Effects of CBT Microinterventions on Mechanisms of Change Among Adults with AUD: Using Eye Tracking to Measure Pre-Post Cognitive Control, Stimulus Salience and Craving

项目摘要/摘要 这提出了R21，CBT微干预对成年人行为改变机制的影响 使用AUD：使用眼动跟踪测量前后认知控制、刺激突显和渴望 对PAR-14-053的反应NIAAA治疗酒精使用障碍的行为改变机制， 使用翻译团队科学的方法来分离和检验三种不同认知的效果 行为疗法(CBT)干预(功能分析(FA)、酒精相关的认知重建 思维(CR)和应对渴望(DC))对特定假设机制(认知控制， 刺激突显，或渴望/唤醒)。这款R21采用了一种创新的模式，将 “微干预”设计(斯图尔特兰等人，2013)，成功地使用眼球跟踪实验室任务来展示 对可卡因和尼古丁线索的认知控制缺陷(DiGirolamo，Smelson，&Guevremont，2015； DiGirolamo等人，2016)，并客观地衡量刺激的显著程度(菲尔德和考克斯，2008)和渴望/唤醒 (Chae等人，2008年；DiGirolamo等人，2016年EBR)对酒精线索的反应。为了实现研究的两个目标 具体目标，80名(30%女性)患有AUD的参与者将接受反眼跳评估(以测量认知能力 控制)和注意偏向(测量刺激突显和瞳孔直径)眼球跟踪任务的基线 (第1周)，然后随机接受四种实验微干预之一，研究治疗师在 第二周，并在之后立即重新评估。三种情况下的每种情况都是不同的60分钟手动指导 来自我们有效的12疗程CBT治疗方案的CBT微干预(FA、CR或DC)(Epstein& McCrady，2009)。第四，对照，条件是对酒精和药物心理教育的微观干预。在… 第三周，在实施第二周中学到的技能一周后，将评估机制和饮酒 再来一次。具体目标1.分离和初步评估特定的CBT微干预对 使用一种新的实验室范例和 由一个翻译科学团队进行。具体目标1包括三个假设：假设1.a 包括功能分析的微干预将导致认知控制的改善 防眼跳眼球跟踪任务，并减少饮酒。假设2.对酒精的认知重构-- 相关想法微干预将导致刺激(酒精暗示)的显著程度降低 喝酒。假设3.“应对饮酒欲望”的微干预会降低饮酒欲望， 对酒精暗示作出反应的唤醒，并减少饮酒。 具体目标2.为了测试CBT干预对特定MOBC影响的特异性，我们将测试每个 微干预对所有三种所谓机制的影响。

Project Summary/Abstract This proposed R21, Effect of CBT Microinterventions on Mechanisms of Behavior Change among Adults with AUD: Using Eye Tracking to Measure Pre-Post Cognitive Control, Stimulus Salience and Craving in response to PAR-14-053 NIAAA Mechanisms of Behavior Change in the Treatment of Alcohol Use Disorder, uses a translational team science approach to isolate and examine the effect of three different Cognitive Behavioral Therapy (CBT) interventions (functional analysis (FA), cognitive restructuring for alcohol related thoughts (CR), and dealing with cravings (DC)) on specific hypothesized mechanisms (cognitive control, stimulus salience, or craving/arousal, respectively). This R21 uses an innovative paradigm pairing a “microintervention” design (Strauman et al., 2013) with eye tracking laboratory tasks used successfully to show deficits of cognitive control over cocaine and nicotine cues (DiGirolamo, Smelson, & Guevremont, 2015; DiGirolamo et al., 2016), and to objectively measure stimulus salience (Field & Cox, 2008) and craving/arousal (Chae et al., 2008; DiGirolamo et al., 2016 EBR) in response to alcohol cues. To achieve the study’s two specific aims, 80 (30% female) participants with AUD will be assessed with antisaccade (to measure cognitive control) and attentional bias (to measure stimulus salience and pupil diameter) eye tracking tasks at baseline (Week 1), then randomized to receive one of four experimental microinterventions with a study therapist in Week 2 and re-assessed immediately after. Each of three conditions is a different 60 minute manual-guided CBT microintervention (FA, CR, or DC) from our efficacious 12 session CBT treatment protocol (Epstein & McCrady, 2009). The 4th, control, condition is a microintervention on alcohol and drug psycho-education. At Week 3, after a week of implementing skills learned in Week 2, mechanisms and drinking will be assessed again. Specific Aim 1. To isolate and preliminarily assess the impact of specific CBT microinterventions on potentially malleable hypothesized mechanisms of change in drinking using a novel laboratory paradigm and conducted by a translational science team. Specific Aim 1 includes three hypotheses: Hypothesis 1. A microintervention comprising functional analysis will lead to improvement in cognitive control measured by an antisaccade eye tracking task, and to reduction in drinking. Hypothesis 2. A Cognitive Restructuring of Alcohol- Related Thoughts microintervention will lead to reduction in stimulus (alcohol cue) salience and to reduced drinking. Hypothesis 3. A “Dealing with Craving to Drink” microintervention will lead to reduced craving and arousal in response to alcohol cues, and reduced drinking. Specific Aim 2. To test specificity of CBT interventions’ effect on particular MOBCs, we will test each microintervention’s effects on all three purported mechanisms.