STRESS, SEROTONIN GENE & HEALTH DISPARITIES

这项研究提案的长期目标是阐明潜在的生物学和行为机制，即紧张的社会和物理环境导致社会经济和种族群体之间的健康差异。为实现这一目标，提出了以下具体目标：目标1--确定作为阿尔茨海默病或其他慢性痴呆症患者配偶照料者的行为和生物学特征是否比没有照看责任的配对对照组更为恶劣。目标2-确定生活在有压力的物理环境中(基于社区特征)是否会导致照顾者比非照顾者更不利的生物行为特征。目的3-确定应激的社会和/或物理环境对损害健康的生物行为特征的影响是否受到敌对人格类型或影响中枢5-羟色胺功能的基因多态的影响。在二次分析中，我们还将评估其他潜在调节因素的缓和效果--例如，潜在的冠心病或其他医疗疾病、种族、性别、社会支持和社会经济地位。我们将招募200名照顾者和200名没有照看责任的配对对照。我们将评估照顾者状态对可能导致健康差异的行为(负面影响和健康实践)和生物学(休息和应激时的心血管和神经内分泌功能，代谢综合征)特征的影响。我们将确定物理邻居环境对生物行为机制的影响，无论是单独的还是与照顾者状态相互作用的。我们还将评估与5-羟色胺相关的基因多态、敌对人格类型和受试者的其他医学/身体和社会特征对照顾和身体环境对生物行为机制的影响的调节作用。除了增加对造成健康差异的生物行为机制的理解外，这些发现还可能指出旨在改善这些差异的特定干预措施的目标。

The long-term objective of this research proposal is to elucidate underlying biological and behavioral mechanisms whereby stressful social and physical environments contribute to health disparities between socioeconomic and racial groups. To achieve this objective, the following Specific Aims are proposed: Aim 1 - To determine whether persons who are caregivers for a spouse with Alzheimer's Disease or other chronic dementia have a more adverse profile of behavioral and biological characteristics than matched controls without caregiving responsibilities. Aim 2 - To determine whether living in a stressful physical environment (based on neighborhood characteristics) leads to a more adverse profile of biobehavioral characteristics among caregivers than noncaregivers. Aim 3 - To determine whether the impact of stressful social and/or physical environments on health-damaging biobehavioral characteristics is moderated by the presence of a hostile personality type or genetic polymorphisms that affect CNS serotonin function. In secondary analyses, we shall also evaluate the moderating effect of other potential moderators - e.g., underlying CHD or other medical disorder, race, gender, social support, and socioeconomic status. We shall recruit a sample of 200 caregivers and 200 matched controls without caregiving responsibilities. We shall assess the impact of caregiver status on behavioral (negative affects and health practices) and biological (cardiovascular and neuroendocrine function at rest and during stress, metabolic syndrome) characteristics likely to underlie health disparities. We shall determine the impact of the physical neighborhood environment, both alone and interacting with caregiver status, upon the biobehavioral mechanisms. We shall also evaluate the moderating effects of serotonin-related genetic polymorphisms, hostile personality type and other medical/physical and social characteristics of the subjects upon the impact of caregiving and physical environments on biobehavioral mechanisms. In addition to increasing understanding of biobehavioral mechanisms responsible for health disparities, the findings could point to targets for specific interventions aimed at ameliorating these disparities.