Minority Stress Reactivity and Hazardous Drinking

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PROJECT SUMMARY/ABSTRACT Disparities in hazardous drinking and alcohol use disorder (AUD) have been documented across several disadvantaged groups (e.g., racial/ethnic and sexual minorities). Hazardous drinking and its consequences are a major public health priority and concern given their significant economic, mortality, and morbidity burdens. Stigma and discrimination-related stressors (i.e., minority stressors) contribute to our understanding of health disparities among these groups. Given the importance of minority stressors in predicting hazardous drinking, the research aims of this Mentored Clinical Scientist Research Career Development Award (K08) are to conduct a rigorous, innovative, and multi-method examination of minority stress and its effects on drinking in the lab and the natural environment among one disadvantaged health disparities group. Sexual minority (SM; i.e., lesbian, gay, or bisexual) adults are at increased risk for hazardous drinking compared to heterosexuals. SMs experience minority stressors, which range from daily and momentary slights to more acute forms of stigma, and are directly correlated with hazardous drinking. However, major limitations of the extant SM literature include the lack of objective measures of reactivity to minority stressors (i.e., biological markers), overreliance on cross-sectional data, and failure to account for individual differences in appraisals of minority stress or the contributions of minority stress on hazardous drinking beyond individual differences in daily general stress and lifetime cumulative stress. In addition, little is known about mediating mechanisms between minority stress and hazardous drinking. Consistent with Institute of Medicine and NIH’s call to expand the scientific knowledge base on factors contributing to SMs’ elevated rates of drinking, the research aims of this K08 are to: 1) examine the effects of psychophysiological mechanisms underpinning appraised minority stress and alcohol craving in a lab experiment of 70 SMs who are at most risk for developing AUD (i.e., heavy drinkers); and 2) use experience sampling methods (i.e., EMA) over a 30-day period, to examine: a) the effects of psychophysiological stress reactivity from the lab on minority stress reactivity and drinking in the natural environment and b) the prospective effects of minority stress on proximal changes in affect and drinking and its consequences in real time. While conducting this research and participating in several training and mentorship activities, the K08 candidate will develop new expertise in: 1) experimental laboratory research; 2) psychophysiological stress research and salivary research methodology; 3) experience sampling field methods (i.e., EMA); and 4) advanced statistical approaches for analyzing intensive longitudinal EMA quantitative data and physiological salivary laboratory data. This proposed project builds upon the candidate’s past work examining the associations between minority stressors and health outcomes among sexual and racial/ethnic minorities. Completion of this K08 award will provide the candidate necessary skills to be an independent researcher capable of advancing our knowledge of stress-specific factors predicting hazardous drinking.