Cognitive Neuroscience of Decision Making in Recovery from Alcoholism

酒精中毒康复决策的认知神经科学

• 批准号: 8515893
• 负责人: MITCHELL P KARNO
• 金额: $ 12.19万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-20 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8515893
• 关键词: Alcohol abuse; Alcohol consumption; Alcoholic beverage heavy drinker; Alcoholism; Alcohols; Area; Attention; Behavior; Behavior Therapy; Biological Models; Biology; Brain; Cognitive; Complex; Consultations; Control Groups; Data; Data Analyses; Data Collection; Data Set; Decision Making; Decision Theory; Development Plans; Devices; Dorsal; Educational workshop; Environment; Equation; Evaluation; Exhibits; Feedback; Frequencies; Functional Magnetic Resonance Imaging; Future; General Population; Goals; Impulsivity; Individual; Intervention; Knowledge; Laboratories; Longitudinal Studies; Measures; Medial; Modeling; Monitor; Neurobiology; Neurology; Neurosciences; Outcome; Pain; Parahippocampal Gyrus; Parietal Lobe; Participant; Population; Prefrontal Cortex; Procedures; Process; Psychiatry; Psychology; Randomized; Randomized Controlled Trials; Reading; Recovery; Relative (related person); Reporting; Research; Research Personnel; Resources; Rewards; Risk; Role; Sampling; Science; Self-control as a personality trait; Substantia nigra structure; System; Testing; Thinking; Time; Ventral Striatum; Waiting Lists; Wireless Technology; Woman; Work; addiction; base; behavior change; career development; cognitive neuroscience; computer science; craving; data sharing; design; drinking; experience; follow-up; improved; interest; intervention effect; longitudinal design; member; men; motivational enhancement therapy; motivational intervention; neuroimaging; neuropsychiatry; phenomics; pleasure; problem drinker; psychosocial; reduced alcohol use

DESCRIPTION (provided by applicant): Research on behavioral treatments for alcoholism has provided little definitive evidence about how treatment influences positive behavior change. Moreover, the difficulty of identifying how people change is not limited to treatment seekers but generalizes to non-treatment seekers. The identification of mechanisms of behavior change is emerging as one of the great challenges to addiction research. Recently, increased attention has been given to the need for cross-disciplinary research that views behavior change as the result of a complex interplay between one's environment, thoughts and behaviors, and brain function and biology. Such research provides tremendous opportunities to identify how people change their alcohol use behavior. This K02 application seeks to promote the applicant's progression into transdisciplinary research on recovery from alcoholism. Building on the applicant's background in studying the mechanisms of action of behavioral treatments, the goal of this application is to gain expertise in cognitive neuroscience as it relates to efforts to change one's alcohol use. The objectives of this proposal are to acquire sufficient knowledge of decision theory, neuroscience, and neuroimaging to permit the candidate to conduct independent research that examines linkages between thought processes and brain activity with changes in alcohol use among problem drinkers. To achieve these objectives a detailed career development plan will be followed that entails formal coursework, workshops, directed readings, ongoing consultations with experts in specific content areas, and experiential work on existing datasets. An important institutional resource that will facilitate the applicant's efforts towards achieving these objectives is the UCLA Consortium for Neuropsychiatric Phenomics (CNP). The CNP is an interdisciplinary, campus-wide effort comprised of 52 investigators with members from the fields of psychiatry, neurology, neurobiology, psychology and computer science collaborating and sharing data. The specific aspects of the CNP especially relevant to the proposed career development plan are its focus on impulse control as one of its two broad cognitive phenotypic domains, its collection of data on an fMRI battery for 500 individuals, and its collection of data on alcohol use by participants. The candidate will work with the CNP and collaborators to receive practical experience in performing decision making and fMRI procedures and analyzing data on relationships between alcohol use, decision making, and brain activity. As a first step in a programmatic line of research, a randomized controlled trial using a repeated measures longitudinal design is proposed to examine decreases in alcohol use among non-treatment seeking heavy drinkers as function of change in brain activity and sensitivity to reward during decision making. Participants (n=114) will include both men and women. A laboratory fMRI-based paradigm will be conducted at baseline, 1-month, and 3-month follow-ups to assess brain activity during decision making tasks. Daily monitoring procedures across the same 3-month period will be used to capture real-time decision making processes, alcohol use, and the perceived effects of alcohol use. After the baseline assessment participants will be randomly assigned to either a 4-session motivational intervention or a wait-list control group. Data will be analyzed with structural equation modeling and with advanced dynamic systems modeling. It is hypothesized that reductions in alcohol use will be predicted from a cascade of interrelated pro-change processes that include decreases in brain activity associated with craving and impulsivity, decreased reward value of alcohol during decision making, and increased non-drinking activities. This longitudinal study of complex systems offers great promise to dramatically improve our understanding of mechanisms of behavior change and to inform efforts to promote this change among heavy drinkers in the general population.

描述（由申请人提供）：关于酗酒行为治疗的研究几乎没有提供关于治疗如何影响积极行为改变的确切证据。此外，确定人们如何改变的困难不仅限于寻求治疗者，而且普遍存在于非寻求治疗者。行为改变机制的识别是成瘾研究面临的最大挑战之一。最近，越来越多的注意力已经给予需要跨学科的研究，认为行为变化是一个人的环境，思想和行为，大脑功能和生物学之间的复杂相互作用的结果。这些研究为确定人们如何改变饮酒行为提供了巨大的机会。此K02应用程序旨在促进申请人的进展到跨学科的研究从酗酒恢复。基于申请人在研究行为治疗作用机制方面的背景，本申请的目标是获得认知神经科学方面的专业知识，因为它涉及改变一个人的酒精使用。该提案的目标是获得决策理论，神经科学和神经影像学的足够知识，以允许候选人进行独立的研究，检查思维过程和大脑活动与问题饮酒者中酒精使用变化之间的联系。为了实现这些目标，将遵循详细的职业发展计划，包括正式的课程，研讨会，指导阅读，与特定内容领域的专家进行持续磋商，以及对现有数据集的经验工作。一个重要的机构资源，将促进申请人的努力，实现这些目标是加州大学洛杉矶分校联盟神经精神表型组学（CNP）。CNP是一个跨学科的，校园范围内的努力，由52名研究人员与来自精神病学，神经学，神经生物学，心理学和计算机科学领域的成员合作和共享数据。CNP的具体方面，特别是有关拟议的职业发展计划是其重点冲动控制作为其两个广泛的认知表型域之一，其收集的数据上的功能磁共振成像电池为500人，其收集的数据对酒精使用的参与者。候选人将与CNP和合作者一起工作，以获得执行决策和fMRI程序的实践经验，并分析有关酒精使用，决策和大脑活动之间关系的数据。 作为第一步，在一个纲领性的研究路线，一个随机对照试验，采用重复测量纵向设计，提出了检查减少酒精使用的非治疗寻求重度饮酒者的功能变化，大脑活动和敏感性，奖励决策。参与者（n=114）将包括男性和女性。将在基线、1个月和3个月随访时进行基于实验室fMRI的范例，以评估决策任务期间的大脑活动。在同一3个月期间的日常监测程序将用于捕获实时决策过程，酒精使用和酒精使用的感知影响。基线评估后，参与者将被随机分配到4个阶段的动机干预组或等待名单对照组。数据将分析与结构方程建模和先进的动态系统建模。据推测，酒精使用的减少将从一系列相互关联的促变化过程中预测，包括与渴望和冲动相关的大脑活动减少，决策过程中酒精的奖励价值降低，以及非饮酒活动增加。这种对复杂系统的纵向研究提供了极大的希望，可以大大提高我们对行为变化机制的理解，并为在普通人群中促进重度饮酒者的这种变化提供信息。