Investigating impulsivity and social network changes as novel mechanisms of behavior change for Alcoholics Anonymous' (AA) positive effects

调查冲动和社交网络变化作为行为改变的新机制对戒酒互诫协会（AA）的积极影响

• 批准号: 9761400
• 负责人: JOHN F. KELLY
• 金额: $ 57.3万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9761400
• 关键词: Address; Age; Alcoholics Anonymous; Alcohols; Behavioral Mechanisms; Behavioral inhibition; Communities; Dose; Enrollment; Etiology; Evidence Based Medicine; Female; Frequencies; Future; Glucuronides; Heavy Drinking; Impulsivity; Individual; Informal Social Control; Investigation; Maps; Measurement; Measures; Mediating; Motor; Nature; Outcome; Outpatients; Participant; Pathway Analysis; Patient Self-Report; Patients; Personality Traits; Persons; Process; Property; Prospective cohort; Recommendation; Recovery; Research Design; Resolution; Rewards; Services; Site; Social Network; Structure; Subgroup; Testing; alcohol abuse therapy; alcohol use disorder; behavior change; behavioral economics; clinical application; clinical practice; clinically relevant; density; design; discount; discounting; drinking; follow-up; graph theory; indexing; insight; knowledge translation; male; meetings; member; novel; older patient; preference; prevent; programs; response; sex; social

ABSTRACT Alcoholics Anonymous (AA) is now well-established in its capacity to help individuals recover from alcohol use disorder (AUD), but there are substantial gaps in understanding the mechanisms by which it does so. Recent studies suggest two novel domains of mechanisms: 1) decreases in impulsivity; and 2) increases in salutary social networks. However, these mechanisms have been investigated in only a small number of studies and the extant studies employed low resolution measurement and suboptimal study designs. The proposed study will address these limitations to systematically investigate impulsivity and social network composition as novel mechanisms of behavior change (MOBCs) for AA’s positive effects on AUD recovery. The first primary aim is to examine impulsivity, fractionating the concept into three distinct forms: 1) steep discounting of future rewards (i.e., delay discounting); 2) poor behavioral inhibition (i.e., inability to inhibit a prepotent response); and 3) impulsive personality traits (i.e., self-attributions about regulatory capacity). The second primary aim is to examine social network properties, quantifying participant social relationships via formal egocentric social network composition analysis. The third primary aim is to examine whether these mechanistic relationships systematically differ according to three important moderators: age, sex, and study site. An exploratory secondary aim is to mine the findings from the primary aims to generate specific recommendations and applications for clinical practice. These aims will be executed in a prospective cohort design that is optimized for characterizing lagged dynamic changes in MOBCs. Specifically, the study design will examine these processes in individuals with AUD who are newly engaging in community outpatient AUD treatment. Participants will receive assessments at baseline, 6-weeks, and 3-, 6-, 9- and 12-months. AA involvement will be measured using both the traditional measure of frequency of meeting attendance and a novel measure of AA program engagement. Outcome variables will include percent days abstinent and percent heavy drinking days. The findings will be disseminated using a comprehensive knowledge translation plan. Collectively, the proposed study has the potential to make major contributions to understanding how AA helps people recover from AUD. In turn, the insights from the study have the potential to substantially contribute to the use of AA and other mutual recovery services in clinical practice.

抽象的 酗酒者匿名（AA）现在已经建立了良好的能力，可以帮助个人从酒精使用中恢复过来 疾病（AUD），但是在理解这样做的机制方面存在很大的差距。最近的 研究表明，机制的两个新领域：1）冲动性下降； 2）有益的增加 社交网络。但是，仅在少数研究中研究了这些机制， 研究范围采用低分辨率测量和次优研究设计。拟议的研究 将解决这些限制，以系统地研究冲动性和社交网络组成作为新颖 行为变化的机制（MOBC）对AA对AUD恢复的积极影响。第一个主要目的是 要检查冲动性，将概念分为三种不同的形式：1）未来的陡峭折扣 奖励（即延迟打折）； 2）行为抑制不良（即无法抑制能力反应）；和 3）冲动性格特征（即有关监管能力的自我归因）。第二个主要目的是 检查社交网络属性，通过正式的以egentric社交来量化参与者的社交关系 网络组成分析。第三个主要目的是检查这些机械关系是否 根据三个重要主持人的系统不同：年龄，性别和研究地点。探索性 次要目的是挖掘主要目的的发现，以产生特定的建议和 临床实践的应用。这些目标将以优化的潜在队列设计执行 用于表征MOBC中滞后的动态变化。具体而言，研究设计将检查这些 刚开始从事社区门诊AUD治疗的AUD个人的过程。 参与者将在基线，6周以及3-、6、9和12个月的情况下接受评估。 AA的参与意志 可以使用传统的会议出勤率的传统测量和新颖的测量 AA计划参与。结果变量将包括戒酒的百分比和大量饮酒百分比 天。这些发现将通过全面的知识翻译计划传播。集体， 拟议的研究有可能为了解AA如何帮助人们康复做出重大贡献 来自aud。反过来，研究的见解有可能为使用AA和 临床实践中的其他相互恢复服务。