Connecting Alcohol Myopia to Real-World Risk Behaviors through Cognitive Ecological Momentary Assessment

摘要 年轻人大量饮酒是一个严重的公共卫生问题，部分原因是酒精的使用是 与可能对个人产生短期和长期后果的风险行为相关， 社会大局酒精近视理论（AMT）已经成为一个突出的框架，以了解为什么 急性酒精中毒与危险行为，如攻击， 无保护性行为和不安全驾驶AMT声称，酒精会缩小人的注意力，减少 一个人可以处理的外部和内部线索，增加了对“此时此地”中心信息的关注， 长期外围信息的成本。理论上，这种注意力狭窄限制了对 可能会抑制风险行为的线索，因为成本和后果往往更外围， 远比眼前的回报来得重要。尽管AMT得到了实验室研究的支持， AMT和现实世界中的冒险行为之间的关系尚不清楚。澄清近视是否确实是一种机制 这将是一个重要的一步，以动态理论为基础的干预措施，针对酒精相关的风险行为。 为了推进理论和告知干预发展，目前的研究将（1）适应基于实验室的 认知任务，以评估基于智能手机的生态瞬间的空间和时间酒精近视 评估（EMA），（2）评估适应智能手机的可行性，可接受性，可靠性和有效性 任务在实验室和EMA设置，和（3）探索AMT内EMA通过测试近视作为中介的 醉酒风险行为协会。为了实现这些目标，将与多达30名年轻人进行面谈， 成年人告知迭代改进，最大限度地提高智能手机上近视任务的可用性。然后，100 大量饮酒的年轻人将完成一个实验室会议，涉及酒精管理，以测试 在受控环境中适应近视任务。这些参与者还将连续八年完成 周末的EMA评估空间和时间近视和风险行为在他们的自然环境中， 同时佩戴基于腕部的透皮酒精生物传感器以客观且不引人注目地评估中毒 程度.通过整合实验室和EMA的研究结果，本研究将产生的任务，允许一个全面的 对酒精性近视的理解，包括近视的人内和人与人之间的变异性，剂量依赖性 AMT在自然饮酒事件中的影响，以及与现实世界风险行为的关联。严谨的 近视认知EMA的开发和测试将为新的即时自适应 针对近视的干预措施，以减少饮酒时的危险行为。通过使用创新的工具和 方法，以推进行为研究和干预，这一建议是符合NIAAA 使命和战略目标，以确定模式和战略，以防止酒精相关的后果。

ABSTRACT Young adults’ heavy drinking represents a substantial public health problem, in part because alcohol use is associated with risk behaviors that can have both short- and long-term consequences for individuals and society as a whole. Alcohol myopia theory (AMT) has emerged as a prominent framework to understand why acute alcohol intoxication is associated with increased likelihood of risk behaviors, such as aggression, unprotected sex, and unsafe driving. AMT asserts that alcohol narrows one’s attention, reducing the range of external and internal cues that one can process, increasing the focus on “here-and-now” central information at the cost of longer-term, peripheral information. This attentional narrowing is theorized to limit the processing of cues that may otherwise inhibit risk behaviors, as costs and consequences tend to be more peripheral or temporally distant than immediate rewards. Although AMT is supported by laboratory research, the connection between AMT and real-world risk-taking remains unclear. Clarifying whether myopia is indeed a mechanism will be an important step toward dynamic theory-based interventions targeting alcohol-related risk behaviors. To advance theory and inform intervention development, the current study will (1) adapt laboratory-based cognitive tasks to assess spatial and temporal alcohol myopia for smartphone-based ecological momentary assessments (EMA), (2) evaluate feasibility, acceptability, reliability, and validity of the adapted smartphone tasks in laboratory and EMA settings, and (3) explore AMT within EMA by testing myopia as a mediator of the intoxication-risk behavior association. To achieve these aims, interviews will be conducted with up to 30 young adults to inform iterative improvements that maximize usability of myopia tasks on smartphones. Then, 100 heavy drinking young adults will complete a laboratory session involving alcohol administration to test the adapted myopia tasks within a controlled setting. These participants will also complete eight consecutive weekends of EMA to assess spatial and temporal myopia and risk behaviors in their natural environments, while wearing a wrist-based transdermal alcohol biosensor to objectively and unobtrusively assess intoxication levels. By integrating laboratory and EMA findings, this study will yield tasks that allow for a comprehensive understanding of alcohol myopia, including within- and between-person variability in myopia, dose-dependent effects of AMT within natural drinking episodes, and associations with real-world risk behaviors. The rigorous development and testing of cognitive EMA for myopia will pave the way for new just-in-time adaptive interventions targeting myopia to reduce risk behaviors when drinking. By using innovative tools and methodologies to advance behavioral research and interventions, this proposal is consistent with the NIAAA mission and strategic goals to identify patterns and strategies to prevent alcohol-related consequences.