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Examining the Role of Sensitivity to Uncertain Threat and Alcohol Response in Risk for AUD following Sexual Assault

Award Number: R01AA032115
ORGANIZATION: NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2031

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Examining the Role of Sensitivity to Uncertain Threat and Alcohol Response in Risk for AUD following Sexual Assault - ABSTRACT Sexual assault (SA) on college campuses is a pervasive problem that substantially contributes to risk for heavy drinking and alcohol use disorder (AUD). It has been suggested that SA victimization is a unique risk pathway to AUD; however, the mechanisms that drive alcohol problems in SA survivors are unclear and there are limited AUD prevention strategies for SA-exposed individuals. Our compelling data suggest that SA victimization may increase neurobiological reactivity to unpredictable stress or threat (U-threat). This, in turn, fuels chronic anticipatory anxiety, heightens sensitivity to the anxiolytic effects of alcohol, and drives heavy drinking. Notably, no prior study has directly tested this biologically informed mechanistic model. The overarching goal of this R01 study is to uncover the degree to which reactivity to U-threat and anxiolytic responses to alcohol contribute to risk for AUD in college-aged young adults with prior SA using an innovative, multimodal project that will bring together converging programs of research from the two MPIs. We will recruit 220 heavy-drinking college-aged individuals (21-29 years) into two groups: 1) heavy drinkers with a history of SA (HD+SA) and 2) heavy drinkers without a history of SA (HD-SA). Participants will complete a study combining psychophysiology, intravenous alcohol administration, ecological momentary assessment (EMA), and transdermal alcohol biosensing to rigorously test our model across settings and time. First, participants will complete three experimental lab sessions, separated by 2-7 days, involving administration of the well-validated No-Predictable-Unpredictable (NPU) threat paradigm. The NPU task is designed to probe reactivity to U-threat and predictable threat (P-threat) and records startle eyeblink potentiation during the task as an objective indicator of aversive responding. The first lab visit will be a ‘sober session’ to capture baseline group differences. The second and third visits will include intravenous (IV) administration of either 80mg% alcohol or placebo (order counterbalanced) to measure alcohol’s acute effects on threat reactivity and subjective responses to alcohol. Immediately following the third lab visit, participants will complete a 21-day EMA tracking period to test the proposed model in the real-world. App-based mobile surveys will be delivered up to 5x per day to capture alcohol consumption and changes in anticipatory anxiety, distress, and other mood states. Surveys will be paired with continuous transdermal alcohol biosensing to obtain real-time objective estimates of alcohol consumption. This multi-method design will allow us to examine whether heavy drinkers with a history of SA display exaggerated baseline reactivity to U-threat (Aim 1). We will also test whether heavy drinkers with a history of SA are more sensitive to alcohol-induced reductions in U-threat reactivity and subjective anxiety in the lab (Aim 2) and experience greater anxiolytic relief during alcohol intoxication in the real-world (Aim 3). Findings from this study will help establish exaggerated U- threat reactivity as a modifiable treatment target for this high-risk population. The study will lay the foundation for the translation of this reinforcement model into personalized approaches for AUD.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $706,409 )
2026	2026	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Alcohol Research Programs	000	1	8/27/2026	NEW	$706,409
														Subtotal = $706,409

Grand Total All Awards = $706,409

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Examining the Role of Sensitivity to Uncertain Threat and Alcohol Response in Risk for AUD following Sexual Assault

Award Number: R01AA032115

ORGANIZATION: NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2031

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