Linking Impulsivity Domains and Subjective Response to Alcohol in Young Adults Using Lab and Daily Assessment Methods

项目概要/摘要 年轻人滥用酒精是一个紧迫的，日益严重的公共卫生危机，因为年轻人的酒精含量最高。 任何年龄组的使用障碍发生率，年轻妇女的使用障碍发生率增加。针对这一人群的干预措施包括 受到影响小、选择少和缺乏针对突出风险因素的定制的阻碍。最近在Addiction上的评论 他认为，为干预提供信息的研究未能解释因素之间关系的复杂性 导致年轻人滥用酒精我们将通过研究以下方面的关系来解决这些需求： 两个主要的病因风险因素：冲动和主观反应酒精（SR）。尽管理论上和 尽管它们之间存在生物学联系，但对这两种风险因素之间的关系或它们之间的联系知之甚少。 它们之间的相互作用可能会促进年轻成人的酒精滥用纵向和瞬间或日常的基础上。之前 将冲动与积极的、有益的酒精效应联系起来的理论和证据主要是学习和 基于期望。在这里，基于令人兴奋的初步结果，我们发现了一种内在的，生物学上的联系， 冲动和高风险SR（刺激增加和镇静减弱）。这项研究是新生的， 知识的多重缺口。我们将通过研究饮酒前的冲动性，SR和酒精来解决这些差距 在实验室环境中使用，并在2年内通过7个10天的每日评估期使用生态瞬时 评估（EMA）（N=250，50%女性）。使用自我报告以及实验室和移动的任务，我们将描述 3个独特的、已建立的冲动性领域：抑制控制不良、延迟折扣和消极紧迫感。Sr 将在实验室中使用精密静脉（IV）方法在连续呼吸酒精水平下进行评估， 然后有机会自己注射更多的酒精我们还将在大致相当的情况下测量SR， 通过每日EMA方法估计血液酒精水平。该设计使得能够在饮用的早期测试SR 事件作为实验室内和日常酒精使用的预测因子，沿着酒精使用和随时间的后果，加上 SR作为冲动/酒精关系中介的潜在作用。最近的研究结果表明， 冲动性预测随后饮酒和后果。这些类型的变化很难捕捉 实验室的方法。日常测量还可以对个人水平的个体差异和 每日，受试者内的影响。然而，目前还没有关于日常冲动和SR的研究发表。 措施在这项研究中，我们将：1）确定基于实验室的冲动和SR之间的关系; 2）确定 日常冲动性和SR之间的关系; 3）将冲动性和SR与酒精滥用纵向相关。 我们假设冲动性与酒精后的刺激增强和镇静减少有关， 将部分调节冲动和酒精滥用之间的关系。证据表明， 冲动域和SR纵向和瞬时/日常基础上将指向特定的干预 目标是改善青年人滥用酒精的两个关键脆弱因素。因此，我们将：1）识别 2）促进预防和治疗研究：两个NIAAA优先领域。

PROJECT SUMMARY/ABSTRACT Young adult alcohol misuse is an urgent, growing public health crisis, as young adults have the highest alcohol use disorder rates of any age group with rates increasing in young women. Interventions for this population are hampered by small effects, few options and lack of tailoring to salient risk factors. A recent review in Addiction argued that research informing interventions fails to account for the complexity of relationships among factors contributing to young adult alcohol misuse. We will address these needs by examining relationships between two cardinal etiologic risk factors: impulsivity and subjective response to alcohol (SR). Despite theoretical and biological links between them, little is known about relations between the two risk factors, or how associations between them may promote young adult alcohol misuse longitudinally and on a momentary or daily basis. Prior theory and evidence linking impulsivity and positive, rewarding alcohol effects have been primarily learning and expectancy based. Here, based on exciting preliminary results, we posit an inherent, biological link between impulsivity and high-risk SR (elevated stimulation and dampened sedation). This research is nascent with multiple gaps in knowledge. We will address these gaps by examining impulsivity pre-drinking, SR and alcohol use in a lab setting and via seven 10-day daily assessment periods over 2 years using ecological momentary assessment (EMA) (N=250, 50% female). Using self-report and both lab and mobile tasks, we will characterize 3 unique, established impulsivity domains: poor inhibitory control, delay discounting and negative urgency. SR will be assessed at successive breath alcohol levels using precision intravenous (IV) methods in the lab, followed by opportunity to self-administer more IV alcohol. We will also measure SR at roughly comparable, estimated blood alcohol levels via daily EMA methods. This design enables testing of SR early in a drinking event as a predictor of in-lab and daily alcohol use, along with alcohol use and consequences over time, plus SR’s potential role as a mediator of impulsivity/alcohol relations. Recent findings indicate daily changes in impulsivity predict subsequent drinking and consequences. These types of changes are challenging to capture with lab methods only. Daily measures also enable modeling of both person-level individual differences and daily, within-subject effects. However, there are no published studies relating daily impulsivity and SR measures. In this study, we will: 1) determine relations between lab-based impulsivity and SR; 2) determine relations between daily impulsivity and SR; and 3) relate impulsivity and SR to alcohol misuse longitudinally. We hypothesize impulsivity will relate to heightened stimulation and less sedation following alcohol and that SR will partially mediate relations between impulsivity and alcohol misuse. Evidence of links between specific impulsivity domains and SR longitudinally and on a momentary/daily basis will point to specific intervention targets to ameliorate two critical vulnerability factors for young adult alcohol misuse. Thus, we will: 1) identify mechanisms of alcohol action and 2) facilitate prevention and treatment research: two NIAAA priority areas.