Identification and characterization of in-the-moment cognitive antecedents to alcohol use among drinkers with PTSD

患有创伤后应激障碍 (PTSD) 的饮酒者饮酒的即时认知前因的识别和特征描述

• 批准号: 10350935
• 负责人: Michelle Josephine Zaso
• 金额: $ 16.87万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10350935
• 关键词: Acute; Acute Post Traumatic Stress Disorder; Address; Affective; Alcohol abuse; Alcohol consumption; Alcohols; Award; Buffaloes; Clinical; Clinical Research; Cognition; Cognitive; Collaborations; Data; Development; Distress; Ecological momentary assessment; Emotional; Emotions; Environment; Etiology; Event; Focus Groups; Frequencies; Future; Grain; Group Interviews; Individual; Intervention; Investigation; Knowledge; Laboratories; Lead; Link; Maps; Measurement; Measures; Mediating; Mentorship; Methodology; Methods; Modeling; Outcome; Pathway interactions; Patient Self-Report; Phase; Post-Traumatic Stress Disorders; Process; Psychology; Public Health; Reporting; Research; Research Institute; Research Personnel; Risk; Role; Schedule; Source; Statistical Models; Survivors; Symptoms; Techniques; Testing; Time; Translations; Trauma; United States National Institutes of Health; Universities; Work; adaptive intervention; addiction; alcohol abuse therapy; alcohol expectancy; alcohol measurement; alcohol use disorder; career; career development; cognitive interview; cognitive process; cognitive testing; coping; design; distress tolerance; drinking; evidence base; experience; field study; innovation; multilevel analysis; negative affect; neglect; novel; programs; skills; stress related disorder

Abstract Posttraumatic stress disorder (PTSD) co-occurs frequently with hazardous alcohol outcomes, presenting considerable public health burdens and challenging traditional treatment approaches. Although accessible interventions able to adapt to individuals’ fluctuating internal risks within their natural environments are emerging, these just-in-time adaptive interventions have largely not yet considered the role of trauma sequalae in alcohol use. To do so, research needs to identify the acute risks for drinking operating in-the-moment as individuals experience PTSD symptoms in their daily lives. There is a critical need to define and operationalize acute cognitive processes underlying PTSD-related drinking (Aim 1), examine variability in such cognitions amid PTSD symptoms in real-world settings (Aim 2), and establish which of these acute cognitions are linked to actual drinking events and mediate PTSD-related drinking (Aim 3). During the K99 phase, Aim 1 comprises a fine-grained qualitative examination into acute risk cognitions among frequent drinkers with PTSD, utilizing focus groups to identify key acute cognitions and cognitive interviewing approaches to operationalize measures of such cognitions. Aim 2 field-tests these cognitive assessments by examining whether they vary across drinkers’ daily lives and are active amid PTSD symptoms within a 14-day ecological momentary assessment (EMA) study. During the R00 phase, Aim 3 considerably extends such work to test whether these acute cognitions are linked to actual drinking events as well as whether they are mechanisms of PTSD-related drinking across another 14-day EMA. Collectively, this mixed methods investigation will identify proximal cognitive mechanisms of PTSD-related drinking that can be targeted in future just-in-time interventions. As a K99/R00 NIH Pathway to Independence Award, these research efforts would support the emergence of a dedicated early career researcher (Dr. Zaso) with unique expertise in acute cognitive trauma-related drinking processes. This K99/R00 also would afford Dr. Zaso instrumental development in acute PTSD-related drinking processes, momentary assessment of affective alcohol cognitions, and the methodological/statistical techniques necessary to characterize momentary, real-world drinking processes. The mentorship team offers expertise in the intersection of trauma and alcohol use (Dr. Jennifer Read), with collaboration support on daily processes in PTSD-related drinking (Dr. Tracy Simpson), acute activation of alcohol cognitions (Dr. Robert Dvorak), optimization of mobile alcohol assessment and intervention (Dr. Tammy Chung), and statistical modeling of multilevel alcohol etiologies (Dr. Craig Colder). Dr. Zaso’s career development will occur within the Department of Psychology and Clinical and Research Institute on Addictions at the University at Buffalo, which comprise a rich intellectual environment with a network of productive addictions researchers. Overall, this K99/R00 will propel Dr. Zaso’s emergence as an independent trauma-related alcohol researcher with the skills necessary to maintain a clinically impactful research program aimed at curtailing alcohol harms.

摘要 创伤后应激障碍（PTSD）经常与危险的酒精后果同时发生，呈现 公共卫生负担沉重，传统治疗方法面临挑战。虽然可以访问 能够适应个人在自然环境中波动的内部风险的干预措施， 这些及时的适应性干预措施在很大程度上尚未考虑创伤后遗症的作用 在饮酒方面。要做到这一点，研究需要确定饮酒的急性风险， 人们在日常生活中经历PTSD症状。迫切需要界定和实施 急性认知过程潜在的创伤后应激障碍相关的饮酒（目的1），检查这种认知的变异性 在现实世界中的PTSD症状中（目标2），并确定这些急性认知中的哪些是相关的 实际饮酒事件和介导PTSD相关饮酒（目标3）。在K99阶段，目标1包括 对患有PTSD的频繁饮酒者的急性风险认知进行了细粒度的定性检查， 焦点小组，以确定关键的敏锐认知和认知访谈方法， 这种认知的衡量标准。目标2-实地测试这些认知评估，检查他们是否不同 在饮酒者的日常生活中，在14天的生态瞬间内， 评估（EMA）研究。在R 00阶段，Aim 3大大扩展了此类工作，以测试这些 急性认知与实际饮酒事件有关，以及它们是否是PTSD相关的机制。 在接下来的14天EMA中饮酒。总的来说，这种混合方法调查将确定近端 PTSD相关饮酒的认知机制可以在未来的及时干预中成为目标。作为 K99/R 00 NIH独立之路奖，这些研究工作将支持出现一个 专注的早期职业研究人员（Zaso博士）在急性认知创伤相关饮酒方面具有独特的专业知识 流程.这种K99/R 00也将为Zaso博士在急性PTSD相关饮酒方面提供工具性发展 过程，情感酒精认知的瞬时评估，以及方法学/统计学 描述瞬时的、真实的饮酒过程所必需的技术。导师团队提供 创伤和酒精使用交叉方面的专业知识（Jennifer Read博士），日常协作支持 PTSD相关饮酒过程（Tracy Simpson博士），酒精认知的急性激活（Robert Dvorak）、移动的酒精评估和干预的优化（Tammy Chung博士）以及统计学 多层次酒精病因学建模（克雷格科尔德博士）。Zaso博士的职业发展将发生在 布法罗大学的心理学系、临床和成瘾研究所， 其中包括一个丰富的知识环境与生产成瘾研究人员的网络。总的来说， K99/R 00将推动Zaso博士成为独立的创伤相关酒精研究人员， 必要的技能，以维持一个临床上有影响力的研究计划，旨在减少酒精的危害。