Beyond the impact of infection itself, the COVID-19 pandemic has resulted in far-reaching effects on behavioral, social, psychiatric, and substance use outcomes. Early data has documented increases in alcohol use in the wake of the pandemic, consistent with prior evidence of increased alcohol consumption during times of stress and following traumatic events. Immediate and downstream implications of increased alcohol use, and development of alcohol use disorder (AUD), on public health include the interplay between alcohol use and psychiatric distress (i.e., posttraumatic stress disorder; PTSD), potential for problematic alcohol use to increase behavioral risk for infection/transmission of COVID-19, and the possibility that weakened immune systems and health conditions associated with AUD may impact disease severity in those who develop COVID-19. The overarching goals of this K01 Supplement are twofold. First, this supplement aims to extend the PI's training to incorporate health impacts of AUD and how it relates to COVID-19 risk and severity, along with analytic training in longitudinal modeling and methodological training in an intensive time-series data collection method to try and develop a mechanistic understanding of the functional relations between alcohol use, PTSD, risky behaviors, and health outcomes. Second, two new research aims associated with these training aims were added which seek to address gaps in the current stress and alcohol use literature by leveraging an existing, longitudinal dataset, with prospective (i.e., pre-pandemic) data. The two new research aims are to 1) assess the immediate, and trajectory of, COVID-19 impacts on alcohol phenotypes (e.g., consumption, binge drinking, problems) in comparison to pre-pandemic data and 2) in the context of COVID-19 as an ongoing stressor, collect repeated, time-series data to examine the temporal relations between alcohol phenotypes, PTSD, and COVID-specific risky behaviors (e.g., lack of social distancing). To achieve these training and research aims, an additional mentor with expertise in both the health impact of AUD and COVID-19 treatment trials has been added to the multidisciplinary mentorship team. Further, the PI's primary K01 mentor has specific expertise in the implementation of COVID-19 surveys on substance and mental health outcomes and experience with time-series data collection in traumatic stress populations. The proposed research represents an important contribution towards advancing our understanding of the complicated interrelationship between AUD, PTSD, and risky behaviors in the context of the COVID-19 pandemic to determine not only who is at risk, but when risk behaviors occur. This information will be important for attempts to plan for a public health response during and after the pandemic. Under the umbrella of a career development award, this pilot data will inform future large-scale studies and R-level grants aimed at identification and prevention of COVID-19-related impact, further positioning the PI to continue this line of work by adapting ongoing training to be responsive to medical pandemics and decrease the burden of alcohol-related problems, consistent with NIAAA research priority.
The COVID-19 pandemic has become a collective traumatic event with wide-reaching impact on mental health problems including posttraumatic stress disorder (PTSD) and alcohol consumption and related problems, disorders that co-occur and may be functionally related to each other. This project will leverage existing, prospective data from a registry cohort to recruit Veterans, a population at risk for alcohol misuse and PTSD, into a new research protocol in the wake of the pandemic to understand the acute and longitudinal change in alcohol use phenotypes following COVID-19 as well as the temporal relationships between alcohol use and psychiatric and behavioral risk outcomes. Additionally, as this supplement is stemming from a K01 grant, additional training aims have been added to help prepare the candidate to effectively use the data generated from this study to help inform future attempts to plan for and mount a public health response, both during and after the pandemic.
