Trauma and Neurobiological Threat Reactivity as Risk Factors for Alcohol Abuse in Youth

创伤和神经生物学威胁反应作为青少年酗酒的危险因素

• 批准号: 10368089
• 负责人: Stephanie Gorka
• 金额: $ 61.03万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-10 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10368089
• 关键词: 19 year old; Address; Alcohol Phenotype; Alcohol abuse; Alcohol consumption; Anterior; Anxiety; Area; Behavior; Behavioral; Brain; Cognitive; Data; Data Reporting; Detection; Development; Dorsal; Early Intervention; Event; Exposure to; Frequencies; Future; Goals; Heavy Drinking; Individual; Individual Differences; Insula of Reil; Intervention; Knowledge; Literature; Measures; Mediating; Modeling; Motivation; Neurobiology; Neurophysiology - biologic function; Ohio; Patient Self-Report; Performance; Physiology; Prevention; Psychophysiology; Recording of previous events; Research Personnel; Risk; Risk Behaviors; Risk Factors; Risk Marker; Sampling; Sexual abuse; Stress; Surveys; Testing; Time; Trauma; Work; Youth; alcohol risk; alcohol use disorder; behavioral response; binge drinking; brain behavior; cingulate cortex; cohort; coping; design; disorder prevention; drinking; drinking behavior; experience; follow-up; high risk; high risk population; innovation; interpersonal trauma; longitudinal design; multimodal data; multimodality; network dysfunction; neurobiological mechanism; novel; physical abuse; prospective; psychiatric symptom; recruit; stressor; trauma exposure; underage drinking; young adult

Underage drinking causes tremendous burden, and there is an urgent need to understand who is vulnerable, and why/how, to facilitate accurate detection and prevention. Exposure to interpersonal trauma (e.g., physical or sexual abuse) is a well-established risk factor for alcohol problems in youth; however, the developmental mechanisms through which trauma leads to alcohol use are unclear. In addition, millions of youth experience interpersonal trauma but only a subset develop alcohol use disorder (AUD). Identifying these high-risk youth, and the neurobiological mechanisms contributing to their risk, can pinpoint objective early intervention targets and aid in AUD prevention. Data from the Early Stage Investigator (ESI) PI suggests that youth with interpersonal trauma exposure and high levels of aversive reactivity to unpredictable threats (U-threat; temporally unpredictable and/or ambiguous) are at the greatest risk for the development of alcohol problems in young adulthood. To date, however, a mechanistic test of this hypothesis has never been conducted in a high-risk, trauma-exposed sample. The overarching goal of the study is to therefore validate a novel neurobiological risk phenotype for alcohol problems in trauma-exposed youth using multimodal U-threat reactivity data. Leveraging our unique access to high-risk youth in the central Ohio area, we will recruit a cohort of 200, 16-19 year olds, with and without a history of interpersonal trauma exposure (125 with trauma and 75 without) and conduct multimodal (neural function, physiology, behavior, and self-report) assessments of U-threat reactivity and alcohol use. Six months after baseline we will conduct a second multimodal lab assessment of U-threat reactivity. Every 3 months post-baseline we will assess youths’ alcohol use and relevant psychiatric symptoms and behaviors via online survey (up to 24-months). This innovative, longitudinal design will allow for a well-controlled test of whether interpersonal trauma exposure and neurobiological reactivity to U-threat synergistically interact to predict escalations in alcohol use in youth (Aim 1). The study will also address whether reactivity to U-threat is a stable risk factor for alcohol problems or a modifiable target that corresponds to changes in drinking behaviors over time (Aim 2). If reactivity to U-threat does indeed track behavior, it can be used as an objective, mechanistic target for future ‘Fast-Fail’ treatment studies. Lastly, given our multi-layered approach, we will conduct innovative analyses to integrate data across ‘units of analysis’ (brain, physiology, behavior, self-report) to predict the onset of alcohol problems in trauma- exposed youth and develop a new and replicable predictor with the highest accuracy performance (Aim 3). Findings from this work will provide critical new knowledge aiding in the identification of youth most at-risk for alcohol problems. The study will also validate a mechanistic, neurobiological risk model that identifies targets for intervention during a peak developmental risk window for alcohol use to ultimately help reduce the burden of AUD in this high-risk population.

未成年人饮酒造成巨大负担，迫切需要了解谁是弱势群体， 以及为什么/如何，以促进准确的检测和预防。暴露于人际关系创伤(例如，身体创伤 或性虐待)是青少年酗酒问题的一个公认的危险因素；然而，发育 创伤导致饮酒的机制尚不清楚。此外，数以百万计的青年体验 人际关系创伤，但只有一小部分人会患上酒精使用障碍(AUD)。识别出这些高危青年， 而导致其风险的神经生物学机制，可以准确地确定客观的早期干预目标 并协助预防澳门氏症。来自早期调查人员(ESI)PI的数据表明，患有 人际关系创伤暴露和对不可预测威胁的高度厌恶反应(U-威胁； 时间上不可预测和/或模棱两可)是发展成酒精问题的最大风险 在年轻的成年期。然而，到目前为止，对这一假设的机械测试从未在 高风险的创伤暴露样本。因此，这项研究的首要目标是验证一部小说 多模式U-Threat用于创伤暴露青年酒精问题的神经生物学风险表型 反应性数据。利用我们在俄亥俄州中部地区接触高危青年的独特渠道，我们将招聘一名 队列中有200人，16-19岁，有和没有人际关系创伤暴露史(125人有创伤 75个)，并进行多模式(神经功能、生理、行为和自我报告)评估 U威胁的反应性和酗酒。基线六个月后，我们将进行第二个多模式实验室 U-威胁反应性评估。在基线后每3个月，我们将评估青少年的酒精使用情况，并 相关精神症状和行为通过在线调查(最长24个月)。这一创新的， 纵向设计将允许很好地控制测试人际创伤暴露和 对U威胁的神经生物学反应协同作用预测青少年酒精使用的升级(AIM 1)。这项研究还将探讨对U-威胁的反应性是否是酒精问题的稳定风险因素或 可修改的目标，对应于饮酒行为随时间的变化(目标2)。如果对U-威胁的反应性 确实跟踪行为，它可以被用作未来快速失败治疗的客观的、机械的目标 学习。最后，鉴于我们的多层方法，我们将进行创新分析，以跨 “分析单位”(大脑、生理、行为、自我报告)来预测创伤中酒精问题的发生-- 暴露年轻人，并开发一种新的、可复制的、具有最高准确度性能的预测指标(目标3)。 这项工作的发现将提供关键的新知识，帮助识别最有风险的青年 酒精问题。这项研究还将验证识别目标的机械性神经生物学风险模型 在酒精使用的发展风险高峰期进行干预，最终帮助减轻负担 在这一高危人群中患上澳门氏症。