Mediators of Violence Exposure and Substance Use (MoVES)

项目摘要 暴力暴露大大增加了药物的使用和滥用，使开发出一种物质的风险加倍 使用障碍和对总体使用水平和复发有很大贡献，但个体机制 对与暴力有关的物质使用增加的解释没有得到很好的审查。拟议的研究将集中于 关于暴力暴露维持和加剧药物使用的三种候选机制：负面 情绪、欲望和压力失调。每种机制都单独与暴力暴露和 先前研究中的物质使用情况。然而，这项研究几乎完全集中在城市人口上 或酒精或尼古丁的使用者。本研究将通过重点关注农村人口和 可卡因、安非他明和鸦片类药物的使用者。将实现三个具体目标：划定消极因素的作用 情感是非法药物使用的近端预测因子，也是暴力暴露和药物使用之间的中介 在使用EMA方法的活跃吸毒者样本中(目标1)；描述渴望作为近端的作用 在同一人群中，非法药物使用的预测因素和负面影响与物质使用之间的中介因素 使用EMA方法(目标2)；并说明应激调节在物质使用频率中的作用 将以实验室为基础的程序和环境影响评估方法结合起来进行人口调查(目标3)。为了实现这些目标，这个项目 将从更大的农村吸毒者纵向队列中招募一个亚样本(n=75)进行基于实验室的研究和 跟踪监测。参与者将完成评估压力失调的受控程序， 然后在五周的时间里对渴望、负面影响和物质使用进行实时评估。 这项研究将采取创新的步骤，将基于实验室的程序与经过验证的生态学相结合 提供关于个体在原地操作的基本行为和认知过程的新数据的措施 吸毒者的环境。为了为未来的研究奠定基础，该项目还将结合以下多项措施 压力和压力响应，包括自我报告和通过新数据收集的客观生理数据 将实时生理数据与实时自我报告测量相联系的技术，因此在很大程度上 扩大目前以农村毒品使用为重点的研究能力。这个项目为长期的 目标是开发暴力暴露对农村成瘾的影响的完整模型，反过来， 针对这一紧迫的国家问题进行有针对性的干预。这些长期目标实现了多个优先重点领域 国家药物滥用研究所2016-2020年战略计划的一部分，通过调查 环境刺激可以与[生物]网络相互作用，扰乱它们的平衡“(焦点领域1)， 共同的基础底物和促成共同合并症的生物机制“(焦点 领域3)和“可能提供干预目标的潜在机制和进程”(重点领域4)。

PROJECT ABSTRACT Violence exposure substantially increases substance use and abuse, doubling the risk of developing a substance use disorder and contributing substantially to overall use levels and relapse, yet the individual mechanisms that account for violence-related increases in substance use are not well examined. The proposed research will focus on three candidate mechanisms by which violence exposure maintains and exacerbates substance use: negative affect, craving, and stress dysregulation. Each mechanism has been individually linked to violence exposure and substance use in prior research. However, that research has focused almost exclusively on urban populations or users of alcohol or nicotine. The present study will address these gaps by focusing on rural populations and users of cocaine, amphetamines, and opiates. Three specific aims will be achieved: delineate the role of negative affect as a proximal predictor of illicit drug use and a mediator between violence exposure and substance use among a sample of active drug users by using EMA methods (Aim 1); delineate the role of craving as a proximal predictor of illicit drug use and a mediator between negative affect and substance use in the same population by using EMA methods (Aim 2); and delineate the role of stress regulation in substance use frequency among this population by combining lab-based procedures and EMA methods (Aim 3). To achieve these aims, this project will recruit a subsample (n=75) of a larger longitudinal cohort of rural drug users for lab-based research and follow-up monitoring. Participants will complete controlled procedures for assessing stress dysregulation, followed by real-time assessments of craving, negative affect, and substance use over a period of five weeks. This research will take the innovative step of combining lab-based procedures with validated ecological measures to provide novel data on the basic behavioral and cognitive processes operating in situ in an individual drug user’s environment. To set the stage for future research, the project will also combine multiple measures of stress and stress responding, including self-report and objective physiological data via novel data collection technology that links real-time physiological data with real-time self-report measures, thus substantially expanding current research capabilities focused on rural drug use. This project sets the stage for a long-term goal of developing a complete model of the effects of violence exposure on rural addiction, and, in turn, more targeted interventions for this pressing national problem. These long-term goals fulfill multiple priority focus areas of the National Institute on Drug Abuse strategic plan for 2016-2020 by investigating “how social and environmental stimuli can interact with [biological] networks to perturb their balance” (Focus Area 1), “the common underlying substrates and biological mechanisms that contribute to common comorbidities” (Focus Area 3), and “potential mechanisms and processes that may provide targets for intervention” (Focus Area 4).