Chronic Stress, Inflammation, and Resilience: Predictors of Social Integration in Recently Housed Black and White Veterans

尽管退伍军人事务部在通过永久性住房减少无家可归的退伍军人数量方面取得了相当大的成功， 支持性住房仍然是一个根本问题。长期住房是必要的，但还不够， 成功的社会融合。许多退伍军人仍然孤立，没有足够的社会支持后， 安置好了黑人退伍军人不成比例地经历无家可归，但在心理学方面仍然研究不足。 科学更好地了解种族差异的风险和保护因素的社会融合， 最近入住的黑人和白色退伍军人可以告知新的康复干预措施的发展。 这个职业发展奖（CDA-2）建议利用创新的，多模式的方法来检查 压力、炎症和恢复力对社会融合的贡献， 白色老兵。无家可归是非常紧张和黑人退伍军人可能会遇到额外的压力源 这是因为系统性的不平等可能阻碍社会融合。此外，心理社会压力与 体内有炎症反应反过来，炎症可能会加剧社会问题， 鉴于越来越多的证据表明其对社会行为的影响，然而，以前的工作发现更好的 无家可归的黑人退伍军人与白色退伍军人相比， 保护性因素，减轻压力对黑人退伍军人社会融合的影响。韧性是一 可改变的特征，可能有助于缓冲压力和炎症对社会的负面影响， 一体化这些因素在多大程度上差异影响社会融合在最近居住的黑人 而白色退伍军人则相对不为人知。这项纵向研究的总体目标是检查种族 压力、炎症和恢复力对最近入住的布莱克社区的社会融合的影响的差异 和白色老兵首先，我们将研究应力的横截面和纵向关联， 炎症以及社会融合的韧性。其次，我们将研究种族是否会缓和这些问题。 协会.作为一个探索性的目标，我们将研究一个社会融合的综合纵向模型， 包括上面列出的风险和保护因素以及精神症状，在最近收容的黑人和 白色老兵。这项研究的结果有可能促进我们对风险的理解， 保护机制的社会融合在最近安置的黑人和白色退伍军人，并告知创新 康复治疗，减轻压力和炎症的影响，以改善社会融合。 本CDA将提供申请人，德里克M。Novacek博士，在以下领域接受培训：（1）社会 整合和退伍军人无家可归;（2）压力和炎症，包括多种方法来评估 炎症标志物;（3）退伍军人的种族健康差异。申请人的职业目标是成为 VA研究心理学家，致力于改善无家可归的退伍军人的社会融合和文化发展 一致的干预措施。本CDA申请中概述的培训将为申请人奠定基础 在退伍军人事务部内制定一项独立的研究计划，重点关注社会融合的决定因素， 无家可归的老兵VA RR&D中心加强无家可归退伍军人的社区融合 （THRIVe），VISN 22精神疾病研究，教育和临床中心（MIRECC）在VA大洛杉矶 洛杉矶医疗保健系统（GLA）和加州大学洛杉矶分校（UCLA）提供了一个优秀的 环境和基础设施，以完成拟议的研究。主要导师将是迈克尔F。绿色， 博士，THRIVe的主任，VISN 22 MIRECC治疗单位的主任，和一个既定的研究员 退伍军人无家可归申请人还将接受研究专家的专门培训， 易受伤害的退伍军人（莉莲盖尔伯格，医学博士，公共卫生硕士），在炎症的主要研究人员（史蒂芬W。科尔，博士）， 和一位著名的学者在种族健康差异的退伍军人（唐娜L。华盛顿，MD，MPH）。的 申请人还将获得生物统计学家Catherine A的统计咨询。Sugar博士

Despite the VA’s considerable success in reducing the number of homeless Veterans through permanent supportive housing, a fundamental problem remains. Permanent housing is necessary, but not sufficient, for successful social integration. Many Veterans remain isolated and without adequate social support after being housed. Black Veterans disproportionately experience homelessness yet remain understudied in psychological science. A better understanding of racial differences in risk and protective factors of social integration in recently housed Black and White Veterans could inform the development of novel rehabilitative interventions. This Career Development Award (CDA-2) proposes to utilize an innovative, multimodal approach to examine the contributions of stress, inflammation, and resilience to social integration in recently housed Black and White Veterans. Homelessness is extremely stressful and Black Veterans may experience additional stressors due to systemic inequities that could impede social integration. Furthermore, psychosocial stress is associated with an inflammatory response in the body. Inflammation could, in turn, exacerbate problems with social integration given the increasing evidence of its effect on social behavior. However, previous work finds better social integration in homeless Black Veterans compared to White Veterans, suggesting the presence of protective factors that mitigate the effects of stressors on social integration in Black Veterans. Resilience is a modifiable trait that might help buffer the negative consequences of stress and inflammation on social integration. The extent to which these factors differentially impact social integration in recently housed Black and White Veterans is relatively unknown. The overall goal of this longitudinal study is to examine racial differences in the effects of stress, inflammation, and resilience on social integration in recently housed Black and White Veterans. First, we will examine the cross-sectional and longitudinal associations of stress, inflammation, and resilience with social integration. Second, we will examine whether race moderates these associations. As an exploratory aim, we will examine an integrative longitudinal model of social integration, including the risk and protective factors listed above and psychiatric symptoms, in recently housed Black and White Veterans. Findings from this study have the potential to advance our understanding of risk and protective mechanisms of social integration in recently housed Black and White Veterans and inform innovative rehabilitative treatments that mitigate the effects of stress and inflammation to improve social integration. This CDA will provide the applicant, Derek M. Novacek, PhD, with the training in the areas of: (1) social integration and Veteran homelessness; (2) stress and inflammation, including multiple methods to assess inflammatory markers; and (3) racial health disparities in Veterans. The applicant’s career goal is to become a VA research psychologist, working to improve social integration in homeless Veterans and develop culturally congruent interventions. The training outlined in this CDA application will lay the groundwork for the applicant to develop an independent research program within the VA focused on determinants of social integration in homeless Veterans. The VA RR&D Center on Enhancing Community Integration for Homeless Veterans (THRIVe), VISN 22 Mental Illness Research, Education, and Clinical Center (MIRECC) at the VA Greater Los Angeles Healthcare System (GLA), and the University of California, Los Angeles (UCLA) provide an excellent environment and infrastructure to complete the proposed study. The primary mentor will be Michael F. Green, PhD, the Director of THRIVe, Director of the VISN 22 MIRECC Treatment Unit, and an established researcher in Veteran homelessness. The applicant will also receive specialized training from an expert in research with vulnerable Veterans (Lillian Gelberg, MD, MPH), a leading researcher in inflammation (Steven W. Cole, PhD), and a renowned scholar in racial health disparities in Veterans (Donna L. Washington, MD, MPH). The applicant will also receive statistical consultation from biostatistician, Catherine A. Sugar, Ph.D.