Mediators of Violence Exposure and Substance Use (MoVES)

项目摘要 暴力暴露大大增加了物质的使用和滥用，使形成物质的风险增加一倍 使用障碍，并大大有助于整体使用水平和复发，但个别机制， 与暴力有关的药物使用增加的原因没有得到很好的审查。本次研究将重点 关于暴力暴露维持和加剧物质用途：使用的三种候选机制：否定 情感渴望和压力失调每个机制都单独与暴力暴露联系在一起， 在以前的研究中使用的物质。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。本研究报告将通过重点关注农村人口来解决这些差距， 可卡因、安非他明和鸦片制剂的使用者。三个具体目标将实现：划定的作用，消极的 影响作为非法药物使用的近端预测因子和暴力暴露与物质使用之间的中介 使用EMA方法（目的1）在活跃药物使用者的样本中;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子和负面影响与药物使用之间的中介因子， 使用EMA方法（目标2）;并描述压力调节在物质使用频率中的作用， 通过结合基于实验室的程序和EMA方法（目标3）对人群进行评估。为了实现这些目标，本项目 将招募一个更大的农村吸毒者纵向队列的子样本（n=75）进行实验室研究， 后续监测。参与者将完成评估压力失调的控制程序， 随后是对五周内的渴望，负面影响和物质使用的实时评估。 这项研究将采取创新的一步，结合实验室为基础的程序与验证生态 提供关于个体在原位运行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，该项目还将结合联合收割机的多种措施， 压力和压力反应，包括通过新数据收集的自我报告和客观生理数据 将实时生理数据与实时自我报告措施联系起来的技术， 扩大目前以农村吸毒为重点的研究能力。这个项目为长期的 目标是建立一个完整的模型，说明暴力暴露对农村成瘾的影响，反过来， 针对这一紧迫的国家问题采取有针对性的干预措施。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，通过调查“社会和 环境刺激可以与[生物]网络相互作用，扰乱它们的平衡”（重点领域1），“ 共同的潜在底物和生物学机制，有助于共同的合并症”（焦点 重点领域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).