣，包括 HIV 阳性者、静脉注射吸毒者和非母亲伴侣，4,5 并且更有可能 进行无保护的性行为6-8 和性交易9 并报告更多的性伴侣。4,7] PTSD 在 暴露于 IPV 的女性（31% 至 84%），3,10 且 IPV 相关的 PTSD 症状与药物呈正相关，11-13 酒精，14,15 和吸烟16,17 以及艾滋病毒/性风险。18,19 尽管 PTSD 在这方面具有明确的临床相关性， 人群，特别是在药物使用和危险性行为方面，没有研究阐明其机制 这可能解释了创伤后应激障碍症状与物质使用和艾滋病毒/性危险行为之间的关系 在 IPV 暴露的女性中，情绪功能障碍已被确定为发病机制的关键机制。 各种心理困难和适应不良行为，20 包括创伤后应激障碍 (PTSD)，21-24 药物滥用，25- 29 和艾滋病毒/性风险。25,30-32 然而，对这些健康结果的潜在机制的研究，以及 尤其是在暴露于 IPV 的女性中，不存在情绪功能障碍的潜在机制。 构成与其他遭受创伤的人群不同的独特人群，女性是慢性病； 经常受到伴侣的伤害，并反复受到潜在的创伤性刺激 环境。33,34 这种独特的环境会增加患 PTSD 症状、情绪功能障碍、 药物使用和艾滋病毒/性风险的现有干预模型。 药物滥用和/或危险性行为（例如，寻求安全、35 Project Connect36）并不是针对以下女性而制定的： 仍然处于不安全的情况下，很少以社区为基础，并且没有全面关注 IPV、PTSD、 与当前的举措（例如 NIH 战略计划37）一致，确定艾滋病毒/性风险。 跨多个系统（即生理和行为）的机械过程，是关系的基础 在这一人群中，将创伤后应激障碍（PTSD）、物质使用和艾滋病毒/性风险纳入其中是发展的关键的第一步。 对社区中感染 IPV 的妇女安全的有针对性的干预措施。102,103 拟议的研究 通过创新、针对具体情况的多方法方法解决研究中的此类关键差距 对目前正在经历 IPV 并使用药物的 150 名女性进行调查，调查结果将[确定之间的关系。 身体、性和心理 IPV 和情绪功能障碍；] 阐明情绪功能障碍在 实验室中的创伤后应激障碍症状和冒险倾向以及现实世界中的物质使用和艾滋病毒/性风险； 并测试实验室和现实世界数据的收敛有效性。情绪功能障碍在 PTSD 症状中的作用。 冒险倾向将通过一种新颖的实验范式在实验室和现实世界中进行测量 通过每日评估（即经验抽样）。 Weiss 博士非常适合指导以患者为导向的研究职业发展 她是一位高产的 NIDA 资助的 T32 博士后。 耶鲁大学精神病学系药物滥用预防研究研究员 在拟议的培训期间，Weiss 博士将被安置在医学系。 她还将利用耶鲁大学医学院提供的丰富资源。 通过康涅狄格大学健康中心临床和转化科学研究所以及 在这些环境中，她将能够访问科罗拉多大学丹佛安舒茨医学校区。 Weiss 博士在研究设计、方法论和分析方面拥有世界一流的专业知识。 情绪功能障碍在创伤后应激障碍（PTSD）和相关物质使用中的作用和 她发表了关于这些主题的 [12] 篇第一作者和 [8] 篇共同作者手稿。 长期目标是成为旨在预防和减少药物使用以及艾滋病毒/性风险研究的领导者 在遭受亲密伴侣暴力（IPV）的患有创伤后应激障碍（PTSD）的女性中建立强大的多学科； 建立伙伴关系，以确定物质使用的潜在生理机制和行为过程 暴露于 IPV 且患有创伤后应激障碍 (PTSD) 的女性的艾滋病毒/性风险，并制定预防和干预措施； 针对患有 PTSD 的 IPV 暴露妇女的药物使用和 HIV/性行为风险 继续。 赞助、指导和定向研究将促进高级研究技能的发展，因此博士。 韦斯可以处于这些领域的前沿研究的前沿，短期职业目标集中在以下方面。 熟练掌握 (a) 生理学（即交感神经、副交感神经和神经内分泌）和 (b) 微观纵向研究设计， 方法和分析；以及 (c) [最佳设计和实施策略，例如道德和安全 与对经历 IPV 和使用药物的女性进行研究相关的问题。]