Predicting Classes of Functional Trajectories: Malleable Risk Factors

预测功能轨迹类别：可塑性风险因素

• 批准号: 8679866
• 负责人: Sandra B. Morissette
• 金额: --
• 依托单位: OLIN TEAGUE VETERANS CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8679866
• 关键词: Accounting; Afghanistan; Alcohol abuse; American; Award; Centers of Research Excellence; Chronic; Clinical; Common Data Element; Compassion; Conflict (Psychology); Data; Data Set; Department of Defense; Development; Diagnostic; Disease; Early Intervention; Early treatment; Enrollment; Ensure; Family; Family Study; Fostering; Foundations; Freedom; Funding; Genetic; Goals; Impairment; Intervention; Interview; Iraq; Knowledge; Longevity; Measures; Mental Depression; Mental disorders; Military Personnel; Movement; Occupational; Outcome Study; Participant; Patient Self-Report; Personal Satisfaction; Phase; Physical Function; Post-Traumatic Stress Disorders; Probability; Process; Psychosocial Factor; Public Health; Quality of life; Questionnaires; Recovery; Recovery of Function; Rehabilitation therapy; Research; Research Design; Research Personnel; Resources; Risk; Risk Factors; Role; Sample Size; Sampling; Services; Sorting - Cell Movement; Symptoms; Testing; Time; Treatment outcome; Veterans; War; Work; alcohol misuse; alcohol use disorder; base; clinically relevant; cohort; combat; community reintegration; coping; emotion regulation; expectation; follow-up; functional disability; functional outcomes; improved; malleable risk; member; operation; physical conditioning; programs; prospective; psychosocial; psychosocial rehabilitation; public health relevance; research study; social; stressor; success; therapy development; treatment planning; treatment program

DESCRIPTION (provided by applicant): There is a well-established relationship between commonly occurring mental health disorders, such as post-traumatic stress disorder, depression, and alcohol use disorders, and poor functional outcomes. However, less is known about long-term functional trajectories among returning Veterans and specific factors that predict who will follow better or worse courses of readjustment. Building upon the successful foundation of our currently RR&D-funded MERIT award, this second submission of our renewal application proposes to continue following the existing carefully-characterized cohort of 300 Veterans who served as part of Operations Enduring and Iraqi Freedom and New Dawn (OEF/OIF/OND) for an additional 2-year period. The sample size will also be expanded to include 500 Veterans. The Specific Aims are to identify clinically relevant, modifiable psychosocial factors that: 1) prospectively predict improvements in long-term functioning and community reintegration over time; (2) predict membership in latent class trajectories of functioning; and (3) predict transitions between classes of functional trajectories. Veterans will complete state-of-the-art diagnostic interviews and self-report questionnaires at baseline and 24-months. Follow-up questionnaires will be mailed at 6-, 12-, and 18-months. Multiple domains of functioning will be evaluated, including occupational, family, social, and physical functioning, as well as community reintegration. The long-term objective of this programmatic line of research is to improve functional outcomes and quality of life of returning OEF/OIF/OND Veterans. In keeping with the VHA's goal of operationalizing principles of recovery and rehabilitation in treatment planning, this research wil provide a platform of empirical data to help guide refinement and further development of meaningful treatment programs to assist OEF/OIF/OND Veterans with optimal post-war readjustment over time. Upon completing the study, data from this project will inform allocation of VA resources and targets for clinical interventions that have the highest probability of ensuring that Veterans recover following deployments to warzones.

描述（由申请人提供）： 常见的精神健康障碍（例如创伤后应激障碍、抑郁症和酗酒障碍）与功能不良结果之间存在明确的关系。然而，人们对回归退伍军人的长期功能轨迹以及预测谁将遵循更好或更差的重新调整过程的具体因素知之甚少。在我们目前由 RR&D 资助的 MERIT 奖的成功基础上，我们第二次提交续签申请，建议继续关注现有的 300 名经过仔细描述的、曾在持久行动、伊拉克自由和新黎明行动 (OEF/OIF/OND) 中服役的退伍军人，再延长 2 年。样本规模也将扩大到包括 500 名退伍军人。具体目标是确定临床相关的、可改变的心理社会因素，这些因素：1）前瞻性地预测长期功能和社区重新融入随着时间的推移的改善； (2) 预测潜在阶级功能轨迹中的成员资格； (3)预测功能轨迹类别之间的转变。退伍军人将在基线和 24 个月内完成最先进的诊断访谈和自我报告问卷。后续调查问卷将在 6、12 和 18 个月时邮寄。将评估多个功能领域，包括职业、家庭、社会和身体功能，以及重新融入社区。这项计划性研究的长期目标是改善返回的 OEF/OIF/OND 退伍军人的功能结果和生活质量。为了与 VHA 在治疗计划中实施恢复和康复原则的目标保持一致，这项研究将提供一个经验数据平台，帮助指导有意义的治疗计划的完善和进一步发展，以帮助 OEF/OIF/OND 退伍军人随着时间的推移进行最佳的战后调整。研究完成后，该项目的数据将为退伍军人管理局资源的分配和临床干预目标提供信息，这些干预措施最有可能确保退伍军人在部署到战区后康复。