Posttraumatic Stress and Cardiovascular Risk in Women: Tests of Biological Mechanisms

女性创伤后应激和心血管风险：生物机制测试

基本信息

批准号：
9014122
负责人：
Jennifer A Sumner
金额：
$ 16.56万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-12-15 至 2020-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9014122
关键词：
Accounting Acute Address American American Heart Association Angioplasty Atherosclerosis Autonomic nervous system Biological Biological Markers Biological Models Biological Testing Blood Cardiac Cardiovascular Diseases Cardiovascular system Caring Cause of Death Cessation of life Chronic Cohort Studies Complex Coronary Artery Bypass Data Data Analyses Development Diagnosis Dimensions Disease Distal Elements Enrollment Epidemiologic Studies Epidemiology Event Female Fright Functional disorder Galvanic Skin Response Genetic Risk Goals Health Heart Rate Hospitalization Hospitals Hypertension Incidence Inflammation Intervention Interview K-Series Research Career Programs Knowledge Lead Master of Science Measurement Measures Mental Depression Mental disorders Mentors Methods Modeling Myocardial Infarction Neurologic New York Nurses&apos Health Study Outcome Pathway interactions Patient Self-Report Patients Physiological Physiology Post-Traumatic Stress Disorders Presbyterian Church Prevention Preventive Intervention Prospective Studies Psychopathology Psychophysiology Publishing Reaction Recurrence Reporting Research Research Activity Research Personnel Research Training Risk Stress Stroke Symptoms Testing Thrombophilia Time Training Training Activity Trauma Universities Woman Women&apos s Health acute coronary syndrome base cardiovascular disorder prevention cardiovascular disorder risk cardiovascular health cardiovascular risk factor career clinical application clinical epidemiology design dysphoria effective intervention epidemiologic data experience follow-up hospital readmission meetings men multidisciplinary patient oriented research post-traumatic stress predicting response programs psychologic public health relevance response skills

项目摘要

DESCRIPTION (provided by applicant): This K01 Career Development Award will provide Dr. Jennifer Sumner with the necessary skills to establish an independent research career focused on elucidating the psychological and biological mechanisms by which traumatic experiences contribute to cardiovascular disease (CVD) in women, the leading cause of death worldwide. Posttraumatic stress disorder (PTSD), the quintessential stress-related mental disorder, prospectively predicts increased CVD incidence. However, PTSD is a complex and heterogeneous disorder, and the aspects of PTSD that drive CVD risk are unknown. Mechanistic knowledge, particularly in women, is also lacking. These limitations impede the development of clinical applications to offset CVD risk. The overall aim of this K01 proposal is to begin to test a theoretically based biological model by which a core element of PTSD-posttraumatic fear responses (e.g., hypervigilance, re-experiencing)- relates to CVD and intermediate markers of cardiovascular health in women. Supported by a multidisciplinary team of expert mentors, Dr. Sumner will examine how posttraumatic fear responses (measured across self- report and psychophysiological levels of analysis) relate to cardiovascular health in women. The training plan will provide Dr. Sumner with required background and skills in several domains in order to become an independent investigator with an integrative research program on the mechanisms by which the psychological sequelae of trauma contribute to CVD in women. Through coursework, hands-on training, and mentored meetings, Dr. Sumner will address prior gaps in training and develop skills in 1) cardiovascular, neurological, and clinical epidemiology, 2) quantitative methods for analyzing epidemiologic and longitudinal data, 3) CVD- related physiology and biomarkers, and 4) psychophysiological measures of fear responses. The training plan also includes completion of a Master's of Science degree in Patient-Oriented Research from Columbia University. The proposed research program harnesses two richly characterized ongoing cohort studies to test how posttraumatic fear responses relate to cardiovascular risk in women. Using data from the Nurses' Health Study II (NHS II), a longitudinal epidemiologic study of women's health, Dr. Sumner will determine if self- reported posttraumatic fear symptoms relate to hypertension and CVD incidence and CVD-related biomarkers. In the REactions to Acute Care and Hospitalization (REACH) study, a study of risk for PTSD after acute coronary syndrome and its relation to recurrent cardiac events at New York-Presbyterian Hospital, Dr. Sumner will collect data to test associations between fear responses at multiple levels of analysis-self-report symptoms and psychophysiological indicators (i.e., skin conductance and heart rate)-with hospital readmission and cardiac event recurrence. These research and training activities will inform an R01 application that will comprehensively test the biological mechanisms by which posttraumatic fear symptoms across multiple levels of analysis contribute to CVD in women.

描述（由申请人提供）：该 K01 职业发展奖将为 Jennifer Sumner 博士提供必要的技能，以建立独立的研究职业，重点是阐明创伤经历导致女性心血管疾病 (CVD) 的心理和生物机制，创伤后应激障碍 (PTSD) 是一种典型的与压力相关的精神障碍，它前瞻性地预测了 CVD 发病率的增加。然而，PTSD 是一种复杂且异质性的疾病，其各个方面都存在问题。导致 CVD 风险的 PTSD 机制尚不清楚，尤其是女性，这些限制阻碍了抵消 CVD 风险的临床应用的开发。在多学科专家导师团队的支持下，开始测试基于理论的生物模型，通过该模型，创伤后应激障碍（PTSD）的核心要素（例如过度警觉、重新体验）与女性心血管健康的中间标志物相关。萨姆纳博士将研究创伤后恐惧反应（通过自我报告和心理生理学分析水平进行衡量）与女性心血管健康的关系。培训计划将为萨姆纳博士提供多个领域所需的背景和技能。萨姆纳博士将成为一名独立调查员，负责研究创伤心理后遗症导致女性心血管疾病的机制，通过课程作业、实践培训和指导会议，萨姆纳博士将解决之前在培训和发展技能方面的差距。 1) 心血管、神经学和临床流行病学，2) 分析流行病学和纵向数据的定量方法，3) CVD 相关生理学和生物标志物，以及 4) 恐惧反应的心理生理学测量。完成哥伦比亚大学以患者为导向的研究理学硕士学位。拟议的研究计划利用两项特征丰富的正在进行的队列研究，利用护士健康研究 II 的数据来测试创伤后恐惧反应与心血管风险的关系。 NHS II）是一项针对女性健康的纵向流行病学研究，Sumner 博士将确定自我报告的创伤后恐惧症状是否与高血压和 CVD 发病率以及 CVD 相关生物标志物有关。 (REACH) 研究是纽约长老会医院急性冠脉综合征后 PTSD 风险及其与复发性心脏事件关系的研究，萨姆纳博士将收集数据，以测试多个分析自我报告水平的恐惧反应之间的关联这些研究和培训活动将为 R01 应用提供信息，该应用将全面测试跨多个分析级别的创伤后恐惧症状的生物学机制。导致女性CVD。