# Trauma and Neurobiological Threat Reactivity as Risk Factors for Alcohol Abuse in Youth

> **NIH NIH R01** · OHIO STATE UNIVERSITY · 2021 · $568,801

## Abstract

Underage drinking causes tremendous burden, and there is an urgent need to understand who is vulnerable,
and why/how, to facilitate accurate detection and prevention. Exposure to interpersonal trauma (e.g., physical
or sexual abuse) is a well-established risk factor for alcohol problems in youth; however, the developmental
mechanisms through which trauma leads to alcohol use are unclear. In addition, millions of youth experience
interpersonal trauma but only a subset develop alcohol use disorder (AUD). Identifying these high-risk youth,
and the neurobiological mechanisms contributing to their risk, can pinpoint objective early intervention targets
and aid in AUD prevention. Data from the Early Stage Investigator (ESI) PI suggests that youth with
interpersonal trauma exposure and high levels of aversive reactivity to unpredictable threats (U-threat;
temporally unpredictable and/or ambiguous) are at the greatest risk for the development of alcohol problems
in young adulthood. To date, however, a mechanistic test of this hypothesis has never been conducted in a
high-risk, trauma-exposed sample. The overarching goal of the study is to therefore validate a novel
neurobiological risk phenotype for alcohol problems in trauma-exposed youth using multimodal U-threat
reactivity data. Leveraging our unique access to high-risk youth in the central Ohio area, we will recruit a
cohort of 200, 16-19 year olds, with and without a history of interpersonal trauma exposure (125 with trauma
and 75 without) and conduct multimodal (neural function, physiology, behavior, and self-report) assessments
of U-threat reactivity and alcohol use. Six months after baseline we will conduct a second multimodal lab
assessment of U-threat reactivity. Every 3 months post-baseline we will assess youths’ alcohol use and
relevant psychiatric symptoms and behaviors via online survey (up to 24-months). This innovative,
longitudinal design will allow for a well-controlled test of whether interpersonal trauma exposure and
neurobiological reactivity to U-threat synergistically interact to predict escalations in alcohol use in youth (Aim
1). The study will also address whether reactivity to U-threat is a stable risk factor for alcohol problems or a
modifiable target that corresponds to changes in drinking behaviors over time (Aim 2). If reactivity to U-threat
does indeed track behavior, it can be used as an objective, mechanistic target for future ‘Fast-Fail’ treatment
studies. Lastly, given our multi-layered approach, we will conduct innovative analyses to integrate data across
‘units of analysis’ (brain, physiology, behavior, self-report) to predict the onset of alcohol problems in trauma-
exposed youth and develop a new and replicable predictor with the highest accuracy performance (Aim 3).
Findings from this work will provide critical new knowledge aiding in the identification of youth most at-risk for
alcohol problems. The study will also validate a mechanistic, neurobiological risk mod...

## Key facts

- **NIH application ID:** 10120113
- **Project number:** 1R01AA028225-01A1
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Stephanie Gorka
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $568,801
- **Award type:** 1
- **Project period:** 2021-03-10 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10120113

## Citation

> US National Institutes of Health, RePORTER application 10120113, Trauma and Neurobiological Threat Reactivity as Risk Factors for Alcohol Abuse in Youth (1R01AA028225-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10120113. Licensed CC0.

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