Testing Automatic Action-Tendency Retraining in Heavy Drinking Young Adults Using

描述(申请人提供)：年轻人大量饮酒是一个公共卫生问题。年轻人经常饮酒，这使他们面临受伤、事故和随后的酒精依赖的风险。由于强烈的偶然性支持他们饮酒，而改变的动力有限，年轻的成年饮酒者是一个具有挑战性的人群。目前的行为干预总体上是有效的，但效果不大。鉴于这些因素，需要新的干预措施来针对支持年轻人大量饮酒的认知和行为。双过程模型认为，上瘾行为源于抑制冲动的失败尝试和过度活跃的自动、食欲、接近倾向。目前的行为干预措施通常旨在通过促使努力的行为改变来增强年轻人对过度饮酒的抑制控制。相比之下，自动的方法倾向在很大程度上被行为干预所忽视。在大量饮酒的年轻人中发现了强烈的自动接近倾向，这表明减少这些倾向的干预可能非常适合这一人群。自动动作倾向再培训(Wiers等人2010年；2011年)是一种有理论支持的、新颖的干预措施，有希望获得初步的经验支持。再训练程序需要在反复试验中，对酒精图像做出反应，用操纵杆推开动作。在这项拟议的研究中，自动行为倾向再训练将与大量饮酒的年轻人(N=72)的控制条件进行比较，使用一种新的、自然主义的酒精自我管理模式来削弱对酒精使用的控制(Leeman等人。2012年)。控制障碍是一种偏离有意识地限制饮酒的尝试，这种尝试可能是由于强烈的自动接近酒精的倾向而发生的。值得注意的是，受损的控制范式对过度饮酒产生了抑制作用，为参与者提供了限制饮酒的理由。在这个范例中，过量饮酒忽略了适度饮酒的指导方针，尽管可能会产生负面后果，但仍会发生，因此对问题饮酒的关键要素进行了建模。我们假设，被随机接受自动动作倾向再训练的年轻人将饮酒以显著降低估计的峰值血液酒精浓度，并且总体饮酒量比随机进入对照条件的人更少。还将在试验性再培训和控制条件下对饮酒地形的测量进行探索性比较，包括平均每次饮酒所需的时间。这项研究的发现将为未来的临床试验提供参考，以测试自动动作倾向再训练对年轻成年重度饮酒者的效果。拟议研究的结果也将为后续研究提供参考，将再培训程序与干预相结合，以加强抑制控制。理论和证据表明，自动/隐含和努力/显性干预对减少酒精使用做出了独特的贡献，使它们的结合充满希望。

DESCRIPTION (provided by applicant): Young adult heavy drinking is a public health concern. Young people drink alcohol frequently, which puts them at risk for injuries, accidents and subsequent alcohol dependence. Due to strong contingencies supporting their alcohol use and limited motivation to change, young adult drinkers are a challenging population to treat. Current behavioral interventions are efficacious overall but effect sizes have been modest. Given these factors, new interventions are needed to target cognitions and behaviors that support young adult heavy drinking. Dual process models posit that addictive behaviors stem from failed attempts at inhibiting impulses and overactive automatic, appetitive, approach tendencies. Current behavioral interventions typically aim to enhance young adults' inhibitory control over excessive drinking by prompting effortful behavior change. In contrast, automatic, approach tendencies have been ignored largely in behavioral interventions. Findings of strong automatic approach tendencies among heavy drinking young adults suggest that an intervention to reduce these tendencies may be well-suited to this population. Automatic action tendency retraining (Wiers et al. 2010; 2011) is a theoretically-supported, novel intervention with promising initial empirical support. The retraining procedure entails pushing away motions with a joystick in response to alcohol images over repeated trials. In the proposed study, automatic action tendency retraining will be compared to a control condition in heavy drinking young adults (N = 72), using a novel, naturalistic alcohol self-administration model of impaired control over alcohol use (Leeman et al. 2012). Impaired control is a deviation from a conscious attempt to limit alcohol use that may occur due to strong automatic approach tendencies toward alcohol. Notably, the impaired control paradigm creates disincentives for drinking alcohol excessively, providing participants with reasons to limit alcohol use. Excessive alcohol use in this paradigm ignores a guideline for moderate use and occurs despite possible negative consequences, thus modeling key elements of problem drinking. We hypothesize young adults randomized to automatic action tendency retraining will drink to significantly lower peak estimated blood alcohol concentrations and consume fewer drinks overall than those randomized to the control condition. Exploratory comparisons will also be made between the experimental retraining and control conditions on measures of drinking topography including mean time taken to consume each drink. Findings from this study will inform future clinical trials to test the efficacy of automatic action tendency retraining for young adult heavy drinkers. Results of the proposed study will also inform subsequent research to combine the retraining procedure with an intervention to enhance inhibitory control. Theory and evidence suggest automatic/implicit and effortful/explicit interventions contribute uniquely to alcohol use reduction, making their combination promising.