Minority Stress Reactivity and Hazardous Drinking

项目摘要/摘要 在危险饮酒和酒精使用障碍(AUD)方面的差异已经被记录在几个 弱势群体(例如，种族/族裔和性少数群体)。危险饮酒及其后果是 考虑到他们巨大的经济、死亡率和发病率负担，这是一个主要的公共卫生优先事项和关切。 耻辱和与歧视相关的压力源(即少数族裔压力源)有助于我们对健康的理解 这些群体之间的差距。鉴于少数人应激源在预测危险饮酒方面的重要性， 本次导师临床科学家研究职业发展奖(K08)的研究目的是 对少数民族压力及其对饮酒的影响进行严格、创新和多方法的检查 实验室和自然环境在一个弱势健康差距群体中。性少数(SM； 即女同性恋、男同性恋或双性恋)成年人与异性恋者相比，危险饮酒的风险更高。 短信经历了少数人的压力源，从日常和短暂的轻蔑到更严重的 耻辱，并与危险饮酒直接相关。然而，现有SM的主要局限性 文献包括缺乏对少数民族应激源(即生物标记物)反应的客观衡量， 过度依赖横断面数据，在对少数群体的评估中没有考虑到个体差异 压力或小众压力对危险饮酒的贡献超过日常生活中的个体差异 一般应力和终身累积应力。此外，人们对两者之间的调解机制知之甚少。 少数民族压力和危险饮酒。与医学研究所和NIH的呼吁一致，扩大 基于科学知识导致短信饮酒率上升的因素，本研究的目的是 K08是为了：1)检查支持评估的少数民族应激的心理生理机制的影响 在一项由70名最有可能患上AUD的短信(即重度短信)的实验室实验中发现，他们对酒精的渴望 饮酒者)；和2)使用30天内的经验抽样方法(即EMA)，以检查：a)效果 来自实验室的心理生理应激反应对少数民族应激反应和在天然环境中饮酒的影响 环境和b)少数民族应激对情感和饮酒的近期变化的预期影响及其 实时的后果。在进行这项研究并参与多项培训和指导时 K08候选人将在以下方面发展新的专业知识：1)实验实验室研究；2) 心理生理应激研究和唾液研究方法；3)经验样本场方法 (即EMA)；以及4)用于分析密集纵向EMA定量数据的高级统计方法 和生理唾液实验室数据。这个提议的项目建立在候选人过去工作的基础上 检查少数民族应激源与性别和种族/民族之间的健康结果之间的关系 少数族裔。完成这项K08奖项将为候选人提供成为独立人士所需的技能 有能力提高我们对预测危险饮酒的压力特定因素的认识的研究人员。

PROJECT SUMMARY/ABSTRACT Disparities in hazardous drinking and alcohol use disorder (AUD) have been documented across several disadvantaged groups (e.g., racial/ethnic and sexual minorities). Hazardous drinking and its consequences are a major public health priority and concern given their significant economic, mortality, and morbidity burdens. Stigma and discrimination-related stressors (i.e., minority stressors) contribute to our understanding of health disparities among these groups. Given the importance of minority stressors in predicting hazardous drinking, the research aims of this Mentored Clinical Scientist Research Career Development Award (K08) are to conduct a rigorous, innovative, and multi-method examination of minority stress and its effects on drinking in the lab and the natural environment among one disadvantaged health disparities group. Sexual minority (SM; i.e., lesbian, gay, or bisexual) adults are at increased risk for hazardous drinking compared to heterosexuals. SMs experience minority stressors, which range from daily and momentary slights to more acute forms of stigma, and are directly correlated with hazardous drinking. However, major limitations of the extant SM literature include the lack of objective measures of reactivity to minority stressors (i.e., biological markers), overreliance on cross-sectional data, and failure to account for individual differences in appraisals of minority stress or the contributions of minority stress on hazardous drinking beyond individual differences in daily general stress and lifetime cumulative stress. In addition, little is known about mediating mechanisms between minority stress and hazardous drinking. Consistent with Institute of Medicine and NIH’s call to expand the scientific knowledge base on factors contributing to SMs’ elevated rates of drinking, the research aims of this K08 are to: 1) examine the effects of psychophysiological mechanisms underpinning appraised minority stress and alcohol craving in a lab experiment of 70 SMs who are at most risk for developing AUD (i.e., heavy drinkers); and 2) use experience sampling methods (i.e., EMA) over a 30-day period, to examine: a) the effects of psychophysiological stress reactivity from the lab on minority stress reactivity and drinking in the natural environment and b) the prospective effects of minority stress on proximal changes in affect and drinking and its consequences in real time. While conducting this research and participating in several training and mentorship activities, the K08 candidate will develop new expertise in: 1) experimental laboratory research; 2) psychophysiological stress research and salivary research methodology; 3) experience sampling field methods (i.e., EMA); and 4) advanced statistical approaches for analyzing intensive longitudinal EMA quantitative data and physiological salivary laboratory data. This proposed project builds upon the candidate’s past work examining the associations between minority stressors and health outcomes among sexual and racial/ethnic minorities. Completion of this K08 award will provide the candidate necessary skills to be an independent researcher capable of advancing our knowledge of stress-specific factors predicting hazardous drinking.