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Development of a Risk Factor Screen for Mental Health Problems after Sudden Illness or Injury

突发疾病或受伤后心理健康问题风险因素筛查的开发

基本信息

批准号：
9899113
负责人：
EVE B CARLSON
金额：
$ 61.01万
依托单位：
PALO ALTO VETERANS INSTIT FOR RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-20 至 2024-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9899113
关键词：
Acute Post Traumatic Stress Disorder Adult African American American Area Asians Baltimore Caring Childhood Chronic Communities Data Data Collection Development Discrimination Disease Dissociation Distress Early Intervention Early intervention trials Education Emergency Medicine Enrollment Ethnic Origin Ethnic group Exposure to Functional disorder Gender Goals Healthcare Home environment Hospitals Impairment Individual Injury Intervention Studies Knowledge Latino Life Life Stress Measures Medical Medicine Mental Depression Mental Health Mental disorders Methodology Methods Minority Groups National Institute of Mental Health Natural Disasters Occupational Outcome Patient Care Patients Performance Personal Satisfaction Population Population Heterogeneity Post-Traumatic Stress Disorders Preventive Intervention Preventive care Primary Health Care Prospective Studies Psychopathology Race Randomized Controlled Trials Research Research Personnel Research Project Grants Risk Risk Factors Sampling Severities Site Social Functioning Social Sciences Social support Socioeconomic Status Specificity Stigmatization Subgroup Sudden Death Suicide Symptoms Terrorism Thinking Time Trauma Trauma patient Traumatic injury Violence Work acute symptom cohesion criminal behavior disability disparity reduction expectation experience health care service health disparity high risk loved ones novel strategies post-trauma prevent programs public health emergency racial and ethnic racial and ethnic disparities racial minority racism response rural counties rural disparities rural dwellers rurality screening social social stigma statistics theories therapy development trauma exposure traumatic event traumatic stress

项目摘要

PROJECT SUMMARY Posttraumatic stress disorder (PTSD) can be debilitating and is related to impaired occupational and social functioning, chronic medical problems, disability, and increases in suicidality, violence, and criminal behavior. Over 10 million Americans are treated annually for sudden, severe illnesses or injuries that require very urgent treatment; and an estimated 20% of hospitalized traumatic injury patients have persisting mental health problems. Identifying those at risk for later disorder is difficult, and no screens can accurately predict PTSD in Americans exposed to traumatic stress. In research on adults exposed to traumatic injury, theory-driven pre- trauma, time-of-trauma, and post-trauma risk factors were strongly related to outcomes and accurately identified those who later had elevated PTSD symptoms. We propose to extend our work to a population level to create a screen for use in U.S. hospitals. In diverse populations of sudden illness or injury patients at hospitals sites in Baltimore, MD, Akron, OH, and Palo Alto, CA, data will be collected on theory-driven, highly predictive pre-trauma (gender, education, socioeconomic status, ethnicity/race, childhood home life and parental dysfunction, past trauma exposure); time-of-trauma (trauma intensity, pre-trauma home life; pre- trauma life stress), and post-trauma (acute PTSD and dissociation symptoms, negative thinking; post-trauma life stress; post-trauma social support; post-trauma social constraints) risk factors and later symptoms of disorder in 1,500 patients, including 1,100 (76%) ethnic/racial minorities. Data will also be collected on five variables found to relate to disparities in mental health or PTSD: discrimination/racism, competing needs, community cohesion, stigma, and negative expectations about treatment. Data collected will include sufficiently large samples of African American, Latino, Asians, and mixed ethnicity/race patients for separately analyses for these groups. Relationships of all predictors and disparities variables to outcomes and covariance among predictors and disparities variables will be examined to select risk factor and disparities variables that are highly predictive, similarly related to outcomes across subgroups, and can be measured with the fewest items and items that are briefer and less personal, stigmatizing, and difficult to understand. In Wave II of data collection, predictive performance will be assessed in a new sample of 1,500 patients, including 1,100 (76%) ethnic/racial minorities with a goal of identifying at least 80% (sensitivity) of those who later have high PTSD symptoms and at least 70% (specificity) of those who recover well.

项目摘要创伤后应激障碍（PTSD）可以使人衰弱，并且与受损的职业和社会关系有关。功能，慢性医疗问题，残疾，自杀，暴力和犯罪行为的增加。每年有超过1000万美国人因突发的严重疾病或受伤而接受治疗，治疗;估计20%的住院创伤患者有持续的心理健康问题识别那些有后期障碍风险的人是困难的，没有筛查可以准确预测PTSD。美国人遭受创伤压力。在对遭受创伤的成年人的研究中，理论驱动的预- 创伤、创伤时间和创伤后风险因素与结果密切相关，找出了那些后来出现PTSD症状的人。我们建议将我们的工作扩展到人口层面， to create创建a screen屏幕for use in U.S. hospitals医院.在不同的突发疾病或受伤患者人群中，位于马里兰州巴尔的摩、俄亥俄州阿克伦和加利福尼亚州帕洛阿尔托的医院站点，将收集理论驱动的、高度预测性创伤前（性别、教育、社会经济地位、种族/人种、童年家庭生活和父母功能障碍，过去的创伤暴露）;创伤时间（创伤强度，创伤前家庭生活; 创伤后应激障碍（急性创伤后应激障碍和分离症状，消极思维;创伤后生活压力;创伤后社会支持;创伤后社会限制）风险因素和后期症状 1，500例患者，包括1，100例（76%）少数民族/种族。还将收集五个数据发现与心理健康或创伤后应激障碍差异有关的变量：歧视/种族主义，竞争需求，社区凝聚力、耻辱感和对治疗的负面期望。收集的数据将充分包括非裔美国人、拉丁裔、亚洲人和混合种族/人种患者的大样本，用于单独分析对于这些群体。所有预测因子和差异变量与结果的关系以及将检查预测因素和差异变量，以选择风险因素和差异变量，高度预测性，与亚组之间的结局相似，并且可以用最少的项目进行测量以及更简短、不那么个人化、侮辱性和难以理解的项目。在第二波数据中收集，将在1，500例患者的新样本中评估预测性能，包括1，100例（76%）少数民族/种族，目标是识别至少80%（敏感性）后来患有高度创伤后应激障碍的人症状和至少70%（特异性）恢复良好的患者。