A Multi-Method Study of Extreme Alcohol Drinkers in the Lab and in Real-Life: Increasing Precision of Assessments of Extreme Drinking Determinants

高水平的酒精消费显然使个人处于极大的风险之中，并对健康和经济造成重大影响。 社会的负担。新出现的证据表明，许多年轻人从事什么可以被称为极端饮酒 (i.e.,饮酒水平可能导致BAC> .16）。尽管最近人们开始注意到极端饮酒5，6，但令人惊讶的是， 除了完全依赖于回顾性研究的横断面研究所揭示的相关性之外， 自我报告这项拟议的研究旨在提供一些关于对环境影响的第一批全面数据， 极端饮酒表型，并比较这些与那些确定为典型的酗酒表型。 极端饮酒（与狂饮相比）是否有独特的原因和相关性是一个经验问题 还没有经过测试。调查极端饮酒存在挑战，包括1）克服限制 回顾性自我报告，2）充分衡量个人和环境的影响，3）捕捉 这些不同影响的时间关联及其对极端饮酒场合的影响。拟建项目 旨在通过结合实验室、遗传学和生态学的瞬时评估来应对这些挑战 (EMA)方法.我们的多方法方法将结合联合收割机实验室酒精管理、EMA和真实的实时BAC 评估，以捕捉广泛的潜在影响之间的相互作用，极端饮酒，扩大我们的 在实验室外和自然饮用环境中进行调查，并探索 对极端饮酒的影响我们关注当前成瘾理论模型的四个核心结构， 假设通过即时过程影响物质使用：奖励敏感性（RS），激励显着性 (IS)、冲动/失控（Imp）和消极情感（NA）。我们将招募400名年轻人（年龄 21 - 29），从全州DMV数据库中确定，他们最近有一个法律的行动，记录的BAC符合 过度饮酒（≥ .12）。使用纵向突发设计，我们将在12个月的时间内跟踪参与者， 自我报告评估和四次两周EMA爆发基线实验室会议将评估行为，特质， 核心研究结构的电生理学标志物。我们的目标是（1）评估真实的实时的有效性和实用性 用于识别极端饮酒和酒精相关行为的评估。这一目标可以为估计方法提供信息 用于描述极端饮酒的特征，并指导对有问题的饮酒特征的定义进行细化。(2)表征 稳定的个体差异、短暂的个体内因素和环境变量的结构性影响 关于危险、狂饮和极端饮酒的场合以及与酒精相关的负面后果。这一目标将揭示 状态（EMA）和特质的增量效度（实验室;基线问卷;多基因风险评分[PRS]，如适用） 预测个体内部和个体之间极端饮酒情况的核心研究结构指数;以及测试 他们与特定的背景因素的相互作用，以预测极端饮酒行为。(3)识别多维 与稳定或高度可变的狂饮和极端饮酒行为相关的特征。我们的纵向爆破设计 可以让我们检验饮酒行为随时间变化的稳定性的假设。

High levels of alcohol consumption clearly place individuals at great risk and present a significant health and economic burden to society. Emerging evidence indicates that many young adults engage in what can be called extreme drinking (i.e., drinking at levels likely to lead to BACs > .16). Despite recent attention to extreme drinking5,6, we know surprisingly little about this behavior beyond associations revealed by cross‐sectional studies that rely exclusively on retrospective self‐report. The proposed study is designed to provide some of the first comprehensive data about influences on the extreme drinking phenotype, and to compare these with those identified for the typical binge drinking phenotype. Whether there are unique causes and correlates of extreme drinking (compared to binge drinking) is an empirical question that has not been tested. There are challenges to investigating extreme drinking, including 1) overcoming the limitations of retrospective self‐report, 2) adequately measuring personological and environmental influences, and 3) capturing the temporal associations of these diverse influences and their impact on extreme drinking occasions. The proposed project is designed to meet these challenges using a combination of laboratory, genetic, and ecological momentary assessment (EMA) methods. Our multi‐method approach will combine laboratory alcohol administration, EMA, and real‐time BAC assessment to capture the interplay between a broad range of potential influences on extreme drinking, extend our investigation outside the lab and into the natural drinking environment, and explore the temporal associations of influences on extreme drinking. We focus on four core constructs central to current theoretical models of addiction that are hypothesized to influence substance use through in‐the‐moment processes: reward sensitivity (RS), incentive salience (IS), impulsivity/loss of control (Imp), and negative affectivity (NA). We will recruit a sample of 400 young adults (ages 21‐29), ascertained from a statewide DMV database, who have a recent legal action with a recorded BAC consistent with extreme drinking (≥ .12). Using a longitudinal burst design, we will follow participants over a 12‐month period, with five self‐report assessments and four, two‐week EMA bursts. A baseline laboratory session will assess behavioral, trait, and electrophysiological markers of core study constructs. We aim to (1) Evaluate the validity and utility of real‐time assessments for identifying extreme drinking and alcohol‐related behavior. This aim could inform estimation methods for characterizing extreme drinking and guide refinement of definitions of problematic drinking profiles. (2) Characterize the structural influence of stable individual differences, transient intra‐individual factors, and environmental variables on risky, binge, and extreme drinking occasions and alcohol‐related negative consequences. This aim will reveal the incremental validity of state (EMA) and trait (lab; baseline questionnaires; polygenic risk scores [PRSs] when applicable) indices of core study constructs in predicting extreme drinking occasions within and between individuals; as well as test their interaction with specific contextual factors to predict extreme drinking behavior. (3) Identify multidimensional profiles associated with stable or highly variable binge and extreme drinking behavior. Our longitudinal burst design allows us to test hypotheses about the stability of drinking behavior over time.