Ambivalence Model of Craving: Re-examining the Craving-Drinking Relationship

描述(由申请人提供)：NIAAA要求获得以患者为导向的研究职业发展奖(K23)，以促进候选人作为一名多产的、独立的临床科学家的专业发展。具体地说，候选人将利用这项为期五年的奖项接受相关培训，以检查被诊断为酒精使用障碍(AUDS)的人在饮酒过程中成功改变的相关过程，重点是应用一种新的理论模型来研究渴望。通过应用渴望的矛盾心理模型，该模型将渴望视为一种复杂的经历，需要考虑情境和其他因素，包括使用(接近)和不使用(回避)的愿望，应试者将在接受短暂的酒精干预之前、期间和之后重新检查被诊断为AUDS的人的渴望-饮酒关系。更好地了解康复过程中的渴求过程有可能为当前的治疗策略提供信息，并强调与饮酒前改变、治疗开始和积极治疗结果相关的重要过程。应聘者的长期职业目标是调查个人成功改变有问题的饮酒行为的过程，并将这些知识应用于治疗计划的开发、改进和实施。拟议的五年培训计划和研究研究是候选人职业发展的基本步骤，将侧重于以下方面的广泛培训和指导：1)临床试验方法学，2)日常过程方法学，3)复杂日常数据建模的高级统计技术(即多水平建模)，以及4)在酒精相关研究中使用自动化和基于网络的技术。此外，该奖项将为候选人作为临床科学家的专业发展提供持续指导，包括进一步培训负责的 进行研究。作为这项职业发展奖的一部分，候选人提出了一项结合临床试验和日常过程方法的研究，以检查在接受短暂酒精干预之前、期间和之后，被诊断为AUDS的人的日常方法和回避倾向(即渴望)与饮酒行为之间的动态纵向关系。假设每天的回避倾向将显著缓和日常接近倾向对饮酒行为的影响，并且在进入治疗之前观察到回避倾向显著增加，随后在治疗期间接近倾向显著减少。成瘾研究所的研究环境，加上精心挑选的专家指导团队，将在颁奖期间为候选人提供出色的支持和指导。拟议的职业发展奖中概述的培训和研究经验将为候选人提供必要的技能，以继续开展独立研究计划，解决被诊断为AUDS的人在渴望饮酒关系中的复杂性。

DESCRIPTION (provided by applicant): A Mentored Patient-Oriented Research Career Development Award (K23) is requested from NIAAA to facilitate the candidate's professional development as a productive, independent clinical scientist. Specifically, the candidate will use the five-year award to receive training relevant to examining processes associated with successful changes in drinking among those diagnosed with alcohol use disorders (AUDs), with a particular focus on applying a novel theoretical model for studying craving. Through the application of the Ambivalence Model of Craving, which views craving as a complex experience requiring consideration of contextual and other factors, including both desires to use (approach) and desires to not use (avoidance), the candidate will re-examine the craving-drinking relationship among those diagnosed with AUDs prior to, during, and after receiving a brief alcohol intervention. Greater understanding of craving processes during the course of recovery has the potential to inform current treatment strategies, and to highlight an important process associated with pretreatment changes in drinking, treatment initiation, and positive treatment outcomes. A long term career goal of the candidate is to investigate the processes by which individuals successfully change problematic drinking behaviors, and applying this knowledge to the development, refinement and implementation of treatment programs. The proposed five-year training plan and research study are a fundamental step in the candidate's professional development, and will focus on extensive training and mentoring in: 1) clinical trial methodology, 2) daily process methodology, 3) advanced statistical techniques for modeling complex daily data (i.e., multilevel modeling), and 4) the use of automated and web-based technologies in alcohol-related research. Further, the award will provide ongoing guidance for the professional development of the candidate as a clinical scientist, including further training in the responsible conduct of research. As part of this career development award, the candidate proposes a study combining both clinical trial and daily process methodology to examine the dynamic longitudinal relationships between daily approach and avoidance inclinations (i.e., craving) and drinking behaviors in those diagnosed with AUDs prior to, during, and after receiving a brief alcohol intervention. It is hypothesized that daily avoidance inclinations will significantly moderate the effect of daily approach inclinations on drinking behaviors, and that significant increases in avoidance inclinations will be observed prior to treatment entry, followed by significant decreases in approach inclinations during treatment. The research environment at the Research Institute on Addictions, combined with the carefully selected expert mentoring team, will provide the candidate with excellent support and guidance during the award period. The training and research experiences outlined in the proposed career development award will provide the necessary skills for the candidate to pursue a program of independent research addressing the complexities in the craving-drinking relationship among those diagnosed with AUDs.