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

CBT 微干预对成人 AUD 变化机制的影响：使用眼动追踪测量前后认知控制、刺激显着性和渴望

• 批准号: 9246144
• 负责人: Gregory James DiGirolamo
• 金额: $ 24.08万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9246144
• 关键词: Adult; Alcohol consumption; Alcohols; Arousal; Behavior Control; Behavior Therapy; Behavioral Mechanisms; Brain Diseases; Caliber; Cessation of life; Clinic; Clinical Research; Cocaine; Cognitive; Cognitive Therapy; Cognitive deficits; Communities; Cues; Evidence based treatment; Experimental Designs; Eye; Female; Individual; Investigation; Laboratories; Link; Manuals; Measures; Mediator of activation protein; National Institute on Alcohol Abuse and Alcoholism; Neurocognitive; Nicotine; Outcome; Participant; Pharmaceutical Preparations; Pilot Projects; Population; Pre-Post Tests; Prevalence; Protocols documentation; Psychiatric Diagnosis; Pupil; Randomized; Research; Rewards; Running; Science; Specificity; Stimulus; System; Testing; Therapeutic Intervention; Thinking; Translational Research; Treatment Cost; Treatment Protocols; Work; alcohol abuse therapy; alcohol craving; alcohol cue; alcohol response; alcohol reward; alcohol use disorder; attentional bias; behavior change; cognitive control; cognitive neuroscience; craving; design; drinking; evidence base; improved; innovation; intervention effect; novel; primary outcome; psychoeducation; public health relevance; research study; response; reward circuitry; sample fixation; skills

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.

项目总结/摘要 R21：CBT微干预对成年人行为改变机制的影响 使用AUD：使用眼动追踪来测量前后认知控制，刺激显着性和渴望 对PAR-14-053 NIAAA酒精使用障碍治疗中的行为改变机制的反应， 使用翻译团队科学的方法来隔离和检查三种不同认知的影响， 行为治疗（CBT）干预（功能分析（FA），酒精相关的认知重建） 思想（CR），和处理渴望（DC））对特定的假设机制（认知控制， 刺激显著性或渴望/唤醒）。这款R21采用了创新的范例， “微干预”设计（Strauman等人，2013）与眼动跟踪实验室任务成功地使用，以显示 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），并客观地测量刺激显着性（Field &考克斯，2008）和渴望/唤醒 (Chae例如，2008; DiGirolamo等人，2016 EBR）对酒精线索的反应。为了实现研究的两个目标， 为了达到特定目的，将对80名（30%为女性）AUD受试者进行抗accade评估（以测量认知能力 控制）和注意偏差（测量刺激显着性和瞳孔直径）眼动跟踪任务在基线 (Week 1），然后随机接受研究治疗师的四种实验性微干预之一， 第2周，之后立即重新评估。三种条件中的每一种都是不同的60分钟手册指导 CBT微干预（FA，CR或DC）来自我们有效的12次CBT治疗方案（Epstein & McCrady，2009）。第四，控制，条件是对酒精和毒品心理教育的微观干预。在 第3周，在实施第2周所学技能一周后，将评估机制和饮酒 再具体目标1。分离并初步评估特定CBT微干预对 使用一种新的实验室范例， 由一个转化科学团队进行。具体目标1包括三个假设：假设1。一 包括功能分析的微干预将导致认知控制的改善， antiscacade眼动追踪任务，并减少饮酒。假设2.酒精的认知重构- 微干预将导致刺激（酒精提示）显著性降低， 喝酒假设3.一个“处理渴望喝酒”的微干预将导致减少渴望， 对酒精暗示的反应，以及减少饮酒。 具体目标2。为了测试CBT干预对特定MOBC影响的特异性，我们将测试每一种 微观干预对所有三种机制的影响。