Evaluating Change in Drinking Identity as a Mechanism for Reducing Hazardous Drinking

 描述（由申请人提供）：拟议研究的总体目标是评估饮酒身份（一个人将自己与饮酒联系在一起的程度）的变化是否可以减少当前和即将毕业的大学生中的危险饮酒（HD;重度饮酒和与酒精相关的负面后果）。这项工作解决了NIAAA战略计划的两个关键优先事项：（1）确定使一些年轻人在没有正式治疗的情况下过渡出HD的因素，以及（2）测试这些因素是否可以被操纵，以帮助开发新的行为方法来减少HD。年轻成人HD的公共卫生负担是巨大的：尽管经过数十年的研究，HD在很大程度上没有减弱，而且在大学人群中的严重程度似乎在增加。虽然在确定HD风险因素和制定干预措施方面取得了进展，但HD水平仍然居高不下。此外，最近的研究结果质疑旨在减少大学生HD的干预措施的有效性，强调需要改进。我们建议，饮酒身份是一个有前途的因素，调查作为一个潜在的认知机制，有助于自然减少HD发生的许多大学毕业生。最近的研究结果表明，饮酒身份是一个强大的预测大学生HD的横截面和随着时间的推移，饮酒身份的变化导致酒精消费的变化，反之亦然。此外，与身份，饮酒和物质使用相关的认知可以被操纵，这可能导致拒绝物质的自我效能增加，并减少对该物质的渴望。尽管有这样的承诺，饮酒身份尚未被评估为过渡出HD的预测;没有研究试图直接改变饮酒身份;没有大学HD干预直接针对饮酒身份。因此，拟议的研究，试图弥合这一差距，评估自然（研究1）和实验诱导（研究2）的变化，饮酒的身份。这项自然主义研究将跟踪400名即将毕业的大学HD样本，并在基线和毕业后2年内每4个月评估他们的饮酒身份和饮酒行为。这将允许检查内和人与人之间的变化，在一个关键的发展时期，当减少HD发生饮酒身份和HD。实验研究将操纵饮酒身份（通过叙事写作任务），以提高自我效能，减少酒精渴望，并最终减少HD。将招募328名大学生HDs样本进行为期3周的实验室研究，包括2周，1个月和3个月的随访，以测试饮酒，自我效能，渴望和现实世界饮酒更持久，持久变化的潜力。这项研究特别重要，因为它评估了一个有前途的认知因素，目前在现有的HD行为治疗中没有针对性，提供了对拟议的变化机制的直接测试，并最终可能导致减少大学生HD的新的，简短的干预措施。

 DESCRIPTION (provided by applicant): The overarching objective of the proposed research is to evaluate whether changes in drinking identity (how much one associates one's self with drinking) can reduce hazardous drinking (HD; heavy alcohol use and negative alcohol-related consequences) among current and graduating college students. This work addresses two key priorities of NIAAA's strategic plan: (1) to identify factors that enable some young adults to transition out of HD without formal treatment, and (2) to test whether these factors can be manipulated to aid in the development of novel behavioral approaches to reduce HD. The public health burden of young adult HD is substantial: despite decades of research, HD is largely unabated and appears to be increasing in severity among college populations. While progress has been made towards identifying HD risk factors and developing interventions, HD levels remain persistently high. Moreover, recent findings question the effectiveness of interventions aimed at reducing college student HD, highlighting the need for improvement. We propose that drinking identity is a promising factor to investigate as a potential cognitive mechanism that contributes to the natural reductions in HD that occur for many college graduates. Recent findings have revealed drinking identity to be a robust predictor of college student HD cross-sectionally and over time, and changes in drinking identity lead to changes in alcohol consumption and vice-versa. Further, cognitions related to identity, drinking, and substance use can be manipulated, which can lead to increased self-efficacy to refuse a substance and reduced craving for that substance. Despite this promise, drinking identity has not been evaluated as a predictor of the transition out of HD; no studies have sought to change drinking identity directly; and no college HD interventions directly target drinking identity. The proposed studies, therefore, seek to bridge this gap by evaluating naturalistic (Study 1) and experimentally-induced (Study 2) change in drinking identity. The naturalistic study will follow a sample of 400 soon-to-graduate college HDs and evaluate their drinking identity and drinking behaviors at baseline and every 4 months for the 2-year period after graduation. This will allow for examination of within- and between-person change in drinking identity and HD at a key developmental period when reductions in HD occur. The experimental study will manipulate drinking identity (via narrative writing tasks) to increase self-efficacy and decrease alcohol craving and ultimately, reduce HD. A sample of 328 college student HDs will be recruited for a 3-session, lab-based study that includes 2-week, 1-month, and 3- month follow ups to test the potential for more durable, lasting change in drinking, self-efficacy, craving, and real-world drinking. The proposed research is particularly important because it evaluates a promising cognitive factor that is not currently targeted in existing behavioral treatments for HD, provides direct test of proposed mechanisms of change, and could ultimately lead to novel, brief interventions for reducing college student HD.