Synergistic Effects of Anxiety and Alcohol Use among Latinos and its Sociocultural Mechanisms

摘要 这是一个指导病人为导向的研究职业发展奖（K23）的应用程序，以支持 申请人的学术生涯发展。这位候选人的长期目标是成为一名独立人士。 临床研究者和国家领导人在研究焦虑和物质使用共病的群体 容易出现健康差距，特别强调焦虑和焦虑的双向和动态影响， 西班牙裔/拉丁裔酗酒。申请人进行了研究，重点是开发 焦虑症在整个生命周期，包括其与物质使用结果的关联。本申请 建立在申请人在焦虑领域的专业知识，并遵循逻辑，但新颖的，从以前的进展 研究和培训经验，以发展一个新的专业领域，在酒精焦虑症 在健康不平等的人群中。该应用程序提出了培训经验，是必要的，为下一个 这一研究计划的一步，包括滥用药物的精神药理学的高级培训;健康 差异;先进的统计方法;以及赠款撰写和科学传播技能。的辅导 一组经过挑选的高级研究人员将在一个有前途的新研究领域促进候选人的发展。 本研究的目的是研究（1）与之相关的药理学和预期机制 在酒精的急性焦虑效应中，（2）酒精和焦虑的急性焦虑效应之间的协变- 诱导动机消费酒精，和（3）社会文化（感知种族歧视）的影响，在这些 结果在中度至重度饮酒的成年西班牙裔/拉丁美洲人年龄21-65的样本。这种方法是新颖的 因为它的目的是研究西班牙裔/拉丁裔之间的几个复杂的酒精焦虑协会在一个 总体模型，尚未在人类实验范式中尝试。这项建议是 概念化为跨学科翻译研究的典型例子，可以解释 从多方法框架的机制，以提高我们对复杂的焦虑-酒精关系的理解， 并作为一种催化剂，促进今后在这一新兴领域的工作，在一个容易出现健康差距的群体中。的 拟议的研究将使用严格的评估方法来解决三个主要目标：1）测试 急性酒精应激抑制的药理学和预期作用，2）测试焦虑的近端 前因的冲动喝酒和即兴饮酒，和3）测试之间的关联感知种族 歧视和目标1和2的结果在西班牙裔/拉丁美洲人的大样本。培训和研究 本建议书中概述的内容将使候选人具备一套独特的必要技能，以提高知识， 这一重要但研究不足的领域。从长远来看，这项研究的数据将加强对 西班牙裔/拉丁裔之间的酒精焦虑联系所涉及的机制，并将直接告知， 从战略上指导开发针对健康差距人群的新疗法。

ABSTRACT This is an application for a Mentored Patient-Oriented Research Career Development Award (K23) to support the academic career development of the applicant. The candidate's long term goal is to become an independent clinical investigator and national leader in the study of anxiety and substance use comorbidity among groups prone to health disparities, with a particular emphasis on bidirectional and dynamic influences of anxiety and alcohol abuse among Hispanics/Latinos. The applicant has conducted research focused on the development of anxiety disorders across the lifespan, including their association with substance use outcomes. This application builds on the applicant's expertise in the area of anxiety and follows a logical, but novel, progression from prior research and training experiences to the development of a new area of expertise in alcohol-anxiety comorbidity in a health disparities population. The application proposes training experiences that are necessary for the next step in this research program, including advanced training in psychopharmacology of drugs of abuse; health disparities; advanced statistical methods; and grant writing and science dissemination skills. The mentorship of a select group of senior investigators will foster the candidate's development in a promising new area of research. The goals of the proposed study are to examine (1) the pharmacological and expectancy mechanisms implicated in the acute anxiety effects of alcohol, (2) the covariation between acute anxiety effects of alcohol and anxiety- induced motivation to consume alcohol, and (3) sociocultural (perceived racial discrimination) influences in these outcomes in a sample of moderate-to-heavy drinking adult Hispanics/Latinos ages 21-65. This approach is novel in that it aims to examine several complex alcohol-anxiety associations among Hispanics/Latinos in one overarching model, which has yet to be attempted in a human experimental paradigm. This proposal is conceptualized as a prototypical example of cross-disciplinary translational research that can explicate mechanisms from a multi-method framework to enhance our understanding of complex anxiety-alcohol relations, and serve as a catalyst for future work in this emerging domain among a group prone to health disparities. The proposed study will use rigorous methods of assessment to address three primary aims: 1) to test the pharmacological and expectancy effects of acute alcohol stress dampening, 2) to test anxiety a proximal antecedent of urge to drink and ad lib alcohol consumption, and 3) to test associations between perceived racial discrimination and Aim 1 and 2 outcomes in a large sample of Hispanics/Latinos. The training and research outlined in this proposal will equip the candidate with a unique set of necessary skills to advance knowledge in this important yet understudied area. Over the long-term, data from this study will enhance understanding of the mechanisms involved in the alcohol-anxiety connection among Hispanics/Latinos and will directly inform and strategically guide the development of novel treatments for health disparities populations.