Nursing Inquiry: Stress & Immune Response with Battering

描述：(由申请人提供)临床研究-和 基于人口的样本显示，至少60%的受虐妇女 经历创伤后应激障碍(PTSD)。而皮质醇的变化 与创伤后应激障碍相关的水平、免疫状态和长期健康后果 在几个创伤幸存者群体中进行了研究，但很少有这样的研究 研究对象一般为女性，尤其是受虐待的女性。另外， 确定创伤后应激障碍的具体预测因素的文献很少。 受虐女性的症状。这项研究的目的是考察 亲密伴侣暴力、创伤病史、创伤后应激障碍之间的关系 受虐妇女的症状、皮质醇水平和免疫状态。这个 具体目标是：1)确定哪些经验性的亲密指标 伴侣暴力(实际身体暴力、情感虐待、性暴力、 杀人风险、暴力威胁和虐待关系的持续时间)是 更好地预测受虐女性的创伤后应激障碍症状；2)检查亲属 儿童期虐待和成年创伤史对儿童创伤后应激障碍症状的影响 遭受虐待的妇女；3)检查童年虐待作为创伤后应激障碍的调节因素 受虐妇女的症状；4)通过白细胞计数描述免疫状态， 淋巴细胞亚群计数(CD4细胞、CD8细胞、B细胞和自然杀伤细胞)， CD4：CD8比率，过去6个月的病毒疾病数量和IgA水平 5)检查创伤后应激障碍症状与唾液的关系 受虐妇女的皮质醇水平；以及6)检查 亲密伴侣暴力、精神创伤史、创伤后应激障碍症状、皮质醇水平以及 受虐妇女的免疫状态。 中描述的模型构造之间的理论相互关系 将对收容所的135名遭受虐待的妇女进行抽样调查，以确定具体目标。 以及整个社区。软建模，或最小变量通径分析 偏最小二乘、结构方程建模方法及多重 回归将用于测试模型之间的指定关系 构造在所提出的模型中。 该提案还旨在加强调查员作为一名 具有高级临床和统计技能的护士科学家 研究生理和心理社会之间的复杂相互关系 对亲密暴力的反应。调查员？S的长期目标是 开发、改进和/或扩展整体干预措施，目标是延迟 慢性应激者疾病的发生和发展 暴力或创伤的结果。

DESCRIPTION: (provided by applicant) Research with clinical- and population-based samples has shown that at least 60 percent of battered women experience posttraumatic stress disorder (PTSD). While changes in cortisol levels, immune status, and long-term health consequences associated with PTSD have been studied in several trauma survivor groups, there has been little such research with women in general, and battered women in particular. Additionally, there is a paucity of literature identifying specific predictors of PTSD symptoms in battered women. The purpose of this study is to examine the relationship between and among intimate partner violence, trauma history, PTSD symptomatology, cortisol levels, and immune status in battered women. The specific aims are to: 1) identify which empirical indicators of intimate partner violence (actual physical violence, emotional abuse, sexual violence, risk of homicide, threats of violence, and length of abusive relationship) are more predictive of PTSD symptoms in battered women; 2) examine the relative effects of childhood maltreatment and adult trauma history on PTSD symptoms in battered women; 3) examine childhood maltreatment as a moderator of PTSD symptoms in battered women; 4) describe immune status via leukocyte count, lymphocyte subset counts (CD4 cell, CD8 cell, B-cell, and natural killer cell), CD4:CD8 ratio, number of viral illnesses the past 6 months, and IgA levels in battered women; 5) examine the relationship between PTSD symptoms and salivary cortisol levels in battered women; and 6) examine the relationship between intimate partner violence, trauma history, PTSD symptoms, cortisol levels, and immune status in battered women. The theoretical interrelationships among the model constructs delineated in the specific aims will be examined in a sample of 135 battered women from shelters and the community. The soft modeling, or Least Variable Path Analysis with Partial Least Squares, approach to structural equation modeling and multiple regression will be used to test the specified relationships among the model constructs in the proposed model. The proposal also aims to enhance the development of the investigator as a nurse scientist with the advanced clinical and statistical skills needed to investigate the complex interrelationships between physiologic and psychosocial responses to intimate violence. The investigator?s long-term objectives are to develop, refine, and/or expand holistic interventions with the goal of delaying the onset and progression of disease in persons experiencing chronic stress as a result of violence or trauma.