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; 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.

项目摘要 意义：黑人饮酒者即使在同等水平上也比白人饮酒者更多的酒精问题 饮酒。这些问题普遍存在，发生在身体，社会和法律结果之间。这 解释为什么黑人饮酒者遇到酒精问题风险较高的原因是 研究且不理解，但可能涉及压力水平和对 酒精。拟议的R01检查了实验室和自然中的这些结构 使用生态瞬时评估（EMA）来确定两者的近端干预点 黑白饮酒者。目的：AIM 1将检查酒精对抗焦虑作用的种族差异 在实验室的压力诱导之后。 AIM 2将直接测试是否在实验室中测量差异性酒精反应 加强压力与酒精认知之间的关联（渴望酒精，饮酒动机）和 这些认知中的种族差异。 AIM 3将检查基于实验室的酒精的程度 通过12个月的随访，应对压力的反应和日常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 与白人饮酒者相比，酒精以及对酒精以及升高压力的敏感性将预测 EMA中有风险的酒精认知增加。另外，压力与酒精认知之间的关联 对于对酒精的抗焦虑作用敏感的参与者，将会更强大。 Ema酒精 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个月的随访中。这些过程及其交易将 部分解释了为什么黑人饮酒者相对于白人饮酒者会遇到更多的酒精问题。 方法：年轻的成年饮酒者（N = 280; 21-30岁； 50％黑色，50％女性）将从 社区。参与者将首先完成半结构化诊断面试和问卷调查，并 然后，将完成两个具有标准压力的实验室会议（安慰剂和酒精；随机秩序） 评估急性酒精反应的任务。接下来，参与者将完成17天的EMA协议以记录 压力，酒精认知，酒精反应，酒精使用/问题的波动。允许预测 将在6个月和12个月进行预期结果随访评估，并将包括过去6个 一个月自我报告的酒精使用，酒精问题，压力和酒精认知以及90天的时间表 跟随后卫采访。该R01提案直接符合NIAAA的战略优先事项 压力在与酒精问题有关并减少健康差异方面的作用。拟议的研究 迈出关键的一步，以增加我们对黑人饮酒者为何饮酒风险更大的理解 问题，最终将为干预工作提供量身定制的干预工作，这些工作是根据研究不足的，处于危险的人群中量身定制的。