Elucidating the role of cognitive and physiological aspects of affect in alcohol use relapse

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R&R7. Project Summary/Abstract There is a pressing need to better understand specific factors that lead to relapse among individuals seeking treatment for alcohol use disorder (AUD) in order to improve existing treatments and develop new interventions for this pervasive and costly disorder. While psychological and affective factors have been investigated as predictors of relapse, little is currently known about physiological markers of relapse risk, and most existing research has not taken advantage of newer real-time psychological assessment methods. This investigation is novel in that it will study simultaneously, cognitive factors associated with alcohol relapse such as anxiety and craving, and associated autonomic nervous system processes as they occur in the environment, in order to identify psychological and biological vulnerabilities that may heighten relapse risk for AUD. The study's goal to identify patterns of real-time affect and patterns of affective lability that predict relapse, as well as attendant biomarkers of affect regulation that operate outside of conscious awareness, and thus may add important, objective information about affective regulation that can complement self-report measures in the study of AUD. Further, the training plan outlined in this fellowship will provide the principal investigator with an important set of skills that will grow his capacity to conduct cutting edge research in the areas of substance use disorders (SUDs) and other mental disorders characterized by affect dysregulation. This will be achieved through specialized training in ecological momentary assessment (EMA), a powerful research modality for studying affective and behavioral processes in real time, as individuals interact with their environment. The long-term goal of this program of research and the attendant training plan is to develop integrated biobehavioral treatments for alcohol and other SUDs that address individual vulnerabilities that can undermine individuals' attempts to achieve lasting remission. This study will provide valuable information about the utility and feasibility of applying novel assessment techniques like EMA and ambulatory psychophysiological assessment to the study of addictive disorders, which has the potential to open up new avenues of research.