The role of stress, social support, and brain function on alcohol misuse in women

压力、社会支持和大脑功能对女性酗酒的影响

• 批准号: 10676428
• 负责人: Andrea Maxwell
• 金额: $ 4.22万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-29 至 2027-05-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10676428
• 关键词: Accounting; Affect; Alcohol consumption; Alcohols; Algorithms; Anterior; Brain; Brain region; Buffers; Centers for Disease Control and Prevention (U.S.); Child; Child Care; Child Development; Clinical; Clinical assessments; Collection; Craniofacial Abnormalities; Cues; Data; Decision Trees; Development; Dorsal; Emotional; Etiology; Family; Fetal Alcohol Spectrum Disorder; Functional Magnetic Resonance Imaging; Functional disorder; Gender; Goals; Hydrocortisone; Inferior; Insula of Reil; Intervention; Interview; Knowledge; Link; Lobule; Machine Learning; Measures; Medicine; Mothers; Neurodevelopmental Disorder; Neurosciences Research; Parietal; Participant; Patient Self-Report; Patients; Perinatal; Persons; Physicians; Play; Pregnancy; Pregnant Women; Premature Labor; Prevention; Public Health; Relapse; Reporting; Research; Risk Assessment; Risk Factors; Role; Sampling; Scientist; Signal Transduction; Social support; Spontaneous abortion; Stimulus; Stress; Techniques; Testing; Training; United States; United States National Institutes of Health; Woman; Work; addiction; alcohol abuse therapy; alcohol consumption during pregnancy; alcohol cue; alcohol misuse; alcohol misuse prevention; alcohol use disorder; binge drinking; biobank; career; cingulate cortex; cohort; cost; data-driven model; developmental disease; early alcohol use; gender difference; high risk; large datasets; machine learning method; men; multimodality; neural circuit; neurobehavioral; neuroimaging; novel; obstetrical complication; prenatal risk factor; prepregnancy; prevent; protective factors; recruit; resilience factor; sex; social; stillbirth; stress management; stress reactivity; substance use; trend; young adult

PROJECT SUMMARY/ABSTRACT Prenatal alcohol use (PAU) is associated with increased likelihood of obstetric complications, including preterm labor, miscarriage, and stillbirth, and is also the direct cause of Fetal Alcohol Spectrum Disorders, a collection of neurodevelopmental disorders that cause lifelong neurobehavioral and craniofacial abnormalities. In 2020, the Center for Disease Control and Prevention reported that approximately 1 in 7 pregnant women had consumed alcohol in the past month, which is in line with increasing trends since 2011. Thus, PAU is a major and growing public health problem, so it is imperative to understand the risk factors for PAU to inform prevention and intervention. Stress is one such key risk factor. Pregnant women with frequent stress have a 3- fold higher risk of binge drinking than pregnant women without frequent stress. Furthermore, pre-pregnancy alcohol use is consistently associated with PAU, suggesting that understanding the etiology of alcohol misuse outside of pregnancy is essential for preventing PAU. Correspondingly, stress plays a crucial role in Alcohol Use Disorder (AUD) in women outside of pregnancy, as women are more vulnerable to relapse following stressful triggers relative to men. This vulnerability may in part be driven by sex/gender (SG) differences in neurocircuitry related to processing stress in AUD. Increased stress vulnerability has been linked to dysfunction in the “salience network” (SN), which is a collection of brain regions, primarily the insula, the dorsal anterior cingulate cortex, and inferior parietal lobule, that responds to salient, potentially stressful stimuli and is also highly reactive to substance use cues, including alcohol. Furthermore, social support may serve as a resilience factor against stress-related alcohol misuse, particularly in women. If and how social support can also buffer the brain’s heightened vulnerability to stress in AUD, and if there are SG differences in this effect, remains to be examined. Moreover, whether stress and social support similarly affect PAU is unclear. My overarching hypothesis is that women, relative to men, are more vulnerable to stress-related alcohol misuse via enhanced SN reactivity; however, social support will have a stronger buffering effect on this relationship in women. The specific aims of this project are to (1A) assess SG differences in the role of the SN on the relationship between stress reactivity and alcohol use levels in people with AUD, (1B) assess SG differences in whether social support protects against alcohol misuse by altering stress-related SN reactivity, and (2) determine risk and protective factors for prenatal alcohol use. Achieving these goals will inform scientifically- grounded treatments for AUD in women during and outside of pregnancy, as well as prepare me for a successful career as a physician-scientist in academic medicine.

项目摘要/摘要 产前饮酒（PAU）与产科并发症的可能性增加有关，包括早产 劳动，流产和死产，也是胎儿酒精谱系障碍的直接原因 引起终身神经行为和颅面异常的神经发育障碍。在2020年 疾病控制与预防中心报告说，大约有7个孕妇中有1个 在过去的一个月中，饮酒与2011年以来趋势的增加相符。 以及越来越多的公共卫生问题，因此必须了解PAU通知的风险因素 预防和干预。压力就是这样的关键危险因素。经常压力的孕妇有3- 折叠暴饮暴食的风险比没有频繁压力的孕妇更高。此外，怀孕前 饮酒始终与PAU相关，这表明了解滥用酒精的病因 在怀孕之外，对于预防PAU至关重要。相应地，压力在酒精中起着至关重要的作用 在怀孕以外的妇女中使用障碍（AUD），因为女性更容易接力。 相对于男性，压力很大。这种脆弱性可能部分由性/性别（SG）驱动 与AUD的加工应力有关的神经记录。压力脆弱性增加与 “显着性网络”（SN）的功能障碍，该功能是大脑区域的集合，主要岛，背面 前扣带回皮层和壁叶下叶，对显着，潜在的压力刺激做出反应，IS 还对包括酒精在内的物质提示的高度反应性。此外，社会支持可能是 抵抗与压力有关的酒精滥用的弹性因素，尤其是在女性中。是否以及社会支持如何 还可以缓冲大脑在AUD中压力的脆弱性，如果这种效果存在SG差异， 还有待检查。此外，压力和社会支持是否同样影响PAU尚不清楚。我的 总体假设是，相对于男性，女性更容易受到与压力有关的滥用 通过增强的SN反应性；但是，社会支持将对这种关系具有更强的缓冲作用 女性。该项目的具体目的是（1a）评估SN在SN上的作用的差异 压力反应性和饮酒水平之间有AUD的人的关系，（1B）评估SG的差异 社会支持是否通过改变与压力相关的SN反应性来保护酒精滥用，并且（2） 确定产前饮酒的风险和保护因素。实现这些目标将科学地告知 在怀孕期间和外部为妇女的aud的扎根治疗，并为我做好准备 作为学术医学的身体科学家的成功职业。