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

使用以下方法测试重度饮酒年轻人的自动行为倾向再训练

• 批准号: 8490624
• 负责人: ROBERT F LEEMAN
• 金额: $ 7.1万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8490624
• 关键词: Accidents; Addictive Behavior; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcoholic beverage heavy drinker; Alcohols; Behavior; Behavior Therapy; Blood alcohol level measurement; Clinical Trials; Cognition; Computers; Conscious; Disincentive; Elements; Future; Goals; Guidelines; Heavy Drinking; Image; Injury; Intervention; Joystick; Laboratories; Measures; Methods; Modeling; Motion; Motivation; Participant; Population; Population Intervention; Procedures; Process; Public Health; Randomized; Research; Risk; Self Administration; Testing; Time; alcohol response; base; behavior change; cost effective; drinking; efficacy testing; novel; problem drinker; public health relevance; stem; theories; young adult

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.

描述（由申请人提供）：年轻人酗酒是一个公共健康问题。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。由于支持他们饮酒的强烈偶然性和有限的改变动机，年轻成年饮酒者是一个具有挑战性的人群治疗。目前的行为干预总体上是有效的，但效果不大。考虑到这些因素，需要新的干预措施来针对支持年轻人酗酒的认知和行为。双重过程模型认为，成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。目前的行为干预通常旨在通过促进努力的行为改变来增强年轻人对过度饮酒的抑制控制。相反，在行为干预中，自动的接近倾向在很大程度上被忽略了。在大量饮酒的年轻人中发现强烈的自动接近倾向，这表明减少这些倾向的干预措施可能非常适合这一人群。自动行动倾向再训练（Wiers et al. 2010; 2011）是一种有理论支持的新型干预措施，具有初步的实证支持。再训练过程需要在反复试验中，用操纵杆推开对酒精图像的反应。在拟议的研究中，自动动作倾向再训练将与重度饮酒的年轻人（N = 72）的控制条件进行比较，使用一种新的、自然的酒精自我管理模型来损害酒精使用的控制（Leeman et al. 2012）。控制障碍是由于对酒精有强烈的自动接近倾向而导致的对限制酒精使用的有意识尝试的偏离。值得注意的是，受损控制范式为过度饮酒创造了抑制因素，为参与者提供了限制饮酒的理由。在这个范例中，过度饮酒忽略了适度饮酒的指导原则，并且不顾可能产生的负面后果而发生，从而模拟了问题饮酒的关键因素。我们假设，随机分配到自动行动倾向再训练组的年轻人会比随机分配到对照组的年轻人喝到明显更低的血液酒精浓度峰值，并且总体上喝得更少。还将探索性比较实验再训练和控制条件对饮酒地形测量的影响，包括消耗每杯饮料的平均时间。这项研究的结果将为未来的临床试验提供信息，以测试自动行为倾向再训练对年轻成年重度饮酒者的效果。该研究的结果也将为后续研究提供信息，以结合再训练过程和干预措施来增强抑制控制。理论和证据表明，自动/隐性干预和努力/显性干预对减少酒精使用有独特的作用，因此它们的结合很有希望。