Quantifying Exposure to Illicit Drugs & Psychosocial Stress in Real Time

由于吸毒和心理社会压力往往是短暂的，难以准确回忆，因此对吸毒和心理社会压力的评估十分复杂。 由于因果关系的复杂性和环境的难以捉摸，评估它们之间的因果关系及其遗传和环境决定因素变得复杂。 在拟议的研究中，我们将通过生态瞬时评估（EMA）近实时地评估药物使用和心理社会压力，参与者使用手持电子日记记录事件发生时的情况，并报告最近或正在发生的事件，以响应全天随机定时的提示。 我们还将通过让参与者携带全球定位系统（GPS）设备以几米的空间分辨率跟踪他们的行踪，实时记录所报告的事件发生的地点。 扩大环境因素的定义，我们将评估社区层面的药物暴露和压力，这些指数是专门开发的指数，即药物环境指数（DEI）和社区心理社会危害指数（NPH），每个指数都基于公共来源的客观统计数据，独立于自我报告。 为了进行比较，还将通过回顾性音频计算机辅助结构访谈（ACASI）和生物样本（毛发和汗液）评估药物暴露，并将通过ACASI和生理测量（心率和非稳态负荷）评估应激。 该项目代表了NIDA IRP（我们已经在使用EMA治疗多种药物依赖的门诊患者）和约翰霍普金斯ALIVE研究调查者（跟踪一个特征良好的药物滥用者社区队列，其中大多数人没有接受治疗）之间的合作。 在NIDA的开发工作与ALIVE的现场试验相关联之后，其结果预计将是一套可现场部署的，最先进的工具，对于未来研究影响药物使用和压力的基因-环境相互作用不可或缺。

Assessment of exposure to drug use and psychosocial stress is complicated by the fact that each is often transient and difficult to recall accurately. Assessment of their causal connections with one another, and of their genetic and environmental determinants, is complicated by the complexity of the causal connections and by the elusive nature of what constitutes the environment. In the proposed study, we will assess drug use and psychosocial stress in near-real time through Ecological Momentary Assessment (EMA), in which participants use handheld electronic diaries to record events as they occur and to report recent or ongoing events in response to randomly timed prompts throughout the day. We will also maintain real-time records of where the reported events occurred by having participants carry Global Positioning System (GPS) devices to track their whereabouts with a likely spatial resolution of several meters. Broadening the definition of environmental factors, we will evaluate neighborhood-level exposures to drugs and stress measured in terms of specially developed indices, the Drug Environment Index (DEI) and the Neighborhood Psychosocial Hazards index (NPH), each based on objective statistical data available from public sources and independent of self-report. For comparison, drug exposure will also be assessed through retrospective audio-computer assisted structure interview (ACASI) and from biological specimens (hair and sweat), and stress will be assessed through ACASI and physiological measures (heart rate and allostatic load). The project represents a collaboration between the NIDA IRP (where we are already using EMA with polydrug-dependent outpatients) and Johns Hopkins ALIVE Study investigators (following a well-characterized community cohort of drug abusers, most of whom are not in treatment). After developmental work at NIDA linked to field trials in ALIVE, the result is expected to be a set of field-deployable, state-of-the-art tools indispensable to future studies of gene-environment interactions affecting drug use and stress.