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）：本申请是根据 PA-08-167“现有酒精流行病学数据的二次分析”(R01) 提交的。患有创伤后应激障碍 (PTSD) 的女性中酒精使用障碍 (AUD) 的患病率要高得多，而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女性。然而，关于 PTSD 对危险酒精使用和酒精治疗利用过程的影响以及 IPV 在这种关系中可能发挥的作用，仍有大量未解答的问题。此外，人们对种族和民族健康差异如何调节这些复杂关系知之甚少。鉴于纵向研究的缺乏以及与临床研究相关的偏差，全国代表性的纵向流行病学研究对于澄清这些问题至关重要，特别是那些与差异相关的问题。将利用两波全国酒精及相关疾病纵向流行病学调查 (NESARC) 进行前瞻性队列研究。这项研究将利用回顾性和前瞻性数据，涵盖酒精和其他药物使用、精神疾病、创伤经历以及这些事件发生的社会背景。这些丰富数据的使用为实现本研究的具体目标提供了一个独特且具有成本效益的机会：1) 研究 PTSD 对非酒精使用（即暴饮暴食、频繁酗酒和 AUD）的总体影响。 -有 IPV 受害创伤史的西班牙裔白人、西班牙裔/拉丁裔和黑人/非裔美国女性与无 IPV 受害史的女性相比，以及有 IPV 创伤史的女性是否近期感染过 IPV增加 PTSD 对酒精结果的影响； 2) 研究有 IPV 受害创伤史的女性与没有 IPV 受害史的女性相比，PTSD 对饮酒结果影响的种族/民族差异，以及美国出生或文化适应和歧视是否会增加相关的不良饮酒结果的风险患有创伤后应激障碍； 3) 研究种族、IPV 和 PTSD 在酒精治疗利用和感知的未满足的酒精治疗需求中的作用。这项研究的结果有可能：1) 为针对受 IPV 和 PTSD 影响的女性制定二级预防和干预措施以及三级预防措施（包括旨在改善受创伤女性获得酒精治疗的机会）提供信息; 2) 为少数民族制定有效且与文化相关的酒精预防和治疗计划提供信息； 3) 提醒医疗保健提供者和治疗计划注意可能影响少数族裔客户的社会文化因素，从而提供更具文化敏感性和针对性的护理，提高治疗完成率和治疗满意度； 4) 降低与饮酒和服务利用相关的社会成本。 公共卫生相关性：这项研究的结果有可能为二级和三级预防策略提供信息，以降低女性酒精使用障碍的风险并限制这些疾病的严重程度和进展。这项研究的结果还可能有助于说明 AUD 和酒精治疗的种族特定途径，从而为制定与文化相关的酒精预防、干预和治疗计划提供信息。最后，鉴于通过创伤知情服务改善结果的潜力，这些发现的影响可能与受虐待的妇女特别相关。