Examining the Impact of Stress on the Emotionally Reinforcing Properties of Alcohol in Heavy Social Drinkers: A Multimodal Investigation Integrating Laboratory and Ambulatory Methods

长期以来，酒精在面对压力时改善情绪的能力是其最珍贵的强化特性之一， 研究人员认为，这对了解酒精使用障碍（AUD）的病因至关重要。 绝大多数饮酒者都报告说，他们从酒精中获得的情绪增强效果在 压力的背景下，和个人谁报告更高水平的压力缓解酒精是在发展的风险 澳元。但是，试图利用实验方法来捕捉酒精强化的这一关键因素， 产生了惊人的不一致结果。这项先前实验研究的一个显著特征是， 试图捕捉酒精的缓解压力的效果，研究人员已经远远超出了范围， 压力源通常在典型的饮酒环境中遇到，这些环境在本质上是压倒性的社会环境。 在拟议的研究中，我们使用一种新的方法重新审视这些关键问题， 人们实际上喝了酒，以确定能够捕获酒精缓解压力的操作。更 具体来说，我们探讨了两个最基本的社会压力-缺乏社会熟悉和贫穷 关系质量-作为酒精强化的调节剂。我们研究酒精是否更能强化 在不熟悉与熟悉的社会互动的背景下，以及酒精是否更能加强 在低质量与高质量社会关系的背景下。在以下背景下捕捉酒精的影响 自然的社会话语提出了巨大的方法论挑战，我们带来了多种方法来承担 我们的问题，结合实验和流动的方法， 情绪和酒精消耗的测量。我们检查我们的研究目标，在一个样本的个人与 对于理解AUD病因学的高度相关性-年轻的重度社交饮酒者。在实验室的手臂， 在这项研究中，360名受试者将被随机分配到中等剂量的酒精或对照组。 在熟悉或不熟悉的人的公司饮料。在这些人中，180人还将 参加为期21天的门诊评估，以检查酒精和社会压力的相互作用， 日常生活在门诊研究组中，参与者将佩戴经皮踝环以评估BAC （在实验室会议中为每个人校准），并将进一步提供有关其 情绪和他们的社会背景对随机提示的反应。面部动作编码系统 一个全面的，基于解剖学的面部肌肉运动分类系统，将被用来 评估实验室和门诊两组研究对象的情绪。这项研究有助于 通过解决酒精文献中最基本的问题之一来理解AUD- 问人们为什么喝酒。此外，通过观察“真实的生活”来识别压力源， 可能对AUD病因学和干预措施产生各种关键影响，包括减少危害， 预防计划，降低复发率，以及确定那些有AUD风险的人。

Alcohol’s ability to improve mood in the face of stress is among its most prized reinforcing properties, long held by researchers to be of critical importance for the understanding of the etiology of alcohol use disorder (AUD). Drinkers overwhelmingly report that the mood-enhancement they gain from alcohol is most pronounced in the context of stress, and individuals who report higher levels of stress relief from alcohol are at risk for developing AUD. But attempts to capture this key element of alcohol reinforcement using experimental methods have yielded strikingly inconsistent results. One remarkable feature of this prior experimental research is that, in attempting to capture alcohol’s stress-relieving effects, researchers have strayed far outside the range of stressors typically encountered in typical drinking contexts, contexts that are overwhelmingly social in nature. In the proposed study, we revisit these critical questions using a novel approach, looking to the settings in which people actually drink alcohol to identify manipulations capable of capturing alcohol stress-relief. More specifically, we explore two of the most fundamental social stressors—lack of social familiarity and poor relationship quality—as moderators of alcohol reinforcement. We examine whether alcohol is more reinforcing within the context of unfamiliar vs. familiar social interaction and, further, whether alcohol is more reinforcing within the context of low vs. high quality social relationships. Capturing alcohol’s effects within the context of natural social discourse presents formidable methodological challenges, and we bring multiple methods to bear on our questions, combining experimental and ambulatory methods and employing state-of-the-science measures of emotion and alcohol consumption. We examine our study aims in a sample of individuals with high relevance for the understanding of AUD etiology—young heavy social drinkers. In the laboratory arm of the study, 360 individuals will be randomly assigned to consume either a moderate dose of alcohol or a control beverage in the company of either familiar or unfamiliar individuals. Of these individuals, 180 will also participate in a 21-day ambulatory assessment period to examine the interaction of alcohol and social stress in daily life. In the ambulatory study arm, participants will wear transdermal ankle bracelets to assess BAC (calibrated for each individual within the laboratory session) and will further provide information about their mood and their social contexts in response to random prompts. The Facial Action Coding System, a comprehensive, anatomically-based system for categorizing facial muscle movement, will be employed to assess emotion in both laboratory and ambulatory arms of the study. The proposed research contributes to the understanding of AUD by addressing one of the most fundamental questions in the alcohol literature—the question of why people drink. In addition, by looking to “real life” to identify stressors, the proposed study might have a variety of key implications for AUD etiology and interventions, including for harm-reduction and prevention programs, reducing rates of relapse, and the identification of those at risk for AUD.