Data_Sheet_1_Gender Differences in the Psychosocial Determinants Underlying the Onset and Maintenance of Alcohol Use Disorder.pdf

A large number of different mechanisms have been linked to Alcohol Use Disorder (AUD), including psychosocial, neurocognitive, affective, and neurobiological factors. Gender has been shown to impact the presentation and progression of AUD; yet, little work has been done to parse the different mechanisms underlying AUD within the lens of gender differences. A review of the literature on adolescence revealed that psychosocial factors, in particular lack of family social support and interactions with peers, drive the onset of alcohol use more strongly in girls relative to boys. However, research done on gender differences in disease progression in adults remains limited. Our gender-specific analysis of the mechanisms underlying AUD in adults revealed that lack of social support was causally linked to negative affect, mental health symptoms, and AUD symptom severity in women, but not men. These novel results suggest that psychosocial factors may play a gender-specific role not only in the onset of use in adolescence, but also in the maintenance of addiction in adults. If confirmed, this suggests the need for investigating gender-specific recovery trajectories. In this perspective piece, we review the literature regarding gender differences in the onset and maintenance of AUD and present original data that support unique risk factors in women.

酒精使用障碍（Alcohol Use Disorder, AUD）的发病机制涉及多种不同路径，涵盖社会心理、神经认知、情感及神经生物学等多个维度。研究表明，性别会对AUD的临床表现与疾病进展产生影响，但目前鲜有研究从性别差异的视角剖析AUD背后的各类发病机制。
针对青少年群体的相关文献综述显示，社会心理因素——尤其是家庭社会支持匮乏与同伴交往不足——相较于男性青少年，更易促使女性青少年出现饮酒行为。然而，针对成年群体中AUD疾病进展的性别差异相关研究仍较为匮乏。
本团队针对成年群体AUD发病机制开展的性别特异性分析显示，在女性群体中，社会支持匮乏与负性情感、心理健康症状及AUD症状严重程度存在因果关联，而男性群体中未发现此类关联。上述创新性研究结果提示，社会心理因素的作用可能具有性别特异性：不仅影响青少年时期饮酒行为的起始，还会参与成年群体成瘾行为的维持过程。
若该结论得到进一步验证，则提示亟需开展针对性别特异性康复轨迹的相关研究。本观点性文章将系统梳理AUD起病与维持阶段的性别差异相关文献，并展示支持女性群体存在特异性饮酒障碍危险因素的原创性研究数据。