A rigorous test of dual process model predictions for problematic alcohol involvement

对有问题的酒精参与的双过程模型预测的严格测试

• 批准号: 10679252
• 负责人: BRUCE D BARTHOLOW
• 金额: $ 70.57万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-20 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679252
• 关键词: 21 year old; Accounting; Acute; Affect; Age; Alcohol abuse; Alcohol consumption; Alcohols; Area; Behavior; Behavioral; Censuses; Characteristics; Chronic; Cognitive Science; Data; Databases; Decision Making; Desire for food; Development; Drunk driving; Etiology; Failure; Family; Heterogeneity; Individual; Individual Differences; Influentials; Intoxication; Knowledge; Legal; Licensing; Life; Link; Measurement; Measures; Methodology; Missouri; Modality; Modeling; Motivation; Outcome; Participant; Patient Self-Report; Persons; Population; Prevention; Process; Public Health; Questionnaires; Recording of previous events; Reporting; Research; Risk; Role; Rural; Sampling; Societies; Structure; Testing; Work; addiction; alcohol availability; alcohol consequences; alcohol effect; alcohol exposure; alcohol involvement; alcohol related problem; alcohol seeking behavior; cognitive control; cognitive system; college; contextual factors; design; drinking; driving behavior; effective intervention; executive function; experience; experimental study; follow up assessment; high risk; improved; indexing; innovation; minimum drinking age; multimodality; neurobehavioral; neurophysiology; peer; predictive modeling; recruit; remediation; sobriety; standard measure; trait; young adult

Abstract Problematic alcohol involvement (PAI), characterized by alcohol consumption that leads to or increases risk for acute and/or chronic negative consequences in one or more life domains, poses an enormous public health burden to drinkers, their families, and society. Heterogeneity in PAI’s etiology has been identified as the single most important barrier to progress in remediating this burden. More effective characterization of neurobehavioral traits that increase PAI risk is critical to the development of more effective intervention and prevention efforts. Cognitive science approaches to addiction etiology have suggested PAI risk reflects an interaction between two internal cognitive systems: appetitive motivation for alcohol (AMA) impelling alcohol seeking and use, and executive function (EF) regulating the influence of appetitive drives. This Dual Process Model has been highly influential, but prior studies have failed to support its main interaction hypothesis. We argue this failure is attributable to weaknesses in the rigor of prior research, and propose several innovative refinements to the DPM framework to improve its predictive utility. First, individual differences in AMA and EF have not been adequately characterized in prior studies, most of which represent these constructs with single indicators. Innovations in neuroclinical assessment indicate that neurobehavioral trait constructs are better characterized with measures representing self-report, behavioral, and neurophysiological units of analysis. Second, DPMs assume risk for PAI reflects only the influence of internal processes, implying no role for context. This is a major limitation, as strong evidence indicates that both environmental contexts (e.g., legal constraints; alcohol access) and alcohol exposure (e.g., acute effects of alcohol on EF and AMA) strongly affect the extent to which person-level factors relate to PAI. Finally, given that PAI behaviors are the result of decisions people make while drinking, accounting for heterogeneity in drinking-related decision strategies can improve prediction of PAI, including the role of DPM constructs. We propose a multi-session, within-subject alcohol challenge experiment, combined with online follow-up assessments, structured to take advantage of the abrupt change in contextual factors that occurs with transition to the minimum legal drinking age (MLDA; i.e., 21st birthday). This transition broadly increases risk for PAI within persons, but little is known about the role of specific etiologic factors in this increased risk. Participants (N=220) will be recruited from rural census tracts in mid-Missouri, identified through state administrative and driver’s license databases. Such individuals are broadly underrepresented in PAI research, particularly alcohol challenge research, and tend to experience more chronic (less transient) and severe PAI than their relatively advantaged, college-attending age peers. This sampling approach also will permit over-sampling of individuals at higher risk for DUI arrest (e.g., based on parental history of DUI and area characteristics). Thus, this study will fill important gaps in knowledge concerning PAI etiologic factors in an understudied population.

摘要 有问题的酒精参与(PAI)，特征是饮酒导致或增加风险 一个或多个生活领域的急性和/或慢性负面后果，构成巨大的公共卫生 给饮酒者、他们的家庭和社会带来负担。PAI病因的异质性已被确定为单一的 在补救这一负担方面取得进展的最重要障碍。更有效地描述神经行为 增加PAI风险的特征对于制定更有效的干预和预防努力至关重要。 认知科学对成瘾病因的研究表明，PAI风险反映了两者之间的相互作用 内部认知系统：酒精的胃口动机(AMA)推动酒精的寻求和使用，以及 执行功能(EF)调节食欲驱动的影响。此双进程模型已高度 有影响力，但之前的研究未能支持其主要的相互作用假说。我们认为这一失败是 归因于先前研究的严谨性不足，并对DPM提出了几项创新性的改进 框架，以提高其预测效用。首先，AMA和EF的个体差异还不够充分 在以前的研究中具有特点，其中大多数都是用单一指标表示这些结构。创新： 神经临床评估表明，神经行为特质结构具有更好的测量特征 代表自我报告、行为和神经生理单元的分析。第二，DPM承担风险 PAI仅反映内部过程的影响，暗示不受上下文的影响。这是一个主要限制，因为 强有力的证据表明，环境背景(例如，法律限制；酒精获取)和酒精 暴露(例如，酒精对EF和AMA的急性影响)强烈影响个人水平因素的程度 与PAI相关。最后，鉴于PAI行为是人们在饮酒时做出决定的结果，会计 由于饮酒相关决策的异质性，策略可以改善PAI的预测，包括DPM的作用 构造。我们提出了一个多时段、受试者内的酒精挑战实验，并结合在线 后续评估，旨在利用以下情况发生的背景因素突然变化 过渡到最低法定饮酒年龄(MLDA；即21岁生日)。这一过渡广泛地增加了 PAI在人内，但对特定的病因因素在这种增加的风险中所起的作用知之甚少。参与者 (n=220)将从密苏里州中部的农村人口普查地区招募，通过州行政和行政部门确定 驾照数据库。在PAI研究中，这类人的代表性普遍偏低，尤其是酒精 挑战研究，并倾向于经历更慢性(不那么短暂)和严重的PAI，而不是相对 有优势的，上大学的同龄人。这种抽样方法还将允许对个人进行过度抽样。 酒后驾车被捕的风险较高(例如，根据父母酒后驾车的历史和地区特征)。因此，这项研究将 在研究不足的人群中填补PAI病因知识的重要空白。