STRESS, SEROTONIN GENE & HEALTH DISPARITIES

这项研究计划的长期目标是阐明潜在的生物和行为机制，即压力的社会和物理环境导致社会经济和种族群体之间的健康差异。为了实现这一目标，提出了以下具体目标：目标1 -确定照顾患有阿尔茨海默病或其他慢性痴呆症的配偶的人是否比没有照顾责任的对照组有更不利的行为和生物学特征。目的2 -确定生活在一个有压力的物理环境中（基于邻里特征）是否会导致照顾者比非照顾者更不利的生物行为特征。目的3 -确定应激性社会和/或物理环境对损害健康的生物行为特征的影响是否会被影响中枢神经系统血清素功能的敌对人格类型或遗传多态性的存在所缓和。在二次分析中，我们还将评估其他潜在调节因素的调节作用，例如潜在的冠心病或其他医学障碍、种族、性别、社会支持和社会经济地位。我们将招募200名护理人员和200名没有护理责任的匹配对照。我们将评估照顾者状态对行为（负面影响和健康习惯）和生物学（休息和压力时的心血管和神经内分泌功能，代谢综合征）特征的影响，这些特征可能是健康差异的基础。我们将确定物理邻里环境对生物行为机制的影响，无论是单独的还是与照顾者状态的相互作用。我们还将评估与血清素相关的遗传多态性、敌对人格类型和受试者的其他医疗/身体和社会特征对护理和物理环境对生物行为机制的影响的调节作用。除了加深对造成健康差异的生物行为机制的理解外，这些发现还可以指出旨在改善这些差异的具体干预措施的目标。

The long-term objective of this research proposal is to elucidate underlying biological and behavioral mechanisms whereby stressful social and physical environments contribute to health disparities between socioeconomic and racial groups. To achieve this objective, the following Specific Aims are proposed: Aim 1 - To determine whether persons who are caregivers for a spouse with Alzheimer's Disease or other chronic dementia have a more adverse profile of behavioral and biological characteristics than matched controls without caregiving responsibilities. Aim 2 - To determine whether living in a stressful physical environment (based on neighborhood characteristics) leads to a more adverse profile of biobehavioral characteristics among caregivers than noncaregivers. Aim 3 - To determine whether the impact of stressful social and/or physical environments on health-damaging biobehavioral characteristics is moderated by the presence of a hostile personality type or genetic polymorphisms that affect CNS serotonin function. In secondary analyses, we shall also evaluate the moderating effect of other potential moderators - e.g., underlying CHD or other medical disorder, race, gender, social support, and socioeconomic status. We shall recruit a sample of 200 caregivers and 200 matched controls without caregiving responsibilities. We shall assess the impact of caregiver status on behavioral (negative affects and health practices) and biological (cardiovascular and neuroendocrine function at rest and during stress, metabolic syndrome) characteristics likely to underlie health disparities. We shall determine the impact of the physical neighborhood environment, both alone and interacting with caregiver status, upon the biobehavioral mechanisms. We shall also evaluate the moderating effects of serotonin-related genetic polymorphisms, hostile personality type and other medical/physical and social characteristics of the subjects upon the impact of caregiving and physical environments on biobehavioral mechanisms. In addition to increasing understanding of biobehavioral mechanisms responsible for health disparities, the findings could point to targets for specific interventions aimed at ameliorating these disparities.