Insomnia Treatment and Cardiometabolic Health in Older Adults with Posttraumatic Stress Disorder

患有创伤后应激障碍的老年人的失眠治疗和心脏代谢健康

• 批准号: 10369496
• 负责人: Monica R Kelly
• 金额: $ 18.93万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10369496
• 关键词: Address; Age; Aging; Arousal; Behavioral; Biological Markers; Cardiometabolic Disease; Cause of Death; Circadian Rhythms; Clinical Investigator; Clinical Psychology; Clinical Sciences; Clinical Trials; Clinical Trials Design; Cognitive; Cognitive Therapy; Comorbid Insomnia; Data; Diabetes Mellitus; Disease Management; Disease remission; Doctor of Philosophy; Dyslipidemias; Education; Elderly; Environment; Evidence based intervention; Failure; Fellowship; Foundational Skills; Foundations; Funding; Geriatrics; Gerontology; Glycosylated hemoglobin A; Goals; Health; Healthcare Systems; Heart Diseases; Hyperglycemia; Hypertension; Individual; Institutes; Insulin; Insulin Resistance; Intervention; Knowledge; Licensure; Link; Lipids; Measures; Mediating; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Morbidity - disease rate; Multi-Institutional Clinical Trial; Neurobehavioral Manifestations; Obesity; Older Population; Outcome; Participant; Patients; Pilot Projects; Plant Roots; Play; Population; Post-Traumatic Stress Disorders; Professional Competence; Psychotherapy; Quality of life; Randomized; Randomized Controlled Trials; Research; Research Methodology; Research Personnel; Research Training; Residual state; Resources; Risk; Risk Factors; Role; Severities; Sleep; Sleep Apnea Syndromes; Sleep disturbances; Sleeplessness; Stress; Stroke; Symptoms; Training; Translational Research; Trauma; United States National Institutes of Health; Veterans; Vietnam; Work; cardiometabolic risk; cardiometabolism; career; career development; clinical care; clinical center; cognitive benefits; cohort; disorder risk; effective therapy; evidence base; experience; falls; fasting glucose; follow-up; functional disability; high risk; improved; individualized medicine; medical schools; military veteran; modifiable risk; mood symptom; mortality; physical conditioning; poor sleep; professor; programs; randomized trial; skill acquisition; sleep health; theories; trauma exposure; trial design; young adult

Project Summary/Abstract Monica Kelly, PhD is an Adjunct Assistant Professor at the David Geffen School of Medicine at UCLA. She is fully committed to becoming an independently funded investigator specializing in the study and treatment of sleep, cardiometabolic health and posttraumatic stress disorder (PTSD) in older adults. Dr. Kelly is an ideal candidate for this field of research with over 10 years of sleep and PTSD research experience, advanced geriatrics fellowship training, and licensure in clinical psychology. This K23 award will provide foundational career development skills for achieving her long-term goal of understanding and improving mental and physical health outcomes for older adults with insomnia and PTSD. Data collected will provide the basis of a larger, randomized controlled trial designed to examine the most effective treatment sequencing for mental health and cardiometabolic disease risk outcomes among older adults with comorbid insomnia disorder and PTSD. Career Development and Training Plan: The proposed work will be carried out at the UCLA and take advantage of available resources within the VAGLAHS, providing a rich training environment and the ability to conduct the proposed research and training plans. Dr. Kelly's team of nationally renowned mentors include Drs. Jennifer Martin (primary mentor; behavioral sleep interventions expert; K24 awardee), Cathy Alessi (geriatric sleep and health expert), Peter Liu (cardiometabolic health and sleep expert; K24 awardee), and Thomas Neylan (PTSD and sleep expert). Available resources include UCLA's Clinical and Translational Science Institute (CTSI), Multicampus Program in Geriatric Medicine and Gerontology (MPGMG), and the Geriatric Research, Education and Clinical Center (GRECC). Her training plan features carefully curated didactic and experiential training aligning her research and training goals in 1) clinical trials, 2) cardiometabolic health, 3) circadian rhythms, and 4) career skills necessary to become an independent clinical investigator. Research Plan: The proposed pilot randomized controlled trial will address a gap in knowledge related to addressing modifiable risk factors for cardiometabolic disease through treating residual insomnia in the context of PTSD in older adults. This project utilizes evidence-based interventions and standard clinical care measures. The study will evaluate the benefits of 5 sessions of Cognitive Behavioral Therapy for Insomnia (CBT-I) versus control, following 12 sessions of Cognitive Processing Therapy (CPT) for PTSD in older Veterans, an expanding group of individuals at elevated risk for PTSD, insomnia and cardiometabolic disease morbidity and mortality. The aims of this project are to 1) Evaluate the added benefits of CBT-I versus control on sleep, PTSD, and cardiometabolic risk biomarkers; 2) Evaluate CBT-I versus control following CPT on cardiometabolic risk biomarkers and quality of life; and 3) Evaluate the durability of the sleep, cardiometabolic and quality of life benefits of CBT-I following CPT versus control following CPT at 6-month follow-up.

项目总结/文摘