Internal Sources of Minority Stress and Alcohol Consumption

7.项目总结/摘要 与NIAAA明确的目标一致，即了解问题酒精使用风险的性别差异， 目前的建议是，建立有助于高风险社区内已知差距的目标机制， 试图研究少数民族压力的内部来源的作用（即，边缘化群体所特有的压力 社区）在加强重度酒精使用，特别是在女性和男性双性恋/双性恋+个体。 以前的工作几乎完全集中在那些已经确定为少数民族的压力来源上。 女同性恋男同性恋或双性恋拟议的项目旨在研究生理和心理机制 这解释了那些报告对自己的性取向或性取向不确定的成年人的消费， 身份不确定性（SIU）。不确定性-同一性理论表明，当某人对一个核心感到不确定时， 他们的身份方面，他们的动机，以减少由此产生的心理困扰，这可以解释 增加酒精消费。到目前为止，还没有研究使用实验设计来检查生理 应激反应乙醇消费后暴露于内部来源的少数民族的压力。的 拟议的工作将测试消费和减轻痛苦的差异，部分基于参与者的 生理应激反应和乙醇的药理作用。本申请拟招聘 200名具有不同SIU水平的顺性别参与者，并使用3 x 2 x 5混合因子设计。参与者 将被随机分配到三个演讲中的一个，作为特里尔社会压力测试的一部分 （TSST）：（a）相关近端压力源-TSST：其性行为的发展，包括任何性感觉， 不确定性;（B）无关近端压力-TSST：其性别认同的发展，包括任何感觉 或（c）Control-TSST：最近的一本书，电影或电视节目。参与者将参加一个35- 10分钟随意味觉试验（乙醇，安慰剂）。项目设计包括：（a）基线调查和（B） 实验实验室会议，测量（i）酒精消耗量和5项评估：（ii）呼吸酒精 浓度，（iii）唾液应激激素，（iv）心率，（v）血压，（vi）心理困扰，和 (vii)意识到中毒。参与者的SIU和生物性别将改变条件对消费的影响。 预期会产生间接影响，例如接触少数民族压力的相关内部来源， 增加压力反应，这将解释那些具有较高SIU的人的饮酒量。我们还将 确定在何种程度上生理压力阻尼效应和感知中毒占 饮酒后痛苦的减少，取决于参与者的性别，饮料是否含有乙醇（或 不），以及对酒精影响的积极信念。研究结果将为针对生理和 心理过程，特别是那些在暴露于内化的少数群体压力源后加强使用的心理过程。

7. Project Summary/Abstract Consistent with NIAAA’s expressed goal to understand sex differences in risk of problem alcohol use and target mechanisms that contribute to known disparities within high-risk communities, the current proposal seeks to examine the role of internal sources of minority stress (i.e., stress unique to those from marginalized communities) in potentiating heavy alcohol use, particularly among female and male bisexual/bi+ individuals. Prior work has focused almost exclusively on sources of minority stress among those who already identify as lesbian, gay, or bisexual. The proposed project seeks to examine physiological and psychological mechanisms that account for consumption among adults who report uncertainty about their sexual orientation, or sexual identity uncertainty (SIU). Uncertainty-identity theory suggests that when someone feels uncertain about a core aspect of their identity, they are motivated to reduce resulting psychological distress, which can account for increased alcohol consumption. No study, to date, has used an experimental design to examine physiological stress responses to ethanol consumption following exposure to internal sources of minority stress. The proposed work will test for differences in consumption and alleviation of distress based, in part, on participants’ physiological stress responses and the pharmacological effects of ethanol. This application proposes to recruit 200 cisgender participants with varying levels of SIU and uses a 3 x 2 x 5 mixed-factorial design. Participants will be randomly assigned to give one of three speeches, as part of an adapted Trier Social Stressor Test (TSST): (a) Relevant Proximal Stressor-TSST: development of their sexuality, including any feelings of uncertainty; (b) Irrelevant Proximal Stressor-TSST: development of their gender identity, including any feelings of uncertainty; or (c) Control-TSST: a recent book, movie, or TV show. Participants will then engage in a 35- minute ad libitum taste-test (ethanol, placebo). Project design includes: (a) a baseline survey and (b) experimental lab session that measures (i) alcohol consumption and 5 assessments of: (ii) breath alcohol concentration, (iii) salivary stress hormones, (iv) heart rate, (v) blood pressure, (vi) psychological distress, and (vii) perceived intoxication. Participants’ SIU and biological sex will alter the effect of condition on consumption. Indirect effects are expected, such that exposure to relevant internal sources of minority stress is expected to increase stress responses, which will account for drinking amount among those with higher SIU. We will also determine the extent to which physiological stress-dampening effects and perceived intoxication account for reductions in distress following drinking, depending on participant sex, whether beverages contain ethanol (or not), and positive beliefs about alcohol’s effects. Results will inform interventions that target physiological and psychological processes, especially those reinforcing use following exposure to internalized minority stressors.