Psychosocial Factors and Lupus Disease Progression Among African American Women

非裔美国女性的心理社会因素和狼疮疾病进展

• 批准号: 10224407
• 负责人: H. David Chae
• 金额: $ 21.73万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-02 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224407
• 关键词: Psychosocial; Factors; Lupus; Disease; Progression

DESCRIPTION (provided by applicant): There is a lack of research on systematic lupus erythematosus (SLE), a multisystem, chronic, autoimmune disease that shows clear patterns along racial and gender lines. African American women not only have a greater prevalence of SLE, but also experience greater severity and faster progression compared to their White counterparts, being more frequently affected by organ damage and comorbid conditions that emerge as a consequence of disease activity and disease-related chronic inflammation and tissue damage. Racial disparities in SLE complications and mortality are well documented; however, the reasons for these disparities are poorly understood. To address these gaps in knowledge, this study aims to: (1) examine the role that psychosocial stressors experienced by African American women have in exacerbating SLE in this population; (2) identify social factors and psychological resources that are protective or buffer the effects of stress on SLE-related health declines; and (3) explore the biological implications of psychosocial stressors and SLE, in relation to elevated systemic inflammation and accelerated aging at the cellular level. The experiences of African American women with SLE are particularly challenging, and include psychosocial stressors related to disease management, as well as disproportionately greater poverty and living in disadvantaged communities; in addition to routine stressors such as those associated with work, family and relationship demands, parenting, and caregiving. Experiences of racial discrimination constitute a qualitatively distinct source of psychosocial stress, adding o existing everyday hassles. In this study, we will examine how these stressors impact SLE severity and progression through a longitudinal study design. We will collect three waves of data from 480 African American women, all with validated SLE. Participants will be recruited from the Georgians Organized Against Lupus (GOAL) cohort, a truly one-of-a-kind, population-based study of SLE in Atlanta, including a full spectrum of patients from all levels of socioeconomic strata, across a range of disease severity. We will examine the effects of racial discrimination, financial and neighborhood-related strains, and other stressors associated with various role strains. Potential protective factors, including those related to racial identity and social suppor will also be assessed. We will collect dried blood spots (DBS), a minimally invasive alternative to venipuncture, to examine indicators of biological dysregulation which we hypothesize will be impacted by psychosocial stress as well as SLE activity. This study will be the most in-depth investigation of the multifactorial nature of psychosocial stressors and their impact on SLE disease progression among African American women, and thus fills an important gap in the science on this understudied disease. This research is important in advancing knowledge of how aspects of the social environment and psychological processes impact health among African American women with SLE, and also contributes to scientific knowledge on the underpinnings of racial disparities in the progression of this disease.

描述（由申请人提供）：系统性红斑狼疮（SLE）是一种多系统慢性自身免疫性疾病，在种族和性别方面表现出明显的模式，目前缺乏对SLE的研究。与白人女性相比，非裔美国女性不仅有更高的SLE患病率，而且病情更严重，进展更快，更容易受到器官损伤和疾病活动、疾病相关的慢性炎症和组织损伤引起的共病的影响。系统性红斑狼疮并发症和死亡率的种族差异已得到充分证明；然而，人们对这些差异的原因知之甚少。为了解决这些知识上的空白，本研究旨在：(1)研究非裔美国女性所经历的社会心理压力因素在该人群中加剧SLE的作用；(2)识别保护或缓冲压力对语言障碍相关健康衰退影响的社会因素和心理资源；(3)探索社会心理压力源和SLE的生物学意义，在细胞水平上与全身性炎症升高和加速衰老有关。非裔美国女性SLE患者的经历尤其具有挑战性，包括与疾病管理相关的社会心理压力，以及不成比例的更大贫困和生活在弱势社区；除了日常的压力源，如与工作、家庭和关系需求、养育子女和照顾有关的压力源。种族歧视的经历是社会心理压力在质量上的独特来源，增加了现有的日常烦恼。在这项研究中，我们将通过纵向研究设计来研究这些压力源如何影响SLE的严重程度和进展。我们将从480名非裔美国女性中收集三波数据，这些女性均患有SLE。参与者将从格鲁吉亚组织对抗狼疮（GOAL）队列中招募，这是亚特兰大一项真正独一无二的、基于人群的SLE研究，包括来自各个社会经济阶层、不同疾病严重程度的全谱系患者。我们将研究种族歧视、金融和社区压力以及与各种角色压力相关的其他压力源的影响。还将评估潜在的保护因素，包括与种族认同和社会支持有关的因素。我们将收集干血点（DBS），这是一种静脉穿刺的微创替代方法，以检查生物失调的指标，我们假设这些指标将受到社会心理压力和SLE活动的影响。本研究将是对非裔美国女性SLE疾病进展的多因素心理社会压力源及其影响的最深入研究，从而填补了这一未被充分研究的疾病的重要科学空白。这项研究对于了解社会环境和心理过程如何影响患有SLE的非裔美国妇女的健康具有重要意义，同时也有助于了解该病进展中种族差异的科学基础。