Cardiovascular risk in relation to posttraumatic stress disorder in young women

年轻女性与创伤后应激障碍相关的心血管风险

• 批准号: 7515802
• 负责人: Jeffrey L. Kibler
• 金额: $ 18.99万
• 依托单位: NOVA SOUTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-17 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7515802
• 关键词: Adult; Age; Area; Attenuated; Behavior; Behavior Therapy; Behavioral Model; Blood Pressure; Cardiac Output; Cardiovascular Diseases; Cardiovascular system; Cholesterol; Clinic; Clinical; Cognitive; Communities; Control Groups; Diagnosis; Diagnostic; Exhibits; Forcible intercourse; Goals; Health; Health behavior; Healthy People 2010; Heart Diseases; Heart Rate; High Blood Pressure; Individual; Intervention; Interview; Lipids; Mediating; Mental Depression; Mental Health; Morbidity - disease rate; Numbers; Obesity; Participant; Pattern; Peripheral Resistance; Post-Traumatic Stress Disorders; Prevention; Psychological Stress; Public Health; Rate; Recording of previous events; Recovery; Recruitment Activity; Relative (related person); Research; Risk; Risk Factors; Risk Reduction; Services; Sexual abuse; Smoking; Standards of Weights and Measures; Stress; Symptoms; Testing; Trauma; Trauma recovery; Traumatic Stress Disorders; Veterans; Woman; Women' s Health; automobile accident; cardiovascular disorder risk; cardiovascular risk factor; cigarette smoking; comparison group; depressive symptoms; disorder prevention; disorder risk; experience; improved; physical assault; pre-clinical; programs; psychologic; psychological stressor; response; stress management; young adult

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.

描述(由申请人提供)：研究表明创伤后应激障碍(PTSD)与心血管健康状况不佳之间存在关系。这些证据主要涉及对表现出心血管疾病(CVD)临床症状的退伍军人进行的回顾性检查。许多平民还因性虐待/强奸、身体攻击和车祸等事件而遭受创伤后应激障碍的折磨。患有创伤后应激障碍的平民，特别是妇女，在心血管风险方面的研究一直不足。确定心血管疾病的风险因素是2010年《健康人》的一项重要举措，对疾病预防和及时干预具有重要意义。对患有创伤后应激障碍但目前没有心血管疾病的年轻人的心血管危险因素的研究可能对于理解创伤后应激障碍如何增加心血管疾病的风险至关重要。在少数研究了创伤后应激障碍心血管风险的研究中，风险因素聚集还没有得到系统的评估。这项拟议研究的主要目的是比较确诊为创伤后应激障碍的年轻女性(18-39岁)与抑郁症(无创伤后应激障碍)和非精神病对照组的心血管危险因素、心血管反应性和对心理应激源的恢复情况。由于抑郁通常与创伤后应激障碍并存，并与心血管疾病风险和心血管反应有关，因此确定创伤后应激障碍是否比抑郁症状带来更大的风险是至关重要的。第二个目标是检查对压力的认知评估是否调节了创伤后应激障碍与心血管疾病风险和反应性/恢复的关系。创伤后应激障碍小组将从创伤康复诊所和社区心理健康诊所招募。抑郁症组将从成人服务诊所和社区心理健康诊所招募。对照组将从社区招募。诊断性面谈将决定是否纳入研究小组。具体地说，假设1)创伤后应激障碍组比对照组有更多的心血管危险因素，2)对于每个危险因素，患有创伤后应激障碍的参与者在风险连续体上将更高，3)创伤后应激障碍组的血压(BP)和总外周阻力反应性将比对照组更大；创伤后应激障碍组和抑郁组将表现出与非精神病组相当的心率和心输出量反应性，以及更大的心率和心输出量反应性；4)创伤后应激障碍组的血压和外周阻力恢复将比对照组更少；创伤后应激障碍组和抑郁组的心率和心输出量恢复程度与非精神病组相当，而心率和心输出量恢复程度低于非精神病组；5)威胁认知评估将中介诊断组与血压和外周阻力反应/恢复的关系，认知评估将中介诊断组与心血管危险因素的关系。公共卫生相关性：该项目将有助于为经历创伤后应激障碍的妇女确定改善健康的方法。这项研究将提供开发健康风险降低和/或压力管理计划所需的信息，如果与标准谈话疗法一起使用，这些计划可能会降低心脏病的发生率。

项目成果

Cardiovascular risks in relation to posttraumatic stress severity among young trauma-exposed women.

• DOI: 10.1016/j.jad.2018.08.007
• 发表时间: 2018-12-01
• 期刊: Journal of affective disorders
• 影响因子: 6.6
• 作者: Kibler JL;Ma M;Tursich M;Malcolm L;Llabre MM;Greenbarg R;Gold SN;Beckham JC
• 通讯作者: Beckham JC

Psychophysiological Reactivity and PTSD Symptom Severity among Young Women.

年轻女性的心理生理反应和创伤后应激障碍症状严重程度。

• 发表时间: 2016
• 期刊: International journal of psychology and neuroscience
• 作者: Malcolm,Lydia;Kibler,JeffreyL;Ma,Mindy;Tursich,Mischa;Augustin,Dyona;Greenbarg,Rachel;Gold,StevenN
• 通讯作者: Gold,StevenN

Body mass index in relation to cardiovascular recovery from psychological stress among trauma-exposed women.

体重指数与遭受创伤的女性从心理压力中恢复心血管的关系。

• DOI: 10.1007/s00406-019-01054-5
• 发表时间: 2020
• 期刊: European archives of psychiatry and clinical neuroscience
• 影响因子: 4.7
• 作者: Kibler,JeffreyL;Ma,Mindy;Llabre,MariaM
• 通讯作者: Llabre,MariaM

An Extension of the Perseverative Cognition Hypothesis to Posttraumatic Stress Disorder Symptomatology: Cardiovascular Recovery in Relation to Posttraumatic Stress Disorder Severity and Cognitive Appraisals of Stress.

• DOI: 10.1002/jts.22252
• 发表时间: 2018-03
• 期刊: Journal of traumatic stress
• 影响因子: 3.3
• 作者: Kibler JL