Testing a Biopsychosocial Model of Violence Exposure, Minority Stressors, and Hazardous Drinking among Sexual Minority Women

项目总结/摘要 与男子相比，妇女遭受暴力的比例更高;21-23然而，暴力侵害妇女行为并不 随机分布。部分由于其被污名化的身份，性少数群体妇女（SMW） 21、24-26许多妇女使用酒精来科普暴力， 暴力的负面后果（例如，28由于法定最低工资与创伤后应激障碍有关， 心理社会压力源的经历（即，暴力和歧视等少数群体压力因素）。 为受害的法定最低工资制定有针对性的酒精治疗方法的公共卫生必要性， 酒精治疗模式没有具体说明这一人群的独特压力源和临床需求。符合 NIAAA的研究重点，11，14，K 01将在理解生物心理社会方面提供重大进展 机构（例如，少数应激源、生理反应性、PTSD）和调节因子（例如，种族/民族） 影响法定最低工资中危险饮酒的异质性，以及这些核心因素 在法定最低工资对治疗的不同需求和反应中发挥作用。该项目将包括：1）流行病学 评估揭示法定最低工资中不同的心理社会压力因素组合， 社会心理压力源类别的差异，并确定这些模式的社会心理压力源 预测共病PTSD和危险饮酒超过11年（n = 450-600）; 2）一项基于实验室的研究， 少数应激源对非稳态负荷的影响的知识（例如，唾液皮质醇，心率，心率 变异性和皮肤电导）受害SMW（n = 125）;和，3）每天一次的生态 21天的瞬时评估（EMA）方法，确定少数压力源的作用， 使用同一个法定最低工资样本， 实验室研究本K 01应用程序中的拟议培训计划将提供基本知识和技能 首席研究员Jillian R. Scheer博士需要成为一个独立的，跨学科的 酒精科学家。Scheer博士通过这个及时和创新的项目获得的高级培训将针对 3目的：（1）严格的酒精研究方法及其在研究酒精影响因素中的应用 危险的饮酒模式;（2）压力反应的生理测量作为评估生物学的工具 少数压力源对共病PTSD和危险饮酒影响的潜在机制;以及，（3） EMA方法评估少数压力源对日常共病PTSD和危险性PTSD的近端影响 在不同种族的法定最低工资中饮酒Scheer博士将主要由耶鲁大学的John Pachankis博士指导 大学，由Tonda Hughes博士（哥伦比亚大学）、Rajita Sinha博士（耶鲁大学）提供额外指导 大学），塔米沙利文，博士（耶鲁大学），约书亚沃伦，博士（耶鲁大学），和罗伯特Pietrzak， 耶鲁大学哲学博士、公共卫生硕士。Scheer博士通过K 01奖的培训将确保她作为一名 独立科学家，其工作为公共卫生和临床工作提供信息，以减少SMW中的酒精使用。

Project Summary/Abstract Women disproportionately experience violence compared to men;21-23 however, violence against women is not distributed randomly. Due, in part, to their stigmatized identity, sexual minority women (SMW) are 2-3 times more likely to face violence than heterosexual women.21, 24-26 Many women use alcohol to cope with the negative sequelae of violence (e.g., PTSD).28 This comorbidity may be exacerbated among SMW given their experiences of psychosocial stressors (i.e., violence and minority stressors such as discrimination).11 Despite the public health necessity of developing targeted alcohol treatment approaches for victimized SMW, current alcohol treatment models do not specify unique stressors and clinical needs of this population. Consistent with the NIAAA’s research priorities,11, 14 the K01 will provide major advances in understanding biopsychosocial mechanisms (e.g., minority stressors, physiological reactivity, PTSD) and moderators (e.g., race/ethnicity) influencing the heterogeneity in hazardous drinking among SMW as well as the role that these core factors play in SMW’s differential need for and response to treatment. The project will include: 1) an epidemiologic assessment that uncovers distinct combinations of psychosocial stressors among SMW, identifies racial/ethnic differences in classes of psychosocial stressors, and determines how these patterns of psychosocial stressors predict comorbid PTSD and hazardous drinking over 11 years (n = 450-600); 2) a lab-based study that advances knowledge of the influence of minority stressors on allostatic load (e.g., salivary cortisol, heart rate, heart rate variability, and skin conductance) among victimized SMW (n = 125); and, 3) a once-daily ecological momentary assessment (EMA) approach over 21 days that determines the role of minority stressors as antecedents to daily fluctuations in PTSD and hazardous drinking using the same sample of SMW from the lab-based study. The proposed training plan in this K01 application will provide essential knowledge and skills that the principal investigator, Jillian R. Scheer, PhD, needs to become an independent, interdisciplinary alcohol scientist. The advanced training acquired by Dr. Scheer via this timely and innovative project will target 3 objectives: (1) rigorous alcohol research methodology and its application to studying determinants of hazardous drinking patterns; (2) physiological measurement of stress reactivity as a tool to assess biological mechanisms underlying the influence of minority stressors on comorbid PTSD and hazardous drinking; and, (3) EMA approaches to assess the proximal effects of minority stressors on daily comorbid PTSD and hazardous drinking among racially diverse SMW. Dr. Scheer will be primarily mentored by John Pachankis, PhD, at Yale University, with additional mentoring from Tonda Hughes, PhD (Columbia University), Rajita Sinha, PhD (Yale University), Tami Sullivan, PhD (Yale University), Joshua Warren, PhD (Yale University), and Robert Pietrzak, PhD, MPH (Yale University). Dr. Scheer’s training through the K01 award will ensure her success as an independent scientist whose work informs public health and clinical efforts to reduce alcohol use among SMW.