Contextual Influences on Alcohol Response and its Relation to Drinking Outcomes

描述(由申请人提供)：酒精反应(AR)的个体差异是长达25年的酒精相关问题的可靠预测因子。[然而，几乎没有人努力将这种关于AR高风险模式的知识应用于预防/干预计划。这与针对其他众所周知的风险标志(例如酗酒家族史)的协调努力形成了直接对比。为了将AR的高风险模式应用于经验支持的干预措施，我们必须解决文献中的重要空白。]首先，赋予最大风险的AR的具体模式仍未得到很好的理解。尽管有明确的证据表明，对负面酒精效应(如昏昏欲睡、头晕)的低水平反应与后来出现问题的风险增加有关，但对AR的其他方面知之甚少。到目前为止，只有一项研究考察了高唤醒积极效应(例如兴奋、健谈)与后来饮酒结果之间的关系，还没有关于低唤醒积极效应(例如放松、平静)对以后出现问题的风险的影响的研究。这是一个关键问题，因为更强烈的负面强化饮酒动机是饮酒问题的有力预测因素。其次，以前的纵向研究已经在不能代表典型饮酒环境的环境中评估了AR(例如，在实验室单独饮酒)。因此，我们对更“真实”的饮酒环境中的AR与后来的不良后果风险之间的关系知之甚少。[这一信息至关重要，因为不适用于更真实世界的AR的高风险模式可能具有有限的实用价值。这项拟议的研究将描述预测后续酒精相关问题的AR的特定模式，从而使有关AR相关风险的信息能够直接应用于预防和干预工作。参与者(n=360；50%女性)将被随机分配到三个饮酒环境(单独实验室、团体实验室或团体模拟酒吧)中的一个，每个环境中嵌套着饮料条件(n=70酒精；n=50安慰剂)。这三组设计将允许我们检查社会(单独与小组)和物理(实验室与模拟酒吧)环境对AR的影响。]我们将使用多方法方法(显性、隐性、行为和生物测量)来评估AR的全部范围，包括在先前的纵向研究中未被检验的影响(例如，低唤醒的积极影响和高唤醒的负面影响)。在安慰剂控制的酒精挑战之后，我们将使用两年两次的调查(总共4次评估)来跟踪随后的饮酒行为和与酒精相关的问题。[这项研究设计将使我们能够检验酒精对未来饮酒和问题的预测作用，并确定AR和以后饮酒结果之间的关系是否取决于背景。]拟议研究的结果将为传播关于AR特定高危模式的更详细信息提供基础，特别是个人在典型饮酒环境(例如集体饮酒或在酒吧饮酒)中容易识别的AR模式。]

DESCRIPTION (provided by applicant): Individual differences in alcohol response (AR) are robust predictors of later alcohol-related problems over periods as long as 25 years. [Yet, there has been little effort to apply this knowledge about high risk patterns of AR to prevention/intervention programs. This is in direct contrast to concerted efforts to target other well- known markers of risk (e.g. family history of alcoholism). In order to move toward the application of high-risk patterns of AR to empirically supported interventions, we must address important gaps in the literature.] First, the specific pattern of AR that confers greatest risk is till not well understood. Although there is clear evidence that a low level of response to negative alcohol effects (e.g. drowsy, dizzy) is associated with increased risk for later problems, much less is known about other aspects of AR. To date, only one study has examined the relation between high arousal positive effects (e.g. excited, talkative) and later drinking outcomes, and there are no studies on the effects of low arousal positive effects (e.g. relaxed, calm) on risk fo later problems. This is a critical issue as stronger negative reinforcement motives for drinking are robust predictors of drinking problems. Second, prior longitudinal studies have evaluated AR in settings that are not representative of typical drinking contexts (e.g. solitary drinking in a laboratory). Thus, we know little about relations between AR in more "real world" drinking contexts and later risk for negative outcomes. [This information is vital as high risk patterns of AR that do not generalize to more real-world settings may have limited practical utility. The proposed study will characterize specific patterns of AR that predict subsequent alcohol-related problems, thereby allowing the direct application of information about AR-related risks to prevention and intervention efforts. Participants (n = 360; 50% female) will be randomly assigned to one of three drinking contexts (solitary lab, group lab, or group simulated bar) with beverage condition nested within each context (n = 70 alcohol; n = 50 placebo). This three group design will allow us to examine the impact of both social (solitary vs. group) and physical (lab vs. simulated bar) context on AR.] We will use a multi-method approach (explicit, implicit, behavioral, and biological measures) to assess the full range of AR, including effects that have not been examined in prior longitudinal studies (e.g. low arousal positive and high arousal negative effects). Following the placebo controlled alcohol challenge; we will track subsequent drinking behavior and alcohol-related problems using bi-annual surveys over a two year period (4 total assessments). [This study design will allow us to examine the full range of alcohol effects as predictors of future drinking and problems, and determine if relations between AR and later drinking outcomes are dependent on context.] Findings of the proposed study will provide the basis for disseminating more detailed information about specific high-risk patterns of AR, particularly patterns of AR that individuals are readily able to discern in typical drinking contexs (e.g. group drinking or drinking in a bar setting).]