Cyclical deficits in emotion regulation as a risk factor for alcohol misuse in premenopausal females

项目总结 酒精滥用在女性中的比例正在上升。因为女性可能会经历比男性更糟糕的健康后果 与酒精滥用相关的女性特有的风险，阐明女性特有的因素对于建立 更好地了解女性酗酒和制定酒精预防策略 在女性身上滥用。一篇关于维度经前焦虑症(DPMDD)的小型文献 情绪障碍的特征是临床上有明显的情绪、行为和身体症状 黄体晚期通过卵泡中期完全消退--这是酒精的关键女性特有的危险因素 误用和黄体期酒精使用增加。然而，到目前为止，还没有研究评估共享的 DPMDD和酒精滥用的生理和情感途径。情绪调节包括 对情绪的认识和识别，以及调整情绪反应的策略。情绪调节 也可能是生理上的表现。心率变异性(HRV)，副交感神经控制的一个指标 心率，被认为是情绪调节的外周心理生理标志。约化主观性 客观(即心率变异性)情绪调节被证明与酒精滥用有关。然而， 研究还没有调查情绪调节的周期性变化如何可能成为酒精的风险因素 滥用，以及与没有dPMDD相比，这在女性之间是否不同。心率变异性显示最低 黄体期的水平，我们的试点数据显示，黄体期HRV的下降幅度更大，映射到更多 黄体期负性情绪明显增加。我们的中心假设是患有dPMDD的女性 由于孕激素相关的心率变异性和黄体酮水平下降，大量饮酒导致黄体期反复增加。 情绪调节方面的相关缺陷。这项拟议的研究将招募患有重度绝经前疾病的女性 酒精使用(50%dPMDD)，将完成4周的前瞻性筛查；5周的生态 瞬时评估(EMA)和心率变异性评估。AIM 1测试了dPMDD将显示更大的假设 与无dPMDD相比，酗酒者黄体期增加。目标2检验了周期性赤字的假设 在情绪调节方面，会预测酒精滥用的周期性增加。《目标3》检验了个人 从卵泡到黄体期HRV降低程度的不同将预示更大的黄体 酒精变量中的位相增加。这项研究的结果将对NIH的战略做出重要贡献 针对性别/性别差异和女性健康的研究计划。具体来说，这项研究将提供 关于酒精滥用与周期性情绪调节相关的信息，这将为 大量饮酒对情绪调节的影响及其病因的研究进展 女性酗酒与情绪调节在dPMDD中的重叠。

PROJECT SUMMARY Alcohol misuse is rising in females. As females may experience worse health consequences then males and female-specific risks associated with alcohol misuse, elucidating female-specific factors is essential to build a better understanding of alcohol misuse in females and the development of prevention strategies for alcohol misuse in females. A small literature implicates dimensional premenstrual dysphoric disorder (dPMDD)—a mood disorder characterized by clinically significant emotional, behavioral, and physical symptoms during the late luteal that completely resolve by the mid follicular—as a critical female-specific risk factor for alcohol misuse and luteal phase increases in alcohol use. However, no studies to date have evaluated the shared physiological and emotional pathways of dPMDD and alcohol misuse. Emotion regulation encompasses the awareness and identification of emotion, and strategies to modify the emotional response. Emotion regulation may also be physiologically represented. Heart rate variability (HRV), an index of parasympathetic control over heartrate, is considered a peripheral psychophysiological marker of emotion regulation. Reduced subjective and objective (i.e., HRV) emotion regulation has been shown to associate with alcohol misuse. However, studies have not investigated how cyclical changes in emotion regulation may act as a risk factor for alcohol misuse and whether this differs between females with compared to without dPMDD. HRV shows the lowest levels during the luteal phase and our pilot data shows greater luteal phase reductions in HRV map onto more significant increases in luteal phase negative emotion. Our central hypothesis is that females with dPMDD suffer from recurrent luteal phase increases in heavy drinking due to progesterone-related declines in HRV and associated deficits in emotion regulation. The proposed study will recruit premenopausal females with heavy alcohol use (50% dPMDD) who will complete 4 weeks of prospective screening; and 5 weeks of Ecological Momentary Assessment (EMA) and HRV assessment. Aim 1 tests the hypothesis that dPMDD will show larger luteal phase increases in alcohol misuse relative to no dPMDD. Aim 2 tests the hypothesis that cyclical deficits in emotion regulation will predict cyclical increases in alcohol misuse. Aim 3 tests the hypothesis that individual differences in the degree of HRV reduction from the follicular to the luteal phase will predict greater luteal phase increases in alcohol variables. The results of this study will importantly contribute to the NIH strategic plan for research addressing sex/gender differences and female health. Specifically, this study will provide information on cyclical emotion regulation associations with alcohol misuse, which will provide foundational information regarding the influence of emotion regulation in the context of heavy drinking and the etiologic overlap between female alcohol misuse and emotion regulation in dPMDD.