Novel Mechanisms of Behavior Change in Alcoholism Treatment

描述(由申请人提供)：目前治疗酒精使用障碍的方法在理论基础和方法上各不相同，但对临床特征差异很大的客户往往同样有效。基于我们目前对行为改变机制(MOBC)的理解，在客户治疗匹配方面取得的进展有限，这有力地证明了基础到临床科学的翻译研究应该提供创新(威伦布林，2005)。更好地理解支持行为灵活性的机制对于开发更有效的治疗方法是至关重要的。它将通过帮助对具有不同行为改变潜在能力的患者进行分类，澄清当前治疗引发的根本改变过程，并提出潜在的新治疗目标，从而促进客户-治疗匹配。 首要目标是获得在促进基础科学和临床科学之间转换的方法方面的专业知识，以表征新的MOBC。结构化的、多学科的协作专业知识和新的量化技能将应用于申请者正在进行的研究计划中的数据。NIAAA支持的实验重点是酒精和安慰剂挑战对不依赖酒精的年轻成年饮酒者的内隐记忆和自主神经系统对中性、情绪无效和酒精相关线索的反应的影响。这项由NIDA支持的研究重点是临床和高风险样本中的记忆和对相同刺激的反应，以及与药物相关的线索，并检查内隐记忆和自主神经调节过程与干预结果的关系。技能还将应用于试点功能磁共振成像和遗传学研究的数据，这些研究从NIH的这些项目中招募参与者，以表征在线索暴露和记忆任务中具有自主神经反应的双向反馈环中运行的认知控制过程，并测试与调节过程相关的中间表型的遗传标记。对这一应用的支持将使PI能够将开展富有成效的翻译研究所需的理论和方法相互结合，以提高对MOBC在酒精中毒治疗中的理解，并最大限度地发挥她在该领域的贡献。

DESCRIPTION (provided by applicant): Current treatments for alcohol use disorders vary in theoretical foundation and approach, yet are often equally effective across clients who differ substantially in clinical features. Limited progress in client treatment matching, based on our current understanding of mechanisms of behavior change (MOBC), argues strongly for basic to clinical science translation research to provide innovation (Willenbring, 2005). Better understanding of mechanisms that support behavioral flexibility is essential for progress in developing more effective treatments. It would facilitate client-treatment matching by helping to classify clients with different underlying capacities for behavior change, clarify fundamental change processes ctivated by current treatments, and suggest potentially new treatment targets. This K02 competitive renewal application seeks to build upon the knowledge, research skills, and quantitative training the applicant gained during the previous award period to further understand neurobiological and neurocognitive processes that subserve emotional regulation and can act to support or hinder adaptive behavioral change. The overarching goal is to gain expertise in methods that promote translation between basic and clinical science to characterize novel MOBC. Structured, multidisciplinary collaborative expertise and new quantitative skills will be applied to data from the applicant's ongoing research program. NIAAA supported experiments focus on alcohol and placebo challenge effects on implicit memory for, and autonomic nervous system reactivity to, neutral, emotionally valenced and alcohol-related cues in young adult drinkers who are not alcohol dependent. The NIDA supported study focuses on memory and reactivity to the same stimuli, and to drug-related cues, in clinical and high risk samples, and examines the relation of implicit memory and autonomic regulatory processes to intervention outcomes. Skills will also be applied to data from pilot fMRI and genetic studies that recruit participants from these NIH projects to characterize cognitive control processes that operate in bidirectional feedback loops with autonomic reactivity during cue exposure and memory tasks, and test for genetic markers of intermediary phenotypes related to regulatory processes. Support of this application will allow the PI to cross-fertilize theories and methods needed to conduct productive translation research to improve understanding of MOBC in alcoholism treatment, and maximize her contributions to the field.