Approach Bias Modification for Co-Occurring Cannabis and Alcohol Use among Treatment-Seeking Adolescents

项目概要/摘要 酒精和大麻是青少年中第一和第二最常用的物质。 青春期是一个相当大的发展时期，使青少年的大脑特别容易受到影响。 酒精和大麻使用的负面影响。制定和测试针对酒精和 青少年时期使用大麻对减少代价高昂的后果至关重要。认知处理中的偏见 与毒品有关的刺激因素在问题物质使用的发展和维持中起着重要作用。 接近-回避任务（AAT）是一个计算机化的程序，可以有效地评估内隐接近偏向 对于酒精和大麻，参与者推或拉操纵杆，以回应一个无关的功能， 呈现在计算机屏幕上的图像（例如，在纵向时推，在横向时拉）。修饰的 AAT版本（mAAT）也被用作认知偏差修正（CBM）干预， 参与者通过主要在一个对象中呈现目标刺激来对刺激产生隐性偏见或远离刺激 格式（例如，推或拉）。尽管研究表明mAAT干预措施可以有效减少 有问题的酒精和大麻使用，缺乏研究检查这种干预， 青少年。拟议的研究将测试一项综合mAAT的试点随机对照试验 针对寻求治疗的青少年中同时发生的酒精和大麻使用的干预措施（N=52）。 具体目标包括测试干预措施对大麻/酒精刺激的接近偏差的影响（Aim 1)干预后1个月和3个月的大麻/酒精使用（目标2），并检查意图的作用 以及作为治疗条件和使用之间关系的中介的渴望。研究环境， MUSC的设施和资源非常适合成瘾研究的指导职业发展。K23 培训目标是：⑴增加对大麻使用的病因学和治疗机制的了解; ⑵ 在寻求治疗的患者中获得跨临床试验研究阶段的基本知识和经验 有物质使用问题的青少年，包括纳入EMA方法; 3）发展建立信任措施方面的专门知识; 4)获得将EEG纳入以确定物质使用干预措施中的变化机制的经验;以及5） 提高科学交流和整体学术生产力。来自Carla博士的结构化指导 克梅特·丹尼尔森、林赛·斯奎利亚、丽莎·麦克蒂格和小罗伯特·米兰达。确保实现培训目标。 候选人的长期职业目标是指导一个研究组合：1）开发和测试创新 对青少年和新生儿的药物使用问题采取干预措施; 2）提供这些 在现有的现实世界环境中进行创新干预; 3）确定干预措施中的变革机制 使用多个分析单元。本文提出的培训旨在发展这些领域的专业知识， 区域，代表了从以前的培训明显的进展，没有这个K23是不可能的。

PROJECT SUMMARY/ABSTRACT Alcohol and cannabis are the first and second most commonly used substances among adolescents. Adolescence is a period of considerable development, making the adolescent brain particularly vulnerable to negative effects of alcohol and cannabis use. Developing and testing interventions that target both alcohol and cannabis use during adolescence are vital to decreasing costly consequences. Biases in cognitive processing of drug-related stimuli play an important role in the development and maintenance of problematic substance use. The Approach-Avoidance Task (AAT) is a computerized program, effective in assessing implicit approach biases for both alcohol and cannabis, in which participants push or pull a joystick in response to an irrelevant feature of an image presented on a computer screen (e.g., push when in portrait, pull when in landscape). A modified version of the AAT (mAAT) is also used as a Cognitive Bias Modification (CBM) intervention, to retrain participants’ implicit biases toward or away from stimuli by presenting the target stimuli predominantly in one format (e.g., push or pull). Despite research demonstrating the effectiveness of mAAT interventions to reduce problematic alcohol and cannabis use, there is a dearth of research examining this intervention among adolescents. The proposed research will test a pilot randomized controlled trial of an integrated mAAT intervention to target co-occurring alcohol and cannabis use among treatment-seeking adolescents (N=52). Specific aims include to test the effect of the intervention on approach biases for cannabis/alcohol stimuli (Aim 1) and cannabis/alcohol use at 1- and 3-months post-intervention (Aim 2), and to examine the role of intentions and cravings as mediators in the relationship between treatment condition and use. The research environment, facilities, and resources at MUSC are ideally suited for mentored career development in addiction research. K23 training objectives are to: 1) increase knowledge of etiological and treatment mechanisms for cannabis use; 2) acquire essential knowledge and experience across the stages of clinical trial research among treatment-seeking adolescents with substance use problems, including incorporating EMA methods; 3) develop expertise in CBM; 4) gain experience incorporating EEG to identify change mechanisms in substance use interventions; and 5) enhance scientific communication and overall academic productivity. Structured mentorship from Drs. Carla Kmett Danielson, Lindsay Squeglia, Lisa McTeague, and Robert Miranda Jr. will ensure training goals are met. The candidate’s long-term career goal Is to direct a research portfolio that: 1) develops and tests innovative intervention approaches for substance use problems among adolescents and emerging adults; 2) delivers these innovative interventions in existing real-world settings; and 3) identifies change mechanisms within interventions using multiple units of analysis. The training proposed herein is designed to develop expertise across these areas, represents a clear progression from prior training and would not be possible without this K23.