Risk and Protective Factors for Adjustment of College Women After a Mass Shooting

描述(由申请人提供)：拟议研究的具体目标是前瞻性地检查2008年2月14日发生在伊利诺伊州迪卡尔布市的北伊利诺伊大学(NIU)校园大规模枪击事件后的即时和长期(长达2年)的适应结果(即创伤后应激障碍症状、抑郁症状和焦虑症状)。在枪击事件发生时，国立大学的一大批女本科生(N=816)正在参与性再受害的纵向研究。鉴于再受害研究以创伤为重点的性质，它提供了一个独特的机会来检查射击后调整的结果，同时控制射击前的调整水平。到目前为止，653名女性(80%的符合条件的人)完成了一项在线调查，NIU创伤研究(NTS)：时间1，即大规模枪击事件后的平均27天。调查包括对枪击后适应情况、枪击暴露程度以及其他风险和保护因素(如社会支持、创伤后成长)的评估。建议在拍摄后3.5个月、7.5个月、1年和2年进行额外评估。假设有几个因素会影响创伤后调整的变化。这些因素包括枪击前的风险因素[例如童年或其他创伤暴露、应激激素调节失调(即枪击前唾液皮质醇水平)和功能失调的情绪调节策略]、与枪击有关的因素(例如接触的严重程度)和对大规模枪击事件的即时反应(例如创伤周围分离和应对与枪击有关的痛苦的情感调节策略)。除了拟议的风险和保护因素对六个时间点调整水平变化的直接影响外，还将测试一些互动影响。在为期一年的射击后评估之后，将招募一部分参与者(N=160)参加临床重新评估研究，以便将自我报告筛查措施校准为黄金标准的面对面结构化诊断访谈。此外，还提出了一项独特的基于实验室的研究[表现力写作研究(EWS)]，研究对象为在NTS：Time 1报告高和低暴露于射击的参与者(N=100)。在EWS中，参与者将写下大规模枪击事件，然后在收集生理数据的同时大声朗读他们的文章。EWS的一个目的是检查EWS期间的生理反应、唾液皮质醇变化和情绪回避自我报告是否可以预测作为枪击暴露严重程度函数的长期调整结果。表现力写作的具体内容也将被考察。NTS调查的纵向调整跟踪数据也将作为EWS的后续数据。这些拟议项目的数据结合在一起，将提供有关风险因素和保护因素在预测大规模枪击事件后的调整中所起作用的关键和独特的信息。如果成功，拟议的研究将(I)提供有关经历或目睹大规模枪击的心理后果的信息，同时控制枪击前的症状和适应水平；(Ii)确定枪击前调整(例如创伤史、情绪调节失调、应激激素调节失调)对枪击后适应结果的直接和缓和影响；以及(Iii)提供有关作为接触大规模枪击的结果而从事表达能力写作和阅读任务的生理反应(和恢复)的信息。拟议的一套研究旨在促进NIH从纵向角度了解导致创伤后应激障碍和其他与创伤相关的精神疾病的因素(风险和保护性)的兴趣。

DESCRIPTION (provided by applicant): The specific aim of the proposed set of studies is to prospectively examine immediate and long-term (up to 2 years) adjustment outcomes (i.e., posttraumatic stress disorder symptoms, depression symptoms, and anxiety symptoms) following the mass shooting that occurred on the Northern Illinois University (NIU) campus in DeKalb, Illinois, on February 14, 2008. At the time of the shooting, a large sample (N = 816) of female undergraduates at NIU were participating in a longitudinal study of sexual revictimization. Given the trauma- focused nature of the revictimization study, it provided a unique opportunity to examine post-shooting adjustment outcomes while controlling for pre-shooting adjustment levels. To date, 653 women (80% of eligibles) have completed an online survey, NIU Trauma Study (NTS): Time 1, an average of 27 days after the mass shooting. The survey contained assessments of post-shooting adjustment, degree of exposure to the shooting, and additional risk and protective factors (e.g., social support, posttraumatic growth). Additional assessments are proposed for 3.5 months, 7.5 months, 1 year, and 2 years post-shooting. Several factors are hypothesized to influence changes in adjustment in the aftermath of the trauma. These include pre-shooting risk factors [e.g., childhood or other trauma exposure, dysregulation of stress hormones (i.e., pre-shooting salivary cortisol levels), and dysfunctional affect regulation strategies], factors associated with the shooting (e.g., severity of exposure), and immediate reactions to the mass shooting (e.g., peritraumatic dissociation and affect regulation strategies for coping with shooting-related distress). In addition to direct effects of proposed risk and protective factors on changes in adjustment level across the six time points, a number of interactive effects will also be tested. Following the 1-year post-shooting assessment, a subset of participants (N = 160) will be recruited to participate in a clinical reappraisal study in order to calibrate the self-report screening measures to gold-standard face-to-face structured diagnostic interviews. In addition, a unique laboratory-based study [Expressive Writing Study (EWS)] is also proposed for a subset of participants (N = 100) who at NTS: Time 1 report high and low exposure to the shooting. In the EWS, participants will write about the mass shooting and then read their essay aloud to themselves while their physiological data are collected. One aim of the EWS is to examine whether physiological reactivity, salivary cortisol changes, and self-reports of emotional avoidance during the EWS are predictive of longer-term outcomes in adjustment as a function of severity of exposure to the shooting. The specific content of the expressive writing will also be examined. Longitudinal follow-up data on adjustment from the NTS survey will also serve as follow-up data for the EWS. In combination, data from these proposed projects will provide crucial and unique information about the role of risk factors and protective factors in predicting adjustment following a mass shooting. If successful, the proposed research will (i) provide information regarding the psychological consequences of experiencing or witnessing a mass shooting while controlling for pre-shooting levels of symptoms and adjustment; (ii) identify the direct and moderating effects of pre-shooting adjustment (e.g., trauma history, dysfunctional affect regulation, dysregulation of stress hormones) on post-shooting adjustment outcomes; and (iii) provide information regarding the physiological reactivity (and recovery) of engaging in an expressive writing and reading task as a function of exposure to the mass shooting. The proposed set of studies seeks to promote NIH's interests in understanding, from a longitudinal perspective, the factors (risk and protective) that contribute to the development of posttraumatic stress disorder and other trauma-related mental illnesses.