Does Stress Influence Drug Use in Young, Poor Women?

描述（由申请人提供）：本提案寻求四年的资金，通过NIDA指导研究科学家发展奖（K01），发展海伦·吴博士在弱势群体药物成瘾领域的独立研究事业。这个K01将提供额外的培训，旨在整合成瘾理论，药物滥用和依赖的社会病因学，以及高级访谈方法和统计方法。申请人强大的学术背景和研究培训为建立新技能和执行拟议的研究计划提供了良好的基础。具体的培训目标是：1)在成瘾的临床评估方面打下坚实的基础；2)增加对压力如何影响药物使用的理解；3)加强候选人的方法和统计技能；4)实施一项纵向研究，以检验压力源对年轻低收入妇女物质使用的影响；5)制定拨款提案（R01），研究压力对药物使用到滥用和/或依赖发展轨迹的影响；6)培养负责任的研究行为方面的培训。吴博士的职业发展计划包括跟随Linda Cottier博士进行流行病学和药物滥用问题的指导研究；与艾比贝伦森，医学博士，临床研究和一般职业发展；与公共卫生博士詹姆斯·格雷迪（James Grady）合作，研究先进的统计方法；并与Jay Turner博士合作，研究成瘾研究中的压力测量。这些专家组成了一个强大的、多学科的指导团队，这将是吴博士在获奖期间职业发展的基础。候选人寻求K01留在UTMB的原因是，她必须能够从德克萨斯州的区域妇幼保健计划（RMCHP）中获得现成的妇科患者群体，以执行研究计划。具体而言，本研究旨在研究1)总体压力负担是否会预测更多的问题药物使用；2)应激对问题吸毒是否存在阈值效应；3)是否某些高危人群在面对压力时更容易使用药物。为了实现这些目标，候选人将招募300名18-25岁的低收入妇女，她们在RMCHP诊所寻求治疗。她将在基线、6个月和12个月时进行面对面访谈，并对压力源和药物使用及相关症状进行8天的每日日记电话访谈。这项研究将有助于识别和治疗这一弱势群体中与压力相关的药物滥用。相关性：该项目具有创新性，因为它旨在改进在妇科护理诊所的非成瘾治疗临床环境中识别和干预与压力有关的物质使用的方法。这些诊所为预防和干预药物使用提供了理想的环境，因为许多贫穷妇女在整个生命周期中只得到产科医生和妇科医生的护理。

DESCRIPTION (provided by applicant): This proposal seeks four years of funding to develop Dr. Helen Wu's independent research career in the field of drug addiction within vulnerable populations through a NIDA Mentored Research Scientist Development Award (K01). This K01 will provide additional training that is designed to integrate addiction theory, the social etiology of substance abuse and dependence, and advanced interview methodology and statistical methods. The applicant's strong academic background and research training provide an excellent foundation on which to build new skills and carry out the proposed research plan. The specific training goals are to: 1) gain a solid foundation in the clinical assessment of addiction; 2) increase the understanding of how stress influences drug use; 3) strengthen the candidate's methodological and statistical skills; 4) implement a longitudinal study to examine the influence of stressors on substance use among young, low-income women; 5) develop a grant proposal (R01) to study the impact of stress on the trajectory of the progression of drug use to abuse and/or dependence; and 6) foster training in the responsible conduct of research. Dr. Wu's career development plan includes supervised study with Linda Cottier, Ph.D., on epidemiological and substance abuse issues; with Abbey Berenson, M.D., on clinical research and general career development; with James Grady, Dr. P.H., on advanced statistical methods; and with Jay Turner, Ph.D., on stress measurement in addiction research. These experts constitute a strong, multidisciplinary mentoring team that will be fundamental to Dr. Wu's career development during the award period. The reason the Candidate is seeking a K01 to remain at UTMB is because she must have access to a readily-available gynecological patient population from the Regional Maternal and Child Health Program (RMCHP) in Texas to carry out the research plan. Specifically, this study aims to examine 1) whether the overall stress burden will predict more problem drug use; 2) whether there is a threshold effect of stress on problem drug use; and 3) whether certain at-risk subgroups are more susceptible to using drugs when exposed to stress. To accomplish these aims, the candidate will recruit 300 low-income women, 18-25 years of age, who seek care at the RMCHP clinics. She will conduct face-to-face interviews at baseline, 6 and 12 months and an 8-day daily diary telephone interviews of stressors and drug use and related symptoms. This research will contribute to identifying and treating stress-related substance abuse in this vulnerable population. Relevance: The project is innovative because it aims to improve methods of identification and intervention for stress-related substance use in a non-addiction-treatment clinical setting of gynecological care clinics. These clinics provide an ideal setting for substance use prevention and intervention, because many poor women only receive care from obstetricians and gynecologists through the life cycle.