Childhood Trauma Exposure, Loneliness, Mental Health, and Stroke Recovery: Findings From The STRONG Study
Abstract Body: E. Alison Holman, FNP, PhD1, Ryan Shahbaba2, Hengrui Cai PhD3, Steven C. Cramer, MD4; for the STRONG Study Investigators
1Sue & Bill Gross School of Nursing & Dept. Psychol Sci, Univ Calif, Irvine; Irvine, CA 2Sage Hill School, Newport Beach, CA 3Dept. of Statistics, Donald Bren School of Information and Computer Sciences, Univ Calif, Irvine; Irvine, CA 4Dept. Neurology, Univ Calif Los Angeles; LA, CA
INTRODUCTION: Childhood trauma exposure (CTE) is a known risk factor for poor adult mental & physical health, higher mortality, and disability. Understanding the psychosocial mechanisms by which CTE affects functional outcomes could help identify intervention targets to improve outcomes after stroke. We examine post-stroke mental health and loneliness as potential mediators of the association between CTE and functional/cognitive disability at 1-year post-stroke. METHODS: Adults with a new stroke enrolled in the STRONG (Stroke, sTress, RehabilitatiON, and Genetics) study at 28 US sites and were assessed 4 times over 1 year. Assessments included CTE, mental health (depression, anxiety, PTSD), and loneliness 90 days post-stroke, and Stroke Impact Scale (SIS), modified Rankin Scale (mRS), & Telephone Montreal Cognitive Assessment (tMoCA) 1-year post-stroke. Analyses examined 90-d mental health and loneliness as mediators of the link between CTE and 1-year outcomes. RESULTS: The 763 enrollees had age 63.1±14.9 years; initial NIHSS score 4 [2-9]; 41.2% Female; 69.4% White. Complete case (N=332) analysis revealed that controlling for age, gender, race, and acute NIHSS score, CTE was not directly associated with any 1-year functional outcome but was significantly associated with loneliness and mental health symptoms 3-months post-stroke. However, greater CTE was indirectly and significantly linked to worse 1-year mRS and SIS scores through 3-mo loneliness, and to worse 1-year mRS, SIS, and tMOCA scores through 3-mo mental health symptoms. CONCLUSIONS: Mental health and loneliness are pathways through which CTE is linked to post-stroke functional outcomes. Addressing mental health symptoms and loneliness early post-stroke may support improved functional outcome 1-year post-stroke in patients who have experienced CTE.
Holman, Alison
( University of California, Irvine
, Irvine
, California
, United States
)
Shahbaba, Ryan
( Sage Hill School
, Newport Beach
, California
, United States
)
Cai, Hengrui
( University of California, Irvine
, Irvine
, California
, United States
)
Poe, Jaeden
( North Carolina A & T
, Greensboro
, North Carolina
, United States
)
Egharevba, Faithful
( Howard University
, Washington DC
, District of Columbia
, United States
)
Cramer, Steven
( UCLA
, Los Angeles
, California
, United States
)
Author Disclosures:
Alison Holman:DO NOT have relevant financial relationships
| Ryan Shahbaba:No Answer
| Hengrui Cai:DO NOT have relevant financial relationships
| Jaeden Poe:No Answer
| Faithful Egharevba:No Answer
| Steven Cramer:DO have relevant financial relationships
;
Consultant:Constant Therapeutics, BrainQ, Myomo, MicroTransponder, Panaxium, Beren Therapeutics, Medtronic, Stream Biomedical, NeuroTrauma Sciences, and TRCare:Active (exists now)
