Exploring Personal Change Mechanisms in Modifying Drinking Behavior

描述（由申请人提供）：为了提高酒精使用障碍干预的有效性，需要进行发展研究，以了解和评估影响饮酒行为改变的关键变化机制。拟议的R21研究项目将研究机制以及个人变化过程的中介和调节者，这些变化是饮酒在自然或自我变化以及治疗中改变的基础。在这个项目中考虑的候选构念包括改变的阶段和过程、自我控制和执行认知功能、承诺、自我效能、渴望、影响管理、压力、期望和相关的改变历史。本研究的三个阶段将：(1)在项目MATCH和COMBINE数据集的二次分析中探索这些候选变化过程变量，在治疗过程中检查它们，并研究它们与随时间饮酒变化的关系；2)创建和评估一个结构化的访谈评估，即改变任务和机制访谈（CTMI），旨在捕捉饮酒者个人改变过程中关键任务的完成情况，该评估将由40名目前正在接受治疗的参与者、10名临床工作人员和几名独立的录音访谈评判员共同开发；3)结合自我报告和访谈测量，我们将收集和评估综合变化评估电池（CCAB），该电池测量了来自两个临床门诊设置的80名酒精治疗患者的关键自我调节和变化过程维度，这些患者将在入组后的基线、2、4、6、8、12和24周进行评估。该试点将完善并最终确定一种新的评估方法，该方法可以评估个人变化过程，以便更好地理解在自然和干预辅助下饮酒行为改变中活跃的变化机制。

DESCRIPTION (provided by applicant): To increase the effectiveness of interventions of alcohol use disorders developmental research is needed to understand and assess critical mechanisms of change that influence the modification of drinking behavior. The proposed R21 research project will examine mechanisms as well as mediators and moderators of the personal process of change that underlies the modification of drinking both in natural or self-change as well as in treatment. Candidate constructs to be considered in this project include stages and processes of change, self-control and executive cognitive functioning, commitment, self-efficacy, craving, affect management, stress, expectancies, and relevant change history. The three phases of this research will 1) explore these candidate change process variables in secondary analyses of Project MATCH and COMBINE data sets examining them within treatment and for relationships with changes in drinking over time; 2) create and evaluate a structured interview assessment, the Change Tasks and Mechanisms Interview (CTMI), designed to capture how well critical tasks of the personal process of change are accomplished by individual drinkers that will be developed with 40 participants currently in treatment, 10 clinical staff and several independent raters of audio taped interviews; and 3) combining both self-report and interview measures we will assemble and evaluate a Comprehensive Change Assessment Battery (CCAB) that measures critical self-regulation and change process dimensions in a pilot study with 80 alcohol treatment patients from two clinical outpatient settings who will be evaluated at baseline, 2, 4, 6, 8, 12 and 24 weeks after enrollment. This pilot will refine and finalize a novel assessment battery that can evaluate the personal change process in order to better understand mechanisms of change that are active both in natural and intervention-assisted change of drinking behaviors.