Alcohol Response, Cognitive Impairment, and Alcohol-Related Negative Consequences

描述（由申请人提供）：在新生成人中，酒精使用的公共卫生成本在很大程度上可归因于酒精对其他行为风险的影响，如攻击性、不安全性行为和酒后驾驶。越来越多的研究文献表明，酒精中毒会降低执行认知控制，尤其是削弱抑制强性行为反应的能力，这些影响可能会增加参与行为风险的倾向。另一篇文献表明，不同人群对酒精的急性生理和主观反应存在差异，人们越来越认识到，酒精反应反映了稳定的、受基因影响的个体差异。然而，对酒精反应的研究主要集中在它们在酒精使用障碍发展中的作用，而忽略了它们对与急性酒精中毒相关的行为结果的贡献。这项拟议中的研究将测试酒精反应在预测自然环境中与酒精相关的行为风险方面的作用。在第一阶段的研究中，中度至重度饮酒的新成人将在模拟酒吧环境中完成受试者内部安慰剂对照酒精挑战，以评估主观和生理酒精反应以及酒精诱导的抑制性损伤。预计更大的酒精反应与更大的酒精引起的对阳痿反应的抑制损伤有关。在第二阶段，同样的参与者将使用基于网络的日常日记报告他们的酒精使用、主观酒精反应和其他行为风险。在控制事件水平酒精反应和估计血液酒精浓度的情况下，实验室中更大的酒精反应将前瞻性地预测醉酒行为风险，如在事件水平的日常日记中评估的那样。最后，更大的酒精诱导的抑制性损伤有望介导实验室酒精反应与事件级行为风险之间的关联。研究结果有望确定更强烈的酒精反应对事件层面的行为影响。该项目将整合两个独立的研究方向，证明更强烈的酒精反应会加剧酒精对行为风险的去抑制作用。这些结果将允许将酒精反应纳入酒精对行为影响的理论模型，并将有助于解释为什么一些初成年的人在醉酒时比其他人更容易做出有害的行为。

DESCRIPTION (provided by applicant): Among emerging adults, the public health costs of alcohol use are attributable in no small part to the effects of alcohol on other behavioral risks such as aggression, unsafe sex, and driving after drinking. A growing research literature demonstrates that alcohol intoxication decreases executive cognitive control, in particular impairing the ability to inhibit prepotent behavioral responses, and these effects may contribute to an increased propensity to engage in behavioral risks. A separate literature demonstrates that there is variability across the population in acute physiological and subjective responses to the effects of alcohol, with increasing recognition that alcohol responses reflect stable, genetically influenced individual differences. Research on alcohol responses, however, has largely focused on their role in the development of alcohol use disorders at the expense of examining their contributions to behavioral outcomes associated with acute alcohol intoxication. The proposed research will test the role of alcohol responses in predicting alcohol-related behavioral risks in the natural environment. In a first study phase, moderate-to-heavy drinking emerging adults will complete a within-subject, placebo-controlled alcohol challenge in a simulated bar environment to assess subjective and physiological alcohol responses and alcohol-induced inhibitory impairment. Greater alcohol responses are expected to be associated with greater alcohol-induced impairment in the inhibition of prepotent responses. In a second phase, the same participants will report on their alcohol use, subjective alcohol responses, and other behavioral risks using Web-based daily diaries. Greater alcohol responses in the lab will prospectively predict intoxicated behavioral risks as assessed in the event-level daily diaries, controlling for event-level alcohol responses and estimated blood alcohol concentration. Finally, greater alcohol-induced inhibitory impairment is expected to mediate the association between lab-based alcohol responses and event-level behavioral risks. The findings are expected to identify the event-level behavioral effects of greater alcohol responses. This project will integrate two separate lines of research by demonstrating that greater alcohol responses exacerbate the disinhibiting effects of alcohol on behavioral risks. These results will permit the incorporation of alcohol responses into theoretical models of the effects of alcohol on behavior and will help explain why some emerging adults are more likely to engage in harmful behaviors while intoxicated relative to others.