Modeling Individual Heterogeneity in the Alcohol Relapse Process

大约1760万美国人符合酒精滥用或依赖的标准，12.5%符合酒精滥用或依赖标准的人（220万美国人）将接受酒精问题的治疗。在接受治疗的人中，大多数人在治疗后的前12个月内至少喝一杯。这项拟议的研究旨在描述酒精治疗后第一年治疗后饮酒的模式。来自Project MATCH的数据，这是一项由NIAAA赞助的酒精治疗的多地点调查，将用于检验以下假设：个体之间和个体内部的饮酒行为随时间存在显著差异。将出于三个不同的目的对项目MATCH数据进行二级数据分析。拟议研究的第一个目标将是使用潜在生长混合物模型复制先前的研究，以研究初始治疗后饮酒后饮酒轨迹的常见模式和个体差异。第二个目标是使用复发风险因素的生物心理社会模型来描述饮酒轨迹的差异。第三个目标是通过扩展潜在增长混合模型来量化复吸过程的复杂性，以分析个体在戒断过程中的行为。这些分析的目的是了解为什么以及当个人经历饮酒随着时间的推移发生重大变化。拟议的研究的主要目的是提供一个药物驱动的复发模型，其中包括复发过程的个体变异性和突然性，不连续性，如理论和定性报告所示。这项调查的最终目标是为临床医生和他们的客户提供一个高度认识的风险因素，可能使个人倾向于大量饮酒和那些因素，增加从轻度到重度饮酒治疗后过渡的可能性。

DESCRIPTION (provided by applicant): Approximately 17.6 million Americans meet criteria for alcohol abuse or dependence, and 12.5 percent of individuals who meet criteria for alcohol abuse or dependence (2.2 million Americans) will receive treatment for an alcohol problem. Of those who receive treatment, the majority of individuals will have at least one drink in the first 12-months following treatment. The proposed study aims to delineate patterns in post-treatment drinking during the first year following alcohol treatment. Data from Project MATCH, a multi-site investigation of alcohol treatment sponsored by the NIAAA, will be used to test the hypothesis that there is significant variability in the drinking behavior between individuals and within individuals across time. Secondary data analyses of the Project MATCH data will be conducted for three distinct purposes. The first goal of the proposed study will be to replicate previous research using latent growth mixture modeling to investigate common patterns and individual differences in trajectories of drinking after the initial post- treatment drink. The second goal is to describe the differences in drinking trajectories using a biopsychosocial model of relapse risk factors. The third goal is to quantify the complexity of the relapse process by extending the latent growth mixture models to analyze the behavior of individuals who transition in-and-out of abstinence. The goal of these analyses is to understand why and when individuals experience major shifts in drinking over time. The major aim of the proposed research is to provide an empirically-driven model of relapse that incorporates the individual variability and abrupt, discontinuous nature of the relapse process, as illustrated in theoretical and qualitative reports. The ultimate goal of this inquiry is to provide clinicians and their clients with a heightened awareness of risk factors that may predispose an individual to heavy drinking and those factors that increase the probability of transitioning from light-to-heavy drinking following treatment.