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

大量饮酒显然将个人置于极大的风险之中，并对健康和经济产生重大影响 给社会带来负担。新出现的证据表明，许多年轻人都有所谓的极端饮酒行为 (即，饮酒水平可能导致BAC&>16)。尽管最近极端饮酒引起了关注，但令人惊讶的是，我们知道 除了完全依赖于回顾的横断面研究揭示的关联之外，关于这种行为的研究很少 自我报告。这项拟议的研究旨在提供一些关于对健康的影响的第一批全面数据 极端饮酒表型，并将这些表型与典型狂饮表型进行比较。 过度饮酒(与酗酒相比)是否有独特的原因和相关性是一个经验性的问题。 这一点还没有经过测试。调查极端饮酒面临诸多挑战，包括：1)克服限制 回顾自我报告，2)充分衡量个人和环境影响，以及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。拟议中的项目 旨在使用实验室、遗传和生态瞬时评估的组合来应对这些挑战 (EMA)方法。我们的多方法方法将结合实验室酒精管理、EMA和实时BAC 评估以捕捉对极端饮酒的广泛潜在影响之间的相互作用，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 对过度饮酒的影响。我们专注于当前成瘾理论模型的四个核心结构，即 假设通过瞬间过程影响物质使用：奖励敏感度(RS)、激励突显 (IS)、冲动/失控(IMP)和负性情感(NA)。我们将招募400名年轻人(年龄)作为样本 21-29)，从全州机动车管理局数据库中确定，他们最近有法律行动，记录的BAC与 极端饮酒(≥.12)。使用纵向爆发式设计，我们将对参与者进行为期12个月的跟踪调查，共5个月 自我报告评估和四个为期两周的均线突发事件。基础实验室课程将评估行为、特征和 核心研究构建的电生理标记物。我们的目标是(1)评估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。这一目标可以为评估方法提供参考 用于描述极端饮酒的特征，并指导完善有问题的饮酒概况的定义。(2)刻画 稳定的个体差异、暂时性的个体内因素和环境变量的结构性影响 在危险的、狂欢的和极端的饮酒场合以及与酒精相关的负面后果。这一目标将揭示 状态(EMA)和特征的递增有效性(实验室；基线问卷；适用时的多基因风险评分[PRSS]) 核心研究结构在预测个人内部和个人之间极端饮酒场合的指标；以及测试 他们与特定背景因素的相互作用可以预测极端饮酒行为。(3)识别多维 与稳定或高度可变的酗酒和极端饮酒行为相关的特征。我们的纵向爆破设计 使我们能够测试关于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.