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

 描述(由申请人提供)：拟议研究的主要目标是评估饮酒身份的改变(一个人与饮酒有多少联系)是否可以减少在校和即将毕业的大学生中的危险饮酒(HD；酗酒和与酒精相关的负面后果)。这项工作涉及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规治疗的情况下摆脱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：尽管进行了数十年的研究，HD在很大程度上是有增无减的，而且在大学人群中的严重性似乎正在增加。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，最近的研究结果对旨在减少大学生HD的干预措施的有效性提出了质疑，突显了改进的必要性。我们认为，饮酒认同是一个很有希望的因素，可以作为一种潜在的认知机制来研究，它有助于许多大学毕业生自然减少HD。最近的研究发现，饮酒身份是大学生HD的一个强有力的预测指标，而且随着时间的推移，饮酒身份的变化会导致饮酒量的变化，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，这可以导致提高拒绝某种物质的自我效能，并减少对该物质的渴望。尽管有这样的希望，饮酒身份并没有被评估为脱离HD的过渡的预测因素；没有研究试图直接改变饮酒身份；也没有大学HD干预直接针对饮酒身份。因此，拟议的研究试图通过评估饮酒身份的自然改变(研究1)和实验诱导的改变(研究2)来弥合这一差距。这项自然主义研究将跟踪400名即将毕业的大学HDs的样本，评估他们在毕业后两年内的基线和每4个月的饮酒身份和饮酒行为。这将允许在HD减少的关键发展时期检查饮酒身份和HD的人内和人与人之间的变化。这项实验研究将通过操纵饮酒身份(通过记叙性写作任务)来提高自我效能感，减少饮酒欲望，最终减少HD。328名大学生HDs的样本将被招募进行一项为期3个疗程的实验室研究，其中包括2周、1个月和3个月的随访，以测试饮酒、自我效能、渴望和现实饮酒方面更持久、更持久的变化的可能性。这项拟议的研究特别重要，因为它评估了一种有希望的认知因素，目前在HD的行为治疗中没有针对它，提供了对拟议的改变机制的直接测试，并最终可能导致减少大学生HD的新颖、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.