COVID-19 pandemic stress and coping activities, polygenic and neural vulnerabilities in those at risk for Alcohol Use Disorders

项目摘要/摘要 新冠肺炎疫情严重扰乱了人们的日常社交、学习和就业， 对于一些人来说，暴露在重病或家人死亡等创伤应激源中， 以及严重的经济困难。最近对23项研究的回顾发现，新冠肺炎大流行的风险有所增加 酒精使用障碍(AUD)的风险，以及有AUD病史的人的复发[8]。然而，研究表明 需要了解该流行病的哪些特定领域(例如，经济困难、社会脱节、 家庭成员的死亡、医疗保健中断)与澳元的变化最密切相关 干预和预防工作的可修改目标。此外，还需要进行研究，以确定 与新冠肺炎压力相关的澳元风险最大。有证据表明，在那些有高多基因风险的人中 AUD，创伤应激和AUD之间的关联往往更大，而 防护性暴露(例如，健康的应对活动)和AUD往往被降至最低。然而，无论是 具有高遗传风险的个体更容易患上与新冠肺炎应激相关的AUD，或者受益较少 从健康的应对活动中，是未知的。研究还表明，患有澳门氏症的个体在以下方面存在差异 他们的大脑功能，包括阿尔法脑电连贯性，一种衡量神经功能连通性的指标；较低的阿尔法 脑电一直被认为与澳门氏症有关。虽然几十年的研究集中在 在患有和不患有AUD的患者中观察到的神经生理学差异，先前没有研究进行过检验 神经连通性、多基因风险和创伤应激指标之间的相互作用 增加了澳元的风险。酒精中毒遗传学联合研究新冠肺炎初步数据 S正在对成年参与者(30-90岁)进行评估，这些参与者有患澳门氏症的风险，有澳门氏症活动性，或者 先前的AUD，已经证明与COVID相关的感知压力、媒体消费、经济困难和 家族性COVID疾病与酒精和其他物质的使用增加有关，因为 大流行，特别是妇女、中年(30-50岁)患有澳门氏症(活跃期或既往期)的参与者、高 酒精滥用的多基因风险，以及那些阿尔法脑电连接性较低的人。健康的应对活动是 与减少醉酒有关。在COGA现有数据的丰富基础上，该项目将 继续评估和表征不同类型的新冠肺炎相关企业之间的纵向关系 压力源和健康的应对活动，以及AUD风险和AUD严重程度的变化，预期贯穿始终 AUD高危人群以及AUD活动期和缓解期不同阶段的流行，以及 不同水平的生物风险的作用，包括酒精使用问题的多基因风险和神经连接。 拟议研究的结果将使我们更好地了解可能缓冲的可修改因素 酒精滥用和AUD在高危个体的性别、种族/民族和年龄组中的分布，例如 增加获得精神卫生保健的机会，促进社会联系和其他健康应对策略。

PROJECT SUMMARY/ABSTRACT The COVID-19 pandemic has led to significant disruptions in daily social activities, schooling, and employment, and for some individuals, exposure to traumatic stressors such as the grave illness or death of family members, and serious financial hardship. A recent review of 23 studies found that the COVID-19 pandemic has increased risk for alcohol use disorders (AUD), and relapse among those with a history of AUD [8]. However, research is needed to understand which particular domains of the pandemic (e.g., economic hardship, social disconnection, death of a family member, disruption in healthcare) are most strongly associated with changes in AUD to identify modifiable targets for intervention and prevention efforts. Further, research is needed to identify individuals at greatest risk for COVID-19 stress-related AUD. Evidence indicates that among those with high polygenic risk for AUD, associations between traumatic stress and AUD tend to be greater, and inverse associations between protective exposures (e.g., healthy coping activities) and AUD tend to be minimized. However, whether individuals with high genetic risk are more vulnerable to COVID-19 stress-related AUD, or experience less benefit from healthy coping activities, is unknown. Research has also shown that individuals with AUD differ in terms of their brain function, including alpha EEG coherence, a measure of neural functional connectivity; lower alpha EEG has been consistently associated with AUD. While decades of research have focused on neurophysiological differences observed among those with and without AUD, no prior studies have examined interactions between measures of neural connectivity, polygenic risk, and traumatic stress with respect to heightened risk for AUD. Preliminary COVID-19 data from the Collaborative Study on the Genetics of Alcoholism (COGA)’s ongoing assessment of adult participants (ages 30-90) who are at risk for AUD, have active AUD, or prior AUD, has demonstrated that COVID related perceived stress, media consumption, economic hardship and family COVID illness were associated with increased alcohol and other substance use since the start of the pandemic, particularly for women, mid-life (ages 30-50) participants with AUD (active or prior), those with high polygenic risk for alcohol misuse, and those with lower alpha EEG connectivity. Healthy coping activities were associated with decreased drunkenness. Building on the wealth of existing data from COGA, this project will continue to assess and characterize the longitudinal relationships among different types of COVID-19 related stressors and healthy coping activities and changes in risk for AUD, and AUD severity, prospectively throughout the pandemic among individuals at risk for AUD and at various stages of active AUD and remission, and the roles of varying levels of biological risk including polygenic risk for alcohol use problems and neural connectivity. Findings from the proposed research will allow us to better understand modifiable factors that may buffer against alcohol misuse and AUD among gender, racial/ethnic, and age subgroups of high-risk individuals, such as increasing access to mental healthcare, promoting social connections and other healthy coping strategies.