PTSD, TBI, and Neuropsychological Factors in Partner Violence among Veterans

退伍军人伴侣暴力中的 PTSD、TBI 和神经心理因素

• 批准号: 8043958
• 负责人: CASEY T TAFT
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-01 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8043958
• 关键词: Accounting; Age; Agreement; Alcohol dependence; Anger; Area; Arousal; Behavioral; Belief; Boston; Clinical; Cognitive; Cognitive deficits; Cues; Data; Databases; Development; Diagnostic; Disease; Drug Addiction; Eligibility Determination; Family; Family member; Freedom; Funding; Health; Human Resources; Informed Consent; Inpatients; Intervention; Interview; Investigation; Knowledge; Laboratories; Laboratory Procedures; Life; Mails; Massachusetts; Measures; Methodology; Military Personnel; Modification; Moods; Nature; Occupational; Outcome; Outpatients; Participant; Patient Self-Report; Performance; Pharmaceutical Preparations; Population; Post-Traumatic Stress Disorders; Preventive Intervention; Principal Investigator; Procedures; Process; Psychotic Disorders; Questionnaires; Reading; Recording of previous events; Research; Research Design; Research Methodology; Risk; Role; Screening procedure; Severities; Simulate; Source; Symptoms; Telephone; Testing; Thinking; Trauma; Traumatic Brain Injury; Veterans; Work; anger management; combat; design; executive function; experience; improved; indexing; instrument; interest; intimate partner violence; male; meetings; mental state; neuropsychological; operation; partner violence; physical conditioning; prevent; programs; psychologic; psychosocial; response; social; thought control; trait; violence prevention

DESCRIPTION (provided by applicant): This continuation application proposes to extend a funded CRS&D Merit Review project investigating the role of anger and cognitive deficits and biases with respect to the association between PTSD symptom severity and intimate partner violence (IPV) perpetration among Operation Iraqi Freedom (OIF)/ Operation Enduring Freedom (OEF) veterans. In the current application, we propose to examine the contribution of traumatic brain injury (TBI) and executive functioning with respect to these relationships. The primary objective of this study is to test the hypotheses that (a) TBI and executive functioning deficits will be positively and uniquely associated with higher physical and psychological IPV severity; and (b) TBI and executive functioning deficits will moderate the impacts of PTSD symptoms and cognitive deficits/biases on the IPV outcomes. Research Design and Methodology: Participants will be 150 male OEF/OIF veterans over the age of 18 who have been married or cohabitating with a partner for at least one year. Potential participants will be excluded if (a) reading difficulties prevent valid completion of the assessment instruments, (b) the mental status of a participant precludes the completion of study procedures, such as severe organicity, active psychosis, or impaired performance on the Mini-Mental Status Exam (c) the participant has taken any medication that is thought to have significant CNS effects, or (d) the participant meets criteria for current alcohol or drug dependence, OR has been in inpatient treatment or outpatient treatment for alcohol or drug dependence (e.g., AA, NA, or methodone treatment) within the past 60 days. Participants will be drawn from three sources: (a) flyers posted in the Boston area; (b) the already established National Center for PTSD subject recruitment database; and (c) a mass mailing to those on a roster of all male OEF/OIF veterans living in Massachusetts, held by the Defense Manpower Data Center (DMDC), and shared with the VA under a data use agreement signed by DMDC and the VACO. Participation will involve a phone screening and three laboratory sessions, spaced approximately one week apart. The initial screening with the participant will entail the determination of study eligibility. Session 1 will involve informed consent procedures and the administration of the Mini-Mental Status Examination, self-report questionnaires, and diagnostic interviews for PTSD and other Axis I disorders. Session 2 will include the Articulated Thoughts in Simulated Situations (ATSS) laboratory procedure to assess cognitive deficits and biases. This methodology assesses thoughts during anger arousal, since anger- related thoughts are more likely to be accessible and reportable if assessed when angry mood states are activated and relevant contextual cues present. Session 3 will involve the assessment of TBI and the neuropsychological variables of interest. Clinical Relationships: Study findings will potentially have consequences for program modification and development, specifically for anger management and IPV perpetration. Findings may highlight the need for cognitive-behavioral anger management strategies that take into account neuropsychological deficits and history of TBI. Study findings may also elucidate marker variables for IPV and the significance of specific neuropsychological factors that are particularly relevant for understanding and treating IPV in this population. Study findings will also inform the Principal Investigator's ongoing research program focused on developing interventions for the prevention and treatment of IPV. PUBLIC HEALTH RELEVANCE: Relevance to Veterans Health Intimate partner violence (IPV) alienates veterans from family members and negatively impacts support networks, placing the veteran at increased risk for various psychosocial and physical health problems and poor social and occupational functioning. It is critically important that we develop a better understanding of the nature and causes of IPV in this population in order to best prevent and treat such family problems. The current investigation proposes to examine the roles of traumatic brain injury and executive functioning deficits in IPV among returning veterans, as well as their interplay with symptoms of PTSD and cognitive deficits/biases in contributing to IPV. This work will inform the Principal Investigator's current funded efforts to develop and test primary and secondary IPV prevention interventions for veterans with PTSD.

描述（由申请人提供）： 该延续申请建议延长一个受资助的CRS&D Merit Review项目，该项目调查愤怒和认知缺陷和偏见在创伤后应激障碍症状严重程度与伊拉克自由行动（OIF）/持久自由行动（OEF）退伍军人之间的亲密伴侣暴力（IPV）犯罪之间的关联中的作用。在本申请中，我们建议检查创伤性脑损伤（TBI）和执行功能对这些关系的贡献。本研究的主要目的是检验以下假设：（a）TBI和执行功能缺陷将与较高的生理和心理IPV严重程度呈正相关且具有独特性;（B）TBI和执行功能缺陷将缓和PTSD症状和认知缺陷/偏见对IPV结局的影响。研究设计和方法：参加者将是150名18岁以上、已婚或与伴侣同居至少一年的“持久自由行动”/“伊拉克自由行动”男性退伍军人。如果（a）阅读困难妨碍有效完成评估工具，（B）受试者的精神状态妨碍完成研究程序，如重度器质性疾病、活动性精神病或简易精神状态检查中的表现受损，（c）受试者服用了任何被认为具有显著CNS影响的药物，或（d）受试者符合当前酒精或药物依赖的标准，或曾因酒精或药物依赖接受住院治疗或门诊治疗（例如，AA、NA或methodone治疗）。参与者将从三个来源中抽取：（a）波士顿地区张贴的传单;（B）已经建立的国家创伤后应激障碍受试者招募数据库;（c）向居住在马萨诸塞州的所有男性OEF/OIF退伍军人名册上的人群发邮件，该名册由国防人力数据中心（DMDC）持有，并根据DMDC和VACO签署的数据使用协议与VA共享。参与将涉及电话筛选和三个实验室会议，间隔约一周。受试者的初步筛选将需要确定研究资格。第一部分将涉及知情同意程序和管理简易精神状态检查，自我报告问卷，以及PTSD和其他轴I障碍的诊断访谈。第二部分将包括模拟情境中的清晰思维（ATSS）实验室程序，以评估认知缺陷和偏见。这种方法评估愤怒唤醒期间的想法，因为如果在愤怒情绪状态被激活并且存在相关上下文线索时进行评估，则与愤怒相关的想法更可能是可访问和可报告的。第3部分将涉及TBI和感兴趣的神经心理学变量的评估。临床关系：研究结果可能会对程序的修改和开发产生影响，特别是对愤怒管理和IPV犯罪。研究结果可能会强调需要认知行为愤怒管理策略，考虑到神经心理缺陷和TBI的历史。研究结果还可能阐明IPV的标志变量和特定神经心理学因素的意义，这些因素与理解和治疗该人群中的IPV特别相关。研究结果还将告知主要研究者正在进行的研究计划，重点是制定预防和治疗IPV的干预措施。 公共卫生相关性： 亲密伴侣暴力（IPV）使退伍军人与家庭成员疏远，并对支持网络产生负面影响，使退伍军人面临各种心理社会和身体健康问题以及社会和职业功能不良的风险增加。至关重要的是，我们要更好地了解这一人群中IPV的性质和原因，以便最好地预防和治疗此类家庭问题。目前的调查建议检查创伤性脑损伤和执行功能缺陷的作用，在IPV之间返回的退伍军人，以及他们与创伤后应激障碍和认知缺陷/偏见的症状，有助于IPV的相互作用。这项工作将为主要研究者目前资助的努力提供信息，以开发和测试患有PTSD的退伍军人的初级和二级IPV预防干预措施。