Understanding differences in risk for alcohol problems between Black and White drinkers: Integrating alcohol response, stress, and drinking motives

项目摘要 意义：即使在同等水平下，黑人饮酒者比白色饮酒者经历更多的酒精问题 酒精的使用。这些问题是普遍存在的，发生在物理，社会和法律的结果。的 解释为什么黑人饮酒者经历酒精问题的风险较高的原因是 研究不足，没有很好地理解，但可能涉及不同的压力水平和急性反应， 酒精建议的R 01在实验室和自然环境中检查这些结构 环境使用生态瞬时评估（EMA），以确定干预的近点， 黑人和白色饮酒者。目的：目的1将研究在酒精治疗前抗焦虑作用的种族差异。 在实验室进行压力诱导后。目标2将直接测试在实验室中测量的差异酒精反应 加强压力和酒精认知（对酒精的渴望，饮酒动机）之间的联系， 解释了这些认知的种族差异。目标3将研究实验室酒精 压力的反应和每日报告解释了12个月随访中酒精问题的种族差异。 假设：我们假设，黑人饮酒者将增加敏感性的抗焦虑作用， 与白色饮酒者相比，这种对酒精的敏感性以及压力的增加将预测 增加了EMA中的危险酒精认知。此外，压力和酒精认知之间的联系 对于对酒精的抗焦虑作用最敏感的参与者来说，这种作用会更强。EMA醇 认知将部分解释酒精反应、压力和酒精问题之间的联系 EMA期间以及6个月和12个月随访时。这些流程及其交易将 部分解释了为什么黑人饮酒者相对于白色饮酒者，经历更多的酒精问题。 方法：年轻成年饮酒者（N = 280; 21-30岁; 50%黑人，50%女性）将从 社会各界参与者将首先完成半结构化诊断访谈和问卷调查， 然后，我将完成两个实验室会议（安慰剂和酒精;随机顺序）与标准化的压力 评估急性酒精反应。接下来，参与者将完成一项为期17天的EMA协议， 压力波动、酒精认知、酒精反应、酒精使用/问题。为了预测 将在6个月和12个月时进行前瞻性结局随访评估，并将包括过去6个月 一个月自我报告的酒精使用、酒精问题、压力和酒精认知，以及90天的时间轴 后续采访该R 01提案直接符合NIAAA的战略优先事项， 压力在酗酒问题中的作用，并减少健康差距。拟议研究 这是一个重要的步骤，有助于我们更好地理解为什么黑人饮酒者更容易饮酒 这些问题将最终为针对这一未充分研究的高危人群的干预工作提供信息。

Project Summary Significance: Black drinkers experience more alcohol problems than White drinkers even at equivalent levels of alcohol use. These problems are pervasive, occurring across physical, social, and legal outcomes. The reasons that explain why Black drinkers are at elevated risk for experiencing alcohol problems are understudied and not well understood, but may involve differences in level of stress and acute response to alcohol. The proposed R01 examines these constructs both within the laboratory and in the natural environment using ecological momentary assessment (EMA) to identify proximal points of intervention for both Black and White drinkers. Aims: Aim 1 will examine racial differences in the anxiolytic effects of alcohol prior to and after a stress induction in the lab. Aim 2 will directly test if differential alcohol response measured in the lab strengthens the association between stress and alcohol cognitions (craving for alcohol, drinking motives), and accounts for racial differences in these cognitions. Aim 3 will examine the extent to which lab-based alcohol response and daily reports of stress explain racial differences in alcohol problems through 12-month follow-up. Hypotheses: We hypothesize that Black drinkers will have increased sensitivity to the anxiolytic effects of alcohol compared to White drinkers and that this sensitivity to alcohol as well as elevated stress will predict increased risky alcohol cognitions in EMA. Additionally, the association between stress and alcohol cognitions will be stronger for participants with the most sensitivity to the anxiolytic effects of alcohol. EMA alcohol cognitions will partially account for the association between alcohol response, stress, and alcohol problems during the EMA period and at the 6- and 12- month follow-ups. These processes and their transaction will partially account for why Black drinkers, relative to White drinkers, experience more alcohol problems. Approach: Young adult drinkers (N = 280; 21-30 years of age; 50% Black, 50% female) will be recruited from the community. Participants will first complete a semi-structured diagnostic interview and questionnaires and will then complete two laboratory sessions (placebo and alcohol; randomized order) with a standardized stress task to assess acute alcohol response. Next, participants will complete a 17-day EMA protocol to record fluctuations in stress, alcohol cognitions, alcohol response, alcohol use/problems. To allow for the prediction of prospective outcomes follow-up assessments at 6- and 12- months will be conducted and will include past 6 month self-reported alcohol use, alcohol problems, stress, and alcohol cognitions, as well as a 90-day timeline follow-back interview. This R01 proposal is directly in line with the NIAAA's strategic priorities to understand the role of stress in relation to alcohol problems and to decrease health disparities. The proposed research takes a critical step towards increasing our understanding of why Black drinkers are at greater risk for alcohol problems and will ultimately inform intervention efforts that are tailored to this under-studied, at-risk, population.