Ecologic Stressors, PTSD, and Drug Use in Detroit

描述（由申请人提供）：新出现的证据表明，多层次的压力源是精神病理学和行为的重要预测因素。创伤后应激障碍（PTSD）和药物滥用/依赖是最普遍和致残的行为病理学。该项目的目的是确定是否生态压力（集中的劣势，收入分配，居住隔离，建筑环境的质量），影响创伤后应激障碍（PTSD）的风险，和药物滥用/依赖底特律居民。此外，我们将开始通过评估生态应激源，暴露于潜在创伤事件（PTE），创伤后应激障碍，药物滥用/依赖，免疫和炎症功能之间的相互关系，研究生态应激源与长期健康的途径。我们的中心假设是，暴露于生态压力源是人口心理和行为健康的基本决定因素，特别是在城市环境中，生态因素影响（a）PTE暴露的风险，（B）暴露于PTE的PTSD风险，（c）药物滥用/依赖的风险，（d）PTSD和药物滥用/依赖之间的相互关系，以及（e）精神病理学的一些后果。虽然最近的工作表明，在多个层次的压力可能是重要的精神病理学的决定因素，有很少系统的努力，以了解事件的创伤后应激障碍或药物滥用/依赖的风险，同时也占个人的压力，生态压力的贡献。然后，该项目旨在解开压力源在多个层面上的PTSD和药物滥用/依赖的病因学的贡献，以及这些压力源如何塑造这些病理之间的关系。其次，我们建议考虑的后果，创伤后应激障碍的环境中的生态压力，特别是创伤后应激障碍与免疫和炎症功能之间的关系，以及如何塑造这些后果暴露于生态压力。多层次模型主要用于评估生态压力源是否与PTSD和药物滥用/依赖相关，并评估生态压力源、PTSD、免疫功能和炎症指标之间的关系。

DESCRIPTION (provided by applicant): Emerging evidence suggests that stressors at multiple levels are important predictors of psychopathology and behavior. Post-traumatic stress disorder (PTSD) and drug abuse/dependence are among the most prevalent and disabling behavioral pathologies. The purpose of this project is to determine whether ecologic stressors (concentrated disadvantage, income distribution, residential segregation, quality of the built environment), influence the risk of post-traumatic stress disorder (PTSD), and drug abuse/dependence among residents of Detroit. Additionally, we will begin to study the pathways linking ecologic stressors to long-term health through assessing the interrelationship among ecologic stressors, exposure to potentially traumatic events (PTEs), PTSD, drug abuse/dependence, and immune and inflammatory function. Our central hypothesis is that exposure to ecologic stressors is a fundamental determinant of population mental and behavioral health and that, particularly in the urban context, ecologic factors influence (a) the risk of PTE exposure, (b) the risk of PTSD given exposure to a PTE, (c) the risk of drug abuse/dependence, (d) the interrelationship between PTSD and drug abuse/dependence, and (e) some of the consequences of psychopathology. Although recent work has shown that stressors at multiple levels may be important determinants of psychopathology there has been very little systematic effort to understand the contributions of ecologic stressors to the risk of incident PTSD or drug abuse/dependence while also accounting for individual stressors. This project then aims to disentangle the contribution of stressors at multiple levels to the etiology of PTSD and drug abuse/dependence and how these stressors shape the relationship between these pathologies. Secondarily, we propose to consider the consequences of PTSD in the context of ecologic stressors, particularly the relation between PTSD and immune and inflammatory function, and how these consequences are shaped by exposure to ecologic stressors. Multilevel modeling principally will be used to evaluate whether ecologic stressors are associated with PTSD and drug abuse/dependence and to assess the relation among ecologic stressors, PTSD, immune functioning, and inflammatory measures.