Repeat DUI Offenders' Explanations for DUI Behavior

描述(由申请人提供)：醉酒驾驶(DUI)造成的巨大公共健康威胁，加上目前这种行为及其后果的发生率及其后果的稳定性，要求研究人员和治疗提供者更多地了解心理社会概况，包括一般酒后驾车犯罪者，特别是反复酒后驾车犯罪者的认知和信念。如果我们要开发有效的酒后驾车治疗方法，这种理解是至关重要的。我们的R01项目(1 R01 AA014710-01A1)继续前一种做法，评估和分析反复酒后驾车罪犯的精神障碍和共病。这项研究和其他研究发现，精神疾病共病与酒后驾车犯罪之间存在可靠而重要的联系。然而，很少有研究考察酒后驾车行为的更接近的认知预测因素。这些认知因素及其与心理社会变量的相互作用可能被证明是酒后驾车行为干预的重要目标。为了调查这些最近的认知预测因素，这个R03应用程序请求两年的支持，作为我们最初NIAAA资助的研究的一部分，对反复酒后驾车的人产生的酒后驾车行为的解释进行二次分析，以寻求基于证据的治疗以减少酒后驾车复发(1 R01 AA014710-01A1)。这项研究使用了综合国际诊断访谈(CIDI)来前瞻性地检查反复酒后驾车的罪犯的精神障碍特征和酒后驾车之间的关系。它包括收集住院的法院强制治疗的多名酒后驾车罪犯的基线数据(N=779)和一年的随访数据(N=480)，以及从附属告密者的子样本(N=80)收集的后续数据。建议的R03研究试图从内容、语言结构和归因因素方面分析罪犯在后续行动中产生的自由反应解释，以探索重复犯对其酒后驾车行为的理解如何与该行为的持续以及该行为的更远端预测因素有关。具体地说，这项研究将(A)确定这些罪犯如何理解和描述他们的行为(与解释这些相同罪犯行为的间接告密者相比)，(B)调查这些最近的认知预测指标与罪犯累犯之间的关系，以及(C)探索罪犯对其行为的理解如何与他们的心理健康相关，以及这种互动又如何与酒后驾车累犯相关。公共卫生相关性：这项拟议的R03研究将检查重复酒后驾车犯罪者为他们的罪行提供的解释的组成部分。通过研究重复酒后驾车罪犯理解(和/或描述)自己行为的方式，我们可以了解到对他们行为的潜在影响，以及他们对自己行为的归因(即，这些归因是否包含系统性偏见，或者是否可预测地与累犯和心理健康有关)。了解酒后驾车罪犯在治疗中提供的一系列理由对治疗方案本身是有用的，因为这种知识目前无法获得，可以确定重要的干预目标。例如，如果大多数罪犯将缺乏交通工具作为犯罪的理由，这将导致不同类型的干预，而不是大多数人声称他们享受从事危险行为的快感。此外，如果归因偏差与这一人群中的累犯和心理健康有关，针对这些偏见以及它们对应的心理健康问题，可能会改善临床结果。

DESCRIPTION (provided by applicant): The enormous public health threat created by driving under the influence of intoxicants (DUI), coupled with the current stability in the rates of this behavior and its consequences, requires researchers and treatment providers to learn more about the psychosocial profiles, including the cognitions and beliefs of DUI offenders in general and repeat DUI offenders in particular. This understanding is crucial if we are to develop effective treatments for DUI. Our R01 project (1 R01 AA014710-01A1) pursued the former course of action, assessing and analyzing psychiatric disorders and comorbidity among repeat DUI offenders. That study and others have found reliable and significant links between psychiatric comorbidity and DUI offending. However, very few studies have examined the more proximal cognitive predictors of DUI behavior. These cognitive factors, and their interaction with psychosocial variables, might prove to be important targets for DUI intervention. To investigate these proximal cognitive predictors, this R03 application requests support for two years to conduct a secondary analysis of the explanations for their DUI behavior generated by repeat DUI offenders as part of our original NIAAA-funded study, Toward Evidence Based Treatments to Reduce DUI Relapse (1 R01 AA014710-01A1). That study used the Composite International Diagnostic Interview (CIDI) to examine prospectively the relationship between psychiatric disorder profiles and DUI among repeat DUI offenders. It included the collection of baseline (N=779) and one-year follow-up data (N=480) from inpatient court-mandated treatment-seeking multiple DUI offenders, as well as follow-up data from a subsample of collateral informants (N=80). The proposed R03 study seeks to analyze the offenders' free-response explanations, generated at follow-up, in terms of content, language structure, and attributional elements, to explore how repeat offenders' understanding of their DUI behavior relates to the perpetuation of that behavior as well as the more distal predictors of the behavior. Specifically, this study will (a) identify how these offenders understand and describe their behavior (compared to collateral informants explaining these same offender behaviors), (b) investigate the relationship between these proximal cognitive predictors and offenders' recidivism, and (c) explore how offenders' understanding of their behavior relates to their mental health and how that interaction, in turn, relates to DUI recidivism. PUBLIC HEALTH RELEVANCE: This proposed R03 study will examine components of the explanations repeat DUI offenders offer for their offenses. By studying the way repeat DUI offenders understand (and/or describe) their own behavior, we can learn about both potential influences on their behavior, and the attributions they make for their own behavior (i.e., whether those attributions incorporate systematic biases or relate predictably to recidivism and mental health). Knowing the range of reasons offered by DUI offenders in treatment is useful in its own right for treatment programs, since such knowledge is currently unavailable and can identify important targets for intervention. For example, if the majority of offenders offer lack of transportation as a reason for offending, that leads to different types of interventions than if the majority claim that they enjoy the thrill of engaging in risky behaviors. Further, if attributional biases relate to recidivism and mental health in this population, targeting those biases along with the mental health issues to which they correspond, might improve clinical outcomes.