Emotion Regulation Interventions for Preventing Collegiate Escalations in Drinking: A Randomized Controlled Trial to Establish Acceptability, Feasibility and Preliminary Efficacy

在最近的全国药物使用与健康调查(NSDUH；Lipari&Jean-Francois，2016)中，大学- 年龄在18岁到25岁之间的受访者报告饮酒率最高(超过58%)， 在所有年龄段中，酗酒的比例最高。大学生酗酒/酗酒与 伴随着无数的负面后果，包括致命和非致命的伤害和过量服用，损害了学术 职业表现、暴力和其他犯罪、法律问题、意外怀孕 性传播疾病和社会问题。全国共病调查(NCS)强调 在这一时期开始的使用不仅是试验性和娱乐性的，而且可能会对 消费轨迹：对于大多数被诊断为酒精使用障碍的成年人来说，发病发生在 即将进入成年期。在这个发展阶段，情绪调节(ER)发生了巨大的变化， 尤其是与年龄有关的用于管理可能导致酗酒/滥用的痛苦的策略的转变 (即情绪抑制、抑制控制和认知再评价。确凿的证据表明 内质网缺陷与年轻人的酒精使用模式密切相关。特别是，自我的缺陷- 对不适和痛苦的调节，称为痛苦耐受性，可以预测饮酒--具体地说，就是动机 和使用的紧迫性、消费的升级以及可能具有指示性的依赖的发展 酒精使用障碍。将酒精作为应对痛苦情绪的一种方式的新兴成年人 大多数人在成年后都有大量饮酒的风险，并有更严重的酒精不良后果。给定 我们认为，现有减少大学生饮酒的方法的有效性各不相同 干预措施可能因个人特点而不同有效。特别是，学生们 在处理痛苦和不适方面有困难的人可能会受益于更密集的干预措施，以促进 有效ER与常规治疗相比；此外，其他背景特征可能预测疗效 以及每种ER干预方式的可接受性。在此R34应用程序(PA-18-775)中，我们将测试 两种相辅相成的干预措施(瑜伽和痛苦)的可接受性/可行性和初步效果 对180名高危大学生亲属预防饮酒的随机对照试验 像往常一样治疗。我们将评估参与者的酒精使用情况(自我报告和生物标记物测量)和 基线情绪调节(ER)与生理不适敏感性和心理社会预测因子 评估随时间推移的治疗效果，包括治疗后的随访。我们的方法是创新的 在检查不同类型的面向ER的干预措施对高危年轻人的效用方面，包括 创新的测量组件。该项目非常适合R34机制建立 可行性和初步效果。与NIAAA战略计划保持一致，我们针对现实世界 通过将ER作为减少使用的目标机制来预防物质使用的复杂性。

In the most recent National Survey on Drug Use and Health (NSDUH; Lipari & Jean-Francois, 2016), college- aged respondents between 18 and 25 years old reported the highest alcohol use rates (over 58%) as well as the highest rates of binge drinking of any age group. High alcohol use/abuse in college students is associated with myriad negative consequences, including fatal and nonfatal injuries and overdoses, impaired academic and vocational performance, violence and other crime, legal problems, unintended pregnancies and sexually transmitted diseases, and social problems. The National Comorbidity Survey (NCS) underscores that use initiated in this period is not just experimental and recreational but may have lasting effects on consumption trajectories: For the majority of adults diagnosed alcohol use disorders, onset occurred during emerging adulthood. During this stage of development, vast changes in emotion regulation (ER) take place, particularly age-related shifts in the strategies used to manage distress that may lead to alcohol use/abuse (i.e., emotion suppression, inhibitory control, and cognitive reappraisal. Substantial evidence suggests that deficits in ER are strongly related to patterns of alcohol use in young adults. In particular, deficits in the self- regulation of discomfort and distress, called distress tolerance, predict alcohol use – specifically, motivation and urgency for use, escalations in consumption, and the development of dependence that may be indicative of alcohol use disorders. Emerging adults who turn to alcohol as a way of coping with distressing emotions are most at risk for heavy alcohol use into adulthood and more severe negative alcohol consequences. Given the variable effectiveness of existing approaches for reducing college students' alcohol use, we contend that interventions may be differentially effective depending on individual characteristics. In particular, students with difficulties in managing distress and discomfort may benefit from more intensive interventions that promote effective ER compared to treatment as usual; further, other background characteristics may predict the efficacy and acceptability of each type of ER intervention. In this R34 application (PA-18-775), we will test the acceptability/feasibility and preliminary efficacy of two complementary interventions (Yoga and Distress Tolerance) on preventing alcohol use in a randomized controlled trial of 180 high-risk college students relative to treatment as usual. We will assess participants' alcohol use (self-report and biomarker measures) and emotion regulation (ER) at baseline along with physiological discomfort sensitivity and psychosocial predictors of treatment efficacy over time, including a post-treatment follow-up. Our approach is innovative in examining the utility of different types of ER-oriented interventions for high risk young adults and includes innovative measurement components. The project is highly suited for the R34 mechanism to establish feasibility and preliminary efficacy. Aligned with the NIAAA strategic plan, we address the real-world complexities of substance use prevention by focusing on ER as the target mechanism for reductions in use.