Mental illness stigma as a risk factor for substance use among adults with depression

项目摘要/摘要 严重抑郁障碍，最常见的精神疾病之一，和 物质使用是一个重大的公共卫生问题，也是NIDA.1-7的研究重点。 精神疾病污名(即与精神疾病相关的社会贬低和拒绝)的作用 作为抑郁症患者使用药物的风险因素，目前仍未得到充分研究。在……里面 除了阻碍寻求治疗和康复外，8-14岁与耻辱相关的压力抗争会耗尽自我 调节资源，从而可能导致情绪功能障碍(即，强烈、长期的负面影响和 情绪调节不良)，这是抑郁症和药物使用问题的一个关键机制。 29这项拟议的研究利用多方法方法来解释精神疾病污名和 在抑郁症患者中，共发生的情绪障碍是物质使用的危险因素， 目标是为这一高危人群制定有针对性的药物滥用预防措施的未来努力 人口。在过去30天的药物使用中，150名被诊断患有严重抑郁障碍的成年人参与了这项研究 该项目将涉及：(1)一项实验室研究，描述长期暴露于污名对两种生理状态的影响 以及对与污名相关的情绪诱导的反应的情绪障碍的自我报告测量(即Trier 社会压力测试)；以及(2)记录同时存在和滞后的关联的微观纵向研究 在日常耻辱经历中，情绪障碍，以及酗酒和娱乐性药物使用。培训 由首席调查员王鹏博士通过执行这一交叉学科， 创新的研究项目，以及正式的课程、专注的研讨会和一对一的指导， 将针对以下三个培训目标：(1)获得生理评估方面的指导 情绪反应和调节，包括心血管和神经内分泌措施；(2)发展 在微观纵向研究设计、方法和数据分析方面的专业知识；以及(3)在以下方面获得技能 在关注相关的伦理和安全问题的同时，对临床人群进行有效的研究。 王博士将主要由耶鲁大学的约翰·帕钱基斯博士指导，另外还有来自 Rajita Sinha博士(耶鲁大学)、Wendy Mendes博士(加州大学旧金山分校)和Bruce Link博士 (加州大学河滨分校)。此外，她还将接受方法学和分析性咨询。 Mark Hatzenbuehler博士(哥伦比亚大学)和Jonathon Rendina博士(哥伦比亚城市大学亨特学院) 纽约)。王博士建议通过K01奖项进行的培训将使她作为社会健康专家的专业知识更加丰富 心理学家，通过向她提供所需的知识和技能，开始作为一名富有成效的职业生涯 药物滥用预防领域的独立研究科学家。

PROJECT SUMMARY/ABSTRACT The comorbidity between major depressive disorder, one of the most prevalent psychiatric conditions, and substance use represents a significant public health concern and a research priority for NIDA.1-7 Nevertheless, the role of mental illness stigma (i.e., social devaluation and rejection associated with one's psychiatric diagnosis) as a risk factor for substance use among individuals with depression remains under-examined. In addition to hindering treatment seeking and recovery,8-14 contending with stigma-related stress depletes self- regulatory resources and can thus lead to emotion dysfunction (i.e., intense, prolonged negative affect and maladaptive emotion regulation), a key mechanism underlying both depression and substance use problems.15‐ 29 The proposed research utilizes a multimethod approach to explicate the roles of mental illness stigma and co-occurring emotion dysfunction as risk factors for substance use among people with depression, with the goal of informing future efforts to develop targeted substance abuse prevention interventions for this at-risk population. Using 150 adults diagnosed with major depressive disorder with past 30-day substance use, the project will involve: (1) a lab study characterizing the impact of chronic stigma exposure on both physiological and self-report measures of emotion dysfunction in response to a stigma-related emotion induction (i.e., Trier Social Stress Test); and (2) a micro-longitudinal study documenting the concurrent and lagged associations among daily stigma experiences, emotion dysfunction, and alcohol and recreational drug use. The training acquired by the principal investigator, Dr. Peng “Katie” Wang, through the execution of this interdisciplinary, innovative research project, along with formal coursework, focused workshops, and one-on-one mentorship, will target the following three training objectives: (1) obtain instruction in the physiological assessment of emotional reactivity and regulation, including both cardiovascular and neuroendocrine measures; (2) develop expertise in micro-longitudinal research design, methodology, and data analysis; and (3) acquire skills in conducting research effectively with clinical populations while attending to relevant ethical and safety issues. Dr. Wang will be mentored primarily by Dr. John Pachankis at Yale University, with additional mentoring from Drs. Rajita Sinha (Yale University), Wendy Mendes (University of California, San Francisco), and Bruce Link (University of California, Riverside). Additionally, she will receive methodological and analytical consultation from Drs. Mark Hatzenbuehler (Columbia University) and Jonathon Rendina (Hunter College, City University of New York). Dr. Wang's proposed training through this K01 award will round out her expertise as a social-health psychologist by providing her with the knowledge and skills needed to launch a productive career as an independent research scientist in the field of substance abuse prevention.