Racial and Ethnic Disparities in Partner Violence, PTSD and Alcohol Outcomes

伴侣暴力、创伤后应激障碍和酒精后果中的种族和民族差异

• 批准号: 7983996
• 负责人: SHERRY LIPSKY
• 金额: $ 25.94万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7983996
• 关键词: Acculturation; Address; Affect; African American; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Battered Women; Behavioral Model; Caring; Client; Clinical; Clinical Research; Cohort Studies; Complex; Cross-Sectional Studies; Data; Development; Discrimination; Disease; Drug usage; Epidemiologic Studies; Epidemiology; Ethnic Origin; Event; Finches; General Population; Goals; Grant; Health Personnel; Heavy Drinking; Hispanics; Improve Access; Individual; Jordan; Knowledge; Latina; Latino; Lead; Literature; Longitudinal Studies; Mental disorders; Not Hispanic or Latino; Outcome; Pathway interactions; Play; Post-Traumatic Stress Disorders; Prevalence; Prevention strategy; Preventive Intervention; Probability; Race; Recording of previous events; Relative (related person); Risk; Role; Secondary Prevention; Services; Severities; Social Environment; Substance Use Disorder; Substance abuse problem; Surveys; Symptoms; Time; Trauma; United States; United States Dept. of Health and Human Services; Victimization; Violence; Vulnerable Populations; Woman; Work; alcohol abuse therapy; alcohol and other drug; alcohol availability; alcohol epidemiology; alcohol misuse; alcohol prevention; alcohol related problem; alcohol use disorder; binge drinking; cost; ethnic minority population; experience; health disparity; improved; intimate partner violence; partner violence; prospective; public health relevance; racial and ethnic; racial and ethnic disparities; response; satisfaction; service utilization; social; tertiary prevention; treatment program

DESCRIPTION (provided by applicant): This application is submitted in response to PA-08-167, Secondary Analysis of Existing Alcohol Epidemiology Data (R01). The prevalence of alcohol use disorders (AUD) is substantially greater among women with posttraumatic stress disorder (PTSD), and the prevalence of PTSD among women who have experienced intimate partner violence (IPV) exceeds that of women in the general population. Substantial unanswered questions remain, however, regarding the effect of PTSD on the course of hazardous alcohol use and alcohol treatment utilization and the role IPV may play in that relationship. Further, even less is known about how racial and ethnic health disparities might moderate these complex relationships. Nationally representative longitudinal epidemiologic studies are essential to clarify these questions, particularly those related to disparities, given the dearth of longitudinal studies and the biases associated with clinical studies. A prospective cohort study will be conducted using two waves of the longitudinal National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). This study will draw on both retrospective and prospective data covering alcohol and other drug use, psychiatric disorders, traumatic experiences, and the social context in which these events occur. The use of these rich data provides a unique and cost-effective opportunity to address the Specific Aims of this study: 1) To examine the overall effect of PTSD on subsequent alcohol use (i.e. binge drinking, frequent heavy drinking, and AUD) among non-Hispanic White, Hispanic/Latina, and Black/African American women with a traumatic history of IPV victimization relative to women without such a history, and whether recency of IPV among women with a traumatic history of IPV increases the effect of PTSD on alcohol outcomes; 2) To examine racial/ethnic disparities in the effect of PTSD on alcohol use outcomes among women with a traumatic history of IPV victimization relative to women without such a history, and whether U.S. nativity or acculturation and discrimination increase the risk of poor alcohol outcomes associated with PTSD; and 3) To examine the role of ethnicity, IPV and PTSD in alcohol treatment utilization and perceived unmet need for alcohol treatment. The findings derived from this study have the potential to: 1) inform the development of secondary prevention and intervention efforts targeting IPV and PTSD-affected women as well as tertiary prevention efforts, including those aimed at improving access to alcohol treatment for trauma-affected women; 2) inform the development of effective and culturally relevant alcohol prevention and treatment programs for ethnic minorities; 3) alert health care providers and treatment programs to the socio-cultural factors that may affect ethnic minority clients, resulting in more culturally sensitive and specific care, increased treatment completion, and satisfaction with treatment; and 4) reduce the social costs related to alcohol use and service utilization. PUBLIC HEALTH RELEVANCE: The findings derived from this study have the potential to inform secondary and tertiary prevention strategies to reduce the risk of alcohol use disorders among women and limit the severity and progression of those disorders. The results of this study also may serve to illustrate ethnic-specific pathways to AUD and alcohol treatment, and thus inform the development of culturally relevant alcohol prevention, intervention, and treatment programs. Finally, the implications of these findings may be particularly relevant for abused women, given the potential to improve outcomes through trauma-informed services.

描述（由申请人提供）：该申请是针对PA-08-167，现有酒精流行病学数据（R01）的次要分析而提交的。在创伤后应激障碍（PTSD）的女性中，酒精使用障碍的患病率要大得多，并且经历过亲密伴侣暴力（IPV）的女性中PTSD的患病率超过了一般人群中的妇女。然而，关于PTSD对危险饮酒和酒精治疗利用的影响以及IPV在这种关系中的作用，仍然存在重大的未解决问题。此外，关于种族和种族健康差异如何减轻这些复杂关系的知识甚至更少。全国代表性的纵向流行病学研究对于阐明这些问题，尤其是与差异有关的问题至关重要，鉴于纵向研究的匮乏以及与临床研究相关的偏见。一项前瞻性队列研究将使用两次纵向国家饮酒和相关条件的流行病学调查（NESARC）进行。这项研究将借鉴涵盖酒精和其他药物使用，精神疾病，创伤经历以及发生这些事件的社会背景的回顾性和前瞻性数据。这些丰富的数据的使用提供了一个独特且具有成本效益的机会来解决本研究的具体目标：研究PTSD对非西班牙裔白人，西班牙裔/拉丁裔，黑人/非裔非裔美国妇女的饮酒（即暴饮暴食，频繁饮酒，频繁饮酒和AUD）随后的饮酒（即暴饮暴食，频繁饮酒和AUD）的总体影响，而妇女的妇女与妇女的相对历史相对较高，这些历史是否具有跨性别的历史，这些历史是否具有涉及妇女的历史，这些历史是否相对，涉及一名妇女的历史，这些历史是否存在，这些历史是否存在，以及与妇女相对的历史。 IPV增加了PTSD对酒精预后的影响； 2）检查PTSD对具有IPV受害史的妇女饮酒史的影响，相对于没有这种病史的妇女，以及美国的耶稣诞生或培养和歧视是否会增加与PTSD相关的酒精贫困结果的风险； 3）检查种族，IPV和PTSD在酒精治疗利用中的作用以及对酒精治疗的未满足需求。从这项研究中得出的发现有可能：1）告知针对IPV和受PTSD影响妇女的二级预防和干预工作的发展以及第三级预防工作，包括那些旨在改善受创伤受创伤妇女获得酒精治疗的人； 2）告知为少数民族的有效和文化相关的预防饮酒和治疗计划的发展； 3）向可能影响少数民族客户的社会文化因素发出警告，并向社会文化因素发出警报，从而更有文化敏感和特定的护理，增加的治疗完成以及对治疗的满意度； 4）降低与饮酒和服务利用有关的社会成本。 公共卫生相关性：从这项研究中得出的发现有可能为二级和第三级预防策略提供信息，以减少妇女中饮酒障碍的风险，并限制这些疾病的严重性和进展。这项研究的结果还可以说明aut和酒精治疗的民族特异性途径，从而为与文化相关的预防酒精，干预和治疗计划的发展提供了信息。最后，鉴于有可能通过创伤性的服务改善结果，这些发现的含义可能与受虐待的妇女特别相关。