Ecologic Stressors, PTSD, and Drug Use in Detroit

描述(由申请者提供)：新出现的证据表明，多个水平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。该项目的目的是确定生态应激源(集中劣势、收入分配、居住隔离、建筑环境质量)是否影响底特律居民患创伤后应激障碍(PTSD)和药物滥用/依赖的风险。此外，我们将通过评估生态应激源、潜在创伤事件(PTE)暴露、创伤后应激障碍、药物滥用/依赖以及免疫和炎症功能之间的相互关系，开始研究将生态应激源与长期健康联系起来的途径。我们的中心假设是，暴露于生态应激源是人群心理和行为健康的基本决定因素，特别是在城市背景下，生态因素影响(A)PTE暴露的风险，(B)暴露于PTE的风险，(C)药物滥用/依赖的风险，(D)PTSD与药物滥用/依赖之间的相互关系，以及(E)精神病理学的一些后果。尽管最近的研究表明，多个层面的压力源可能是精神病理学的重要决定因素，但在了解生态压力源对创伤后应激障碍或药物滥用/依赖事件风险的贡献，同时也考虑到个体压力源的系统性努力很少。然后，这个项目的目标是理清多个层面的压力源对创伤后应激障碍和药物滥用/依赖的病因的贡献，以及这些压力源如何塑造这些病理之间的关系。其次，我们建议在生态应激源的背景下考虑创伤后应激障碍的后果，特别是创伤后应激障碍与免疫和炎症功能之间的关系，以及这些后果是如何通过暴露于生态应激源而形成的。多水平模型将主要用于评估生态应激源是否与创伤后应激障碍和药物滥用/依赖有关，以及评估生态应激源、创伤后应激障碍、免疫功能和炎症措施之间的关系。

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.