Identifying the Cognitive, Psychological, and Neuroimaging Signatures of Head Trauma in Female Survivors of Intimate Partner Violence

识别亲密伴侣暴力女性幸存者头部创伤的认知、心理和神经影像特征

• 批准号: 10328977
• 负责人: Carrie Lynn Esopenko
• 金额: $ 29.89万
• 依托单位: RBHS-SCHOOL/ HEALTH RELATED PROFESSIONS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-15 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10328977
• 关键词: Acceleration; Affect; Aggressive behavior; Aging; Anoxia; Anterior; Anxiety; Attention; Autopsy; Behavioral; Blunt Trauma; Brain; Brain Concussion; Brain Injuries; Case Study; Choline; Chronic; Clinical; Cognitive; Cohort Studies; Collaborations; Contusions; Coupled; Craniocerebral Trauma; Data; Deceleration; Dementia; Development; Exposure to; Face; Female; Frequencies; Genetic; Glutamates; Glutathione; Goals; Grant; Head and neck structure; Health; Height; Hypoxia; Image; Impaired cognition; Impairment; Injury; Interview; Life; Link; Literature; Longevity; Magnetic Resonance Spectroscopy; Memory; Mental Depression; Mental disorders; Meta-Analysis; Military Personnel; Moods; Nervous System Trauma; Neurologic; Neuropsychology; Outcome; Pathology; Pathway interactions; Patient-Centered Care; Persons; Phenotype; Population; Post-Traumatic Stress Disorders; Prefrontal Cortex; Prevalence; Process; Public Health; Recording of previous events; Reporting; Research; Rest; Risk; Role; Sample Size; Sampling; Short-Term Memory; Site; Sports; Structure; Subgroup; Substance Use Disorder; Survivors; Symptoms; Syndrome; Techniques; Trauma; Traumatic Brain Injury; United States; Verbal Learning; Violence; Woman; Work; behavioral phenotyping; brain volume; chronic traumatic encephalopathy; cingulate gyrus; cognitive function; cognitive process; cohort; comorbidity; early onset; executive function; experience; head impact; high risk; intimate partner violence; member; myoinositol; neuroimaging; psychiatric comorbidity; psychologic; psychological outcomes; relating to nervous system; resilience; response; sexual violence; symptom cluster; symptomatology; trauma exposure; virtual; white matter; working group

Intimate partner violence (IPV), the physical violence, sexual violence, psychological aggression, or stalking by a current or former intimate partner, is a significant public health concern affecting approximately 10 million people in the United States annually. Approximately 33% of women exposed to IPV report physical trauma resulting in heighted risk of head injury in this population. Recent work suggests that anywhere from 40-90% of women experience head trauma due to IPV. IPV-related head trauma is caused by blunt force trauma, being pushed or violently shaken, and/or strangulation, which can result in focal trauma or contusions, acceleration and deceleration injuries, as well as hypoxia and anoxia due to strangulation, respectively. Limited research has shown that women exposed to IPV with head trauma report higher depression, anxiety, and post-traumatic stress disorder symptomatology, as well as impaired cognitive function relative to women with IPV and no exposure to head trauma. Although the clinical features of repeated exposure to head trauma identified in IPV are similar to the effects observed in military traumatic brain injury (TBI) and sports-related concussion, limited work has been done to understand IPV-related head trauma, in particular its chronic cognitive and psychological effects as well as associated brain changes. Through a multi-site research collaboration consisting of members of the Enhancing NeuroImaging and Genetics through Meta-Analysis (ENIGMA) IPV Working Group, the proposed study will characterize the cognitive, psychological, and neural profiles of IPV- related head trauma, as well as determine whether specific symptoms clusters are associated with discernable IPV subgroups. Furthermore, this proposal initiates the process of creating an IPV study cohort that will be re- assessed every 5 years to chronically assess brain and behavioral changes associated with IPV-related head trauma over the lifespan. Semi-structured interviews will be used to obtain IPV specific information such as abuse and head trauma history and frequency. A comprehensive neuropsychological battery will be used to determine cognitive and psychological status, while sophisticated neuroimaging techniques will be used to characterize neural structure, function, and brain metabolites in IPV with exposure to head trauma relative to IPV without exposure to head trauma. Finally, we will use a data-driven approach to determine whether symptom clusters differentiate subgroups of IPV. In aim 1, we will identify the cognitive and psychological profiles of subgroups of IPV. Aim 2 will examine the neuroimaging signatures in subgroups of IPV. In aim 3, we will determine whether symptom clusters are associated with discernible subgroups of IPV. The results from this study will provide critical information about the role of IPV-related head trauma in cognitive and psychological outcomes, as well as the underlying neural changes. This is important not only for understanding the chronic effects of repetitive brain trauma, but also the identification of distinct subgroups of IPV has direct implications for development of patient-centered care approaches for IPV.

亲密伴侣暴力 (IPV)、身体暴力、性暴力、心理攻击或跟踪 现任或前任亲密伴侣是影响约 1000 万人的重大公共卫生问题 每年在美国的人。大约 33% 接触 IPV 的女性表示身体受到创伤 导致该人群头部受伤的风险增加。最近的研究表明，40-90% 的 女性因 IPV 遭受头部创伤。 IPV 相关的头部外伤是由钝器外伤引起的， 推挤或猛烈摇晃，和/或勒颈，可能导致局灶性创伤或挫伤、加速 和减速损伤，以及勒颈引起的缺氧和缺氧。研究有限 研究表明，暴露于 IPV 并伴有头部创伤的女性会出现更高的抑郁、焦虑和创伤后症状 与患有 IPV 且未患有 IPV 的女性相比，应激障碍症状以及认知功能受损 暴露于头部外伤。尽管 IPV 中发现反复遭受头部外伤的临床特征 与军事创伤性脑损伤 (TBI) 和运动相关脑震荡中观察到的效果相似，但有限 已经开展工作来了解 IPV 相关的头部创伤，特别是其慢性认知和 心理影响以及相关的大脑变化。通过多地点研究合作 由通过荟萃分析增强神经影像和遗传学 (ENIGMA) IPV 的成员组成 工作组提出的研究将描述 IPV- 的认知、心理和神经特征 相关的头部外伤，以及确定特定症状群是否与可辨别的相关 IPV 亚组。此外，该提案启动了创建 IPV 研究队列的过程，该队列将重新 每 5 年进行一次评估，以长期评估与 IPV 相关的头部相关的大脑和行为变化 一生中的创伤。将使用半结构化访谈来获取 IPV 的具体信息，例如 虐待和头部外伤的历史和频率。全面的神经心理学电池将用于 确定认知和心理状态，而复杂的神经影像技术将用于 描述 IPV 中的神经结构、功能和脑代谢特征，以及暴露于头部外伤的情况 IPV 无需暴露于头部外伤。最后，我们将使用数据驱动的方法来确定是否 症状群可区分 IPV 亚型。在目标 1 中，我们将确定认知和心理 IPV亚群概况。目标 2 将检查 IPV 亚组的神经影像特征。在目标 3 中，我们 将确定症状群是否与可辨别的 IPV 亚群相关。结果来自 这项研究将提供关于 IPV 相关头部创伤在认知和认知方面的作用的重要信息。 心理结果，以及潜在的神经变化。这不仅对于理解很重要 重复性脑外伤的慢性影响，而且 IPV 不同亚型的鉴定也具有直接的意义。 对发展以患者为中心的 IPV 护理方法的影响。