Matthew Whited, PhD is a clinical psychologist at the University of Massachusetts Medical School. His long- term goal is to elucidate the mechanisms of the association between depression and cardiovascular disease (CVD) and to identify depression treatments that influence both physical and mental long-term health. Depression is strongly and consistently associated with risk for CVD onset, but the influence of depression treatment on CVD onset is poorly understood. This indicates a need to investigate the effects of the various available depression treatments, and to more thoroughly understand the mechanisms of action by which depression treatments could influence CVD risk. The majority of studies that seek to influence CVD through depression treatment are studies of secondary prevention. This proposal will provide Dr. Whited with the training and mentorship needed to develop expertise in both epidemiological and clinical trials approaches that investigate the effects of depression treatments on primary CVD risk (first CVD event). Two studies are proposed to investigate the effects of each of two types of depression treatment (Selective Serotonin Reuptake Inhibitors: SSRIs and Cognitive Behavioral Therapy: CBT) on CVD risk. Autonomic balance (measured by heart rate variability;HRV) is associated with depression, and is also an established risk factor for CVD;autonomic balance will be the main CVD mechanism of interest in these studies. Study 1 of this proposal will help inform clinical recommendations of SSRI treatment by determining if SSRIs differentially influence primary CVD incidence in patients who are at higher or lower risk for CVD according to a predictive risk score (Framingham Risk Score: FRS). Following this, Heart Rate Variability (HRV) will be examined as a mediator of the SSRI and CVD association. Study 2 is a pilot clinical trial that will reduce depressive symptoms via an evidence-based psychotherapy to observe the effect of depression symptom reduction on HRV in the absence of pharmacotherapy. These studies are linked in that they both investigate the effects of depression treatment on autonomic balance by independently focusing on either antidepressant medications or psychotherapy. Dr. Whited's prior research in psychophysiology complements the training plan, which will provide Dr. Whited with additional knowledge in depression, its treatment, cardiovascular physiology, autonomic imbalance, along with the experience and expertise necessary to study primary CVD risk using epidemiological and clinical trials methodology. His long-term program of research will focus on understanding the influence of depression treatment on primary CVD risk and risk factors in order to inform clinical guidelines for depression treatment based on both physiological and psychological assessment and psychological and physiological treatment targets.

Public Health Relevance

Depression is the most common mental illness in the United States and it puts an individual at much higher risk for having a heart attack or stroke. This grant will fund a training program which will allow the Principal Investigator to identify the most appropriate means of treating depression in order to lower risk for having a heart attack or stroke.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23HL109620-01A1
Application #
8384626
Study Section
Special Emphasis Panel (ZHL1-CSR-X (M1))
Program Officer
Ludlam, Shari
Project Start
2012-08-15
Project End
2017-05-31
Budget Start
2012-08-15
Budget End
2013-05-31
Support Year
1
Fiscal Year
2012
Total Cost
$128,452
Indirect Cost
$8,774
Name
East Carolina University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
607579018
City
Greenville
State
NC
Country
United States
Zip Code
27858
Waring, Molly E; Schneider, Kristin L; Appelhans, Bradley M et al. (2016) Interest in a Twitter-delivered weight loss program among women of childbearing age. Transl Behav Med 6:277-84
Schneider, Kristin L; Panza, Emily; Handschin, Barbara et al. (2016) Feasibility of Pairing Behavioral Activation With Exercise for Women With Type 2 Diabetes and Depression: The Get It Study Pilot Randomized Controlled Trial. Behav Ther 47:198-212
Whited, Matthew C; Olendzki, Effie; Ma, Yunsheng et al. (2016) Obstructive sleep apnea and weight loss treatment outcome among adults with metabolic syndrome. Health Psychol 35:1316-1319
Pagoto, Sherry L; Waring, Molly E; Schneider, Kristin L et al. (2015) Twitter-Delivered Behavioral Weight-Loss Interventions: A Pilot Series. JMIR Res Protoc 4:e123
Diaz, Keith M; Veerabhadrappa, Praveen; Brown, Michael D et al. (2015) Prevalence, Determinants, and Clinical Significance of Masked Hypertension in a Population-Based Sample of African Americans: The Jackson Heart Study. Am J Hypertens 28:900-8
Appelhans, Bradley M; Fitzpatrick, Stephanie L; Li, Hong et al. (2014) The home environment and childhood obesity in low-income households: indirect effects via sleep duration and screen time. BMC Public Health 14:1160
Pagoto, Sherry; Schneider, Kristin L; Evans, Martinus et al. (2014) Tweeting it off: characteristics of adults who tweet about a weight loss attempt. J Am Med Inform Assoc 21:1032-7
Whited, Matthew C; Schneider, Kristin L; Appelhans, Bradley M et al. (2014) Severity of depressive symptoms and accuracy of dietary reporting among obese women with major depressive disorder seeking weight loss treatment. PLoS One 9:e90361
Waring, Molly E; Schneider, Kristin L; Appelhans, Bradley M et al. (2014) Early-treatment weight loss predicts 6-month weight loss in women with obesity and depression: implications for stepped care. J Psychosom Res 76:394-9
Appelhans, Bradley M; Bleil, Maria E; Waring, Molly E et al. (2013) Beverages contribute extra calories to meals and daily energy intake in overweight and obese women. Physiol Behav 122:129-33

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