The long-term objective of this research proposal is to elucidate underlying biological and behavioral mechanisms whereby stressful social and physical environments contribute to health disparities between socioeconomic and racial groups. To achieve this objective, the following Specific Aims are proposed:
Aim 1 - To determine whether persons who are caregivers for a spouse with Alzheimer's Disease or other chronic dementia have a more adverse profile of behavioral and biological characteristics than matched controls without caregiving responsibilities.
Aim 2 - To determine whether living in a stressful physical environment (based on neighborhood characteristics) leads to a more adverse profile of biobehavioral characteristics among caregivers than noncaregivers.
Aim 3 - To determine whether the impact of stressful social and/or physical environments on health-damaging biobehavioral characteristics is moderated by the presence of a hostile personality type or genetic polymorphisms that affect CNS serotonin function. In secondary analyses, we shall also evaluate the moderating effect of other potential moderators - e.g., underlying CHD or other medical disorder, race, gender, social support, and socioeconomic status. We shall recruit a sample of 200 caregivers and 200 matched controls without caregiving responsibilities. We shall assess the impact of caregiver status on behavioral (negative affects and health practices) and biological (cardiovascular and neuroendocrine function at rest and during stress, metabolic syndrome) characteristics likely to underlie health disparities. We shall determine the impact of the physical neighborhood environment, both alone and interacting with caregiver status, upon the biobehavioral mechanisms. We shall also evaluate the moderating effects of serotonin-related genetic polymorphisms, hostile personality type and other medical/physical and social characteristics of the subjects upon the impact of caregiving and physical environments on biobehavioral mechanisms. In addition to increasing understanding of biobehavioral mechanisms responsible for health disparities, the findings could point to targets for specific interventions aimed at ameliorating these disparities.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG019605-02
Application #
6372564
Study Section
Special Emphasis Panel (ZES1-JPM-B (HD))
Program Officer
Stahl, Sidney M
Project Start
2000-09-30
Project End
2005-08-31
Budget Start
2001-09-01
Budget End
2002-08-31
Support Year
2
Fiscal Year
2001
Total Cost
$519,737
Indirect Cost
Name
Duke University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
Jiang, Rong; Brummett, Beverly H; Babyak, Michael A et al. (2013) Brain-derived neurotrophic factor (BDNF) Val66Met and adulthood chronic stress interact to affect depressive symptoms. J Psychiatr Res 47:233-9
Brummett, Beverley H; Siegler, Ilene C; Williams, Redford B et al. (2012) Associations of Social Support and 8-Year Follow-Up Depressive Symptoms: Differences in African American and White Caregivers. Clin Gerontol 35:289-302
Brummett, Beverly H; Siegler, Ilene C; Ashley-Koch, Allison et al. (2011) Effects of 5HTTLPR on cardiovascular response to an emotional stressor. Psychosom Med 73:318-22
Siegler, Ilene C; Brummett, Beverly H; Williams, Redford B et al. (2010) Caregiving, residence, race, and depressive symptoms. Aging Ment Health 14:771-8
Kring, Sofia I Iqbal; Brummett, Beverly H; Barefoot, John et al. (2010) Impact of psychological stress on the associations between apolipoprotein E variants and metabolic traits: findings in an American sample of caregivers and controls. Psychosom Med 72:427-33
Bove, Marilisa; Carnevali, Lucio; Cicero, Arrigo F G et al. (2010) Psychosocial factors and metabolic parameters: is there any association in elderly people? The Massa Lombarda Project. Aging Ment Health 14:801-6
Williams, Redford B (2010) Myocardial infarction and risk of suicide: another reason to develop and test ways to reduce distress in postmyocardial-infarction patients? Circulation 122:2356-8
Belsky, J; Jonassaint, C; Pluess, M et al. (2009) Vulnerability genes or plasticity genes? Mol Psychiatry 14:746-54
Brummett, Beverly H; Boyle, Stephen H; Siegler, Ilene C et al. (2008) Effects of environmental stress and gender on associations among symptoms of depression and the serotonin transporter gene linked polymorphic region (5-HTTLPR). Behav Genet 38:34-43
Brummett, Beverly H; Boyle, Stephen H; Siegler, Ilene C et al. (2008) Lipid levels are associated with a regulatory polymorphism of the monoamine oxidase-A gene promoter (MAOA-uVNTR). Med Sci Monit 14:CR57-61

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