Cyclical deficits in emotion regulation as a risk factor for alcohol misuse in premenopausal females

项目摘要 酒精滥用在女性中正在上升。由于女性可能比男性经历更严重的健康后果， 与酒精滥用相关的女性特有风险，阐明女性特有因素对于建立一个 更好地了解女性酗酒问题，制定预防酗酒战略 女性滥用。一个小的文献涉及维度经前焦虑障碍（dPMDD）-a 心境障碍，以临床上显著的情绪、行为和身体症状为特征， 晚期黄体在卵泡中期完全消退--作为女性饮酒的一个重要风险因素 滥用和黄体期增加酒精的使用。然而，迄今为止还没有研究评估过共享的 dPMDD和酒精滥用的生理和情感途径。情绪调节包括 情绪的意识和识别，以及修改情绪反应的策略。情绪调节 也可以是生理上的表现。心率变异性（HRV）是副交感神经控制心率的指标， 心率被认为是情绪调节的外周心理生理学标记。主观性降低 和客观（即，情绪调节与酒精滥用有关。然而，在这方面， 研究还没有调查情绪调节的周期性变化如何成为酒精的危险因素 滥用，以及与无dPMDD相比，女性之间是否存在差异。心率变异性最低 水平在黄体期，我们的试点数据显示，黄体期HRV图的减少更多， 黄体期负面情绪显著增加。我们的中心假设是患有dPMDD的女性 由于与孕酮相关的心率变异性下降，重度饮酒导致反复黄体期增加， 相关的情绪调节缺陷这项研究将招募绝经前女性， 酒精使用（50% dPMDD），将完成4周的前瞻性筛选;和5周的生态 即时评估（EMA）和HRV评估。目的1检验dPMDD将显示更大的 与无dPMDD相比，酒精滥用的黄体期增加。目标2检验了周期性赤字 情绪调节的周期性增长将预测酒精滥用。目标3检验个人 从卵泡期到黄体期HRV降低程度的差异将预测更大的黄体功能。 酒精变量的相位增加。这项研究的结果将有助于国家卫生研究院的战略 关于性/性别差异和女性健康的研究计划。具体而言，本研究将提供 关于周期性情绪调节与酒精滥用的关系的信息，这将为我们提供基础性的 信息的影响情绪调节的背景下，大量饮酒和病因 女性酒精滥用和dPMDD中情绪调节之间的重叠。

PROJECT SUMMARY Alcohol misuse is rising in females. As females may experience worse health consequences then males and female-specific risks associated with alcohol misuse, elucidating female-specific factors is essential to build a better understanding of alcohol misuse in females and the development of prevention strategies for alcohol misuse in females. A small literature implicates dimensional premenstrual dysphoric disorder (dPMDD)—a mood disorder characterized by clinically significant emotional, behavioral, and physical symptoms during the late luteal that completely resolve by the mid follicular—as a critical female-specific risk factor for alcohol misuse and luteal phase increases in alcohol use. However, no studies to date have evaluated the shared physiological and emotional pathways of dPMDD and alcohol misuse. Emotion regulation encompasses the awareness and identification of emotion, and strategies to modify the emotional response. Emotion regulation may also be physiologically represented. Heart rate variability (HRV), an index of parasympathetic control over heartrate, is considered a peripheral psychophysiological marker of emotion regulation. Reduced subjective and objective (i.e., HRV) emotion regulation has been shown to associate with alcohol misuse. However, studies have not investigated how cyclical changes in emotion regulation may act as a risk factor for alcohol misuse and whether this differs between females with compared to without dPMDD. HRV shows the lowest levels during the luteal phase and our pilot data shows greater luteal phase reductions in HRV map onto more significant increases in luteal phase negative emotion. Our central hypothesis is that females with dPMDD suffer from recurrent luteal phase increases in heavy drinking due to progesterone-related declines in HRV and associated deficits in emotion regulation. The proposed study will recruit premenopausal females with heavy alcohol use (50% dPMDD) who will complete 4 weeks of prospective screening; and 5 weeks of Ecological Momentary Assessment (EMA) and HRV assessment. Aim 1 tests the hypothesis that dPMDD will show larger luteal phase increases in alcohol misuse relative to no dPMDD. Aim 2 tests the hypothesis that cyclical deficits in emotion regulation will predict cyclical increases in alcohol misuse. Aim 3 tests the hypothesis that individual differences in the degree of HRV reduction from the follicular to the luteal phase will predict greater luteal phase increases in alcohol variables. The results of this study will importantly contribute to the NIH strategic plan for research addressing sex/gender differences and female health. Specifically, this study will provide information on cyclical emotion regulation associations with alcohol misuse, which will provide foundational information regarding the influence of emotion regulation in the context of heavy drinking and the etiologic overlap between female alcohol misuse and emotion regulation in dPMDD.