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2003 March

Sensitization to Amphetamine by Multiple Inductions of Salt Appetite

Ilene L. Bernstein, PhD
Professor

Psychology

Jeremy J. Clark (graduate student)

Description: Sensitization to drugs, such as amphetamine, is associated with alterations in the morphology of neurons in the nucleus accumbens, a brain region critical to motivation and reward. In preliminary studies we have found that a strong natural motivator, sodium depletion and associated salt appetite, leads to similar alterations in the nucleas accumbens. In addition, a history of sodium depletions was found to have cross-sensitization effects, namely an enhanced psychostimulant response to amphetamine. Thus, neuronal alterations common to salt and drug sensitization may provide a general mechanism for enhanced behavioral responses to subsequent exposures to these challenges. An intriguing aspect of these findings is that prior induction of a strong natural drive, such as sodium depletion and associated salt appetite, can lead to drug sensitization in individuals not previously exposed to those drugs. The proposed studies focus on defining the changes in behavioral and neuronal activation patterns to amphetamine administration that occur as a result of a history of acute sodium depletions. Studies will also assess the possibility that these changes are associated with alterations in the rewarding effects of amphetamine, as assessed in a conditioned place preference paradigm. The long range goal is to examine the hypothesis that neuronal alterations common to salt and drug sensitization represent a general neuronal response to a strong physiological challenge that provides a mechanism for an enhanced behavioral response to subsequent exposures to a variety of motivational challenges.

Resulting articles & projects:

  • Based on the work in this ADAI grant, Dr. Bernstein received a 5-year grant from NIDA, "Neural Plasticity and Sensitization of Salt Appetite," DA014609
  • Bernstein IL. Interaction between natural motivational systems and those which respond to drugs of abuse. Appetite 2003;41:333·334. [PubMed abstract]
  • Clark JJ, Bernstein IL. Reciprocal cross-sensitization between amphetamine and salt appetite. Pharmacology, Biochemistry and Behavior 2004;78:691-698.
  • Clark JJ, Bernstein IL. Sensitization of salt appetite is associated with increased "wanting" but not "liking" of a salt reward in the sodium deplete rat. Behavioral Neurosci 2006;120:206-210. [PubMed abstract]
  • Clark JJ, Bernstein IL. A role for D2 but not D1 dopamine receptors in the cross-sensitization between amphetamine and salt appetite. Pharmacology, Biochemistry and Behavior 2006;83:277-284. [PubMed abstract]
  • Voorhies AC, Bernstein IL. Induction and expression of salt appetite: Effects on fos expression in nucleus accumbens. Behavioral Brain Research 2006;172(1):90-6. [PubMed abstract]

Ethanol and Cholesterol Homeostasis in the Developing Brain

Marina Guizzetti, PhD
Research Scientist

Environmental and Occupational Health Sciences

Description: The proposed studies will address a novel aspect of ethanol's developmental neurotoxicity i.e. its effect on cholesterol homeostatis in astrocytes. While too much cholesterol may be deleterious as in case of atherosclerosis and Alzheimer's disease, too little can engender birth defects. Different degrees of mental retardation are often observed in three documented inborn errors of cholesterol synthesis: mevalonic aciduria, desmosterolosis, and Smith-Lemli-Opitz syndrome, as well as in maternal phenylketonuria, were the accumulating metabolite, phenylacetate, is an inhibitor of cholesterol synthesis. Lack of cholesterol during brain development as a consequence of these genetic defects leads, among others, to severe brain damage including microcephaly and mental retardation, both of which are hallmarks of fetal alcohol syndrome.

The developing brain has a high rate of endogenous sterol synthesis because the uptake of cholesterol from the circulation is low. Astrocytes produce most of the brain cholesterol which is used for astrocyte proliferation, or is released, via astrocyte-secreted high density lipoprotein-like particles containing apolipoprotien E, outside the cell, where it is taken up and utilized by neurons. The effect of ethanol on cholesterol homeostatis has been studied in relation to the cardiovascular system, since moderate alcohol consumption is associated with reduced incidence of coronary heart disease, though higher alcohol consumption may have opposite effects On the other hand, the effect of ethanol on cholesterol homeostatis in the developing brain, and in particular in astrocytes, has not been investigated.

In the present project, we propose to investigate the potential effect of ethanol on cholesterol synthesis, cholesterol efflux, intracellular apolipoprotien E levels, and apolipoprotien E release in rat cortical astrocytes. If any of our hypotheses proves to be correct, this will open the door for a number of investigations on the interaction of ethanol with cholesterol in the developing brain, for which additional funding will be sought.

Resulting articles & projects:

  • This award allowed Dr. Guizzetti to carry out preliminary studies on the possible relationship between alcohol and cholesterol during brain development as a possible mechanism involved in the developmental neurotoxicity of ethanol. She was subsequently awarded an R21 grant from NIH/NIAAA entitled "Ethanol and cholesterol homeostasis in the brain" (AA015443), which will allowed her to continue this research initially funded by ADAI. 1R21AA015443-01A1
  • Guizzetti M, Costa LG. Cholesterol homeostasis in the developing brain: a possible new target for ethanol. Hum Exp Toxicol 2007;26(4):355-60. [PubMed abstract]
  • Guizzetti M, Costa LG. Disruption of cholesterol homeostasis in the developing brain as a potential mechanism contributing to the developmental neurotoxicity of ethanol: an hypothesis. Med Hypotheses 2005;64(3):563-7. [PubMed abstract]
  • Guizzetti M, Chen J, Oram JF, Tsuji R, Dao K, Möller T, Costa LG. Ethanol induces cholesterol efflux and up-regulates ATP-binding cassette cholesterol transporters in fetal astrocytes. J Biol Chem. 2007 Jun 29;282(26):18740-9. [PubMed abstract | Free online]

Instability of 108MET Catechol-O-methyltransferase, a Possible Contributing Factor in Alcoholism

William W. Parson, PhD
Professor

Biochemistry

Description: A common polymorphism of the gene for catechol-O-methyltransferase (COMT) results in substitution of methionine for valine at position 108 of the soluble form of the protein (s-COMT) and position 158 of the membrane-bound form (mb-COMT). 108MET is s-COMT loses activity rapidly at physiological temperatures, so that the enzyme activity in tissues of individuals with the Met/Met genotype is about ¼ that in Val/Val individuals. The 108/158MET allele has been associated with increased risk for several neuropsychiatric conditions including alcoholism. We propose to investigate why 108MET COMT is unstable, with the long-range goal of finding a way to stabilize it. We will (1) measure the enzymatic activity of recombinant 108MET and 108VAL human s-COMT as functions of time, temperature, protein concentration, dithiothreitol, other reductants and oxidants and S-adenosylmethionine; (2) examine the effects on enzymatic activity and stability of replacing individual Cys residues by Ser or Ala; (3) use partial proteolysis and mass spectrometry to identify the sites of disulfide bonds that form as 108MET s-COMT loses activity; (4) use multidimensional NMR techniques to identify regions where the two structures differ or where 108MET s-COMT undergoes larger structural fluctuations; and (5) use molecular-dynamics simulations to explore the structural and dynamic differences between 108MET and 108VAL s-COMT.

Resulting articles & projects:

  • Dr. Parsons moved to the University of Wisconsin - Madison, where he particpates in a Center grant finded by NIH/NCRR, and continues this line of research. 5P41RR002301-23

Pilot Neonatal Ultrasound Study to Detect Fetal Alcohol Brain Damage

Ann P. Streissguth, PhD
Professor

Fetal Alcohol and Drug Unit, Psychiatry & Behavioral Sciences

Fred Bookstein, PhD

Description: The objective of this project is to develop methods and procedures for the earliest detection of babies born with prenatal brain damage from alcohol. This application is for a Pilot Study that would allow us to obtain NIH funding for a full-scale study of several hundred babies to be carried out in several sites simultaneously, including Seattle, South Africa, and the Ukraine. The project proposed here is a downward extension to infancy of our previous work on neuroanatomic-neuropsychologic deficits in adults and adolescents, which had a detection rate of better than 80% for patients with FAS/FAE vs. controls. Here, we propose to use neonatal cranial ultrasound to obtain the images, rather than Magnetic Resonance Imaging as we did for older subjects. We have demonstrated in a small feasibility study that our procedures work, but we need a larger sample to demonstrate quantifiable differences in the hypervariance signal between alcohol exposed and unexposed infants.

For this pilot study we propose to locate and enroll 26 recently postpartum mothers (half heavier drinkers; half controls). Mothers will be screened with a one-page Hospital Screening Questionnaire which is scored for BARC (binge-alcohol rating criteria). Additional information will be obtained from the UW modification of the Addiction Severity Index, and our own Pregnancy Drinking Calendar.

An HDL Ultrasound Scanner using a C8-5 Pediatric Cephalic Transducer with cine memory will be used to obtain between 10 to 30 images of each baby's corpus callosum (CC) in the midsagittal plane. These will be sent electronically to our consultant Dr. Fred Bookstein for data preparation (reconstructing an averaged CC image for each baby) and analysis. We predict that the alcohol-exposed will be hypervariable in shape with respect to the controls.

Resulting articles & projects:

  • The researchers used the initial pilot study that was funded by ADAI to leverage a larger grant from the Collaborative Initiative on Fetal Alcohol Syndrome Disorders (CIFASD) for $60,000 with which they were able to complete the project. The CIFASD is now going in for a renewal and we hope the Neonatal Ultrasound Study will be a fully funded project, with replications in Moscow and South Africa, and perhaps Ukraine and other countries in the consortium. One replication is already underway at the main teaching hospital in Vienna, where Dr. Bookstein is a full Professor.
  • Bookstein FL, Connor PD, Huggins JE, Barr HM, Pimentel KD, Streissguth AP. Many infants prenatally exposed to high levels of alcohol show one particular anomaly of the corpus callosum. Alcohol Clin Exp Res. 2007 May;31(5):868-79. [PubMed abstract]
  • Grant TM, Bookstein FL, Whitney NL, Streissguth AP. Neonatal cranial ultrasound leads to early diagnosis and intervention in baby of alcohol-abusing mothe Mental Health Aspects Developmental Disabilities 2006;9(4):125-127.
  • Bookstein FL, Connor PD, Covell KD, Barr HN, Gleason CA, Sze RW, McBroom lA, Streissguth AP. Preliminary evidence that prenatal alcohol damage may be visible in averaged ultrasound images of the neonatal human corpus callosum. Alcohol 2005;36:151-160. [PubMed abstract]
  • Whitney NL, Streissguth AP, Bookstein Grant TM. Neonatal Cranial Ultrasound Leading to Early Diagnbosis and Early Intervention in Baby of Alcohol-Abusing Mother: A Case Study". Presented at the Annual Meeting of the Teratology Society Meeting 2004, and abstract published in: Birth Defects Research Part A; Clinical and Molecular Teratology, May 2004.
  • Huggins JE, Grant TM, Ernst CC, Barr HM, Streissguth AP. "Screening for FASD at Delivery." Presented at the Annual Meeting of the Teratology Society Meeting 2004, and abstract published in: Birth Defects Research Part A: Clinical and Molecular Teratology, May 2004.
  • Bookstein FL, Streissguth AP, Gleason A, Lalani T, Connor PD, Keener T, Baldwin K, Green SDK. "Ultrasound Imaging of the Neonatal Corpus Callosum is Feasible and Useful. " Platform Presentation at the Teratology Society Annual Meeting in 2004. Abstract published in Birth Defects Research Part A: Clinical and Molecular Teratology, May 2004.

2003 October

Daily Experiences and Alcohol Use: A Web-based Daily Diary Study

Christine M. Lee, PhD
Research Assistant Professor

Psychiatry & Behavioral Sciences

Mary E. Larimer, PhD (original PI)
Associate Professor
Psychiatry & Behavioral Sciences

Description: Motivational models of alcohol use have been used to distinguish between different patterns of alcohol consumption and alcohol- related negative outcomes. Daily diary designs have proven useful in the development of process models linking daily affect, daily positive and negative events, drinking contexts, alcohol consumption, and negative consequences or problems. However, most of these studies have been conducted using adult community and treatment samples. Despite the theoretical relevance, the link between drinking motives (e.g., drinking to enhance positive affect), alcohol use, and positive consequences has not been examined in the alcohol literature. The proposed study will replicate prior daily diary studies and extend Cooper et al.'s (Cooper, Prone, Russell, & Mudar, 1995) affect-regulation model of alcohol consumption by using an intensive daily diary methodology with young adult college students. Participants will include 200 University of Washington undergraduate psychology students who will complete on-line daily assessments for one month about their positive and negative achievement and social experiences, mood, alcohol use, and alcohol-related positive and negative consequences. The goal of the present project is to use a multilevel design to understand the relationship between cognitive, affective, and situational risk factors for heavy drinking, daily consumption and actual experienced consequences of drinking events. Specific aims of the project include: (1) examining a process model of daily achievement and social events, affect, and alcohol use; (2) testing theoretically- and empirically-based moderators of the within-person process model; (3) exploring the situational factors associated with alcohol use and the drinking motives and social norms surrounding use in specific contexts; and (4) examining a process model of alcohol use and alcohol- related positive and negative consequences and to examine whether drinking motives moderate these within-person relationships. The design of the proposed study will be useful for answering questions of clinical and theoretical importance.

Resulting articles & projects:

  • This ADAI small grant formed the basis and provided invaluable pilot work for a funded R21 from NIAAA (PI: Debra Kaysen, R21AA016211)
  • This grant provided pilot work for a successful R01 application to NIAAA in 2008 (PI: Christine Lee, R01AA016979-01A2).
  • Lee CM, Maggs JL, Larimer ME. (2005). Daily Experiences and Alcohol Use Among Emerging Adult College Students. Paper presented at the 2nd annual Conference on Emerging Adulthood, Miami, FL.
  • Lee CM, Patrick ME, Neighbors C, Lewis MA, Tollison SA. Perceptions of Individual Drinking Events: Understanding the Role of Positive and Negative Alcohol-related Consequences. Manuscript in preparation.
  • Lee CM, Patrick ME, Neighbors C, Lewis MA, Tollison SJ, Larimer ME. Exploring the role of positive and negative consequences in understanding evaluations of individual drinking events. Addictive Behaviors 2010 Aug;35(8):764-70. [PubMed abstract]
  • Patrick ME, Lee CM. Comparing numbers of drinks: College students' reports from retrospective summary, follow-back, and prospective daily diary measures. Journal of Studies on Alcohol and Drugs 2010;71(4):554-61. [PubMed abstract]

Screen, Intervene in the EAP (SITE): An Intervention for Screened Problem Drinkers in an Employee Assistance Program

G. Alan Marlatt, PhD
Professor and Director

Psychology, Addictive Behaviors Research Center

Karen Chan, PhD (Co-Investigator)

Description: An estimated 20% of the workforce abuses alcohol at levels high enough to impact job performance. These individuals represent a unique sub-population within the Employee Assistance Program (EAP). These individuals are often mandated to the EAP, are less likely to resolve their problems within the EAP, and are more frequently referred out of the EAP for services. Evidence suggests that early-stage alcohol problems may be largely undetected by EAP providers. This problem is exacerbated by the fact that clients with alcohol-related problems tend to present to the EAP with problems secondary to substance abuse. Screening clients for problem drinking when entering the EAP and providing a brief intervention utilizing Motivational Interviewing may increase problem identification and enhance outcomes. The EAP is an ideal setting for use of efficacious brief interventions because services range from three to eight sessions.

The goals of the current project are threefold: (1) increase identification of problem drinkers in the EAP through implementation of a brief health screening, (2) evaluate the effectiveness of a brief, motivational feedback-based intervention as compared to services as usual, and (3) evaluate gender and mandated EAP status as potential moderators of treatment effectiveness. The proposed study seeks to screen individuals entering the EAP for early stage alcohol problems and/or hazardous consumption on their responses to the AUDIT -C, embedded within a broader assessment of other health behaviors. There will be two stages of recruitment: ( 1) screening clients seeking services at the EAP for alcohol problems (N=1975), and (2) randomly assigning positive screens to a brief intervention or services-as-usual group. Of the 20% who are estimated to screen positive (n=395), we anticipate that 38% (Anderson & Larimer, 2002) will consent to complete the baseline assessment and accept random assignment (n=150: 75 Intervention, 75 EAP services as usual). Follow-up assessments will take place two-weeks and three- months post-baseline.

Resulting articles & projects:

  • Using the data from this project, Dr. Chan (now Osilla) successfully applied to NAAAA for an R21 grant, "Implementing a Screening and Brief Intervention in the EAP for At-Risk Drinkers" 5R21AA017493-02
  • Osilla KC, Zellmer SP, Larimer ME, Neighbors C, Marlatt GA. A brief intervention for at-risk drinking in an employee assistance program. J Stud Alcohol Drugs 2008; 69(1):14-20. [PubMed abstract]
  • Osilla KC, dela Cruz E, Miles JN, Zellmer S, Watkins K, Larimer ME, Marlatt GA. Exploring productivity outcomes from a brief intervention for at-risk drinking in an employee assistance program. Addict Behav 2010;35(3):194-200. [PubMed abstract]
  • Chan KK, Neighbors C, Gilson M, Larimer ME, Alan Marlatt G. Epidemiological trends in drinking by age and gender: providing normative feedback to adults. Addict Behav 2007 May;32(5):967-76. Erratum in: Addict Behav 2009;34(2):236. [PubMed abstract]
  • Osilla, KC, Davis P. (2007, October). Empoweringfor Change: Utilizing Screening, Motivational Interviewing, and Brief Interventions for Clients with Comorbid At-Risk Drinking. Workshop presented at the 2007 annual meeting of the Employee Assistance Professionals Association. San Diego, CA.
  • Osilla KC, Zellmer SP, Larimer ME, Neighbors C, Marlatt GA. (2007, October). A Brief Intervention for Problem Drinking in an Employee Assistance Program. Symposium presentation presented at the 2007 annual meeting of the Addiction Health Services Research. Athens, GA.
  • Chan KK, Zellmer SP, Larimer ME, Neighbors C, Marlatt GA. (2007, July) Brief Motivational Intervention for Drinking in the Employee Assistance Program. Symposium presentation presented at the 2007 annual meeting of the Research Society on Alcoholism. Chicago, IL.
  • Chan KK, Mitchell R, Davis P. (2006, Oct). Back to Our Roots: Integrating a Screening and Brief Intervention in Addressing Alcohol Problems. Workshop panel given at the 2006 annual meeting of the Employee Assistance Professionals Association. Nashville, TN.
  • Chan KK, Zellmer SP, Marlatt GA. (2005, November). A Randomized Trial of Brief Personalized Feedback for Screened Problem Drinkers in the Employee Assistance Program. In K. K. Chan (Chair), Interdisciplinary teams and brief interventions in addictions: Survival strategies and outcome data. Symposium conducted at the meeting of the Association for Behavioral and Cognitive Therapies, Washington DC.
  • Chan KK, Zellmer SP, Marlatt GA. (2005, June). The effectiveness ofa brief intervention in the employee assistance program. In K. K. Chan (Chair), A look towards the future: Outcome data on innovative brief interventions. Symposium given at the 2005 annual meeting of the Research Society on Alcoholism. Santa Barbara, CA.
  • Chan KK. (Chair), Marlatt GA. (Discussant). (2005, June). A look towards the future: Outcome data on innovative brief interventions. Symposium given at the 2005 annual meeting of the Research Society on Alcoholism. Santa Barbara, CA.

The Influence of Nicotine on Positive Affect among Smokers with PTSD

Miles McFall, PhD
Associate Professor

Psychiatry & Behavioral Sciences

Jessica Cook, MA

Description: Introduction: Posttraumatic stress disorder (PTSD) is associated with a high prevalence of smoking, heavy cigarette consumption, and low cessation rates. Despite comorbidity between PTSD and smoking, little is known about the behavioral mechanisms that maintain smoking among persons with PTSD. It has been assumed that those with PTSD smoke cigarettes to temporarily alleviate negative affective symptoms ( e.g., anger, tension) via the axiolytic properties of nicotine. However, omitted from consideration is the possibility that nicotine ameliorates positive affect deficiencies that are integral to PTSD (i.e., nicotine stimulates positive mood states that are otherwise inhibited). The primary aim of this research is to test the hypothesis that nicotine enables smokers with PTSD to experience positive affect during rewarding situations. Secondary aims are to (a) determine the feasibility of subject recruitment, (b) pilot the experimental apparatus, and (c) establish effect size estimates necessary to pursue funding for a large scale experimental trial. Method: Nicotine dependent V A patients with PTSD (N=30) will participate in two experimental trials during which they will undergo a positive mood induction while inhaling either a nicotinized or denicotinized inhaler. Positive affect will be assessed before and at two time points after mood induction. Analytic Plan: Hierarchical linear modeling will be used to examine the effect of nicotine administration on positive affect across time. Significance: Tobacco use, the most lethal of all substance use disorders, remains the single most preventable cause of morbidity and mortality in the US. Smoking contributes to high rates of physical illness and medical service utilization documented for PTSD, which is one of the most prevalent of all mental disorders in the V A and society at large. Basic research characterizing behavioral factors that maintain smoking among individuals with PTSD is needed to provide foundation for developing evidence-based treatments.

Resulting articles & projects:

  • Feasibility data from this study was used in a successful application for a National Institute on Drug Abuse K08 award to Jessica Cook in 2007. "Influence of Nicotine on Positive and Negative Affect in Smokers with PTSD." K08DA021311. This K08 award has resulted in numerous publications.

The role of the 5-HT 1B Receptor on Ethanol Consumption in the Fawn Hooded Rat

John Neumaier, MD, PhD
Assistant Professor

Psychiatry & Behavioral Sciences

Blair Hoplight, PhD

Description: The serotonergic system has been implicated in the regulation of stress, reward, and addiction. The 5-HT 1B receptor is of particular interest, due to associations of this receptor with certain kinds of alcoholism in humans and rodent models. Two experiments are planned to look at the role of this important receptor. Our research strategies will utilize molecular and anatomical precision to avoid the problems with contradicting results present in serotonin-ethanol literature. Experiment 1 will examine the natural variation of the 5-HT 1B gene expression in an ethanol-preferring strain of rat, the Fawn-Hooded strain. Levels of 5-HT 1B mRNA will be measured in key areas of the brain (nucleus accumbens, dorsal raphe, and stiatum) during three time points of ethnol drinking behavior (acquisition, maintenance, withdrawal) using in situ hybridization. This experiment will allow us to elucidate which 5-HT 1B receptors interact with chronic ethanol, and at which point in time. A second experiment will focus on manipulating the levels of 5-HT 1B receptor in th nucleus accumbens using viral-mediated gene transfer. A viral vector will be used to increase levels of 5-HT 1B receptors in neurons that project to the VTA. We will then examine how this modifies the acquisition of drinking behavior in this strain of rat.

Resulting articles & projects:

  • Findings from this ADAI grant were instrumental in Dr. Neumaier's successful application for an NIAAA grant: Regulation of Ethanol Reward by 5HT1B Receptors, 5R21AA015981-02
  • Hoplight BJ, Sandygren NA, Neumaier JF. Increased expression of 5-HT1B receptors in rat nucleus accumbens via virally mediated gene transfer increases voluntary alcohol consumption. Alcohol 2006;38(2):73-9. [PubMed abstract]

Risk and Protective Factors Associated with Substance Use among Lesbian, Gay, Bisexual, and Transgender Adults: A Preliminary Investigation

Jane M. Simoni, PhD
Associate Professor

School of Social Work

Kimberly Balsam, PhD, Research Assistant Professor, School of Social Work (Co-PI)

Description: Prior research has documented higher rates of substance abuse among lesbian, gay, bisexual, and trans gender individuals. However, little is known about the unique risk and protective factors associated with substance abuse in this population. Higher risk has been hypothesized to be linked to the individual and cultural oppression experienced by LGBT individuals. However, this "minority stress" hypothesis has not been adequately examined in empirical studies, in part due to the lack of a clear definition for this construct and the lack of a culturally sensitive instrument to assess it. Furthermore, while some have hypothesized that cultural norms ( e.g., the preponderance of gay and lesbian bars as socialization venues for LGBT adults) may contribute to substance abuse among LGBTs, this has not been systematically investigated. Even fewer studies have examined sociocultural factors that might protect LGBT individuals from substance abuse and facilitate recovery from substance use disorders. Additionally, little is known about how these risk and protective factors might operate among ethnic minority LGBTs, who may face additional challenges associated with both racism and heterosexism.

The proposed project utilizes qualitative methodology to investigate risk and protective factors associated with substance abuse among LGBT adults. Interviews and focus groups will be conducted with specific sub-populations such as ethnic minority LGBT individuals, LGBT individuals in recovery,. leaders in the LGBT community, substance-abuse treatment providers who specialize in working with .LGBT clients, as well as more broadly-defined LGBT samples in urban and rural areas. Qualitative data will be used to generate items and develop survey instruments to assess minority stress and culturally-specific protective factors as they relate to substance abuse among LGBT individuals. This study is the first in a series of studies aimed at building and empirically testing a theory-driven, contextually- based model of substance abuse among LGBTs.

Resulting articles & projects:

  • Dr. Balsam used the findings from this study in a successful application for a KOI grant from NIMH: "Developing Prevention Strategies for Stigmztized Women" (2007-2011), 1K01MH077656-01A1.
  • In addition, the findings were used in a successful grant application to NIAAA: "High Risk Drinking in Emerging Adult At-Risk Women" (PI: Debra L. Kaysen) 1R01AA018292-01A1
  • Lehavot K, Balsam KF, Wells G. Redefining the American quilt: Definitions and experiences of community among ethnically diverse lesbian and bisexual women. J Community Psychol 2009; 37: 439-458. [doi: 10.1002/jcop.20305]
  • Balsam KF, Plummer M, Fieland K, Gutierrez B, Yoshimoto D. (2005). Minority stress among LGBT people of color: A qualitative investigation. In K. F. Balsam & 1. M. Meyer (Chairs), Multiple oppressions: New directions in research with diverse LGBTpopulations, Symposium conducted at the annual convention of the American Psychological Association, Washington, DC.
  • Plummer MD, Balsam KF, Yoshimoto D, Fieland K (2005). Experiences of sexual racism among gay men of color. Paper presentation at the 39th annual convention of the Association for Behavioral and Cognitive Therapies, Washington, DC.
  • Lehavot K, Balsam KF. (2006). Diverse lesbian and bisexual women's sense of community. Paper presented at the Association for Women in Psychology annual conference, Ypsilanti, MI.
  • Szymanski DM, Balsam KF. (2007). Insidious trauma: Examining the relationship between heterosexist events and lesbian’s post-traumatic stress. Poster presented at the National Multicultural Conference and Summit, Seattle, WA.