Behavioral Activation to Reduce Problem Alcohol Use in College Students with ADHD

行为激活可减少多动症大学生的饮酒问题

• 批准号: 9333077
• 负责人: ANDREA CHRONIS-TUSCANO
• 金额: $ 37.6万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-20 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9333077
• 关键词: Accountability; Address; Affect; Age; Alcohol abuse; Alcohol consumption; Attention deficit hyperactivity disorder; Behavior; Behavior Therapy; Behavioral; Characteristics; Collaborations; Comorbidity; Counseling; Data; Dependence; Development; Disease; Drug Compounding; Drug abuse; Drug usage; Ensure; Environment; Executive Dysfunction; Feasibility Studies; Feedback; Focus Groups; Future; General Population; Goals; Heavy Drinking; Hyperactive behavior; Impulsivity; Individual; Informal Social Control; Intention; Intervention; Intervention Studies; Life; Life Style; Manuals; Mental Depression; Methodology; Modification; Mood Disorders; Motivation; Outcome; Participant; Pattern; Pilot Projects; Population; Population Intervention; Populations at Risk; Prevention trial; Procedures; Process; Psychosocial Assessment and Care; Publishing; Randomized; Randomized Controlled Trials; Research; Rewards; Risk Behaviors; Services; Social Functioning; Structure; Students; Supervision; Testing; Time; Training; Universities; Vulnerable Populations; Wolves; alcohol abuse prevention; alcohol availability; alcohol intervention; alcohol related problem; associated symptom; base; behavior change; clinically relevant; college; design; disability; drinking; drinking behavior; experience; high risk population; improved; improved outcome; inattention; mood symptom; negative affect; novel; peer; psychosocial; public health relevance; therapy development; university student

DESCRIPTION (provided by applicant): College students with Attention-Deficit/Hyperactivity Disorder (ADHD) are particularly vulnerable to problematic alcohol use, given their developmentally-inappropriate levels of inattention, hyperactivity and impulsivity, combined with the lifestyle associated with life on a college campus (including increased access to alcohol, decreased structure and parental supervision). Our prior research demonstrates elevated rates of alcohol- related problems and disorders (AUDs) among college students with ADHD; 47% of college students with ADHD meet lifetime criteria for alcohol abuse and 23% meet criteria for dependence, as compared to 12% and 6% of college students from the general population, respectively. There are currently no published randomized controlled studies examining psychosocial interventions for college students with ADHD, and none specifically targeting AUDs in this population at any age, despite the clear indication from emerging research of the need for such interventions. Moreover, brief motivation-based alcohol interventions (BMIs) that generally have been successful for college students show limited benefits among individuals with elevated impulsivity and poor self- regulation, both hallmarks of ADHD, calling for the need to modify BMIs for this vulnerable group. Thus, it is crucial to determine core treatment components that are efficacious for treating AUDs and that are developmentally-appropriate for college students with ADHD and designed in a manner which promotes transportability to the university counseling center setting. Behavioral activation (BA) is a brief behavioral approach that aims to increase individuals' contact with valued environments through systematic efforts to increase rewarding experiences, enjoyment of daily activities, and goal-directed behaviors. We have successfully applied BA to substance users in a range of settings, including college students with problematic drinking patterns. Importantly, BA has clear relevance for addressing ADHD-related executive functioning deficits, which may be associated with an increased propensity for engagement in problematic alcohol use. Further, BA teaches individuals to engage in healthy, goal-directed rewarding behaviors, rather than relying on drinking to provide immediate rewards. Finally, BA is a highly adaptable intervention approach. In the current study, we will develop a BA-based treatment intended to reduce problematic drinking behaviors among college students with ADHD. This treatment will be developed in collaboration with the University Counseling Center, to ensure its applicability within this setting, utilizing focus grou methodology with Center staff. Finalized treatment manuals, altered based on focus group feedback, will be tested in a stage I RCT among 80 college students randomized to 3 sessions of BMI + BA or BMI + supportive counseling (SC). We expect that BMI + BA will be successful with college students with ADHD, in terms of decreasing the escalation of problematic alcohol use behaviors, as compared to BMI + SC. This treatment development study will set the stage for larger-scale RCTs (R01).

描述（由申请人提供）：患有注意力缺陷/多动障碍（ADHD）的大学生特别容易受到酒精使用问题的影响，因为他们的注意力不集中、多动和冲动的程度与发育不适当，再加上大学校园生活的生活方式（包括饮酒增加、结构减少和父母监督）。我们之前的研究表明，在患有多动症的大学生中，酒精相关问题和障碍（AUDs）的发生率升高；47%患有多动症的大学生符合终身酒精滥用标准，23%符合依赖标准，而普通人群中这一比例分别为12%和6%。目前还没有发表的随机对照研究对患有注意力缺陷多动障碍的大学生进行心理社会干预，也没有专门针对任何年龄的这一人群的aud，尽管新兴研究明确表明需要这种干预。此外，基于动机的短暂酒精干预（bmi）在大学生中通常是成功的，但在冲动程度高和自我调节能力差的个体中效果有限，这两种个体都是多动症的标志，因此需要修改这一弱势群体的bmi。因此，至关重要的是确定核心治疗成分，这些成分对治疗AUDs有效，对患有ADHD的大学生发展合适，并以一种促进大学咨询中心环境可运输的方式设计。行为激活（BA）是一种简单的行为方法，旨在通过系统的努力增加个人与有价值的环境的接触，增加对日常活动的享受和目标导向的行为。我们已经成功地将BA应用于各种情况下的物质使用者，包括有问题饮酒模式的大学生。重要的是，BA与解决adhd相关的执行功能缺陷有明确的相关性，这可能与参与问题酒精使用的倾向增加有关。此外，BA教导个人从事健康的、目标导向的奖励行为，而不是依靠饮酒来提供即时奖励。最后，BA是一种适应性很强的干预方法。在目前的研究中，我们将开发一种基于ba的治疗方法，旨在减少患有ADHD的大学生的问题饮酒行为。这种治疗方法将与大学咨询中心合作开发，以确保其在这种情况下的适用性，利用中心工作人员的焦点小组方法。根据焦点小组反馈修改的最终治疗手册将在第一阶段随机对照试验中对80名大学生进行测试，这些大学生被随机分为BMI + BA或BMI +支持性咨询（SC）三组。与BMI + SC相比，我们预计BMI + BA在减少有问题的酒精使用行为升级方面对患有多动症的大学生是成功的。这项治疗发展研究将为更大规模的随机对照试验奠定基础（R01）。