Effects of Stressors on Drug Use in Young, Poor Women

描述（由申请人提供）：本研究的目的是检查压力源对药物滥用和依赖的贡献，并通过应对方式进行修改。在大多数关于压力和药物紊乱的研究中，年轻的低收入妇女没有得到足够的关注，这些年轻妇女处于药物使用和压力负担日益增加的年龄组。将进行一项前瞻性队列研究，以将压力源的增加与药物紊乱的发作以及药物使用的进展、滥用和依赖联系起来。在这项研究中，总共将采访600名12个月的吸毒者（其中311名非西班牙裔白色、103名非西班牙裔黑人和186名西班牙裔女性）。这些详细的访谈将在基线、12个月和24个月时进行。在面对面访谈之间，将每隔一个月进行一次简短的电话访谈。参与者将参加24个国家资助的诊所之一，提供妇科和生殖服务。CAPI方法将用于每次面试。参与者将被要求亲自或通过邮件提供四份唾液样本用于四项皮质醇测试，一份尿液样本用于药物测试小组。该提案的主要目的是：（1）研究和报告年轻低收入女性压力暴露的流行病学，特别是操作性压力源（定义为最近和持续压力源的发生和积累）;（2）通过理论驱动的假设（例如，自我药疗）;（3）检验个体的应对方式是否改变了不同操作性压力源与滥用/依赖的关系。我们的次要目的是（1）检查药物障碍对压力源的相互影响;（2）通过种族/种族地位检查上述关系。我们将对年轻低收入妇女的操作性压力源以及压力源与这一弱势群体药物障碍的关系进行一项相对全面但有重点的调查。澄清这种关系应有助于制定有针对性的有效预防和干预措施，以防止成年后从吸毒过渡到滥用和依赖。

DESCRIPTION (provided by applicant): The purpose of this study is to examine the contribution of stressors to drug abuse and dependence, as modified by coping style. Young, low-income women have received inadequate attention in most studies of stress and drug disorder, and these young women are in an age group with increasing drug use and burdens of stress. A prospective cohort study will be conducted to relate increases in stressors to onset of drug disorder, as well as progression of drug use, to abuse and dependence. In this study, a total of 600 12-month drug users (with 311 non-Hispanic white, 103 non-Hispanic black, and 186 Hispanic women) will be interviewed. These detailed interviews will occur in person at baseline, 12, and 24 months. In between the in-person interviews, brief telephone interviews will be conducted every other month. Participants will attend one of 24 state-funded clinics providing gynecological and reproductive services. CAPI methods will be used for each interview. Participants will be asked to provide, in person or by mail, four saliva samples for four cortisol tests and one urine sample for a drug test panel. The primary aims of this proposal are to: (1) study and report the epidemiology of stress exposure, particularly operant stressors (defined as the occurrences and accumulation of recent and ongoing stressors), in young, low-income women over time; (2) understand and examine the relationships of operant stressors with onset of DSM-IV abuse/dependence over time through theory-driven hypotheses (e.g., self-medication); (3) examine whether an individual's coping style modify the relationships of different operant stressors with abuse/dependence. Our secondary aims are to (1) to examine the reciprocal effects of drug disorder on stressors; (2) to examine the above relationships by ethnic/racial status. We will conduct a relatively comprehensive but focused investigation of operant stressors in young, low- income women and the relation of stressors to drug disorder in this vulnerable population. Clarifying such relationship should help in the development of targeted, effective preventions and interventions to prevent transitions from drug use to abuse and dependence in adulthood.