Understanding differences in risk for alcohol problems between Black and White drinkers: Integrating alcohol response, stress, and drinking motives

了解黑人和白人饮酒者之间酒精问题风险的差异：整合酒精反应、压力和饮酒动机

• 批准号: 10362578
• 负责人: Sarah L Pedersen
• 金额: $ 52.24万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-03-05 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10362578
• 关键词: Acute; Address; Age-Years; Alcohol abuse; Alcohol consumption; Alcohols; Anti-Anxiety Agents; Area; Back; Beverages; Black race; Cognition; Cognitive Therapy; Communities; Data; Diagnostic; Ecological momentary assessment; Environment; Female; Individual; Individual Differences; Intervention; Interview; Laboratories; Lead; Legal; Life Stress; Measurement; Measures; Mediating; National Institute on Alcohol Abuse and Alcoholism; Outcome; Participant; Pathway interactions; Patient Self-Report; Physiological; Placebos; Population; Process; Protocols documentation; Public Health; Questionnaires; Randomized; Reduce health disparities; Reporting; Research; Risk; Risk Factors; Role; Sampling; Standardization; Stress; Structure; Subgroup; Testing; TimeLine; Transact; Visit; alcohol craving; alcohol effect; alcohol measurement; alcohol related problem; alcohol response; alcohol risk; alcohol sensitivity; base; coping; craving; drinking; drinking behavior; experience; follow up assessment; follow-up; health disparity; indexing; negative mood; prospective; racial difference; racial disparity; recruit; response; sex; social; targeted treatment; young adult

Project Summary Significance: Black drinkers experience more alcohol problems than White drinkers even at equivalent levels of alcohol use. These problems are pervasive, occurring across physical, social, and legal outcomes. The reasons that explain why Black drinkers are at elevated risk for experiencing alcohol problems are understudied and not well understood, but may involve differences in level of stress and acute response to alcohol. The proposed R01 examines these constructs both within the laboratory and in the natural environment using ecological momentary assessment (EMA) to identify proximal points of intervention for both Black and White drinkers. Aims: Aim 1 will examine racial differences in the anxiolytic effects of alcohol prior to and after a stress induction in the lab. Aim 2 will directly test if differential alcohol response measured in the lab strengthens the association between stress and alcohol cognitions (craving for alcohol, drinking motives), and accounts for racial differences in these cognitions. Aim 3 will examine the extent to which lab-based alcohol response and daily reports of stress explain racial differences in alcohol problems through 12-month follow-up. Hypotheses: We hypothesize that Black drinkers will have increased sensitivity to the anxiolytic effects of alcohol compared to White drinkers and that this sensitivity to alcohol as well as elevated stress will predict increased risky alcohol cognitions in EMA. Additionally, the association between stress and alcohol cognitions will be stronger for participants with the most sensitivity to the anxiolytic effects of alcohol. EMA alcohol cognitions will partially account for the association between alcohol response, stress, and alcohol problems during the EMA period and at the 6- and 12- month follow-ups. These processes and their transaction will partially account for why Black drinkers, relative to White drinkers, experience more alcohol problems. Approach: Young adult drinkers (N = 280; 21-30 years of age; 50% Black, 50% female) will be recruited from the community. Participants will first complete a semi-structured diagnostic interview and questionnaires and will then complete two laboratory sessions (placebo and alcohol; randomized order) with a standardized stress task to assess acute alcohol response. Next, participants will complete a 17-day EMA protocol to record fluctuations in stress, alcohol cognitions, alcohol response, alcohol use/problems. To allow for the prediction of prospective outcomes follow-up assessments at 6- and 12- months will be conducted and will include past 6 month self-reported alcohol use, alcohol problems, stress, and alcohol cognitions, as well as a 90-day timeline follow-back interview. This R01 proposal is directly in line with the NIAAA's strategic priorities to understand the role of stress in relation to alcohol problems and to decrease health disparities. The proposed research takes a critical step towards increasing our understanding of why Black drinkers are at greater risk for alcohol problems and will ultimately inform intervention efforts that are tailored to this under-studied, at-risk, population.

项目概要 意义：即使在同等水平下，黑人饮酒者比白人饮酒者经历更多的酒精问题 酒精的使用。这些问题普遍存在，涉及身体、社会和法律后果。这 解释为什么黑人饮酒者出现酒精问题的风险较高的原因是 尚未得到充分研究和充分理解，但可能涉及压力水平和对事件的急性反应的差异 酒精。拟议的 R01 在实验室和自然环境中检查这些结构 使用生态瞬时评估（EMA）来确定环境的近端干预点 黑人和白人饮酒者。目标：目标 1 将在酒精抗焦虑作用之前检查种族差异。 在实验室进行压力诱导后。目标 2 将直接测试是否在实验室中测量了差异酒精反应 加强压力和酒精认知之间的联系（对酒精的渴望、饮酒动机），以及 解释了这些认知中的种族差异。目标 3 将检查实验室酒精的程度 通过 12 个月的随访，反应和每日压力报告解释了酒精问题的种族差异。 假设：我们假设黑人饮酒者对以下物质的抗焦虑作用更加敏感： 与白人饮酒者相比，这种对酒精的敏感性以及压力的增加将预测 EMA 中的危险酒精认知增加。此外，压力与酒精认知之间的关联 对于对酒精的抗焦虑作用最敏感的参与者来说，这种效应会更强。 EMA醇 认知将部分解释酒精反应、压力和酒精问题之间的关联 在 EMA 期间以及 6 个月和 12 个月的后续行动中。这些流程及其交易将 部分解释了为什么黑人饮酒者相对于白人饮酒者会经历更多的酒精问题。 方法：将从以下人群中招募年轻成年饮酒者（N = 280；21-30 岁；50% 黑人，50% 女性） 社区。参与者将首先完成半结构化诊断访谈和问卷调查 然后将在标准化压力下完成两个实验室课程（安慰剂和酒精；随机顺序） 评估急性酒精反应的任务。接下来，参与者将完成为期 17 天的 EMA 协议来记录 压力、酒精认知、酒精反应、酒精使用/问题的波动。为了允许预测 将进行 6 个月和 12 个月的预期结果后续评估，其中包括过去 6 个月的结果 每月自我报告的饮酒情况、酒精问题、压力和酒精认知，以及 90 天的时间表 后续采访。该 R01 提案直接符合 NIAAA 的战略重点，需要了解 压力与酒精问题和减少健康差异的作用。拟议的研究 朝着加深我们对黑人饮酒者饮酒风险更大的理解迈出了关键一步 问题，并最终为针对这一研究不足的高危人群量身定制的干预措施提供信息。