Isolation and Loneliness Underlying Misuse and Increased Use of Alcohol as a function of Stress and Coping Efforts

滥用和增加酒精的隔离和孤独感作为压力和压力的函数， 应对努力（ILLUMINATE）项目将测试适应性/适应不良应对作为联系行动的机制 在美国，客观的社会孤立和主观的孤独感与酒精使用/滥用 和压力作为调节这些中介效应在两个独立的研究。我们将提高我们的能力， 在我们的第一项研究中关于孤独、压力、应对和酒精使用的自我报告数据中测试这个模型 在COVID-19大流行期间，改变行政命令通过关闭限制了社会交往 能力降低。我们收集了美国第一个高峰期间全国成年人样本（N= 1，550）的数据。 2020年4月的COVID-19平均每日感染人数以及随后12个月的五个额外点。 我们的调查收集了人们如何应对广泛的社会孤立的关键自我报告数据， 孤独和同时普遍存在的慢性压力和饮酒。我们建议增加地理 样本参与者的位置，这将使我们能够创建基于地点的社会隔离指标， 压力源（包括就地避难指数、社交场所的限制/关闭，以及 新冠肺炎期间每个评估点的失业率）和特定于某个地点的其他压力因素， 经济和社会脆弱性、住房不稳定、种族和民族隔离以及犯罪率。我们 第一个目的是测试适应性（积极应对，重新评价）和适应不良（回避）应对努力， 在大流行期间，行为机制驱动酒精使用和高风险饮酒，测试 这些应对过程在多大程度上介导了社会孤立/孤独与酒精之间的联系 我们的第二个目标是确定累积的多层次压力负担（个人和 基于地点的）调节社会孤立，孤独，适应/适应不良应对之间的联系， 酒精使用/滥用。然后，我们将在全国代表性样本中收集研究2的前瞻性数据， 6个评估点（N= 1 550），再次纳入客观地理空间指标，以测试这些指标的模型 联系（目标1和2），并确定我们的这些关系的模型在多大程度上不同， 一个强制隔离和社区压力的时期，从一个更普通的流行后时期（目标3）。 重要的是，两个样本中的重复测量设计使我们能够模拟酒精使用的轨迹， 滥用和社会孤立，孤独，压力和适应/适应不良之间的复杂关系 随着时间的推移，应对过程。与NIH资助机会公告PAR-21-350密切一致， 我们对2019冠状病毒病大流行和大流行后隔离和孤独的影响的评估 酒精使用/滥用时期对制定预防和干预措施具有相当大的影响 为大流行后的环境进行校准。

The IsoLation and Loneliness Underlying Misuse and INcreased use of Alcohol as a function of sTress and coping Efforts (ILLUMINATE) project will test adaptive/maladaptive coping as the mechanisms of action linking objective social isolation and subjective feelings of loneliness with alcohol use/misuse across the United States and stress as the moderator of these mediational effects in two separate studies. We will enhance our ability to test this model in our in-hand self-reported data from Study 1 on loneliness, stress, coping, and alcohol use during the COVID-19 pandemic when changing executive orders limited social interaction by dint of closures and reduced capacity. We collected data on a national sample of adults (N=1,550) during the first peak of US average COVID-19 daily infections in April, 2020 and at five additional points over the subsequent 12 months. Our surveys collected key self-report data on how people coped in the face of extensive social isolation, loneliness and concurrent pervasive chronic stress and alcohol consumption. We propose to add geographic location of the sample participants, which will allow us to create indicators of place-based social isolation and stressors (including an index of shelter-in-place, restrictions/closing of places of social interaction, and unemployment rates at each assessment point during COVID) and other stressors specific to a location such as economic and social vulnerabilities, housing instability, racial and ethnic segregation, and crime rates. Our first aim is to test adaptive (active coping, reappraisal) and maladaptive (avoidance) coping efforts as the behavioral mechanism driving alcohol use and high risk drinking over the course of the pandemic, testing the extent to which these coping processes mediate linkages between social isolation/loneliness and alcohol use/misuse, and our second aim is to determine whether cumulative-multilevel stress burden (individual and place-based) moderates the linkages between social isolation, loneliness, adaptive/maladaptive coping, and alcohol use/misuse. We will then collect prospective data for Study 2 in a nationally representative sample over 6 assessment points (N=1,550), again integrating objective geospatial indicators, to test the model of these linkages again (Aims 1 and 2) and to determine the extent to which our model of these relationships differed in a time of enforced isolation and communal stress from a more ordinary time period post-pandemic (Aim 3). Importantly, the repeated measures design in both samples allows us to model trajectories of alcohol use and misuse and the complex relationships among social isolation, loneliness, stress, and adaptive/maladaptive coping processes over time. Closely aligned with the NIH Funding Opportunity Announcement PAR-21-350, our assessment of the impact of isolation and loneliness in the COVID-19 pandemic and post-pandemic periods on alcohol use/misuse has considerable implications for developing prevention and intervention efforts calibrated for the post-pandemic environment.