Understanding and Reversing the Effects of Early Life Adversity on Midlife Health: Improving Daily Psychological Stress Responses using an Ecological Momentary Intervention

了解和扭转早年逆境对中年健康的影响：使用生态瞬时干预改善日常心理压力反应

• 批准号: 10319262
• 负责人: Stefanie Eva Mayer
• 金额: $ 24.9万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-15 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10319262
• 关键词: Address; Adherence; Adult; Aging; Area; Award; Biological; Biological Aging; Biological Markers; Biological Process; Blood Pressure; C-reactive protein; Child Abuse and Neglect; Cicatrix; Clinical; Clinical Psychology; Clinical Trials; Cognition; Cognitive; Control Groups; Data; Disease; Ecological momentary assessment; Effectiveness; Emotions; Goals; Growth; Health; Health Psychology; Inflammation; Intervention; Knowledge; Length; Life; Link; Measurement; Measures; Mediating; Mental Health; Mentors; Mindfulness Training; National Heart, Lung, and Blood Institute; National Institute on Aging; Outcome; Participant; Pathway interactions; Pattern; Phase; Physiological; Premature Mortality; Proliferating; Psyche structure; Psychological Stress; Psychologist; Psychoneuroendocrinology; Randomized; Reading; Research; Research Proposals; Resources; Risk; Scientist; Shapes; Stress; Telomere Shortening; Testing; Time; Training; Woman; apprenticeship; base; biological adaptation to stress; design; diaries; early life adversity; experience; improved; indexing; innovation; mHealth; meetings; middle age; mindfulness; mindfulness intervention; mobile computing; negative affect; novel; novel strategies; physical conditioning; physical symptom; prospective; psychologic; randomized trial; response; skills; stressor; telomere; therapy development; trial design

PROJECT SUMMARY/ABSTRACT Early life adversity (ELA), such as childhood maltreatment, can leave a “scar” into adult life and beyond, increasing risk for mental health problems and physical diseases of aging. ELA is also linked with biological indices that are reliable precursors to early disease, such as elevated blood pressure and C-reactive protein, and shortened telomere length–biomarkers I will study in this proposal. Identifying the persistent risk pathways by which ELA worsens midlife health can inform interventions. While research on the biological mechanisms has proliferated, our understanding of the psychological mechanisms, which can inform non-pharmacological interventions, has lagged behind. Congruent with the National Institute on Aging’s initiative on the reversibility of ELA, the proposed project aims to 1) understand daily psychological stress responses (e.g., negative affect, stress appraisals, and perseverative cognitions) as a promising psychological risk pathway, and to 2) develop and 3) pilot test an intervention that improves maladaptive psychological responses to daily stressors. The proposed intervention will use daily mindfulness-based practices that are incorporated into everyday life via mobile technology (Ecological Momentary Intervention). To this end, I will first identify intervention targets by examining relations between ELA, daily psychological stress responses, and health outcomes (mental/physical symptoms; biomarkers) in two existing midlife studies with prospective and retrospective assessments of ELA. Next, I will develop an Ecological Momentary Mindfulness-based Intervention (EMMI) that improves maladaptive daily psychological stress responses using a small micro-randomized trial (n=20). Lastly, I will pilot test acceptability, feasibility, and adherence by randomizing participants with ELA to EMMI (n=35) or Ecological Momentary Assessment-only (n=35). Preliminary findings will inform an R-level application to evaluate the EMMI in an adequately powered study. This research will advance our knowledge of the midlife reversibility of psychological risk pathways related to ELA. Building on my advanced training as a clinical and health psychologist with expertise in stress, psychoneuroendocrinology, and mental health, the K99/R00 Pathway to Independence Award addresses critical training needs in ecological momentary assessment and intervention, mechanism-focused intervention development and testing, mindfulness-based interventions, and measurement and interpretation of aging biomarkers. The training plan includes coursework, meetings, readings, and apprenticeships to fill these gaps; the research proposal provides opportunities to apply the new knowledge. I have assembled an outstanding team of renowned mentors (Drs. Epel, Hecht, Almeida) and specialized advisors (Drs. Danese, Murphy, Mendes, Delucchi) with expertise in these areas. The proposed award will provide me with the necessary experiences to become an independent, transdisciplinary, and translational clinical scientist dedicated to understanding the psychological pathways linking ELA and midlife health and to reversing risk pathways using mindfulness and other psychological interventions.

项目总结/文摘