COVID-19 pandemic stress and coping activities, polygenic and neural vulnerabilities in those at risk for Alcohol Use Disorders

PROJECT SUMMARY/ABSTRACT The COVID-19 pandemic has led to significant disruptions in daily social activities, schooling, and employment, and for some individuals, exposure to traumatic stressors such as the grave illness or death of family members, and serious financial hardship. A recent review of 23 studies found that the COVID-19 pandemic has increased risk for alcohol use disorders (AUD), and relapse among those with a history of AUD [8]. However, research is needed to understand which particular domains of the pandemic (e.g., economic hardship, social disconnection, death of a family member, disruption in healthcare) are most strongly associated with changes in AUD to identify modifiable targets for intervention and prevention efforts. Further, research is needed to identify individuals at greatest risk for COVID-19 stress-related AUD. Evidence indicates that among those with high polygenic risk for AUD, associations between traumatic stress and AUD tend to be greater, and inverse associations between protective exposures (e.g., healthy coping activities) and AUD tend to be minimized. However, whether individuals with high genetic risk are more vulnerable to COVID-19 stress-related AUD, or experience less benefit from healthy coping activities, is unknown. Research has also shown that individuals with AUD differ in terms of their brain function, including alpha EEG coherence, a measure of neural functional connectivity; lower alpha EEG has been consistently associated with AUD. While decades of research have focused on neurophysiological differences observed among those with and without AUD, no prior studies have examined interactions between measures of neural connectivity, polygenic risk, and traumatic stress with respect to heightened risk for AUD. Preliminary COVID-19 data from the Collaborative Study on the Genetics of Alcoholism (COGA)'s ongoing assessment of adult participants (ages 30-90) who are at risk for AUD, have active AUD, or prior AUD, has demonstrated that COVID related perceived stress, media consumption, economic hardship and family COVID illness were associated with increased alcohol and other substance use since the start of the pandemic, particularly for women, mid-life (ages 30-50) participants with AUD (active or prior), those with high polygenic risk for alcohol misuse, and those with lower alpha EEG connectivity. Healthy coping activities were associated with decreased drunkenness. Building on the wealth of existing data from COGA, this project will continue to assess and characterize the longitudinal relationships among different types of COVID-19 related stressors and healthy coping activities and changes in risk for AUD, and AUD severity, prospectively throughout the pandemic among individuals at risk for AUD and at various stages of active AUD and remission, and the roles of varying levels of biological risk including polygenic risk for alcohol use problems and neural connectivity. Findings from the proposed research will allow us to better understand modifiable factors that may buffer against alcohol misuse and AUD among gender, racial/ethnic, and age subgroups of high-risk individuals, such as increasing access to mental healthcare, promoting social connections and other healthy coping strategies.