Physiological Stress Reactivity as a Determinant in Co-occurring Alcohol Use and Anxiety Disorder: Diagnosis and Alcohol Use Outcomes

生理应激反应作为同时发生的酒精使用和焦虑症的决定因素：诊断和酒精使用结果

基本信息

批准号：
10153593
负责人：
JUSTIN Jack ANKER
金额：
$ 14.09万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-05-05 至 2023-02-12
项目状态：
已结题

项目摘要

Training: This application for a Mentored Research Scientist Development Award will assure the candidate's development as an independent clinical investigator in the field of alcohol use disorder and comorbidity research. It will provide support to accomplish the following training objectives establishing expertise in: 1) psychophysiological assessment of stress in alcohol use (AUD) and anxiety (AnxD) disorders, 2) clinical research in the field of alcohol abuse research, 3) advanced statistical methods, and 4) responsible conduct of research. The proposed training combined with strong dedicated mentors will assure success. Research Plan: Comorbid AUD+AnxD is a significant barrier to successful AUD treatment. Converging evidence implicates overlap in dysregulation of systems governing stress response (HPA, ANS, CNS) for symptom development in AUD and AnxD. However, this must be systematically demonstrated in comorbid AUD+AnxD. The overall objective is identification and prospective assessment of stress system function of AUD inpatients with and without comorbid AnxD. Central Hypothesis: Co-occurring AnxD exerts an additive effect on severity and persistence of stress system dysregulation that promotes relapse in AUD and is mitigated by AnxD-CBT. Specific Aims: Evaluate the effect(s) of: 1) co-occurring AnxD on severity of biological stress system parameters in AUD inpatients at pre-treatment; 2) co-occurring AnxD on persistence of stress system dysregulations in AUD inpatients immediately after treatment (post-treatment) and 1 month later (early abstinence); 3) AnxD-CBT treatment on biological stress system re-regulation among AUD patients with co- occurring AnxD; and 4) re-regulation change in biological stress system responding on 4-month AUD clinical outcomes. Innovation includes: a) comparing AUD inpatients with and without co-occurring AnxD to healthy controls to identify the impact of AnxD comorbidity on HPA-ANS-CNS stress system dysregulation; b) identifying severity and persistence of stress system dysregulation as a biomarker of AUD recovery in comorbid AUD+AnxD; c) employing multiple assessment time points, and d) determining if AnxD-CBT treatment normalizes perturbed stress systems while re-regulation during post-treatment abstinence predicts treatment outcomes 4 months later. The proposed research is significant because: a) identification of additive stress system dysregulation in AUD+AnxD vs. AUD alone will provide an integrated, biological systems approach to supplement descriptive symptom-based diagnoses of comorbid AUD+AnxD and b) validating that stress system re-regulation in comorbid AUD+AnxD is modulated by AUD treatment and predicts AUD recovery will facilitate intervention development. Summary: Together, the foregoing activities will permit the candidate to establish a career as an independent scientist who is well equipped to obtain research funding, collaborate with colleagues in bidirectional translational research, and contribute to making significant advances in the field.

培训：申请指导研究科学家发展奖将确保候选人发展成为酒精使用障碍和合并症领域的独立临床研究者它将为实现以下培训目标提供支持，建立以下方面的专业知识：1) 酒精使用 (AUD) 和焦虑 (AnxD) 疾病压力的心理生理学评估，2) 临床酒精滥用研究领域的研究，3) 先进的统计方法，以及 4) 负责任的行为拟议的培训与强大的敬业导师相结合将确保研究计划的成功：合并症 AUD+AnxD 是 AUD 治疗成功的重大障碍。应激反应控制系统（HPA、ANS、CNS）的失调重叠导致症状的发展然而，AUD 和 AnxD 必须在共病 AUD+AnxD 中系统地证明。目的是识别和前瞻性评估 AUD 住院患者的压力系统功能没有共病 AnxD 中心假设：同时发生的 AnxD 对严重程度和影响产生累加效应。压力系统失调的持续存在会促进 AUD 复发，AnxD-CBT 可以缓解这种情况。具体目标：评估以下因素的影响：1）同时发生的 AnxD 对生物应激系统严重程度的影响 AUD 住院患者治疗前的参数；2）同时发生的 AnxD 对压力系统持续性的影响 AUD 住院患者在治疗后立即（治疗后）和 1 个月后（早期）的失调 3) AnxD-CBT 治疗对 AUD 患者生物应激系统重新调节的影响 4) 生物应激系统对4个月AUD临床反应的重新调节变化创新包括：a) 将患有或不患有 AnxD 的患者与健康患者的 AUD 进行比较。确定 AnxD 合并症对 HPA-ANS-CNS 应激系统失调的影响的控制措施 b) 确定压力系统失调的严重性和持续性作为 AUD 恢复的生物标志物共病 AUD+AnxD；c) 采用多个评估时间点，以及 d) 确定是否 AnxD-CBT 治疗使受干扰的压力系统正常化，同时在治疗后禁欲期间重新调节预测 4 个月后的治疗结果拟议的研究具有重要意义，因为：a) 添加剂的鉴定。 AUD+AnxD 与单独使用 AUD 相比，压力系统失调将提供一个集成的生物系统补充 AUD+AnxD 共病的基于描述性症状的诊断的方法和 b) 验证共病 AUD+AnxD 中的应激系统重新调节由 AUD 治疗调节并预测 AUD 恢复将促进干预措施的发展。候选人以独立科学家的身份建立职业生涯，并有能力获得研究经费，与双向转化研究的同事合作，并为取得重大成果做出贡献该领域的进展。