Effects of Stressors on Drug Use in Young, Poor Women

描述（由申请人提供）：本研究的目的是探讨应激源对药物滥用和依赖的影响，并通过应对方式加以修正。在大多数关于压力和药物障碍的研究中，年轻的低收入妇女没有得到足够的关注，这些年轻妇女处于吸毒和压力负担增加的年龄组。将进行一项前瞻性队列研究，以将压力源的增加与药物障碍的发病、药物使用的进展、滥用和依赖联系起来。在这项研究中，总共有600名12个月的吸毒者（其中311名非西班牙裔白人，103名非西班牙裔黑人和186名西班牙裔女性）将被采访。这些详细的访谈将在基线、12个月和24个月进行。在面对面面试之间，每隔一个月将进行简短的电话面试。参与者将前往24家提供妇科和生殖服务的国家资助诊所之一。每次访谈将使用CAPI方法。参与者将被要求亲自或通过邮件提供四份唾液样本用于四次皮质醇测试，一份尿液样本用于药物测试小组。本提案的主要目的是：(1)研究和报告压力暴露的流行病学，特别是操作性压力源（定义为最近和持续的压力源的发生和积累），随着时间的推移，年轻，低收入妇女；(2)通过理论驱动的假设（如自我药物治疗），理解并检验操作性应激源与DSM-IV滥用/依赖的关系；(3)考察个体的应对方式是否影响不同操作性应激源与滥用/依赖的关系。我们的次要目标是：(1)检查药物障碍对压力源的相互作用；(2)以民族/种族身份检视上述关系。我们将对年轻、低收入妇女的操作性应激源以及应激源与这一弱势群体药物障碍的关系进行相对全面而集中的调查。澄清这种关系应有助于制定有针对性的有效预防和干预措施，以防止在成年后从药物使用过渡到滥用和依赖。

DESCRIPTION (provided by applicant): The purpose of this study is to examine the contribution of stressors to drug abuse and dependence, as modified by coping style. Young, low-income women have received inadequate attention in most studies of stress and drug disorder, and these young women are in an age group with increasing drug use and burdens of stress. A prospective cohort study will be conducted to relate increases in stressors to onset of drug disorder, as well as progression of drug use, to abuse and dependence. In this study, a total of 600 12-month drug users (with 311 non-Hispanic white, 103 non-Hispanic black, and 186 Hispanic women) will be interviewed. These detailed interviews will occur in person at baseline, 12, and 24 months. In between the in-person interviews, brief telephone interviews will be conducted every other month. Participants will attend one of 24 state-funded clinics providing gynecological and reproductive services. CAPI methods will be used for each interview. Participants will be asked to provide, in person or by mail, four saliva samples for four cortisol tests and one urine sample for a drug test panel. The primary aims of this proposal are to: (1) study and report the epidemiology of stress exposure, particularly operant stressors (defined as the occurrences and accumulation of recent and ongoing stressors), in young, low-income women over time; (2) understand and examine the relationships of operant stressors with onset of DSM-IV abuse/dependence over time through theory-driven hypotheses (e.g., self-medication); (3) examine whether an individual's coping style modify the relationships of different operant stressors with abuse/dependence. Our secondary aims are to (1) to examine the reciprocal effects of drug disorder on stressors; (2) to examine the above relationships by ethnic/racial status. We will conduct a relatively comprehensive but focused investigation of operant stressors in young, low- income women and the relation of stressors to drug disorder in this vulnerable population. Clarifying such relationship should help in the development of targeted, effective preventions and interventions to prevent transitions from drug use to abuse and dependence in adulthood.