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Primary-Care Based Mindfulness Intervention for Chronically Traumatized Individuals

针对慢性创伤个体的初级保健正念干预

基本信息

批准号：
9752478
负责人：
Abigail Powers Lott
金额：
$ 13.63万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-01 至 2022-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9752478
关键词：
Adult African American Arousal Autonomic Dysfunction Autonomic nervous system Awareness Behavior Control Biological Caring Chronic Clinic Clinical Communities Comorbidity Control Groups Cues Data Data Analytics Data Collection Development Emotional Exposure to Frequencies Galvanic Skin Response Goals Growth Health Impairment Individual Integrative Medicine Intervention Interview Knowledge Learning Low income Major Depressive Disorder Measurement Measures Medical Mental Depression Mental Health Mental disorders Methods Mind-Body Intervention Mindfulness Training Minority Modeling Outcome Parasympathetic Nervous System Patient Self-Report Physiological Population Populations at Risk Post-Traumatic Stress Disorders Primary Health Care Process Program Development Psychophysiology Public Health Public Hospitals Randomized Controlled Trials Reporting Research Research Design Research Infrastructure Risk Risk Factors Services Stress Sympathetic Nervous System Symptoms Techniques Therapeutic Intervention Time Training Training Activity Trauma Treatment outcome Underserved Population Waiting Lists barrier to care base behavioral health behavioral health intervention biopsychosocial career career development depressive symptoms design emotion dysregulation emotion regulation ethnic minority population experience follow-up group intervention health care settings health disparity health service use high risk improved interest mindfulness mindfulness based cognitive therapy mindfulness intervention minority communities parent project post intervention primary care setting programs psychiatric symptom psychologic reduce symptoms response satisfaction screening statistics study population success symptom management trauma exposure trial design urban setting

项目摘要

Project Summary/Abstract Rates of repeated exposure to trauma and levels of trauma-related psychiatric disorders in low-income, urban minority communities far exceed national averages. Despite this, inadequate access and substantial barriers to treatment in urban traumatized populations remain. Mindfulness-based interventions may target emotion dysregulation and dysfunction of the autonomic nervous system, mechanisms that contribute to trauma-related psychiatric outcomes like posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). In line with the strategic goals of the NCCIH to improve care for hard-to-manage symptoms, the purpose of this study is to pilot a primary-care based mindfulness intervention for chronically traumatized African Americans screening positive for PTSD and MDD in primary care clinics within an urban public hospital. The study will utilize a randomized controlled trial (RCT) design along with a multi-method psychological and physiological assessment approach to establish the feasibility and acceptability of a [mindfulness-based cognitive therapy intervention for primary care (MBCT)] versus wait-list control in African Americans with chronic trauma exposure and comorbid PTSD and MDD. Also in line with the strategic goal of NCCIH to advance understanding of mechanisms underlying mind-body intervention approaches, preliminary mechanisms of action and change in outcomes associated with MBCT including emotion dysregulation, autonomic function, and PTSD and MDD symptoms will be evaluated. The data collection and [8-session] group intervention will take place in primary care clinics within an urban public hospital serving primarily low-income, minority individuals (>80% African American). Training activities will take place in an academic medical setting under the umbrella of a broader project aimed at understanding psychological and biological risk factors for PTSD. Training goals for this K23 project include 1) learning how to design, implement, and evaluate the outcomes of complementary and integrative behavioral health interventions, 2) [gaining enhanced training in mindfulness and integrated care], 3) learning longitudinal data analytic techniques, and 4) gathering and analyzing psychophysiological variables and integrating psychophysiological data into treatment research. Ultimately, career goals for the applicant include working to improve treatment for underserved civilian trauma populations in urban settings by taking a complementary integrative health perspective and enhance understanding of mechanisms of change in the context of trauma-related treatment. Bringing measures of objective physiological markers like autonomic function into primary care settings in the context of behavioral health treatments will also aid in our understanding of the biological mechanisms that may change as a result of these treatments and how those underlying biological mechanisms can positively impact health outcomes long term.

项目总结/文摘