Internal Sources of Minority Stress and Alcohol Consumption

7.项目摘要/摘要 与NIAAA明确的目标一致，即了解问题饮酒风险的性别差异 针对在高风险社区内造成已知差异的机制，目前的提案 旨在研究少数群体压力的内部来源(即被边缘化的人所特有的压力)的作用 在加强大量饮酒方面，特别是在女性和男性双性恋/双性恋+人群中。 之前的工作几乎完全集中在那些已经认为自己是 女同性恋、男同性恋或双性恋。拟议中的项目试图检查生理和心理机制。 这解释了成年人的消费情况，他们对自己的性取向或性取向感到不确定 身份不确定性(SIU)。不确定性-同一性理论认为，当一个人对一个核心感到不确定时 在身份认同方面，他们的动机是减少由此产生的心理痛苦，这可以解释 酒精消耗量增加。到目前为止，还没有研究使用实验设计来检查生理学 暴露在少数人应激源的内部之后，对酒精消费的压力反应。这个 拟议的工作将测试消费和缓解痛苦的差异，部分基于参与者的 生理应激反应和乙醇的药理作用。本申请拟招聘 200名具有不同SIU水平的顺性受试者，采用3x2x5混合析因设计。参与者 将被随机分配到三个演讲中的一个，作为调整后的Trier社会压力测试的一部分 (A)相关的近端应激源--TSST：其性取向的发展，包括对 不确定性；(B)无关紧要的最近应激源--TSST：性别认同的发展，包括任何感觉 不确定性；或(C)控制-TSST：最近的一本书、电影或电视节目。然后参与者将参与一项35- 每分钟即兴品尝(酒精、安慰剂)。项目设计包括：(A)基线调查和(B) 实验实验室会议，测量(一)酒精消耗量和五项评估：(二)呼气酒精 注意力，(Iii)唾液应激激素，(Iv)心率，(V)血压，(Vi)心理困扰，以及 (Vii)察觉到的醉酒。参与者的SIU和生物性别会改变条件对消费的影响。 预计会产生间接影响，因此，暴露于有关少数群体压力的内部来源预计将 增加压力反应，这将是SIU较高者饮酒量的原因。我们还将 确定生理压力抑制效应和感知的醉酒在多大程度上 饮酒后痛苦的减少，取决于参与者的性别，饮料是否含有乙醇(或 不是)，以及对酒精影响的积极信念。结果将为干预措施提供针对生理和 心理过程，尤其是那些在暴露于内化的少数民族应激源后强化使用的过程。

7. Project Summary/Abstract Consistent with NIAAA’s expressed goal to understand sex differences in risk of problem alcohol use and target mechanisms that contribute to known disparities within high-risk communities, the current proposal seeks to examine the role of internal sources of minority stress (i.e., stress unique to those from marginalized communities) in potentiating heavy alcohol use, particularly among female and male bisexual/bi+ individuals. Prior work has focused almost exclusively on sources of minority stress among those who already identify as lesbian, gay, or bisexual. The proposed project seeks to examine physiological and psychological mechanisms that account for consumption among adults who report uncertainty about their sexual orientation, or sexual identity uncertainty (SIU). Uncertainty-identity theory suggests that when someone feels uncertain about a core aspect of their identity, they are motivated to reduce resulting psychological distress, which can account for increased alcohol consumption. No study, to date, has used an experimental design to examine physiological stress responses to ethanol consumption following exposure to internal sources of minority stress. The proposed work will test for differences in consumption and alleviation of distress based, in part, on participants’ physiological stress responses and the pharmacological effects of ethanol. This application proposes to recruit 200 cisgender participants with varying levels of SIU and uses a 3 x 2 x 5 mixed-factorial design. Participants will be randomly assigned to give one of three speeches, as part of an adapted Trier Social Stressor Test (TSST): (a) Relevant Proximal Stressor-TSST: development of their sexuality, including any feelings of uncertainty; (b) Irrelevant Proximal Stressor-TSST: development of their gender identity, including any feelings of uncertainty; or (c) Control-TSST: a recent book, movie, or TV show. Participants will then engage in a 35- minute ad libitum taste-test (ethanol, placebo). Project design includes: (a) a baseline survey and (b) experimental lab session that measures (i) alcohol consumption and 5 assessments of: (ii) breath alcohol concentration, (iii) salivary stress hormones, (iv) heart rate, (v) blood pressure, (vi) psychological distress, and (vii) perceived intoxication. Participants’ SIU and biological sex will alter the effect of condition on consumption. Indirect effects are expected, such that exposure to relevant internal sources of minority stress is expected to increase stress responses, which will account for drinking amount among those with higher SIU. We will also determine the extent to which physiological stress-dampening effects and perceived intoxication account for reductions in distress following drinking, depending on participant sex, whether beverages contain ethanol (or not), and positive beliefs about alcohol’s effects. Results will inform interventions that target physiological and psychological processes, especially those reinforcing use following exposure to internalized minority stressors.