Synergistic Effects of Anxiety and Alcohol Use among Latinos and its Sociocultural Mechanisms

摘要 这是一份以患者为导向的导师研究职业发展奖(K23)的申请书，以支持 申请人的学术生涯发展情况。候选人的长期目标是成为无党派人士 焦虑和药物使用群体共病研究的临床研究员和国家领先者 容易出现健康差异，特别强调焦虑和焦虑的双向和动态影响 西班牙裔/拉丁裔的酗酒现象。申请人进行了以发展为重点的研究 一生中的焦虑症，包括它们与物质使用结果的关联。此应用程序 以申请者在焦虑领域的专业知识为基础，遵循一种合乎逻辑但又新颖的进展 研究和培训经验，以发展酒精焦虑症共病的新专业领域 在健康差距较大的人群中。该应用程序提出了下一步所需的培训经验 参与这一研究计划，包括药物滥用的精神药理学方面的高级培训； 不平等；先进的统计方法；以及赠款撰写和科学传播技能。的指导作用 一组精挑细选的高级研究人员将促进候选人在一个有前途的新研究领域的发展。 拟议研究的目标是检查(1)所涉及的药理学和预期机制 在酒精的急性焦虑效应中，(2)酒精的急性焦虑效应和焦虑之间的协变- 诱导的饮酒动机，以及(3)社会文化(感知到的种族歧视)在这些方面的影响 在21-65岁的西班牙裔/拉美裔成人样本中，中度到重度饮酒的结果。这种方法是新颖的。 因为它的目的是研究拉美裔/拉丁裔中几个复杂的酒精焦虑症关联 总体模型，这还没有在人类实验范式中尝试。这项建议是 被概念化为跨学科翻译研究的典型范例，可以解释 来自多方法框架的机制，以增强我们对复杂的焦虑-酒精关系的理解， 并为这一新兴领域中容易出现健康差距的群体未来的工作起到了催化剂作用。这个 拟议的研究将使用严格的评估方法来解决三个主要目标：1)测试 急性酒精应激抑制的药理学和预期效应，2)测试近端焦虑 饮酒冲动和即兴饮酒的前置因素，以及3)测试感知的种族之间的关联 在拉美裔/拉美裔大样本中的歧视和目标1和2的结果。培训和研究 这份建议书中概述的内容将使应聘者具备一套独特的必要技能，以在 这一重要但未被充分研究的领域。从长远来看，这项研究的数据将加强对 参与拉美裔/拉丁裔之间酒精焦虑联系的机制，并将直接告知和 从战略上指导针对健康差距人群的新型治疗方法的开发。

ABSTRACT This is an application for a Mentored Patient-Oriented Research Career Development Award (K23) to support the academic career development of the applicant. The candidate's long term goal is to become an independent clinical investigator and national leader in the study of anxiety and substance use comorbidity among groups prone to health disparities, with a particular emphasis on bidirectional and dynamic influences of anxiety and alcohol abuse among Hispanics/Latinos. The applicant has conducted research focused on the development of anxiety disorders across the lifespan, including their association with substance use outcomes. This application builds on the applicant's expertise in the area of anxiety and follows a logical, but novel, progression from prior research and training experiences to the development of a new area of expertise in alcohol-anxiety comorbidity in a health disparities population. The application proposes training experiences that are necessary for the next step in this research program, including advanced training in psychopharmacology of drugs of abuse; health disparities; advanced statistical methods; and grant writing and science dissemination skills. The mentorship of a select group of senior investigators will foster the candidate's development in a promising new area of research. The goals of the proposed study are to examine (1) the pharmacological and expectancy mechanisms implicated in the acute anxiety effects of alcohol, (2) the covariation between acute anxiety effects of alcohol and anxiety- induced motivation to consume alcohol, and (3) sociocultural (perceived racial discrimination) influences in these outcomes in a sample of moderate-to-heavy drinking adult Hispanics/Latinos ages 21-65. This approach is novel in that it aims to examine several complex alcohol-anxiety associations among Hispanics/Latinos in one overarching model, which has yet to be attempted in a human experimental paradigm. This proposal is conceptualized as a prototypical example of cross-disciplinary translational research that can explicate mechanisms from a multi-method framework to enhance our understanding of complex anxiety-alcohol relations, and serve as a catalyst for future work in this emerging domain among a group prone to health disparities. The proposed study will use rigorous methods of assessment to address three primary aims: 1) to test the pharmacological and expectancy effects of acute alcohol stress dampening, 2) to test anxiety a proximal antecedent of urge to drink and ad lib alcohol consumption, and 3) to test associations between perceived racial discrimination and Aim 1 and 2 outcomes in a large sample of Hispanics/Latinos. The training and research outlined in this proposal will equip the candidate with a unique set of necessary skills to advance knowledge in this important yet understudied area. Over the long-term, data from this study will enhance understanding of the mechanisms involved in the alcohol-anxiety connection among Hispanics/Latinos and will directly inform and strategically guide the development of novel treatments for health disparities populations.