2000 — 2003 |
Delahanty, Douglas L |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Psychophysiological Predictors of Ptsd @ Kent State University At Kent
DESCRIPTION: This application describes a comprehensive research project designed to systematically and prospectively examine the relationship between peritraumatic psychophysiological responses to traumatic stress and subsequent posttraumatic distress and psychopathology. Previous research has demonstrated altered neuroendocrine levels in posttraumatic stress disorder (PTSD) patients, and researchers have hypothesized that trauma victims who subsequently develop PTSD may differ during their initial responses to the trauma from those victims who do not develop PTSD. This suggests that certain victims may be predisposed to developing PTSD after a traumatic event. However, these hypotheses have not been tested. The proposed research will examine serious motor vehicle accident (MVA) victims during their stay in the hospital, and repeatedly after the accident. Urinary hormone levels and acute-phase posttraumatic psychological responses will be used to test if patients who do and do not develop acute stress disorder (ASD) or PTSD differ in psychophysiological reactivity to the accident. Further, the effects of traumatic stress and PTSD on chronic alterations in neuroendocrine and immune levels will be assessed. Finally, as PTSD is more common in those with a history of psychopathology and/or prior trauma experience, the proposed research will test whether peritraumatic responding to the MVA mediates the relationship between prior trauma history and subsequent PTSD.
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2005 — 2007 |
Delahanty, Douglas L |
R34Activity Code Description: To provide support for the initial development of a clinical trial or research project, including the establishment of the research team; the development of tools for data management and oversight of the research; the development of a trial design or experimental research designs and other essential elements of the study or project, such as the protocol, recruitment strategies, procedure manuals and collection of feasibility data. |
Pilot Intervention For Ptsd, Nonadherence and Hiv Risk @ Kent State University At Kent
DESCRIPTION (provided by applicant): This proposal describes a comprehensive research project designed to prospectively pilot test the efficacy of prolonged exposure (PE) therapy at reducing symptoms of HIV-related posttraumatic stress disorder (PTSD) and increasing adherence to antiretroviral medication regimens in people living with HIV (PLWH). Recent studies examining the efficacy of cognitive behavioral interventions at increasing adherence to medications in PLWH have produced, at best, small effect sizes. Failure to address mental health issues in PLWH has been suggested as one explanation for the relatively small impact of these interventions. Previous research has found that symptoms of PTSD (particularly avoidance symptoms stemming from diagnosis/living with HIV) are positively related to non-adherence. PE has been found to be an effective treatment for PTSD; however, its efficacy at reducing PTSD symptoms in patients meeting criteria due to diagnosis with a life-threatening disease is unknown. Further, the extent to which decreasing symptoms of PTSD results in consequent reductions in non-adherence has not been examined. The proposed research will examine the efficacy of PE therapy at reducing HIV-related PTSD and non-adherence in 70 PLWH (20% female, 50% African-American, 50% Caucasian) with PTSD. Participants will be randomly assigned to either the 6-week, 12-session intervention or a weekly monitoring/wait list control group. Follow-up time points at post treatment and three and six months will consist of interviews and questionnaires designed to measure symptoms of HIV-related PTSD and co-morbid disorders. Further, medication adherence (via self-report and electronic monitoring) will also be measured. The proposed research will directly test the efficacy of PE at reducing symptoms of HIV-related PTSD and co-morbid disorders, and non-adherence, and will provide pilot data and effect sizes for a large-scale randomized, multi-site trial.
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2005 — 2007 |
Delahanty, Douglas L |
R34Activity Code Description: To provide support for the initial development of a clinical trial or research project, including the establishment of the research team; the development of tools for data management and oversight of the research; the development of a trial design or experimental research designs and other essential elements of the study or project, such as the protocol, recruitment strategies, procedure manuals and collection of feasibility data. |
Prevention of Ptsd With Early Cortisol Treatment @ Kent State University At Kent
DESCRIPTION (provided by applicant): This application describes a comprehensive research project designed to prospectively examine the efficacy of cortisol treatment, initiated within twelve hours of a traumatic event, at preventing the subsequent development of PTSD symptoms in hospitalized trauma victims. Previous research has found that trauma victims who develop PTSD excrete lower levels of urinary cortisol in the immediate aftermath of the trauma than victims who do not develop PTSD. In addition, theoretical and empirical research in both animal and human samples has suggested mechanisms through which altered cortisol levels can affect memory formation. Low levels of cortisol may lead to aberrant memory formation and "overconsolidated" memories. These memories may then manifest themselves in the intrusive thoughts and hyperarousal symptoms characteristic of PTSD. Increasing levels of cortisol during and following emotionally-arousing events may protect against the development of PTSD. Recent pre-clinical research has found that sepsis and cardiac surgery patients who have cortisol levels elevated through the administration of hydrocortisone have a lower incidence of PTSD than patients who do not receive hydrocortisone. This suggests that exogenously administering hydrocortisone may prevent or buffer the development of PTSD symptoms in trauma victims. However, this hypothesis has not been tested in a randomized, double-blind, controlled trial of heterogeneous trauma victims. The proposed research will examine 52 trauma victims who require admission to a local Level 1 trauma center. Participants will be randomly assigned to a 10-day medication regimen (plus taper) consisting of either cortisol or placebo. Follow-up time points at one and three months will consist of interviews and questionnaires designed to measure symptoms of PTSD and comorbid disorders. Further, urinary cortisol levels will be measured to examine the effects of early cortisol treatment on basal hormone levels. The proposed research will directly test the efficacy of early cortisol treatment at preventing symptoms of PTSD and comorbid disorders and will provide pilot data and estimates of effect sizes for a large-scale randomized, double-blind trial.
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2018 |
Delahanty, Douglas L |
R15Activity Code Description: Supports small-scale research projects at educational institutions that provide baccalaureate or advanced degrees for a significant number of the Nation’s research scientists but that have not been major recipients of NIH support. The goals of the program are to (1) support meritorious research, (2) expose students to research, and (3) strengthen the research environment of the institution. Awards provide limited Direct Costs, plus applicable F&A costs, for periods not to exceed 36 months. This activity code uses multi-year funding authority; however, OER approval is NOT needed prior to an IC using this activity code. |
Emotion Processing Deficits and Risk For Impairment in Child Injury Victims
Project Summary This R15 application seeks to determine better ways of identifying child traumatic injury victims at risk for post-traumatic stress pathology (PTS) and poor functioning/quality of life (QOL) following a traumatic event. Posttraumatic stress disorder (PTSD) researchers have identified a number of risk factors for the development of PTSD; however, together these risk factors account for a relatively small percentage of the variance in subsequent PTSD symptoms. The present study tackles this issue from two directions. First, although threat sensitivity (TS) and inhibitory control (IC) have been found to independently predict PTS, growing evidence supports a model whereby risk associated with high TS may be mitigated by high IC. In contrast, high TS paired with lower levels of IC control may be a uniquely strong predictor/correlate of psychopathology onset, functional limitations, and decreased QOL. Thus, we will examine the extent to which the interaction of these two key interdependent trans-diagnostic mechanisms (TS * IC) predicts persistent post-traumatic negative sequelae. Further, the present proposal also argues that a focus on a single diagnostic outcome (PTSD) may be another reason for our poor identification of at-risk child trauma victims. Instead of attempting to improve the prediction of a single disorder with extremely heterogeneous symptom presentation, the present proposal focuses on the extent to which the interaction TS * IC predicts child PTS (PTSD, depression, anxiety) and functioning (quality of life, functional impairment). An additional variable that must be taken into account in child trauma studies is the influence of family factors on a child's recovery. Prospective examination of the dynamic relationship between a child victim's responses to a traumatic injury and family factors within the home environment (specifically parental TS/IC, parent-child conflict, and positive parenting behaviors) will allow for examination of the development of child symptoms over time as well as the determination of mechanisms through which parent and child post-event symptoms interact to impact child functioning/QOL. We will recruit 400 child traumatic injury patients and their parents/guardians (efforts to target male parents/guardians are detailed). Participants will be recruited in-hospital, and follow-up assessments will occur 1-, 3-, and 6-months later. By focusing on a dimensional perspective to understanding risk for PTS, poor functional outcomes, and decreased QOL in child traumatic injury victims, the present study aims to explore a model designed to improve the early identification of individuals likely to suffer from post-traumatic sequelae who would benefit from targeted intervention approaches, as well as to inform the appropriate matching of therapeutic approaches.
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