Injury Recovery Improvement Study

每年，美国有数百万人遭受创伤，需要紧急医疗护理。对于这些人中的许多人来说，管理发生在他们身上的事情并继续他们的生活需要广泛的应对努力。然而，一部分人将难以应付，有些人将经历严重的心理健康问题。令人惊讶的是，对于这个最初的应对过程是如何展开的，以及是什么预测了谁会做得好，谁会挣扎，我们知之甚少。本项目测试了创伤恢复早期有效应对与无效应对的关键生物学、心理学和社会标志的理论。了解这一点对未来实时干预措施的发展至关重要。研究结果提供了其他社会效益，为医疗保健政策、创伤支持和灾难响应提供信息，并了解幸存者如何从性侵犯、战争和灾难等其他重大创伤中恢复过来。该项目通过发展和扩展理论来解释创伤性损伤恢复后的应对动态，从而开辟了新的科学领域。它侧重于自我调节转移理论，该理论使用动态系统框架来解释心理功能的非线性转移。一个目的是批判性地测试自适应和非自适应复制动力学的假设临界点。第二个目的是评估为即将发生的功能变化发现早期预警信号的可能性。最后的目的是评估在确定的恢复轨迹内非线性位移的频率和时间。该研究采用创新的多源数据收集方法，包括生物传感器、自我报告调查、每日电子日记和音频自我报告数据，追踪了300名受伤幸存者。本项目采用新颖的方法和先进的非线性分析技术，提高了急性创伤适应的基础知识，并改进了当前创伤应激恢复的理论模型。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Every year, millions of people in the U.S. experience a traumatic injury that requires emergency medical care. For many of these people, managing what has happened to them and moving forward with their lives requires extensive coping efforts. However, a subset will struggle to cope, and some will experience serious mental health problems. Surprisingly, very little is known about how this initial coping process unfolds and what predicts who will do well and who will struggle. This project tests a theory of the key biological, psychological, and social markers of effective versus ineffective coping in the early stages of traumatic injury recovery. Gaining this insight is vital to the development of future real-time interventions. Results of the research offer other societal benefits that inform healthcare policy, trauma support and disaster response, and understanding how survivors recover from other major traumas including sexual assault, war, and disasters.This project breaks new scientific ground by developing and extending theory that accounts for coping dynamics following traumatic injury recovery. It focuses on Self-Regulation Shift Theory, which uses a dynamical systems framework to account for nonlinear shifts in psychological functioning. One aim is to critically test hypothesized tipping points for both adaptive and maladaptive copying dynamics. A second aim is to evaluate the possibility of detecting early warning signals for impending shifts in functioning. A final aim is to evaluate the frequency and timing of nonlinear shifts within identified recovery trajectories. The research follows 300 injury survivors using innovative multi-source data collection, including biosensor, self-report survey, daily electronic diary, and audio self-report data. Using novel methods and advanced nonlinear analytic techniques, this project advances basic knowledge of acute trauma adaptation and advances current theoretical models of traumatic stress recovery.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.