Investigating impulsivity and social network changes as novel mechanisms of behavior change for Alcoholics Anonymous' (AA) positive effects

调查冲动和社交网络变化作为行为改变的新机制对戒酒互诫协会（AA）的积极影响

• 批准号: 10456938
• 负责人: JOHN F. KELLY
• 金额: $ 50.78万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10456938
• 关键词: Address; Age; Alcoholics Anonymous; Alcohols; Behavioral Mechanisms; Behavioral inhibition; Communities; Dose; Enrollment; Etiology; Evidence Based Medicine; Female; Frequencies; Future; Glucuronides; Heavy Drinking; Impulsivity; Individual; Informal Social Control; Investigation; Maps; Measurement; Measures; Mediating; Motor; Nature; Outcome; Outpatients; Participant; Pathway Analysis; Patient Self-Report; Patients; Personality Traits; Persons; Process; Property; Prospective cohort; Recommendation; Recovery; Research Design; Resolution; Rewards; Services; Site; Social Network; Structure; Subgroup; Testing; alcohol abuse therapy; alcohol use disorder; behavior change; behavioral economics; clinical application; clinical practice; clinically relevant; density; design; discounting; drinking; follow-up; graph theory; indexing; insight; knowledge translation; male; meetings; member; novel; older patient; preference; prevent; programs; response; sex; social relationships

ABSTRACT Alcoholics Anonymous (AA) is now well-established in its capacity to help individuals recover from alcohol use disorder (AUD), but there are substantial gaps in understanding the mechanisms by which it does so. Recent studies suggest two novel domains of mechanisms: 1) decreases in impulsivity; and 2) increases in salutary social networks. However, these mechanisms have been investigated in only a small number of studies and the extant studies employed low resolution measurement and suboptimal study designs. The proposed study will address these limitations to systematically investigate impulsivity and social network composition as novel mechanisms of behavior change (MOBCs) for AA’s positive effects on AUD recovery. The first primary aim is to examine impulsivity, fractionating the concept into three distinct forms: 1) steep discounting of future rewards (i.e., delay discounting); 2) poor behavioral inhibition (i.e., inability to inhibit a prepotent response); and 3) impulsive personality traits (i.e., self-attributions about regulatory capacity). The second primary aim is to examine social network properties, quantifying participant social relationships via formal egocentric social network composition analysis. The third primary aim is to examine whether these mechanistic relationships systematically differ according to three important moderators: age, sex, and study site. An exploratory secondary aim is to mine the findings from the primary aims to generate specific recommendations and applications for clinical practice. These aims will be executed in a prospective cohort design that is optimized for characterizing lagged dynamic changes in MOBCs. Specifically, the study design will examine these processes in individuals with AUD who are newly engaging in community outpatient AUD treatment. Participants will receive assessments at baseline, 6-weeks, and 3-, 6-, 9- and 12-months. AA involvement will be measured using both the traditional measure of frequency of meeting attendance and a novel measure of AA program engagement. Outcome variables will include percent days abstinent and percent heavy drinking days. The findings will be disseminated using a comprehensive knowledge translation plan. Collectively, the proposed study has the potential to make major contributions to understanding how AA helps people recover from AUD. In turn, the insights from the study have the potential to substantially contribute to the use of AA and other mutual recovery services in clinical practice.

抽象的 戒酒互诫协会 (AA) 现已在帮助个人从酗酒中恢复过来的能力上得到了充分认可 障碍（AUD），但在理解其发生机制方面存在很大差距。最近的 研究表明了两个新的机制领域：1）减少冲动； 2）有益的增加 社交网络。然而，仅在少数研究中对这些机制进行了调查，并且 现有研究采用低分辨率测量和次优研究设计。拟议的研究 将解决这些局限性，系统地研究冲动和社交网络组成作为新颖的 AA 对澳元复苏的积极影响的行为改变机制（MOBC）。第一个主要目标是 为了检查冲动性，将概念分为三种不同的形式：1）对未来的大幅折扣 奖励（即延迟折扣）； 2）行为抑制能力差（即无法抑制优势反应）；和 3）冲动的人格特质（即关于调节能力的自我归因）。第二个主要目标是 检查社交网络属性，通过正式的以自我为中心的社交来量化参与者的社交关系 网络组成分析。第三个主要目标是检查这些机械关系是否 根据年龄、性别和研究地点这三个重要因素的不同，系统性地有所不同。一个探索性的 次要目标是挖掘主要目标的发现，以产生具体建议和 临床实践的应用。这些目标将在优化的前瞻性队列设计中实现 用于表征 MOBC 中滞后的动态变化。具体来说，研究设计将检查这些 新参与社区门诊 AUD 治疗的 AUD 患者的流程。 参与者将在基线、6 周、3、6、9 和 12 个月时接受评估。机管局的参与将 可以使用传统的会议出席频率衡量标准和新颖的会议出席频率衡量标准来衡量 AA 计划参与。结果变量将包括戒酒天数百分比和酗酒百分比 天。研究结果将通过全面的知识翻译计划进行传播。总的来说， 拟议的研究有可能为理解 AA 如何帮助人们康复做出重大贡献 来自澳元。反过来，该研究的见解有可能为 AA 和 其他临床实践中的相互康复服务。

项目成果

Impacts of the COVID-19 public health restrictions on substance use, mental health, and psychosocial functioning among individuals with alcohol use disorder.

COVID-19 公共卫生限制对酒精使用障碍患者的药物使用、心理健康和社会心理功能的影响。

• DOI: 10.1080/00952990.2022.2134021
• 发表时间: 2022
• 期刊: The American journal of drug and alcohol abuse
• 作者: González-Roz,Alba;Haik,AmandaK;Rahman,Liah;Todi,AkshitiA;Kane,Claire;Walji,Alyna;Dickerman,SarahR;Scarfe,Molly;Levitt,EmilyE;Belisario,Kyla;Kelly,JohnF;MacKillop,James
• 通讯作者: MacKillop,James

Naturalistic Research on Recovery Processes: Looking to the Future.

• DOI: 10.35946/arcr.v41.1.02
• 发表时间: 2021
• 期刊: Alcohol research : current reviews
• 作者: Stout RL