Methods

 

 

The Mind Your Heart Study

Methods:

 

 


Overview:

The Mind Your Heart Study is a prospective cohort study of Veterans, with and without Posttraumatic Stress Disorder (PTSD), designed to better understand the impact of PTSD on metabolic and cardiovascular health and outcomes. It has two main aims: 1. to determine whether PTSD is an independent risk factor for subsequent cardiovascular disease and 2. to identify mechanisms responsible for this association.

Inclusion Criteria

All participants needed to be over the age of 18 at the time of recruitment. For the PTSD Cohort, all participants had to have a lifetime and/or current diagnosis of PTSD. For the control group, all participants needed to NOT have a lifetime and/or current diagnosis of PTSD.

Exclusion Criteria

(a) inability to walk one block

(b) acute coronary event within the previous 6 months

(c) planning to move out of the area within the following 3 years

(d) lack of a stable mailing address or contact information

Methods

Participants underwent baseline, in person exams consisting of the measures identified below. Since that time, they have participated in annual interviews. All measures recorded during those follow-up interviews can be found below. A pilot cohort of participants returned during Year 5 for a second, in person exam.

Measures:

BASELINE IN PERSON EXAM

PSYCHOSOCIAL QUESTIONNAIRES
The Medical Outcomes Study (MOS) Short Form (SF-36): Physical Functioning
Brief Trauma Questionnaire (BTQ)
Combat Exposure Scale (CES)
PTSD Checklist (PCL-17)
The Positive Affect Negative Affect Schedule (PANAS)
Depression Assessment for Use in Primary Care (PHQ-9)
Berkman-Syme Social Networks Index (SNI)
Multidimensional Scale of Perceived Social Support (MSPSS)
Hospital Anxiety and Depression Scale (HADS-A)
A Two-Item Measure for Depression Screening
A Social Functioning Item from SF-36
Anger Temperament (T-Anger)
Negative Affectivity, Social Inhibition, and Type D Personality (DS14)
Life Orientation Test (LOT)
Emotion Regulation Questionnaire (ERQ)
Barefoot subset of Cook-Medley Hostility Scale
Full CAPS interview with trauma history, PTSD symptoms for current and lifetime.
CIDI- depression, mania, generalized anxiety disorder, psychosis screen
HEALTH BEHAVIOR QUESTIONNAIRES
Diet- PRIME Screen Dietary Questionnaire
Physical Activity
Smoking
Drinking (AUDIT-C)
Drug
Sleep
NEUROCOGNITIVE QUESTIONNAIRES
Digit Symbol Test
Trailmaking Test A
Trailmaking Test B
Verbal Fluency (L-words and F-words)
Category Fluency (animals and fruits/vegetables)
Hopkins Verbal Learning Test Free Recall and Recognition)
DEMOGRAPHICS/OTHER QUESTIONNAIRES
Age
Sex
Marital Status
Education
Ethnicity
Job/volunteering/satisfaction
Income
Live Alone
Medical Conditions
Medications- Coded in EpoCrates
CARDIAC TESTING
Resting EKG
Exercise Treadmill Test with VO2 max
Resting Echocardiogram
24 Hr. Holter monitor
LABORATORY TESTS
CBC
ESR
Renal Panel (lytes, BUN, Cr, EGFR)
Calcium
Phosphorus
Fasting Glucose
Hemoglobin A1c
Lipid Panel (Total Cholesterol, LDL, HDL, TGs)
Direct LDL
Liver Panel
Fibrinogen
Urinalysis
24-hour urine Epinephrine
24-hour urine Norepinephrine
24-hour urine Dopamine
24-hour urine Cortisol
Urine Microalbumin
Telomeres
Inflammatory biomarkers (CRP, IL-6, -10, -12, 1β)

YEAR 1 PHONE F/U INTERVIEW

Outcomes- Cardiac events, psych/other hosp
PTSD Check List
PTSD Rx (meds, counseling, CAM, other)
Patient Health Questionnaire-9 item
Overall Health
Quality of Life
Physical Activity
SF-36 Physical Functioning
Tobacco (current cig/current other)
Alcohol- AUDIT-C
Illicit Drugs/Prescription drugs

YEAR 2 PHONE F/U INTERVIEW

Outcomes- Cardiac events, psych/other hosp
Military Service History (currently serving, rank, branch, component, job title, MOS, service wars, in theater wars, total years, # warzone deployments, months in warzone)
PTSD Check List
PTSD Rx (meds, counseling, CAM, other)
Patient Health Questionnaire-9 item
Brief Pain Inventory
Insomnia Severity Index
Overall health
Quality of Life
Physical Activity
SF-36 Physical Functioning
Incarceration history
Tobacco (current cig/current other)
Alcohol- AUDIT-C
Detailed Illicit Drug/Prescription Narcotics use history- adapted from the Addiction Severity Index

YEAR 3 PHONE F/U INTERVIEW

Outcomes- Cardiac events, psych/other hosp
PTSD Check List
PTSD Rx (meds, counseling, CAM, other)
Patient Health Questionnaire-9 item
Overall Health
Quality of Life
Physical Activity
SF-36 Physical Functioning
Tobacco (current cig/current other)
Alcohol- AUDIT-C
Illicit Drugs/Prescription drugs
Homelessness
Health Literacy
Traumatic Brain Injury
Sleep Apnea Screening
Medication Inventory (only sleep/psych meds)

YEAR 4 PHONE F/U INTERVIEW

Outcomes- Cardiac events, psych/other hosp
PTSD Check List
PTSD Rx (meds, counseling, CAM, other)
Patient Health Questionnaire-9 item
Overall Health
Quality of Life
Physical Activity
SF-36 Physical Functioning
Tobacco (current cig/current other)
Alcohol- AUDIT-C
Illicit Drugs/Prescription drugs
Medication Inventory (only sleep/psych meds)
Drafted vs. Enlisted in military service

YEAR 5-7 PHONE F/U INTERVIEW

Outcomes- Cardiac events, psych/other hosp
PTSD Check List
PTSD Rx (meds, counseling, CAM, other)
Patient Health Questionnaire-9 item
Overall Health
Quality of Life
Physical Activity
SF-36 Physical Functioning
Tobacco (current cig/current other)
Alcohol- AUDIT-C
Illicit Drugs/Prescription drugs
Medication Inventory (only sleep/psych meds)