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

项目总结/摘要 COVID-19大流行导致日常社交活动、学校教育和就业受到严重干扰， 对一些人来说，暴露于创伤性压力源，如家庭成员的重病或死亡， 严重的经济困难。最近对23项研究的审查发现，COVID-19大流行增加了 酒精使用障碍（AUD）的风险，以及有AUD病史者的复发风险[8]。然而，研究 需要了解流行病的哪些特定领域（例如，经济困难，社会脱节， 家庭成员死亡，医疗保健中断）与AUD的变化最密切相关，以确定 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 COVID-19压力相关澳元风险最大。有证据表明，在具有高多基因风险的人群中， 创伤性应激和AUD之间的关联往往更大， 保护性暴露（例如，健康的应对活动）和AUD趋于最小化。但无论 遗传风险高的个体更容易受到COVID-19压力相关AUD的影响，或受益较少 健康的应对活动，是未知的。研究还表明，AUD患者在以下方面存在差异： 他们的大脑功能，包括阿尔法脑电图的连贯性，神经功能连接的措施;较低的阿尔法 EEG一直与AUD相关。几十年的研究都集中在 在有和没有AUD的人中观察到神经生理学差异，没有先前的研究检查 神经连接、多基因风险和创伤应激指标之间的相互作用 澳元风险上升。酒精中毒遗传学合作研究的初步COVID-19数据 （COGA）正在对有AUD风险、患有活动性AUD或 已经证明，与COVID相关的感知压力、媒体消费、经济困难和 家庭COVID疾病与酒精和其他物质使用的增加有关， 大流行，特别是女性，中年（30 - 50岁）AUD（活动或既往）参与者，高 酒精滥用的多基因风险，以及那些具有较低α EEG连接的人。健康的应对活动是 与减少醉酒有关。在COGA现有数据的基础上，该项目将 继续评估和描述不同类型的COVID-19相关疾病之间的纵向关系 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， 在AUD风险个体和处于活动性AUD和缓解期的不同阶段的人群中流行， 不同程度的生物风险的作用，包括酒精使用问题和神经连接的多基因风险。 拟议研究的结果将使我们能够更好地了解可能缓冲 高风险个体的性别、种族/民族和年龄亚组中的酒精滥用和AUD，例如 增加获得精神保健的机会，促进社会联系和其他健康的应对策略。

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.