Identifying the Effects of Race-Related Stressors on Laboratory- Induced Stress and Craving among African Americans with Alcohol Use Disorder

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PROJECT SUMMARY / ABSTRACT The primary aim of the proposed K23 Mentored Patient-Oriented Research Career Development Award is to provide the candidate (Dr. Delisa Brown) the opportunity to acquire the knowledge and skills necessary to become an independent investigator focused on alcohol use disorder (AUD) and health disparities. Race-related stress (RRS) is common among African Americans (AA) in the U.S. and is associated with increased risk of developing AUD. Research suggests that salient cultural factors, such as positive racial identity, may help mitigate the negative effects of RRS. However, little research has focused on RRS and AUD, and culturally sensitive, evidence-based treatments for AUD among AA populations are lacking. Given the dearth of scientific information available on the effects of RRS among AA individuals with AUD, the proposed study will employ a well-controlled human laboratory paradigm to identify the subjective (craving, stress), physiological (heart rate, galvanic skin conductance), and neuroendocrine (cortisol) reactivity to personalized imagery cues (i.e., RRS, alcohol, and neutral) among AA individuals (N = 60) with AUD. The relationship between racial identity and reactivity to RRS cues will be examined to further inform the science in this highly understudied area, and support the future development of culturally sensitive treatments for AA and other minoritized populations with AUD. Ecological momentary assessment (EMA) will be used to obtain real-time information on alcohol craving, affect, and drinking patterns following exposure to RRS. The data obtained from this project will provide new knowledge and insights to inform our understanding of the link between RRS and AUD in ways not previously possible. The candidate has assembled a mentorship team of experienced and nationally renowned investigators with a history of collaboration who bring expertise in AUD, health disparities, human laboratory paradigms, EMA, clinical trials, and treatment development. On-site mentors and consultants include Drs. Sudie Back, Colleen Halliday, and Erin McClure at MUSC. Off-site mentors and consultants include Dr. Kathleen Burlew at the University of Cincinnati and Dr. Rajita Sinha at Yale University. The proposed project will provide the mentorship, formal coursework, hands-on data collection, and career development opportunities needed to ensure the candidate achieves the following career goals: 1) enhance knowledge of the underlying pathophysiology of AUD among African Americans experiencing RRS, 2) develop new skills to inform cultural adaptions of treatments for AUD, 3) increase competence in conducting alcohol research with racial/ethnic minorities, 4) obtain new training in EMA methods and data analysis, and 5) increase scholarly productivity through manuscript writing, conference presentations, and grant writing. This project aligns closely with NIAAA’s Minority Health and Health Disparities Initiative to eliminate health disparities and increase the number of well-trained scientists from underrepresented backgrounds in the field of alcohol research.