Cardiovascular risk in relation to posttraumatic stress disorder in young women

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DESCRIPTION (provided by applicant): Research has revealed a relationship between posttraumatic stress disorder (PTSD) and poor cardiovascular health. This evidence primarily involves retrospective examinations among combat veterans who exhibit clinical symptoms of cardiovascular disease (CVD). Many civilians also suffer from PTSD resulting from incidents such as sexual abuse/rape, physical assault, and automobile accidents. Civilians with PTSD, women in particular, have been understudied with regard to cardiovascular risk. The identification of risk factors for CVD is a critical initiative of Healthy People 2010, and has implications for disease prevention and timely intervention. Studies of cardiovascular risk factors in young adults with PTSD and no current CVD may be critical in understanding how PTSD confers risk for CVD. Among the few studies that have examined CVD risk in PTSD, risk factor clustering has not been systematically assessed. The primary objective of the proposed study is to compare CVD risk factors, and cardiovascular reactivity and recovery in response to psychological stressors, of young women (ages 18-39) diagnosed with PTSD compared with both a depression (no-PTSD) and a non-psychiatric comparison group. Because depression often co-occurs with PTSD and is associated with both CVD risk and cardiovascular reactivity, it is critical to determine whether PTSD confers any greater risk than depressive symptoms. A second objective is to examine whether cognitive appraisals of stress mediate the relationships of PTSD with CVD risk and reactivity/recovery. The PTSD group will be recruited from a trauma recovery clinic and community mental health clinic. The depression group will be recruited from an adult services clinic and community mental health clinic. The control group will be recruited from community. Diagnostic interviews will determine inclusion in the study groups. Specifically, it is hypothesized that 1) the PTSD group will evidence a greater number of CVD risk factors than the comparison groups, 2) for each risk factor participants with PTSD will be higher on the continuum of risk, 3) the PTSD group will have greater blood pressure (BP) and total peripheral resistance reactivity than the comparison groups; the PTSD and depression groups will exhibit comparable HR and cardiac output reactivity, and greater HR and cardiac output reactivity than the non-psychiatric group, 4) the PTSD group will evidence less BP and peripheral resistance recovery than the comparison groups; the PTSD and depression groups will display comparable HR and cardiac output recovery, and less HR and cardiac output recovery than the non-psychiatric group, 5) cognitive appraisals of threat will mediate the relationships of diagnostic group to BP and peripheral resistance reactivity/recovery, and 6) cognitive appraisals will mediate the relationships of diagnostic group to the cardiovascular risk factors. PUBLIC HEALTH RELEVANCE: This project will help to identify ways of improving health for women who experience posttraumatic stress. This study will provide information needed to develop health risk reduction and/or stress management programs, which could reduce rates of heart disease if used along with standard talk therapies.