Health Mechanisms and Outcomes in an Epidemiological Cohort of Vietnam Era Women Veterans

 描述（由申请人提供）：创伤暴露及其心理健康相关因素-特别是创伤后应激障碍（PTSD）-可能对健康相关结果产生负面影响，特别是在高危人群中，如军人和退伍军人群体。然而，具体的风险机制在老年人中研究不足。虽然有越来越多的证据表明创伤应激和身体健康之间的关联，但对可改变的心理社会因素和风险行为在创伤暴露，应激反应和身体健康结果之间的关系中的作用知之甚少，包括这些风险因素如何长期运作。需要对老年高危人群中与创伤性应激相关的健康风险进行检查，以阐明创伤性应激长期损害健康相关生活质量和功能的潜在可改变机制。此外，迄今为止，绝大多数关于老年退伍军人的研究都是在男性身上进行的，但女性退伍军人是退伍军人中增长最快的群体，与平民和男性退伍军人相比，她们的身心健康状况较差。拟议的研究将克服现有的差距，在文献中有关代表妇女和检查潜在的可修改的风险机制后的压力，也将设置阶段，进一步的纵向研究的风险协会，在此研究的一个重要方向。拟议的研究的重点是研究早期生活创伤应激暴露和心理健康后遗症对晚年健康的影响，在流行病学队列的老年女性退伍军人（N=4219）使用的数据，从越南妇女的健康研究（HealthVieWS），这是最全面的研究女性越战时代退伍军人至今。创伤后应激障碍和抑郁症的作用将被明确检查，将几个潜在的可改变的心理社会因素，包括突出的健康风险行为（吸烟，酗酒，缺乏锻炼）和感知的社会支持。所检查的主要健康结果是与健康有关的生活质量和功能状态、肥胖和健康状况的指标。结果将提供有价值的试点数据，为更大规模的后续行动与此队列调查假设的纵向关联连接早期生活创伤应激暴露（包括军事暴露）与健康结果在晚年，以更好地了解长期影响的军事服务和早期生活压力对健康老龄化的女性退伍军人。

 DESCRIPTION (provided by applicant): Trauma exposure and its mental health correlates - particularly posttraumatic stress disorder (PTSD) - can have negative implications for health-related outcomes, particularly in high-risk populations, such as military and veteran groups. Specific risk mechanisms, however, are understudied in older adults. While there is growing evidence for the association between traumatic stress and physical health, less is known about the role of modifiable psychosocial factors and risk behaviors in the relationships among trauma exposure, stress reactions, and physical health outcomes, including how these risk factors operate over the long term. Examinations of traumatic stress-associated health risk in older, high-risk populations are needed to elucidate potentially modifiable mechanisms by which traumatic stress undermines health-related quality of life and functioning over the long term. Further, to date, the vast majority of research on older veterans has been conducted on men, yet women veterans are the fastest growing group among the veteran population, and they have poorer mental and physical health as compared to their civilian and male veteran counterparts. The proposed research will overcome existing gaps in the literature related to representing women and examining potentially modifiable risk mechanisms in the wake of stress, and will also set the stage for further longitudinal study of risk associations, an important direction in tis research. The focus of the proposed study is to examine the impact of early life traumatic stress exposure and mental health sequelae on later life health in an epidemiological cohort of older women veterans (N=4219) using data from The Health of Vietnam Women's Study (HealthVieWS), which is the most comprehensive study of women Vietnam Era veterans to date. The roles of PTSD and depression will be examined explicitly, as will several potentially modifiable psychosocial factors including salient health-risk behaviors (tobacco use, alcohol abuse, lack of exercise) and perceived social support. The primary health outcomes examined are indicators of health-related quality of life and functional status, obesity, and health conditions. Results will provide valuable pilot data for a larger-scale follow-up with this cohort o investigate hypothesized longitudinal associations linking early life traumatic stress exposure (including military exposure) with health outcomes in later-life, to better understand the long-term impact of military service and early life stress on healthy aging among women veterans.