Trauma exposure and cardiometabolic health

Young people exposed to trauma are vulnerable to a range of adverse mental health outcomes. Increasing evidence links trauma exposure and associated mental health problems to increased risk of cardiovascular disease (CVD).
However, there are important limitations to our knowledge in this area. First, most existing research has taken a disorder specific approach (i.e. studied PTSD, psychosis, depression separately), whereas available evidence shows that traumatic stress underlies a range of mental health difficulties, suggesting that a transdiagnostic approach is appropriate. Second, many existing studies are limited by sample size and retrospective reporting of the traumatic event. Third, we have limited understanding of the factors mediating associations between trauma related psychopathology and CVD. For example, trauma related symptoms of depression may lead to physical inactivity, which in turn increases CVD risk. In addition, inflammation, autonomic nervous system reactivity, endothelial dysfunction, and oxidative stress are all putative biological mechanisms.
This project will straddle psychology and epidemiology, including epigenetics, working at the interface between mental and physical health. The project will comprise include analysis of longitudinal cohort data, primarily ALSPAC (http://www.bristol.ac.uk/alspac/) but also UK Biobank (currently collecting data on trauma), the Danish National Birth Cohort, HUNT, and Drakenstein Child Health Study, a South African cohort with a 70% prevalence of lifetime trauma.
The project will include the following elements: 1. Derive transdiagnostic profiles of longitudinal mental health symptoms that are associated with trauma exposure. 2. Examine associations between the resultant profiles and measures of cardiometabolic health. 3. Investigate potential underlying mechanisms - both behavioural and biological - e.g. smoking, HPA axis activation, epigentics.
The proposed project is an emergent research area with potential for clinical impact, as individuals exposed to trauma are disproportionately represented in health, social care and criminal justice services. Findings will be disseminated via both academic and clinical/service related networks. I will capitalise on relevant PPI groups established via GW4 funding.