Individual and community influences on alcohol use disorders and other mental health behaviors in Mexican Americans

项目总结/摘要 拟议研究的总体目标是进行社区一级的研究，并制定一个多层次， 心理健康和酒精使用障碍的风险和保护因素的生物-心理-社会-生态模型 （AUD）在墨西哥裔美国年轻人（主要是第二代移民）在圣地亚哥县。美国--出生 墨西哥裔美国人的酒精使用率和精神疾病率高于他们在墨西哥出生的祖先 和同龄人。这表明跨代适应美国生活的过程可能在MH中发挥重要作用， 危害健康的行为。这些年轻人居住的社区和社区也会影响他们的健康。 因此，居住在边境附近的第二代墨西哥裔美国人代表了健康风险高的人群 差距。理解这些移民健康差异的原因的一种理论方法是设想 与文化适应相关的压力类似于其他慢性心理社会压力源，随着时间的推移， 身体的自我平衡功能失调，从而损害健康。这种失调的一个衡量标准是非稳态 负荷（AL）由麦克尤恩和Stellar创造的术语，用于操作慢性炎症引起的身体“磨损”。 压力随着时间的推移。在这项研究中，我们将应用新的措施AL的扩展以前确定的交叉- 对年轻的墨西哥裔美国人（18-30岁）进行的截面研究，重点关注个人的生物心理社会 影响MH和AUD的因素。这些初步研究表明，一组独特的生物心理社会 该人群中与MH、酗酒和AUD相关的危险因素。这些相关因素包括： 饮酒发作、睡眠质量降低、电生理学指标、AUD与其他精神疾病的合并症 障碍，创伤和创伤后应激综合征的经验，文化适应压力的措施， 酒精代谢酶是这个群体特有的在本文的研究中，我们将：（1）使用地理编码 程序，以获得社区/邻里数据对我们现有的队列和扩大组的参与者， 提高识别AUD途径的背景影响的能力，包括基因X环境相互作用，以及 评估性别差异;（2）通过在成年后随访我们现有的队列来增加纵向研究 以确定他们是否已经“老化”了早期成人的行为模式或已经发展出更严重的临床结果。 纵向研究还将有助于评估文化适应和迁移到新社区的变化的影响， 或者住在高风险的社区，酗酒和澳元。最后，我们将（3）使用扩展的交叉数据- 分段和纵向样本，以开发一个综合的生物心理社会生态模型的MH和AUDs， 墨西哥裔美国人，包括个人遗传和生理因素，以及人际和社区 影响。拟议的项目汇集了具有社区研究、生物心理社会学 生物识别技术和遗传学来解决这个复杂的问题。最终，这项研究有可能提供 关键信息，以了解如何选择遗传和环境因素可能相互作用的发展， 生活在美国的墨西哥裔美国男性和女性的AUD-墨西哥边境地区。

PROJECT SUMMARY/ABSTRACT The overall objective of the proposed research is to conduct community level research and to develop a multilevel, bio-psychosocial-ecological model of risk and protective factors for mental health (MH) and alcohol use disorders (AUDs) in Mexican American young adults (primarily second generation immigrants) in San Diego county. U.S.-born Mexican Americans have rates of alcohol use and psychiatric disorders that are higher than their Mexican-born ancestors and peers. This suggests trans-generational processes of adapting to life in the U.S. may play an important role in MH and health risk behaviors. The neighborhoods and communities in which these young adults settle also impact their health. Therefore, second generation Mexican Americans living near the border represent a population at high risk for health disparities. One theoretical approach to understanding the cause of these health disparities in immigrants is to envision the stress associated with acculturation as similar to other chronic psychosocial stressors that can over time lead to a dysregulation of the body's homeostatic function and thus impaired health. One measure of this dysregulation is allostatic load (AL) a term coined by McEwen and Stellar to operationalize the “wear and tear” on the body caused by chronic stress over time. In this study, we will apply new measures of AL to an extension of a previously ascertained cross- sectional study of young adult Mexican American population (18-30 yrs) that has focused on individual bio-psychosocial factors that influence MH and AUDs. Those preliminary studies have demonstrated a distinct cluster of bio-psychosocial risk factors associated with MH, binge drinking and AUDs in this population. These associated factors include: early age of onset of drinking, reduced sleep quality, electrophysiological measures, co-morbidity of AUD with other psychiatric disorders, experience of trauma and post-traumatic stress syndrome, measures of acculturation stress, and distributions of alcohol metabolizing enzymes unique to this population. In the studies proposed here, we will: (1) Use geocoding procedures to obtain community/neighborhood data on our existing cohort and an expanded group of participants in order to increase power to identify contextual influences on pathways to AUD, including gene X environment interactions, and to evaluate gender differences; and (2) add a longitudinal study by following up with our existing cohort later in adulthood to determine if they have “aged out” of early adult behavioral patterns or have developed more severe clinical outcomes. The longitudinal study also will enable assessment of effects of changes in acculturation and moving to a new community, or remaining in a high-risk neighborhood, on drinking and AUDs. Finally, we will, (3) use data from the expanded cross- sectional and longitudinal samples to develop a comprehensive bio-psychosocial-ecological model of MH and AUDs in Mexican Americans that includes individual genetic and physiological factors, as well as interpersonal and community influences. The proposed project brings together investigators with expertise in community studies, bio-psychosocial measures, biometrics and genetics to tackle this complex problem. Ultimately this study has the potential to provide critical information for understanding how select genetic and environmental factors might interact in the development of AUDs among Mexican American men and women living in in the U.S.-Mexico border region.