RESUMO
A history of intimate partner violence (IPV) is linked to cardiovascular disorders among women. Static autonomic nervous system (ANS) imbalance may result from chronic stress associated with exposure to IPV. Autonomic nervous system imbalance is associated with an excessive proinflammatory response that may increase the risk for inflammatory diseases, including atherosclerosis. To better understand the process from IPV to poorer health outcomes in women diagnosed with acute coronary syndrome (ACS) we developed and tested a biobehavioral model of the psychological and biological pathway from IPV to chronic illness. We hypothesized that among women hospitalized for ACS, those who reported sexual abuse, with or without physical abuse, would have greater alterations in their serum levels of neuroendocrine markers, proinflammatory cytokines, and cell adhesion molecules and a chemotactic cytokine, at time of hospitalization for ACS, and 3 and 6 months later, than do women with physical abuse only. Participants were 45 women, primarily African American, admitted to a county hospital with a diagnosis of ACS. We evaluated 11 biomarkers and found a moderate group effect size for vascular cell adhesion molecule-1. All others had a small effect size.
Assuntos
Síndrome Coronariana Aguda , Modelos Biológicos , Modelos Psicológicos , Maus-Tratos Conjugais/psicologia , Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/etiologia , Análise de Variância , Doenças do Sistema Nervoso Autônomo/etiologia , Biomarcadores/sangue , Estudos de Casos e Controles , Citocinas/sangue , Desidroepiandrosterona/sangue , Feminino , Promoção da Saúde/organização & administração , Humanos , Hidrocortisona/sangue , Molécula 1 de Adesão Intercelular/sangue , Pessoa de Meia-Idade , Pesquisa em Avaliação de Enfermagem , Prolactina/sangue , Estudos Prospectivos , Maus-Tratos Conjugais/prevenção & controle , Estatísticas não Paramétricas , Transtornos de Estresse Pós-Traumáticos/etiologia , Molécula 1 de Adesão de Célula Vascular/sangue , Saúde da MulherRESUMO
Heart disease, poor mental health, and abuse are epidemic among women worldwide. Our purpose was to identify a group of women with heart disease and explore the relationship between a history of abuse and existing symptoms of depression and post-traumatic stress disorder (PTSD) and analyze the relationships over time. A prospective cohort analysis design with mental health measures repeated at 3 and 6 months postintake was followed. Abused women (n = 25) reported significantly more symptoms of depression (p = .004) and PTSD (p = .003) compared with nonabused women (n = 14). To promote global mental health among women with heart disease, interventions must address a history of abuse.