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.

项目概要/摘要 产前饮酒 (PAU) 与产科并发症（包括早产）的可能性增加有关 分娩、流产和死产，也是胎儿酒精谱系障碍的直接原因 2020 年，导致终生神经行为和颅面异常的神经发育障碍。 疾病控制和预防中心报告称，大约七分之一的孕妇 过去一个月饮酒量与 2011 年以来的增长趋势一致。因此，PAU 是主要的 和日益严重的公共卫生问题，因此有必要了解 PAU 的风险因素以告知 预防和干预 压力是经常承受压力的孕妇的一个关键危险因素。 此外，怀孕前没有经常压力的孕妇酗酒的风险要高出一倍。 饮酒与 PAU 始终相关，这表明了解滥用酒精的病因 怀孕以外的情况对于预防 PAU 至关重要，相应地，压力在酒精中也起着至关重要的作用。 怀孕以外的女性使用障碍（AUD），因为女性在怀孕后更容易复发 与男性相关的压力触发因素可能部分是由性别（SG）差异造成的。 澳元中与处理压力相关的神经回路与压力脆弱性增加有关。 “显着网络”（SN）功能障碍，该网络是大脑区域的集合，主要是岛叶、背侧 前扣带皮层和顶下小叶，对显着的、潜在的压力刺激做出反应， 对药物使用线索（包括酒精）也高度反应。此外，社会支持可以作为一种手段。 抵抗与压力相关的酗酒的复原力因素，特别是对于女性来说，社会支持是否可以以及如何发挥作用。 还可以缓冲 AUD 中大脑呼吸对压力的脆弱性，如果这种效果存在 SG 差异， 此外，压力和社会支持是否同样影响 PAU 尚不清楚。 总体假设是，相对于男性，女性更容易受到与压力相关的酒精滥用的影响 然而，通过增强 SN 反应性，社会支持将对这种关系产生更强的缓冲作用。 该项目的具体目标是 (1A) 评估 SN 在社会角色中的 SG 差异。 AUD 患者的压力反应性与饮酒水平之间的关系，(1B) 评估 SG 差异 社会支持是否通过改变与压力相关的 SN 反应来防止酗酒，以及 (2) 确定产前饮酒的风险和保护因素将提供科学依据。 对女性怀孕期间和怀孕外的 AUD 进行基础治疗，并为我做好准备 作为学术医学领域的医师科学家，取得了成功的职业生涯。