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

项目摘要/摘要 拟议研究的总体目标是进行社区层面的研究，并制定一个多层次的、 精神卫生(MH)和酒精使用障碍风险和保护因素的生物-心理-社会-生态模型 圣地亚哥县的墨西哥裔美国年轻人(主要是第二代移民)中的(AUDS)。在美国出生的 墨西哥裔美国人的饮酒率和精神障碍的比率高于他们在墨西哥出生的祖先 还有同龄人。这表明，适应美国生活的跨代过程可能在MH和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着健康风险很高的人群。 差距。理解移民健康差距原因的一种理论方法是设想 与文化适应相关的压力，与其他慢性心理社会应激源相似，随着时间的推移，可能会导致 身体内环境平衡功能失调，从而损害健康。这种失调的一个衡量标准是异丙肾上腺素 负载(AL)是麦克尤恩和史黛拉创造的一个术语，用来操作由慢性疾病引起的对身体的“磨损” 随着时间的推移会产生压力。在这项研究中，我们将应用AL的新度量来扩展先前确定的交叉- 关注个体生物心理社会的年轻成年墨西哥裔美国人(18-30岁)的部分研究 影响MH和AUDS的因素。这些初步研究表明，生物-心理-社会 该人群中与MH、酗酒和AUDS相关的危险因素。这些相关因素包括：早年 开始饮酒、睡眠质量下降、电生理指标、AUD与其他精神疾病的共同发病率 精神障碍，创伤和创伤后应激综合征的经历，文化适应应激的措施，以及 酒精代谢酶是这一群体特有的。在这里提出的研究中，我们将：(1)使用地理编码 获得关于我们现有队列和扩大的参与者群体的社区/邻里数据的程序 增强识别背景对AUD途径的影响的能力，包括基因X环境相互作用，以及 评估性别差异；以及(2)在成年后对我们现有的队列进行跟踪，增加一项纵向研究 以确定他们是否已经脱离了早期成人的行为模式，或者已经出现了更严重的临床结果。 纵向研究还将能够评估适应文化变化和迁移到新社区的影响， 或留在高危社区，酗酒和AUD。最后，我们将，(3)使用来自扩展交叉的数据- 横断面和纵向样本以建立MH和AUDS的综合生物-心理-社会-生态模型 墨西哥裔美国人，包括个人遗传和生理因素，以及人际和社区因素 影响。拟议的项目汇集了具有社区研究、生物心理学和社会学专业知识的调查人员。 解决这一复杂问题的措施、生物识别和遗传学。最终，这项研究有可能提供 了解选定的遗传和环境因素如何在发育过程中相互作用的关键信息 居住在美墨边境地区的墨西哥裔美国男性和女性中的AUD。

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.