# The role of stress, social support, and brain function on alcohol misuse in women

> **NIH NIH F30** · UNIVERSITY OF MINNESOTA · 2024 · $54,900

## Abstract

PROJECT SUMMARY/ABSTRACT
Prenatal alcohol use (PAU) is associated with increased likelihood of obstetric complications, including preterm
labor, miscarriage, and stillbirth, and is also the direct cause of Fetal Alcohol Spectrum Disorders, a collection
of neurodevelopmental disorders that cause lifelong neurobehavioral and craniofacial abnormalities. In 2020,
the Center for Disease Control and Prevention reported that approximately 1 in 7 pregnant women had
consumed alcohol in the past month, which is in line with increasing trends since 2011. Thus, PAU is a major
and growing public health problem, so it is imperative to understand the risk factors for PAU to inform
prevention and intervention. Stress is one such key risk factor. Pregnant women with frequent stress have a 3-
fold higher risk of binge drinking than pregnant women without frequent stress. Furthermore, pre-pregnancy
alcohol use is consistently associated with PAU, suggesting that understanding the etiology of alcohol misuse
outside of pregnancy is essential for preventing PAU. Correspondingly, stress plays a crucial role in Alcohol
Use Disorder (AUD) in women outside of pregnancy, as women are more vulnerable to relapse following
stressful triggers relative to men. This vulnerability may in part be driven by sex/gender (SG) differences in
neurocircuitry related to processing stress in AUD. Increased stress vulnerability has been linked to
dysfunction in the “salience network” (SN), which is a collection of brain regions, primarily the insula, the dorsal
anterior cingulate cortex, and inferior parietal lobule, that responds to salient, potentially stressful stimuli and is
also highly reactive to substance use cues, including alcohol. Furthermore, social support may serve as a
resilience factor against stress-related alcohol misuse, particularly in women. If and how social support can
also buffer the brain’s heightened vulnerability to stress in AUD, and if there are SG differences in this effect,
remains to be examined. Moreover, whether stress and social support similarly affect PAU is unclear. My
overarching hypothesis is that women, relative to men, are more vulnerable to stress-related alcohol misuse
via enhanced SN reactivity; however, social support will have a stronger buffering effect on this relationship in
women. The specific aims of this project are to (1A) assess SG differences in the role of the SN on the
relationship between stress reactivity and alcohol use levels in people with AUD, (1B) assess SG differences in
whether social support protects against alcohol misuse by altering stress-related SN reactivity, and (2)
determine risk and protective factors for prenatal alcohol use. Achieving these goals will inform scientifically-
grounded treatments for AUD in women during and outside of pregnancy, as well as prepare me for a
successful career as a physician-scientist in academic medicine.

## Key facts

- **NIH application ID:** 10844372
- **Project number:** 5F30AA030900-02
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** Andrea Maxwell
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $54,900
- **Award type:** 5
- **Project period:** 2023-05-29 → 2027-05-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10844372

## Citation

> US National Institutes of Health, RePORTER application 10844372, The role of stress, social support, and brain function on alcohol misuse in women (5F30AA030900-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10844372. Licensed CC0.

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