A Mobile-Based Intervention to Address Heavy Drinking and Binge Eating in College Students

项目总结/摘要 在过去的一个月里，超过5200万美国成年人报告酗酒。酗酒是一种复杂的 与酒精使用障碍的发展有关，并呈指数级增加其风险-一种有害的 与严重的医疗和精神疾病，死亡率升高，以及对常规药物的抵抗有关的疾病 治疗。与此同时，多达4300万美国人参与暴饮暴食，其特征是 大量食物的消耗加上失去控制。暴饮暴食与 暴食症的发展，最普遍的饮食失调表型，和肥胖， 是全球可预防死亡的主要原因之一。最重要的是，酗酒和暴饮暴食经常 共同发生，与强大的数据说明了一个狂欢型行为的双向拮抗作用， 另一个的严重程度和频率，表明共同的潜在机制。虽然共享 支持酗酒和暴食的机制已经得到了很好的解释，很少有治疗方法， 已经开发了针对这些跨诊断维持因子的数据。处理这些机制 早期通过使用可获得的预防方法对公共卫生具有重要意义， 预防有害和难以治疗的疾病的发展。重要的是， 饮酒和暴饮暴食在年轻人中大幅增加，特别是在大学生中， 矛盾的是，这些有问题的行为寻求治疗的比率确实很低。由于两 酒精使用障碍和暴食症最典型的发病在青春期后期，精确的方法， 针对这些症状的行为之前，他们的转换完全阈值的障碍，在人群中最 处于危险之中，至关重要。此外，由于大学里寻求治疗的比率很低， 学生，个性化和大规模访问的精确方法的发展是 特别值得。在这项研究中，我们建议利用我们小组在开发移动的 基于手机的行为健康干预，开发移动的干预，以减少同时发生的 酗酒和暴饮暴食，通过针对他们共同的潜在机制。这两个阶段的研究将 首先设法制定和进行干预措施的系统性测试，测试内容包括 在20名参加狂欢的男女大学生中， 吃喝随后，我们将在一项随机对照试验中对精细干预进行初步测试， 300名大学生，从事这两种行为，谁将接受干预（N=150）或标准 接受资源（对照; N=150），以确定干预措施在减少狂欢频率和相关 问题结果将提供第一个已知的数据，涉及一个可扩展的和transdiagnostic方法， 在高风险和有限的治疗寻求人群中减少暴饮暴食的频率。

Project Summary/Abstract More than 52 million American adults report binge drinking in the past month. Binge drinking is intricately linked to, and exponentially increases the risk for, the development of an alcohol use disorder - a pernicious illness linked to severe medical and psychiatric morbidity, elevated mortality, and a resistance to conventional treatments. In tandem, up to 43 million Americans engage in episodes of binge eating, characterized by the consumption of a large amount of food coupled with a loss of control. Binge eating is inherently linked to the development of binge eating disorder, the most prevalent eating disorder phenotype, and obesity, which is among the leading causes of global preventable death. Crucially, binge drinking and binge eating frequently co-occur, with robust data illustrating a bidirectional antagonistic effect of one binge type behavior upon the severity and frequency of the other, indicative of shared underlying mechanisms. Although the shared mechanisms underpinning both binge drinking and binge eating have been well-explicated, few treatments to date have been developed to target these transdiagnostic maintaining factors. Addressing these mechanisms early through the use of accessible prevention approaches has important public health implications for preventing the development of harmful and difficult-to-treat disorders. Importantly, the risk for both binge drinking and binge eating are substantially elevated in young adults, and particularly among college students, where paradoxically, rates of treatment seeking for these problematic behaviors are reliably low. Since both alcohol use disorder and binge eating disorder most typically onset in late adolescence, precision methods to target these symptomatic behaviors prior to their conversion to full threshold disorders, in the populations most at-risk, is of critical importance. Moreover, and owing to the reliably low rates of treatment seeking in college students, the development of precision approaches that are personalized and accessible on a large scale are especially warranted. In this study, we propose to leverage our group’s experience in developing mobile phone-based behavioral health interventions, to develop a mobile intervention to dually reduce co-occurring binge drinking and binge eating by targeting their shared underlying mechanisms. This two-phase study will first seek to develop and conduct a systematic beta test of the intervention, comprised of components of evidence-based treatments vetted with experts, in 20 male and female college students who engage in binge drinking and eating. Subsequently, we will pilot test the refined intervention in a randomized controlled trial of 300 college students who engage in both behaviors, and who will receive the intervention (N=150) or standard receipt of resources (control; N=150), to ascertain intervention efficacy in reducing binge frequency and related problems. Results will provide the first known data relating to a scalable and transdiagnostic approach to reducing binge drinking and eating frequency in a population at heightened risk and limited treatment-seeking.