PI: Roger McIntosh, PhD
Primary Mentor: Gail Ironson, PhD
Title: Assistant Professor of Psychology, University of Miami

Study Title: Psychoneuroimmunological Outcomes Associated with a Culturally Adapted Written Emotional Disclosure Intervention in Traumatized Hispanic/Latina Women Living with HIV

Abstract: Individuals with PTSD often recall traumatic experiences with distress (e.g., flashbacks, nightmares); however, reactivation of these traumatic memories is also an opportunity, i.e., a method for intervention. Trauma exposure and risk for posttraumatic stress disorder (PTSD) is especially high for Hispanic women living with Human Immunodeficiency virus (HIV). For Spanish-English bilinguals, matching the language at the time of traumatic memory retrieval with the language of the initial trauma may allow unique access to these events and facilitate the healing process [1, 2]; however, the mechanism is unclear. Individuals with PTSD exhibit neuropsychological (e.g., dysregulated limbic-hypothathalmic-pituitary-adrenal (LHPA) system),neuroendocrine (e.g., glucocorticoid), and inflammatory-immune response. This study seeks to determine the impact of conducting augmented written emotional disclosure (WED) intervention, culturally adapted in the same language as when the trauma was encoded, on the psycho-neuro-immunological response to trauma recall in 36 bilingual Hispanic/Latina women living with HIV. We hypothesize that writing about traumatic experiences in one’s primary language concordant with the trauma, i.e., Spanish-WED, will show positive changes in neuropsychological, neuroendocrine, and inflammatory-immune burden. Women will be randomized to one of three groups: Spanish-WED, English-WED, and wait-list control condition. Individuals assigned to WED will complete 4 weekly 30-min sessions of journaling about their traumatic experience in Spanish or English. Functional magnetic resonance imaging (fMRI), serum and saliva will be collected at baseline and post-intervention. Inside the MRI scanner, brain activity will be measured while women are (a) at rest in a task-free state, (b) performing a verbal learning and memory task, and (c) recalling a of traumatic memory. Serum and saliva will also be obtained to measure gene expression of inflammatory-immune and glucocorticoid function. This study will answer the question of whether culturally adapting a trauma intervention previously shown to be effective in HIV+ women enhances positive changes in functional brain activity(primarily in the medial prefrontal cortex and hippocampus), stress hormone regulation (primarily glucocorticoids) and inflammatory-immune control in traumatized Hispanic/Latina women with the broader goal of enhancing treatment response and long-term disease outcomes.