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

防止大学饮酒升级的情绪调节干预措施：一项旨在确定可接受性、可行性和初步有效性的随机对照试验

• 批准号: 10023248
• 负责人: MICHAEL FENDRICH
• 金额: $ 23.14万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-25 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10023248
• 关键词: 20 year old; Accidents; Acute; Address; Adherence; Adult; Aftercare; Age; Age of Onset; Age-Years; Alcohol abuse; Alcohol consumption; Alcohols; Behavioral; Biological Markers; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Clinical Trials; Cognitive; Consumption; Control Groups; Crime; Daughter; Dependence; Development; Diagnosis; Distress; Drug usage; Effectiveness; Emotions; Exposure to; Family Characteristics; Gender; Health; Heavy Drinking; Impairment; Individual; Informal Social Control; Injury; Intervention; Knowledge; Lead; Legal; Measurement; Measures; Mediator of activation protein; Mental Health; Mind-Body Intervention; Motivation; National Institute on Alcohol Abuse and Alcoholism; Onset of illness; Outcome; Overdose; Participant; Patient Self-Report; Pattern; Perception; Performance; Personal Satisfaction; Physiological; Predisposition; Prevention; Prevention approach; Prevention program; Psychophysiology; Public Health; Randomized Controlled Trials; Regulation; Reporting; Respondent; Risk; Sampling; Self-Examination; Sexually Transmitted Diseases; Social Problems; Strategic Planning; Students; Substance Use Disorder; Surveys; Testing; Time; Treatment Efficacy; Violence; Work; Yoga; age group; age related; aged; alcohol consequences; alcohol misuse; alcohol use disorder; attributable mortality; base; binge drinking; body-mind; brief motivational intervention; cognitive reappraisal; college; college student alcohol abuse; comorbidity; coping; coping mechanism; deter alcohol use; distress tolerance; drinking; drinking behavior; emerging adult; emerging adulthood; emotion regulation; follow-up; group intervention; high risk; improved; innovation; mindfulness; participant retention; physical conditioning; prevent; preventable death; psychosocial; recruit; satisfaction; skills; substance use prevention; treatment as usual; trend; unintended pregnancy; university student; young adult

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.

在最近的全国药物使用与健康调查（NSDUH；Lipari & Jean-Francois，2016）中，大学- 18 至 25 岁之间的老年受访者报告饮酒率最高（超过 58%），并且 所有年龄段中酗酒率最高的。大学生大量饮酒/滥用酒精与 造成无数负面后果，包括致命和非致命伤害、服药过量、学业受损 和职业表现、暴力和其他犯罪、法律问题、意外怀孕 以及性传播疾病和社会问题。国家合并症调查 (NCS) 强调 这一时期开始的使用不仅仅是实验性和娱乐性的，而且可能对 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 即将成年。在这个发展阶段，情绪调节（ER）发生巨大变化， 尤其是与年龄相关的用于管理可能导致酗酒/滥用的痛苦的策略的变化 （即情绪抑制、抑制控制和认知重新评估。大量证据表明 ER 缺陷与年轻人的饮酒模式密切相关。尤其是自身能力的缺陷 对不适和痛苦的调节，称为痛苦耐受性，可以预测酒精的使用——特别是动机 使用的紧迫性、消费的升级以及可能具有指示性的依赖性的发展 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 最有可能在成年后大量饮酒并产生更严重的酒精负面后果。鉴于 我们认为，减少大学生饮酒的现有方法的有效性各不相同 干预措施的效果可能因个人特征而异。尤其是学生 难以管理痛苦和不适的人可能会受益于更强化的干预措施，这些干预措施可以促进 与常规治疗相比有效的 ER；此外，其他背景特征可以预测功效 以及每种类型 ER 干预的可接受性。在此 R34 应用程序 (PA-18-775) 中，我们将测试 两种补充干预措施（瑜伽和遇险）的可接受性/可行性和初步效果 耐受性）在一项针对 180 名高危大学生亲属的随机对照试验中预防饮酒 照常治疗。我们将评估参与者的饮酒情况（自我报告和生物标志物测量）和 基线情绪调节（ER）以及生理不适敏感性和心理社会预测因素 随着时间的推移治疗效果，包括治疗后随访。我们的方法是创新的 检查不同类型的以急诊为导向的干预措施对高危年轻人的效用，包括 创新的测量组件。该项目非常适合R34机制建立 可行性及初步成效。与 NIAAA 战略计划保持一致，我们致力于解决现实世界的问题 通过将 ER 作为减少使用的目标机制来关注预防物质使用的复杂性。