Understanding differences in risk for alcohol problems between Black and White drinkers: Integrating alcohol response, stress, and drinking motives

项目摘要 意义：即使在同等水平下，黑人饮酒者比白人饮酒者经历更多的酒精问题 酗酒的人。这些问题无处不在，发生在物理、社会和法律后果上。这个 解释为什么黑人饮酒者经历酒精问题的风险增加的原因是 研究不足，理解不充分，但可能涉及压力水平和对 酒精。建议的R01在实验室内和在自然环境中检查这些结构 环境使用生态瞬时评估(EMA)来确定两者的近端干预点 黑人和白人饮酒者。目标：目标1将研究酒精在缓解焦虑效果方面的种族差异 在实验室进行应激诱导后。目标2将直接测试在实验室中测量的差异酒精反应 加强压力和酒精认知(对酒精的渴望、饮酒动机)之间的联系，以及 解释了这些认知中的种族差异。目标3将检查实验室酒精的程度 通过12个月的随访，反应和每日压力报告解释了酒精问题的种族差异。 假设：我们假设黑人饮酒者会对酒精的抗焦虑作用更加敏感。 酒精与白人饮酒者的比较，这种对酒精的敏感性以及增加的压力将预测 EMA中高风险的酒精认知增加。此外，压力和酒精认知之间的联系 对于对酒精的焦虑作用最敏感的参与者来说，这种作用会更强。EMA酒精 认知将部分解释酒精反应、压力和酒精问题之间的联系。 在EMA期间以及6个月和12个月的随访中。这些流程及其交易将 这部分解释了为什么黑人饮酒者比白人饮酒者经历更多的酒精问题。 方法：年轻的成年饮酒者(N=280；21-30岁；黑人占50%，女性占50%)将从 社区。参与者将首先完成半结构化诊断访谈和问卷调查，并 然后将完成两个实验室疗程(安慰剂和酒精；随机顺序)，并进行标准化压力测试 评估急性酒精反应的任务。接下来，参与者将完成为期17天的EMA协议以记录 压力波动、酒精认知、酒精反应、酒精使用/问题。考虑到…的预测 将在6个月和12个月进行预期结果跟踪评估，并将包括过去6个月 每月自我报告的酒精使用、酒精问题、压力和酒精认知，以及90天的时间表 后续采访。该R01提案直接符合NIAAA要理解的战略优先事项 压力在酒精问题和缩小健康差距方面的作用。拟议的研究 朝着增加我们对黑人饮酒者饮酒风险更大的理解迈出了关键的一步 问题，并最终将为针对这一研究不足的高危人群而量身定做的干预努力提供信息。

Project Summary Significance: Black drinkers experience more alcohol problems than White drinkers even at equivalent levels of alcohol use. These problems are pervasive, occurring across physical, social, and legal outcomes. The reasons that explain why Black drinkers are at elevated risk for experiencing alcohol problems are understudied and not well understood, but may involve differences in level of stress and acute response to alcohol. The proposed R01 examines these constructs both within the laboratory and in the natural environment using ecological momentary assessment (EMA) to identify proximal points of intervention for both Black and White drinkers. Aims: Aim 1 will examine racial differences in the anxiolytic effects of alcohol prior to and after a stress induction in the lab. Aim 2 will directly test if differential alcohol response measured in the lab strengthens the association between stress and alcohol cognitions (craving for alcohol, drinking motives), and accounts for racial differences in these cognitions. Aim 3 will examine the extent to which lab-based alcohol response and daily reports of stress explain racial differences in alcohol problems through 12-month follow-up. Hypotheses: We hypothesize that Black drinkers will have increased sensitivity to the anxiolytic effects of alcohol compared to White drinkers and that this sensitivity to alcohol as well as elevated stress will predict increased risky alcohol cognitions in EMA. Additionally, the association between stress and alcohol cognitions will be stronger for participants with the most sensitivity to the anxiolytic effects of alcohol. EMA alcohol cognitions will partially account for the association between alcohol response, stress, and alcohol problems during the EMA period and at the 6- and 12- month follow-ups. These processes and their transaction will partially account for why Black drinkers, relative to White drinkers, experience more alcohol problems. Approach: Young adult drinkers (N = 280; 21-30 years of age; 50% Black, 50% female) will be recruited from the community. Participants will first complete a semi-structured diagnostic interview and questionnaires and will then complete two laboratory sessions (placebo and alcohol; randomized order) with a standardized stress task to assess acute alcohol response. Next, participants will complete a 17-day EMA protocol to record fluctuations in stress, alcohol cognitions, alcohol response, alcohol use/problems. To allow for the prediction of prospective outcomes follow-up assessments at 6- and 12- months will be conducted and will include past 6 month self-reported alcohol use, alcohol problems, stress, and alcohol cognitions, as well as a 90-day timeline follow-back interview. This R01 proposal is directly in line with the NIAAA's strategic priorities to understand the role of stress in relation to alcohol problems and to decrease health disparities. The proposed research takes a critical step towards increasing our understanding of why Black drinkers are at greater risk for alcohol problems and will ultimately inform intervention efforts that are tailored to this under-studied, at-risk, population.